Volume 3, Issue 4: Industry News – Medical Travel & Digital Health News

The Year’s Severe Flu Exposes a Serious Flaw in our Medical System

By: Morten Wendelbo, Christine Crudo Blackburn

TheConversation.com – Flu season in the U.S. typically peaks in February, but this year’s outbreak is already one of the worst on record. As of Jan. 6, 20 children have died from the flu, and overall mortality caused by the flu is already double that of last year’s.

One reason the flu is so severe this season is that the dominant strain is H3N2, which has an impressive ability to mutate and is particularly aggressive against Americans over 50.

Making the threat worse is the fact that most of the IV saline bags used in common medical treatments and procedures – including severe cases of the flu – are made in Puerto Rico, which is still reeling from Hurricane Maria. Hospitals in some areas around the country that are operating at or above capacity because of the flu are quickly running low on saline, resorting to time-consuming and potentially dangerous treatments of patients.

The IV saline shortage is unlikely to cause a life-threatening breakdown of medical treatments. But the shortage does expose a dangerous flaw in the medical supply chains that everyone relies on to counter disease outbreaks or bioterrorism. Many different types of important medical equipment and medicines either come from abroad or rely on a single producer.

Global supply chains

Globalization has changed the way we produce, transport and store almost anything, including medicines and medical supplies. Now that it’s inexpensive to transport goods, many can be easily produced abroad at substantially lower costs. In nearly all cases, that benefits producers and consumers alike.

For the medical industry, approximately 80 percent of all pharmaceuticals used by Americans are produced overseas. The majority of this production takes place in China and India.

Forty-three percent of saline in the U.S. comes from Puerto Rico. The U.S. was already running below optimal levels of saline when Hurricane Maria hit.

Rapid transportation of goods also allows most industries to rely on “just in time” deliveries. That means goods arrive only shortly before they are needed, rather than arriving in large shipments.

In most situations, and for most goods, that causes few issues. However, when there’s an insufficient stockpile, delivery delays can be life-threatening. Many of our hospitals receive shipments of critical pharmaceuticals three times a day.

Unhappy coincidences

As researchers studying how countries can prepare for disease and disasters, it’s clear to us that the IV saline shortage is just the tip of a gigantic iceberg.

There are two ways the “just in time” system can be disrupted: an unexpected surge in demand or a delay in delivery. In this case, both occurred simultaneously. The U.S. is dealing with an unusually potent strain of the flu, while Hurricane Maria brought production in Puerto Rico to a grinding halt. If only one of the two had occurred, it’s unlikely the U.S. would have experienced a shortage.

Now, hospitals overrun with flu patients have to turn to alternatives to IV saline. One is an IV push procedure, in which medications are manually “pushed” into the IV line. This can be deadly if not done correctly.

In the case of IV saline, the simultaneous occurrence of both demand and delay was accidental. Unfortunately, it’s not only possible that such confluence will occur in the future – it’s likely. In the case of pandemics or biological warfare, there will likely be both a surge in demand for important goods and a simultaneous disruption of production and delivery.

If a pandemic disease severely affected China or India, where large shares of medicines come from, production could be knocked out or slowed. That would leave the rest of the world vulnerable to the disease’s spread, because there would be no supply of crucial medicines to combat it. The 1918 influenza pandemic caused disruptions that prevented coal from being delivered to the northeastern U.S. That left some without heat in the height of winter, causing people to freeze to death and compounding the deadly pandemic.

Today, such a breakdown could leave hospitals and other crucial infrastructure without electricity. If the spread of the disease is intentional, as in cases of bioterrorism or bio-warfare, adversaries could target global supplies of crucial treatments.

Preparing for problems

The destruction in Puerto Rico and the impact it has had on the supply of small IV saline bags in American hospitals is a warning. This time, it’s IV saline. Next time, it might be electricity to run intensive care units or critical antibiotics to treat infections.

Global supply chains are a massive puzzle, but public health and emergency preparedness officials need to, at a minimum, understand every link in the chain of critical goods. Without a thorough understanding of the supply chain, it’s difficult to preempt problems that could arise in times of emergency. Hospitals and other crucial infrastructure, such as power plants and the transportation industry, may want to diversify their suppliers of critical goods and encourage those suppliers to not focus production in a single area, especially not to an area prone to natural disaster. A final, but far more costly, option is to ensure we can produce most of these goods domestically in times of emergency.

In our view, the solution depends on a partnership between government and industry. Federal, state and local governments have to alter procedures, but private companies involved in the production and delivery of critical goods have to plan ahead for emergencies.

If these weaknesses in our global supply chains are not addressed, especially as they relate to medical supplies, pharmaceuticals and other critical goods, we are headed for disaster.

To view the original article, click here.

