Friday Five: Typhoon Haiyan and the Philippines

This week, I focus on the aftermath of the typhoon that hit the Philippines last Friday. One of the strongest storms to ever hit the archipelago, the typhoon is known as Yolanda within the Philippines and is called Haiyan internationally. Background and Geography

Source: Google maps

“Typhoon” is the name for a hurricane that forms in the northwest Pacific Ocean. The Philippines has been hit by four typhoons this year alone, and Haiyan is the third Super Typhoon (roughly equivalent to Category Five in the Atlantic) to bring destruction to the islands in the past five years. The Philippines is particularly susceptible to typhoons because of its location in the warm, tropical Pacific.

Source: New York Times

Haiyan wreaked havoc on some areas more than others. Ormoc, Leyte and Tacloban, Samar were hit particularly hard.

Extent of the human cost and property damage

Source: New York Times

The UN estimates that 11.8 million Filipinos were affected by Haiyan, though the country’s government estimates far fewer. Nearly one million people have been displaced and 2.5 million people are in need of food assistance.

As of this morning, the Official Gazette of the Office of the President of the Philippines reports:

  • 2,360 dead
  • 3,853 injured
  • 77 missing
  •  253,049 houses damaged (136,247 totally / 117,802 partially)
  • All bridges and roads that were previously unpassable are now open
  • Some areas do not have clean water:  Capiz and Iloilo, and the Municipality of Barbaza, Antique, in particular
  • Electricity and cell communications are spotty
  • Food, shelter and medical care are in short supply

Countries providing aid (not comprehensive)

Asian Development Bank: $500 million emergency loans and $23 million in grants

Australia: A$30 millon ($28 million)

China: 10m yuan ($1.6million) in relief goods plus $200,000 from government and Red Cross

European Commission: $11 million

Indonesia: Logistical aid including aircraft, food, generators and medicine

Japan: $50 million, 25-person medical team

South Korea: $5 million, 40-person medical team

UAE: $10 million

UK: $32 million aid package, sending aircraft carrier

US: $20 million, 300 military personnel, aircraft carrier

Potential health concerns

Filipinos are now at risk of tetanus, acute respiratory infections, measles, leptospirosis, and typhoid. Implementing water, sanitation, and hygiene (WASH) facilities, starting a measles vaccine campaign, and restoring the vaccine cold chain are priorities for the Department of Health. In particular, an oral polio vaccine campaign is necessary but cannot be started because there is no way to keep the vaccine cold. An estimated 70,000 pregnant and lactating women and 112,000 children need food. There are limited mental health services to help people begin processing loss and grief. For a far more extensive breakdown, see this report from the UN’s OCHA Philippines.

What can we do to help?

The best thing to do is send money. Choose your favorite organization and give as much as you can. I suggest these organizations for their reliability and proven track record of relief:

Friday Five: heat, Bloomberg, Texas, heroin, ACA

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Let’s all do the heat wave! Just in case you’ve ignored the Facebook status updates, tweets, and complaints from co-workers, I want to inform you that it is Very Hot Outside. Growing up in Florida gives a person a skewed sense of the appropriate level of summertime heat and humidity, but this week has been tough even for me. In all seriousness, the heat is severe and dangerous, especially because so many people in the affected areas (map) don’t have air conditioning. So follow the heat advisory instructions: stay inside, run that AC (if you have it), drink water, and check in on seniors—they’re especially susceptible to high temperatures. And remember, we’ll all look back fondly this week while we wait for snow plows in January.

Bloomberg’s at it again But this time, he just wants New Yorkers to bypass the elevator and take the stairs instead. Mayor Bloomberg signed an executive order on Wednesday that requires all government building to be laid out using “Active Design” principles in order to promote physical activity like taking the stairs. We often talk in public health about making the healthy choice the easy choice and changing the built environment to encourage physical fitness. Bloomberg’s latest move may spark an interest in healthier buildings. Could Active Design be the new LEED certification?

You haven’t heard the whole story about Texas This was a big week for abortion controversy in Texas, and there’s already extensive coverage of what happened, so here’s some news you may have missed:

  •  You can now purchase Rick Perry voodoo dolls (cultural appropriation isn’t just for Miley Cyrus)
  • Texas Democrat Rep. Harold Dutton introduced a bill that would ban all abortion legislation until the state abolishes the death penalty.
  • The pink running shoes Wendy Davis wore during her filibuster have over 280 positive reviews on Amazon, and not all of them extol the arch support.

