Massachusetts | Boston launches regional climate preparedness effort

Today, on the two-year anniversary of Hurricane Sandy, Mayor Martin J. Walsh announced the City of Boston will be convening a regional summit to better prepare Greater Boston for the impacts of climate change. The announcement also marked the kickoff of an international design competition focused on climate preparedness, as well as an update of the City of Boston’s ongoing climate efforts.

“There is no issue more urgent than climate action. When we work together, the steps we take do more than protect us: they can bring us closer together, they can create good jobs, they can improve our health, our public space, and our civic life,” said Mayor Walsh. “I look forward to working closely with the MAPC, the Metro Mayor’s Coalition, and the Commonwealth on this critical issue.”

The half-day summit, which will be held at the University of Massachusetts Boston next spring, is a first-of-its-kind convening on regional climate preparedness and will establish a mechanism for coordination of regional, cross-government action going forward. It will include regional and state agencies such as MassPort, MassDOT, and the Massachusetts Water Resources Authority (MWRA), as well as Mayors from the Metropolitan Area Planning Council’s (MAPC) Metro Mayor’s Coalition. The Metro Mayor’s Coalition includes Boston, Cambridge, Chelsea, Everett, Malden, Melrose, Medford, Quincy, Revere, Somerville, Brookline, Winthrop, and Braintree.

“Our cities share infrastructure, our residents cross borders every day between work and home, and our natural resources—rivers, wildlife, coastlines—intersect our region. We are one region and neither the Atlantic Ocean nor the weather will respect municipal boundaries,” said Somerville Mayor Joseph A. Curtatone. “We will be more resilient when we share common principles and work toward shared goals. This summit is an opportunity to ask how we can use a shared understanding of climate science to make smart decisions about our shared infrastructure, to engage our common stakeholders, and challenge ourselves to take a broad look at our climate threats and not adapt but mitigate our impact on climate change.”

“It is essential that communities in the Boston metropolitan area work together on climate change,” said Richard C. Rossi, Cambridge City Manager. “Climate change is creating new stresses on our communities, and while we are individually doing a lot within our borders, what is missing is a regional strategy.”

“Climate change is a threat that municipalities throughout our region are already confronting. Chelsea, a coastal city, knows this is not a challenge we can face alone, and we are excited to work with our partners in the Metro Mayors Coalition to find common solutions,” said Chelsea City Manager Jay Ash. “The effort we’re launching today will ensure that all communities are aware of the effects that climate change will likely bring to the region, and will empower us with the tools we need to be prepared.”

“The impacts of climate change do not respect municipal boundaries,” said Marc Draisen, Executive Director of the Metropolitan Area Planning Council (MAPC). “It’s incredibly important that all of the cities and towns in Greater Boston work together to address issues like sea level rise, coastal flooding, and rising temperatures. Cooperation and planning are the keys to success.”

The announcement was made at the Architecture Boston Expo (ABX) 2014, hosted by the Boston Society of Architects (BSA), and coincided with the kickoff of the international design competition “Boston Living with Water.” The competition is being led by the Boston Redevelopment Authority, the Mayor’s Office of Environment, Energy and Open Space, the BSA, and the Boston Harbor Association.

The competition invites multi-disciplinary teams to submit design solutions to sea-level rise for three sites in the City that will help better prepare the site and the surrounding community for climate change. The three sites are located in the North End, Fort Point Channel, and Morrissey Boulevard. The competition will conclude in the spring, with a first place prize of $20,000. It is funded through a grant from the Massachusetts Office of Coastal Zone Management, and the Barr Foundation. Details about the design competition can be found at

These announcements build on the City of Boston’s ongoing climate preparedness efforts. A year ago, the City released the report, Climate Ready Boston: Municipal Vulnerability to Climate Change, which was a cross-departmental effort led by the Mayor’s Office of Environment, Energy, and Open Space.

“Last year’s vulnerability assessment was a critical step to making Boston’s municipal operations more prepared for the impacts of climate change,” said Brian Swett, Chief of Environment, Energy and Open Space. “We continue to build on this study and take action across all departments to ensure we are prepared for the future climate.”

