November 11 – 17, 2019




1. Regional Coalition Meeting

The Northwest Region Healthcare Coalition will hold its monthly meeting Thursday November 14 beginning at 10:30 am. The agenda, the October meeting minutes, and the conference dial-in information will be sent to the routine attendees on the Tuesday prior to the meeting. The meeting will be held via our Ring Central conference call line.

2. Save the Dates

Upcoming training and conferences:

          a. The Coalition will host the MGT – 349 Pediatric Disaster Response and Emergency Preparedness course November 18 – 19, 2019 in Harrisonburg, VA.  Please see the link for more details.

          b. The Coalition will host a Basic Disaster Life Support course December 10, 2019 in Harrisonburg, VA. Please contact our Exercise and Training Coordinator Matt Cronin to register.

Questions regarding upcoming training, please contact our Exercise and Training Coordinator, Matt Cronin. 

Crisis Standards of Care: Ten Years of Successes and Challenges

November 21 – 22, 2019

The National Academies is conducting a two-day public workshop in Washington, DC to explore the evolution and implementation of crisis standards of care (CSC) since the publication of the NASEM report Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report in 2009. Specific topics that will be discussed include:

  • The experiences, successes and challenges of planning for and implementing CSC plans at the local, state and federal level;
  • Shifts in planning assumptions as a result of specific operational experiences, changes to treatment protocols, availability of new or difference resources, and advances in technology;
  • Accepted issues and outstanding legal and ethical challenges; and
  • Potential opportunities for continued development and implementation of crisis standards of care plans for the next ten years.

The workshop will include plenary sessions, small breakout sessions, and a published proceedings. It is free and open to the public via in-person attendance or live webcast.

Register Now »

3. Clinical Advisor

The Northwest Region Healthcare Coalition is seeking a part-time physician to serve as a clinical advisor. The job announcement can be found here. We ask healthcare organizational staff to please assist us by spreading the word about this open position. As part of our grant funding requirement, we must hire a physician before the next grant period begins.

4. Memorandum of Understanding

We are pleased to announce that the Northwest Region Healthcare Coalition continues to receive requests to sign a Memorandum of Understanding (MOU) between the coalition and non-hospital facilities. The MOU is designed for healthcare facilities that are not classified as an Acute Care or Critical Access hospital, and it is good for five (5) years before it will need to be renewed. If your organization resides within the Northwest Region and you have not signed the MOU, you can contact either the Regional Coordinator or the Medically Vulnerable Populations Coordinator to find out more details.

We are expanding our outreach to healthcare agencies within the region as a way of offering assistance to you and your organization. We ask for everyone’s help to spread the word by talking with your colleagues about the Northwest Region Healthcare Coalition. You can contact us by clicking the Contact Us tab on our website.

Virginia Hospital & Healthcare Association Credit:

Virginia Department of Health

Virginia Department of Health Weekly Influenza Activity Report

The Virginia Department of Health monitors the level of activity of influenza-like illness (ILI) each week from October through May. Those are the months when influenza (“flu”) is most likely to occur in Virginia, and that time period is referred to as the “flu season”.

Data Sources:
The Virginia Department of Health uses a number of different data sources to determine the level of flu activity that is occurring each week during flu season. The main data sources that are used to make the weekly flu activity level determination are:

  • laboratory reports
  • outbreak reports, and
  • data on visits to hospital emergency departments and urgent care centers for flu-like illness.

Flu Activity Levels:
Flu surveillance is not designed to count every person who has the disease. That would be nearly impossible because not all people with the disease are diagnosed by a physician and even fewer have their illness confirmed by a laboratory test.

Instead, VDH monitors changes in flu activity from week to week in each of the five health planning regions to look for increases compared to a baseline period. Activity is based on illness complaints that lead people to seek care in a hospital emergency department or urgent care center. Flu-like illness is defined as a fever along with a cough and/or a sore throat.

To view the weekly report, click here.


Health & Human Services

 Assistant Secretary for Preparedness and Response


Assistant Secretary for Preparedness and Response Technical Resource,                                                                                                           Assistance Center, and Information Exchange

Hospital Preparedness Program




1. The Express
November 2019

In this issue of The Express, we highlight The Exchange, information on updated websites, an upcoming event, and updates from our three domains.

‘Tis the season to be thankful, and we sincerely appreciate our ASPR TRACIE stakeholders for allowing us to share their resources and experiences. As we go to press, we are thinking of those of you in the path of, experiencing, and/or recovering from wildfires. We invite you to review these related resources:

Other topics include: New: Preparing for and Responding to Chemical Incidents, Updated: CMS Emergency Preparedness Rule Resource Page, ASPR TRACIE Website Update, REMM Website Update
Read More »

2. The Healthcare and Public Health Sector Highlights
The HPH Sector Highlights – Preparedness, Resilience, and Response Edition is a weekly email produced by the HHS ASPR Division of Critical Infrastructure Protection (CIP) on behalf of the HPH Sector Partnership. It provides updates on healthcare and public health critical infrastructure resources, tools and events related to preparedness, resilience, and response.