What did I miss?

Heroin’s popularity is growing in Northern New England In New Hampshire, the number of fatal heroin overdoses jumped from just seven in 2003 to a surprising 40 in 2012. The increase has also been observed in Vermont, with a 40% increase in heroin addiction treatment, and Maine, which had three times the heroin overdoses in 2012 as in 2011. There are a few factors that may contribute to this growing problem: increased control over prescription painkillers, the relative cheapness of heroin compared to painkillers, and because heroin can be sold at a higher price in rural areas than in urban centers, distributors are incentivized to sell more. Heroin is now taking up most of drug enforcement agents’ time in the area. Controlling infectious diseases like HIV and Hepatitis C will be the next challenge for the area’s public health community.

Curious about what’s happening next with the ACA? Kaiser Family Foundation released a new ACA video starring its charming YouToons. This one, a follow up to 2010’s “Health Reform Meets Main Street,” explains how to “Get Ready for Obamacare.” (Interesting, the change in terminology over three years!) This easy to understand breakdown of the complicated law is accessible to all audiences. Anyone talking to the public should be emulating this kind of clear communication. http://www.youtube.com/watch?v=JZkk6ueZt-U

Friday Five: sterilization, pain robot, brains, surgeons, Sharknado

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Rural women are more likely to be sterilized

Tubal ligation, also known as sterilization or “getting your tubes tied,” is far more common among rural women as compared to urban women. Of rural women, 23% said they had been sterilized; urban women, 13%. There is only speculation about why this difference exists. Some of the theories floating around are: less access to other forms of birth control; piggybacking tubal ligation onto post-partum Medicaid coverage; lower educational level. Importantly, 39% of those rural women regret their decision. We should be asking why they didn’t choose a long-term, reversible birth control such as an IUD or an implant (like Implanon) instead.

Somewhat cute robot helps reduce kids’ pain and suffering during injections

As a needle phobic myself, I was very excited to learn that there’s an innovation in helping kids’ distress during shots. The robot not only talks to the child in order to distract him or her from the scary needle, but encourages exhalation during the injection to help with muscle relaxation (video here). There are two reasons why reducing pain and anxiety for children receiving immunizations is important: excessive worry can make other parts of the exam difficult, and in the future, an adult who had a bad medical experience as a child may be more likely to avoid care. These both have significant health implications. If this robot can help, I say let’s get one in every pediatrician’s office—and maybe in internist’s offices too, for ‘fraidy cats like me.

Brain pathways involved with learning and changing behavior charted

This week the NIH published a study identifying neural pathways associated with learning and changing behavior in mice. The nerves associated with the switch from moderate to compulsive drinking were found to also have a role in learning and decision making. Researchers hope that their insights will be helpful in understanding alcoholism and addiction. Learning more about why some people can use substances in moderation while others become addicted is crucial to improving mental and physical health. Hopefully, these findings will also apply for humans.

Surgery residents operate less often under new rules

Medical residents (doctors who are done with medical school and are completing their practical training) work notoriously long shifts and even longer workweeks. Restrictions created in 2011 limited shifts to 16 hours for first-year residents and 28 hours for the more advanced doctors and everyone’s week is limited to 80 hours. Surgical residents have in turn participated in fewer hours of surgery because of the limits on working hours. Many doctors are concerned that this will put the budding surgeons at risk for not gaining enough experience. There has to be a balance between allowing doctors to get enough rest while also learning enough to practice on one’s own—the question is, how

Kathleen Sebelius may in fact have a sense of humor

Twitter blew up last night with references to Sharknado, a horribly wonderful movie about a tornado that blew sharks into a city. (I don’t know how that works, I didn’t watch it!) Buzzfeed immediately wrote an article claiming “There is no Obamacare coverage for pre-existing Sharknado injuries.” Kathleen Sebelius replied: https://twitter.com/Sebelius/status/355766513334108160 Hey, an ACA joke!

I leave you this weekend with an excellent infographic explaining pretty much everything you need to know about gender, sexual orientation, and the like…The Genderbread Person!