The report identified the City’s vulnerabilities to climate change in order to help departments take action to prepare. In the past year, the City has made significant progress on reducing these vulnerabilities, especially in the areas of emergency response, extreme heat preparedness, flood and stormwater management, capital planning, and community engagement. Efforts include:

Backup power at emergency shelters: As a result of $1.32 million in grant funding from the Commonwealth, four emergency shelters will be getting solar photovoltaic (PV) arrays to provide at least three days of backup power during an emergency. In addition, the Office of Emergency Management (OEM) and Boston Centers for Youth and Families (BCYF) are conducting an Emergency Generator Study to outfit four BCYF Community Centers with emergency generators.

Facility improvements to address extreme heat: BCYF has purchased tents and water access (sprinklers) to help handle extreme heat at outdoor programming sites during the summer. In addition, the BCYF Paris Street Community Center capital project includes installation of an emergency generator and air conditioning throughout the building, allowing the facility to serve as a cooling center.

Increased food resilience: With funding from the Kendall Foundation and the Urban Sustainability Directors Network, the Mayor’s Office of Food Initiatives has recently commissioned a team to complete a city-wide food resilience study. The Department of Neighborhood Development also continues its efforts to transform vacant lots into urban agriculture.

Flooding and stormwater management: A number of green infrastructure projects that help mitigate flooding have recently been completed or are underway.

  • The Public Works Department worked with the Charles River Watershed Association and the Boston Groundwater Trust to repave an alley in the South End with porous pavement.

Increased education and awareness: Greenovate Boston, Boston Public Health Commission (BPHC), and OEM have teamed up to deliver concerted messaging during National Preparedness Month. This included the launch of a new webpage with daily tips, as well as a community preparedness event that attracted over 200 residents.

Better prepared buildings and development:

  • The BRA has implemented a mandatory climate preparedness questionnaire as part of the Article 80 development review process. So far over 60 projects have completed this new requirement.

  • The Mayor’s new Housing 2030 plan incorporates climate preparedness goals and actions.

  • This fall, the City added a new partner to its property insurance team. FM Global is an international, mutual-insurance firm with a focus on loss-prevention engineering. FM Global will work with the City to identify and prioritize solutions for risks to the City’s 33 largest buildings, and contribute loss-prevention expertise to the City’s building design processes. The risks of flooding and high winds, which will increase with climate change, are priorities at FM Global. Through this partnership, the City gains research and engineering expertise to help address these risks.

These efforts, along with future actions to better prepare the community, will be part of the 2014 Climate Action Plan Update, which will be released the second week of November for public comment. Interested parties may view and comment on the draft strategies and actions currently posted at

Vermont | State is carefully monitoring travelers from Ebola-affected regions

The Vermont Department of Health has requested a Vermonter who has just returned from West Africa to enter voluntary quarantine and active monitoring for fever or symptoms of Ebola for 21 days. This individual agreed, and began quarantine on Oct. 27.

This person does not have an elevated temperature, has no signs or symptoms of illness and is not a health risk to anyone at this time. A person infected with Ebola cannot pass the infection on to others until he or she has symptoms – and then only through direct contact with bodily fluids. Ebola is not an airborne virus.

Public health and law enforcement officials from Vermont met this individual at JFK International Airport on Oct. 27, and provided transport back to Vermont.

Federal officials assessed this person before allowing travel back to the U.S. and concluded there was not a health risk to the traveling public. The reason for the Vermont Health Department to request quarantine in this circumstance is that the individual was in the West African countries of Guinea and Sierra Leone with the stated intention of personally investigating the Ebola epidemic in those countries, and while he has represented himself in public statements as a physician, he is not licensed as a doctor or health professional in Vermont. He was not traveling or affiliated with any governmental, public health, medical or aid organization.

“We do not know whether this person had exposure to the virus while in West Africa,” said acting Health Commissioner Tracy Dolan. “Because we can’t determine this – and combined with what we know about this person’s unsupervised travel, intent to help as a medical doctor, and his statements – we are taking the precaution of quarantine while we actively monitor temperature and symptoms for 21 days.”

Twenty-one days is the longest it can take from the time a person is infected with Ebola until that person has symptoms of Ebola. Any individual returning to Vermont from the affected countries will be actively monitored during that time and, depending on individual circumstances, active monitoring may include voluntary or mandatory quarantine.