Cybersecurity Edition Week of November 8, 2019

  • Critical Infrastructure Security and Resilience Month
  • CISA Launches “Cyber Essentials”
  • Pre-Disaster Planning Tribal Guide
  • Communicating in a Crisis: Risk Communication Guidelines for Public Officials
  • FEMA Introduces Updated Field Manual
  • PrepTalks: Our Changing World: The Challenge for Emergency Managers from FEMA
  • New Resources Available from ASPR TRACIE

The HPH Sector Highlights – Cybersecurity Edition is a weekly email produced by the HHS ASPR Division of Critical Infrastructure Protection (CIP) on behalf of the HPH Sector Partnership. It provides updates on threat information, resources, and situational awareness related to healthcare cybersecurity. 

Cybersecurity Edition Week of November 8, 2019

  • Critical Infrastructure Security and Resilience Month
  • CISA Launches “Cyber Essentials”
  • Upcoming HC3 Webinar on “APT41”
  • ONC Annual Meeting Registration is Open
  • HC3 Intelligence Briefing: Social Engineering and You
  • Failure to Encrypt Mobile Devices Leads to $3 Million HIPAA Settlement
  • Microsoft Ending Support for Windows 7 and Windows Server 2008 R2

Credit: Centers for Disease Control and Prevention

CDC identifies chemical in fluid from vaping-associated lung injuries

The Centers for Disease Control and Prevention today identified vitamin E acetate as a “potential chemical of concern” in biologic samples from patients with vaping-associated lung injuries. The agency tested lung fluid samples from 29 patients with the condition (called EVALI) in 10 states and found vitamin E acetate in all 29 samples. “These findings provide direct evidence of vitamin E acetate at the primary site of injury within the lungs,” CDC said. It also found tetrahydrocannabinol (THC) in 82% of the samples and nicotine in 62% of the samples. CDC yesterday updated the number of people with confirmed or probable lung injuries associated with electronic cigarette use or vaping products to 2,051 in 49 states, the District of Columbia and the U.S. Virgin Islands, including 39 confirmed deaths. CDC and the Food and Drug Administration continue to investigate the cause of the illness, and encourage health care providers to report possible cases to their state or local health department.

Read More »

Source: AHA Today

Credit: U.S. Food & Drug

1. UPDATE: The FDA Warns that Biotin May Interfere with Lab Tests: FDA Safety Communication

The U.S. Food and Drug Administration (FDA) is updating our safety communication to remind the public, health care providers, lab personnel, and lab test developers that biotin, often found in dietary supplements, can significantly interfere with certain lab tests and cause incorrect results that may go undetected. The FDA wants to make the public and health care providers aware about biotin interference with lab tests so that patients, physicians, and laboratories can work together to help prevent adverse events. 

The FDA has posted a webpage on Biotin Interference with Troponin Lab Tests – Assays Subject to Biotin Interference to notify the public about troponin assays where the risk of biotin interference has not yet been addressed.

Read More »

2. MiniMed Insulin Pumps by Medtronic: Class I Recall – Due to Potential Cybersecurity Risks 

AUDIENCE: Patient, Endocrinology, Health Professional, Risk Manager

BACKGROUND: People who have diabetes may use the MiniMed insulin pump to deliver insulin for the management of their diabetes. The pump includes a remote controller which is designed to communicate wirelessly with the pump to deliver a specific amount of insulin to the person with diabetes.

ISSUE: Medtronic is recalling the specified insulin pumps due to potential cybersecurity risks.  An unauthorized person (someone other than a patient, patient caregiver, or health care provider) could potentially record and replay the wireless communication between the remote and the MiniMed insulin pump. This person could instruct the pump to either over-deliver insulin to a patient, leading to low blood sugar (hypoglycemia), or stop insulin delivery, leading to high blood sugar and diabetic ketoacidosis, even death.

To date, the FDA is not aware of any reports of patient harm related to these potential cybersecurity risks.

The affected products are the MiniMed Model 500 Remote Control and 503 Remote Transmitter (MMT-500 and MMT-503).

Read Recall »

Credit: Centers for Medicare and Medicaid Services


         U.S. Department of Homeland Security 

Federal Emergency Management Agency


Virginia Department of Emergency Management

Course Offerings

L0102 Science of Disasters course is scheduled for November 18-20, 2019. Please see the flyer for additional details.