Genderbread-Person

Friday Five: Chicago, ACA, firefighters, prescription drugs, vaccine recall

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Fourth of July shootings in Chicago

This Fourth of July weekend is proving to be deadly for Chicago. Yesterday, eight people were killed and more than 30 were hurt in shootings across the city. The youngest victim is just five years old, and was shot while attending a party in a park with his family. These shootings are a disgrace, as is the lack of national coverage of the violence permeating Chicago. Victims’ stories should be plastered across every news station and website, and the nation should be reviving the post-Sandy Hook gun conversation in light of this inexcusable violence.

 

Another ACA delay

The Obama administration added to the confusion surrounding the Affordable Care Act by pushing the employer mandate deadline back one year to January 1, 2015. Another instance of caving to private sector demands means increased misunderstanding for the public. The law was incredibly complicated as written, and the administrative tweaks, House repeals, and flat-out lies disseminated by the media ensure that nobody has any idea what’s going on. The ACA is the single most important change to health care the US has seen since 1965, and its frustrating to watch it falter. Hopefully, the exchanges will still open as scheduled on October 1.

 

Firefighters killed in Arizona fires

Nineteen elite firefighters were killed on Sunday battling a blaze that is still only 45% contained. Their deaths have reminded us that the people suffering from these fires are not only those who lose their homes, but the people who are willing run into the flames to try to protect those homes. We’re learning about the hotshot teams specially trained to fight wildfires, an aspect of firefighting that was unknown to many people. I’ve been trying to imagine what it’s like to do what these teams do: go out to the fire, live near it for days, battling it while awake and smelling it while you sleep. I am in awe and very grateful.

 

More ‘scripts, more problems

This was a big week for news about prescription drugs. A brief rundown:

  • 70% of Americans take at least one prescription a day, mostly antibiotics, antidepressants, or painkillers
  • The number of fatal overdoses in women quadrupled between 1999 and 2010, and approximately 42 women die daily from overdoses
  • The FDA busted 1600 illegal online pharmacies

 

Hepatitis B Vaccine recall

Merck issued a recall this week for one lot of the Hepatitis B vaccine Recombivax. The issue is not with the vaccine itself, but with the glass vials that may easily crack. Merck is concerned about the sterility of the vaccine, and the FDA assures consumers there’s no need to be revaccinated if a doctor administered one of the recalled lot. The anti-vaccine websites I visited seem to have not picked this up yet, so maybe this vaccine news won’t be misconstrued. We can only hope.

In honor of yesterday's Fourth of July holiday, here's a little Katy Perry to get you dancing:

http://www.youtube.com/watch?v=QGJuMBdaqIw

Friday Five: Sarah Murnaghan, Plan B, Arizona, wildfires, mindfulness

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. The triumph of Sarah Murnaghan

Follow up from two weeks ago: Sarah Murnaghan got new lungs! After a judge ruled that she must be added to the top of the adult transplant list, Sarah was matched with organs within days. The Murnaghan family will now step out of the public eye and, as Sarah’s mother says, they will be “focusing all of [their] attention on Sarah” as she recovers from surgery. Sarah is not the only one to benefit from her family’s perseverance—11 year old Javier Acosta was also added to the list. This judicial intervention will certainly inspire ethical debate about who can get which organs, and hopefully children’s lives will be valued as much as adults’.

 

Judge Korman: New hero of reproductive rights?

After the Obama administration finally dropped its appeal of Judge Edward Korman’s ruling that all products containing levonorgestrel be made available over the counter, the administration decided to make available only Plan B One Step (containing just one pill rather than two). Korman is not happy about this. Plan B One Step is manufactured by Teva, and if it is the only emergency contraceptive authorized to be sold over the counter, Teva will be able to set its price and have no competition. Korman argues this unduly burdens low-income women and that “it is the plaintiffs, rather than Teva, who are responsible for the outcome of this case, and it is they, and the women who benefited from their efforts, who deserve to be rewarded.” Korman also makes it clear that if the FDA or Teva drag their feet on getting Plan B One Step to the drugstore shelves, they should expect to be sued again.