PRESS RELEASE: HEALTHMINE SURVERY: 25% OF U.S. EMPLOYEES HAVE WORKED WITH AN EXECUTIVE WHOSE SEVERE ILLNESS AFFECTED THE COMPANY’S BUSINESS

DALLAS, Jan. 25, 2018 /PRNewswire/ — One quarter (25%) of U.S. employees surveyed have worked with an executive who became severely ill and whose illness affected the company. This finding of the HealthMine 2018 Rising Risk Survey highlights the need for companies to do a better job of identifying key employees who are at-risk for a chronic illness. Once risks are identified, plan members can engage in personalized health actions to help ward off disease. In addition, companies can implement contingency and succession plans should these employees suddenly become sick.

“Chances are people who are most important to a company’s success are working 50- or 60-hour weeks and could be neglecting their own personal health,” said Bryce Williams, president and CEO of HealthMine. “As a result, many have one or more diseases and do not know it. This is important because the health status of key employees is a major component of a company’s risk profile. Failing to intervene early, or to plan for illness, can have a detrimental impact on the performance of the business. That such a high percentage of employees have found themselves in situations in which executive illness has created problems for their company suggests there is more work to be done in coming to terms with the risk.”

According to the Centers for Disease Control (CDC), chronic diseases are responsible for seven of 10 deaths each year, and treating people with chronic diseases accounts for 86% of U.S. healthcare costs. However, it has been reported that the rising-risk chronic disease population group typically represents 20-30% of a defined population, and due to their numbers, can actually account for a higher total healthcare spend than the high-risk population.

About the Survey

The HealthMine 2018 Rising Risk Survey queried 500 full-time U.S. employees age 26-64 who are enrolled in a healthcare plan sponsored by their employers. The survey was fielded by Research Now SSI (formerly Survey Sampling International) in December 2017 and January 2018. Data were collected via an opt-in panel. The margin of error was 4%. Research Now SSI has been the worldwide leader in survey sampling and data collection solutions across every mode for 40 years.

For more details, please visit www.healthmine.com.

CDC: One in Ten Deaths Were Flu-Related in Most Recent Data – This flu season is ‘on track to break some recent records’

By: Molly Walker, Staff Writer, MedPage Today

More bad news about flu season, as about 10% of deaths were flu-related and hospitalizations are now significantly higher than when CDC first started using its current tracking system in 2010.

The latest FluView data found that flu-related deaths rose to 10.1% for the week ending January 20 — far above the epidemic threshold figure of 7.3% for that week. There were also an additional 10 pediatric deaths reported, bringing the total to 63 pediatric deaths this flu season. Over the next few weeks it would make sense to see more flu-related deaths, as those potential deaths will likely come from current influenza-related hospitalizations, CDC researchers said.

Overall, cumulative hospitalizations rose to 59.9 per 100,000 in this week’s data — up from 51.4 per 100,000 in last week’s data. CDC investigators noted that this year’s most recent data are “approaching the end of the 2014-2015 season rate,” which was the last high-severity season.

“We were hoping to have better news to share today, but influenza activity is still on the rise overall. We may be on track for a record,” Anne Schuchat, MD, acting director of the CDC, said on a conference call with the media.

What continues to be be notable about this season in particular is the cumulative hospitalization rate among older adults ages 50-64 (63.1 per 100,000 compared to 35.1 per 100,000 in 2014-2015, CDC researchers said) and the rate of outpatient visits for influenza-like illness. This week’s data showed outpatient visits for influenza-like illness comprised 7.7% of all visits — up from 7.1% in last week’s data.

Schuchat had a special message for clinicians about the importance of antiviral therapy, especially among those at risk of developing severe flu complications, or in young children, elderly adults, pregnant women, or those with preexisting conditions, such as heart or lung disease.

“If persons look like they have the flu, don’t wait on a test result — you should treat immediately if it’s a person with severe presentation or underlying risk conditions,” she said.

Schuchat noted that while influenza A (H3N2) remains the predominant strain, influenza B viruses are comprising about 30% of viruses reported in this week’s data. Researchers noted that it is not uncommon to see influenza B activity, and “we usually see better vaccine protection against B viruses.”

On the subject of vaccines, Schuchat added that the Department of Health and Human Services is “looking at this season’s data very carefully” and understands the “need to talk about longer-term approaches to improved flu vaccines.” But she said that while there could be merits in exploring other types of vaccine production, such as cell-based or recombinant vaccines, the effectiveness of these different types of vaccines hasn’t been fully studied yet.

Schuchat said that while this year’s virus “isn’t new in terms of antigenic drift,” virologists are studying it to see if there are “other explanations for the more severe disease we’re seeing.”

This week’s data indicated that flu activity remained widespread in 48 states. CDC researchers noted there may be the potential for several more weeks of elevated influenza activity, and it is only week 11.

“I don’t know if we’ve hit peak yet,” Schuchat said.