L0102 Course Announcement Prince William County EOC

L956 All Hazards Position Specific Liaison Officer course is scheduled for December 2-3, 2019. Please see the flyer for additional details.

L956 Course Announcement Alexandria

L0103 Planning: Emergency Operations course is scheduled for December 4-5, 2019. Please see the flyer for additional details.

L0103 Course Announcement Stafford County Public Safety Center

PER 211 Medical Management of Chemical, Biological, Radiological, Nuclear and Explosives, (CBRNE) Events course is scheduled for December 7-8, 2019. Please see the flyer for additional details.

PER 211 Medical Management of Chemical, Biological, Radiological, Nuclear and Explosives, (CBRNE) Events Course Stafford

NWS Basic SKYWARN course is scheduled for December 9, 2019. Please see the flyer for additional details.

SKYWARN Course Bowling Green

L954 All Hazards Position Specific Safety Officer course is scheduled for December 16-19, 2019. Please see the flyer for additional details.

L954 Course Announcement Manassas Park

1. Health care leaders urge Congress to address shortage of critical drugs

Drug shortages threaten the quality of patient care, narrow treatment options and often result in the use of potentially less effective alternative medications, hospital and health system leaders said at a briefing today on Capitol Hill, urging Congress to pass the AHA-supported Mitigating Emergency Drug Shortages Act (S.2723). 

Introduced last week by Sens. Susan Collins, R-Maine, and Tina Smith, D-Minn., the legislation would require manufacturers to disclose the root causes and expected duration of shortages, and develop contingency plans to ensure an ongoing supply, among other provisions. 

“We need to get past the notion that this is a temporary problem that sometimes occurs when there’s a hurricane in Puerto Rico,” Collins said at the start of the briefing. “That can be a factor and indeed has been a factor, but this is a far more complicated problem with root causes that we need to address.” 

More than 100 drugs are currently in short supply, presenting a major challenge for every segment of health care. 

Peter Adamson, M.D., an oncologist at the Children’s Hospital of Philadelphia, spoke about the shortage of vincristine, a chemotherapy drug essential to the treatment of most pediatric cancers. Adamson said his hospital uses it to treat almost three out of four children with cancer. 

“We had to tell families they couldn’t get it,” he said, describing difficult conversations with parents and family members. “The MEDS Act is an important next step.” 

Edward Mariano, M.D., chief of anesthesiology and perioperative care services at the 
Department of Veteran Affairs’ VA Palo Alto (Calif.) Health Care System, underscored the need for providers to have the means to perform at their best. 

“Not having the right drugs at the right time for our patients, it really forces us to use alternatives that may be less acceptable, if they exist at all,” Mariano said. “And this represents a form of moral injury that is a huge contributor to the epidemic of physician burnout. We need to consider this because we need a physician workforce that can fulfill its calling and take care of our population.” 

Using alternative medications and treatments isn’t as simple as some think, said Daniel Teich, vice president of pharmacy purchasing and contracting for Fairview Pharmacy Services, part of Minneapolis-based Fairview Health Services. 

“These products are carefully picked and embedded in our care plans to treat our patients in a thoughtful, careful clinical model,” Teich said. “And this disruption caused by these continuous drug shortages are a distraction from the real mission for caring and healing patients we serve.” 

The AHA, American Society of Anesthesiologists, American Society of Clinical Oncology, American Society of Health-System Pharmacists, American Society for Parenteral and Enteral Nutrition, Children’s Hospital Association, Federation of American Hospitals, and Premier hosted the briefing.

Source: AHA Today

2. Explosive devices found at Wisconsin hospital

Police found two explosive devices at Ascension NE Wisconsin Mercy Hospital in Oshkosh on Nov. 6, according to the Oshkosh Northwestern.

According to Oshkosh police, a 39-year-old man brought the two explosive devices to the hospital in the early-morning hours. The devices were found in the man’s belongings, according to the report. Police said no threats were mentioned during the incident.

The local bomb squad removed the devices, according to the report.

Source: Ayla Ellison of Becker’s Hospital Review

3. Illinois researchers develop lab-on-a-smartphone system to detect infectious diseases

Infectious diseases such as Zika and Dengue remain a top contributor to death and disability across the globe, according to the World Health Organization. Diagnosing and treating these diseases, which often have similar symptoms, is especially difficult in developing countries, where access to health care and laboratories is often limited.

Researchers at the University of Illinois at Urbana-Champaign are developing a lab-on-a-smartphone system that will enable healthcare professionals to detect disease at the point of care. Funded by the National Institutes of Health, the 4-year grant will enable the team to develop a handheld instrument that can detect and report the presence of pathogens in less than 30 minutes using a single drop of blood – all with a smartphone clip-on instrument that costs less than $10.

Read More »

Source: James Ives of News medical Life Sciences