 

Arizona finally decides to expand Medicaid

Despite her deep opposition to the Affordable Care Act, Governor Jan Brewer now accepts that the ACA is here to stay and that Arizona should get in on the billions of dollars available to the state. Her website even touts the Medicaid expansion as “the conservative choice for Arizona.” Imagine that: after realizing that “uninsured Arizonans get sick just like the rest of us” (because uninsured people are markedly different from the insured, of course) providing them with Medicaid would help reduce the rates paid by the insured! Brewer even denies the state is participating in “ObamaCare” by crediting former (Republican) Governor Fife Symington with coming up with the idea of the expansion in the 1990s. I’m pleased that 57,000 additional Arizonans will have access to Medicaid, but Brewer can obviously see the advantages of the expansion and yet spent months rabidly fighting the ACA…what a hypocrite.

 

Wildfires? Denver Post has us covered

Multiple wildfires in Colorado are causing serious problems for the state, and the Denver Post is taking care of business when it comes to covering the fires. It’s providing maps of the perimeters of each fire, the properties damaged, and a map of all fires across the country. There are chilling before-and-after photos of neighborhoods turned to ashes. The Denver Post is doing an excellent job of keeping people informed, spotlighting the firefighters, and reminding residents of preparedness procedures without being alarmist. With two people killed and hundreds of homes burned down, the fires are a significant natural disaster, and the Denver Post will keep us all informed.

 

Mindfulness classes in high school

Central Bucks High School East will add a new subject to its curriculum: mindfulness. Using techniques from Learning to BREATHE, the school hopes to teach students to regulate their emotions, manage stress, and strengthen their ability to focus. Central Bucks East hopes the mindfulness training will help high-achieving students feel less stressed about AP classes, applying for college, and taking the SAT while the training will also be taught in a program designed for students to learn how to live independently. Acknowledging that stress hurts students (whether they are in classes about healthy interpersonal relationships or European History) shows that Central Bucks East is trying to see its students as whole people. I’m eager to see this program evaluated—will mindfulness change test scores or graduation rates?

 

Start the weekend off right with the evolution of Daft Punk and Pharrell's new song Get Lucky as it would have sounded if it was made in the past.

http://www.youtube.com/watch?v=3r3BOZ6QQtU

 

Friday Five: Building collapse, Oklahoma tornadoes redux, Hepatitis A, cavities, vacation

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Building collapses in Philadelphia

The storefront of the Salvation Army thrift store crushed by the falling building. I took this photo on Thursday after the collapse and before the storefront was taken down.

Mid-morning on Wednesday, a building being demolished at 22nd and Market Streets in Philadelphia collapsed onto a Salvation Army thrift store, killing 6 and injuring 13 people. One resident was worried about unsafe demolition practices and lodged a formal complaint with the city, but the inspection deemed the conditions safe. One lawsuit has already been filed, and the city has put in place new demolition standards. There is some question about whether or not the contractor, Griffin Campbell, violated federal safety standards and was otherwise negligent. This story will continue to unfold, educating all Philadelphians about the importance of hiring knowledgeable and safe construction companies.

 

Oklahoma slammed by more tornadoes

At least 10 tornadoes touched down in Oklahoma last Friday, one of which was nearly 2 miles wide and is reported to have had winds near 300 miles per hour. Most upsetting is that because of a combination of rush hour traffic and people leaving their homes to avoid the tornadoes, many people were in their cars at the time; at least 8 people killed during the storm were in their vehicles. Despite the standard instruction to stay indoors (and get underground if possible) during a tornado warning, perhaps residual fear from the Moore tornado caused panic. Interestingly, one of the major activities of relief workers has been administering tetanus vaccines. Because tetanus bacteria live in soil and enter the body through puncture wounds, cleaning up after a disaster is a likely way to become exposed.

 

Berry mix causes a Hepatitis A outbreak

A frozen organic berry-pomegranate mix is the latest food borne illness culprit, sickening 61 people in seven states as of June 5. Hepatitis A is spread by contaminated food, which in the US generally occurs due to improper hand hygiene. The virus is genetically linked to other Hepatitis A viruses found in the Middle East, and the berry mix included pomegranate sees from Turkey. A unintended consequence of a global food market may be sharing food borne illnesses internationally.  The CDC has detailed information about which lots are being recalled—if you have a bag of Townsend Farms frozen berries in your freezer, please make sure it’s safe to eat.

 

Chances are, you need a cavity filled

Approximately 66% of people worldwide have serious untreated dental problems. Globally, the major oral health problems are shifting from tooth loss to severe gum disease and unfilled cavities. This means that people are keeping their teeth longer, but the teeth they’re keeping aren’t too healthy. Considering anti-fluoride rhetoric abounds, I’m not surprised. As most of Europe refuses to fluoridate and 780 million people worldwide lack access to safe water, basic oral health principles are often ignored.

 

Going on vacation is good for you...if you turn off your phone!

This infographic from Expedia UK explains how technology changes your thought patterns and causes stress, while touts the restorative power of vacations free from smartphones, laptops, and tablets. Of course, Expedia wants you to travel for their own reasons, but this might be the push we all need to put down the phone, pick up the sunscreen, and enjoy the summer!

Holidays_Unplugged_Expedia_Infographic

Friday Five: Oklahoma tornado, MERS, 3D printing, polio, live-tweeting surgery

Each Friday, I use  five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week.  

Tornado in Moore, OK is the latest national disaster

On Monday, a mile wide tornado with 200+ mph winds decimated Moore, OK. Approximately 10,000 people were directly affected, 240 injured, and 24 killed, including nine children. Reports of heroism abound, as do shocking photos. Coming just months after the shooting at Sandy Hook and weeks after the Boston Marathon bombing, the Moore tornado victims may find themselves on the losing end of American disaster fatigue. Hopefully Moore will stay in the forefront of American’s minds and not blend in with other communities rebuilding from natural and human-made tragedies.

 

MERS is on the move

After a slow march toward notoriety, MERS is becoming a real threat. This novel coronavirus dubbed Middle East Respiratory Syndrome has been confirmed in 44 people across multiple countries and caused 22 deaths. In this month alone, two new outbreak clusters surfaced—one in Saudi Arabia infected 22 people and killed 10, the other in France infected two, one of whom contracted MERS from a hospital roommate. However, the exact mode of transmission, incubation period, and reservoir (meaning whether or not the virus lives someplace outside of humans) are unknown and research is stymied due to restrictions placed on the virus by Erasmus Medical Center in the Netherlands. For a virus with a 50% mortality rate so far, this is an egregious example of the problems with commercializing organisms needed for public health research. How many others will fall ill and die because of Erasmus’s patent?

 

Child’s life is saved by 3D printed trachea splint

In a groundbreaking and heartwarming use of the new technology of 3D printing, University of Michigan researchers created and implanted a trachea splint in a young child. Kaiba Gionnfrido, who had spent nearly all of his 20-month long life in a hospital on a respirator due to his trachobrochomalacia, or the softening and subsequent collapse of the windpipe. The splint, made to fit Kaiba perfectly, will give structure to his trachea to allow it to grow and is composed of a biopolymer that will be absorbed by his body in about three years. After years of requiring daily resuscitation, the splint allowed Kaiba to come off the respirator three weeks later. We can look forward to the emerging practice of saving lives using 3D printing to create custom-made medical devices.

 

Polio in Kenya and Somalia threatens eradication effort

A four-month old girl developed symptoms of paralysis and two other children tested positive for polio in a Kenyan refugee camp. Just a few weeks ago, Somalia reported its first wild case in five years. Vaccination rates in these areas are low, and nearly 500,000 people travel to and from the Kenyan refugee camp annually, increasing risk for an epidemic. This development complicates the newly adopted six year plan for polio eradication, and mass vaccination campaigns in the area are underway in hopes of containing the virus. Maintaining vaccination in vulnerable areas, even after years pass with no new infections, is crucial to destroying polio forever.

 

Brain surgery documented on Twitter and Vine

In this week’s example of how social media is revolutionizing health care and medicine, UCLA Hospital live tweeted Vine videos of brain surgery. Brad Carter, an actor and musician, underwent awake brain surgery to implant a pacemaker to calm his essential tremors. The Vine videos show distinct improvement in Carter’s guitar playing once the pacemaker was in place. By using Twitter and Vine to document the surgery, UCLA surgeons and Carter do the public a great service—showing exactly how incredible medicine can be. The videos inspire awe while simultaneously taking some of the mystery out of surgery.

 

This week's song to celebrate the end of the week: The Cure's "Friday I'm in Love"

[youtube=http://www.youtube.com/watch?v=b69XWDUtMew]