This action is being taken both to protect others and ensure this person receives early and high quality care in the unlikely event that illness develops. Throughout the 21 days of quarantine, this individual will receive twice-daily health checks, plus food, shelter and other comforts. Local public health officials will be monitoring and in contact with this individual throughout quarantine.

To protect privacy and security, neither this person’s identity nor the location of quarantine will be released by the state.

Quarantine and Active Monitoring
Quarantine is a well established, although rarely used, public health action that separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick. If a person is under quarantine, it means that he or she must stay in their home or at an alternate location deemed appropriate by the Health Department.

Active monitoring means that health officials stay in daily contact – by phone or other technology and/or visit for the entire 21 days following a person’s last possible date of exposure to Ebola virus.

If a traveler begins to show symptoms, the Health Department will take immediate action to implement protocols to transport the patient to a designated facility such as Fletcher Allen Health Care. The Health Department has been working closely with health care providers and hospitals to prepare in the event a symptomatic individual requires treatment.

About Ebola
Ebola is a dangerous viral disease that is epidemic in Liberia, Guinea and Sierra Leone, where public health and health care infrastructure has been insufficient to control its spread.

Ebola is only spread through direct contact with the blood or bodily fluids of a person who is sick or has died from Ebola. Health care workers or people caring for patients with Ebola or the dead are most at risk of contracting the disease.

Ebola is NOT spread by casual contact. It is not spread through the air, water or food produced in the U.S. Ebola does not spread easily from person to person like the flu, measles or active tuberculosis.

New Hampshire | Monitoring protocols for individuals returning from countries affected by Ebola outbreak

Continuing efforts to protect the health of New Hampshire citizens, Governor Maggie Hassan today announced intensive monitoring protocols for any Granite Staters who may have had contact with Ebola patients and all individuals arriving in New Hampshire who have been in Guinea, Liberia or Sierra Leone, the three West African countries affected by the Ebola outbreak, in the previous 21 days.

Any returning traveler from an Ebola-affected country who had contact with Ebola patients will be monitored for illness for 21 days following their return while staying in their home. Public health officials will also monitor individuals returning from impacted areas but did not have any direct contact with Ebola patients with temperature checks twice a day for 21 days following the last possible exposure to the illness. The state is asking these individuals to avoid attending large public gatherings and using public transportation, as well as recommending other limits to their mobility. In the event that travelers develop signs or symptoms of possible infection, public health and emergency management officials will coordinate safe transportation for immediate medical attention and evaluation.

“Our intensive monitoring protocols are an effective, science-based approach to help protect the health of Granite Staters in the unlikely occurrence of an individual in New Hampshire becoming infected,” Governor Hassan said. “With these measures to closely monitor all individuals returning from the affected countries, we will be able to quickly identify potential cases, provide appropriate and safe care and isolate the patient so that we can prevent the spread of this serious disease. State and local public health and emergency management officials will continue to work closely with health care providers in order to ensure effective response plans. The threat of an outbreak remains low, and I will continue to take actions deemed appropriate by public health experts to ensure that we are prepared to protect the health and safety of our citizens.”

The New Hampshire Department of Health and Human Services will be provided the names and contact information for all travelers from the affected countries with destinations or residing in New Hampshire by the federal government.

“Our public health officials and health care providers treat infectious diseases across the state every day,” said Dr. José T. Montero, Director of the Division of Public Health Services. “The state’s monitoring protocols are an intensive approach to build on our ongoing efforts to develop effective response plans.”

Plans are also in place for Brigadier General Peter Corey, deputy commanding general for U.S. Army Africa who is currently in Liberia, and Dr. Elizabeth Talbot, deputy state epidemiologist with the Department of Health and Human Services and infectious disease doctor at Dartmouth-Hitchcock who leaves for Liberia later this week, to monitor for illness and self-quarantine at home for 21 days upon their return to New Hampshire.

“Brigadier General Corey and Dr. Talbot truly represent the best of the talent and humanitarian spirit that define the Granite State, and we remain incredibly proud for their selfless service to help combat the crisis in West Africa,” Governor Hassan said.

Today’s announcement builds on the coordination efforts between the state, local governments and health care providers to ensure emergency preparedness for Ebola. State public health officials have held several webinars with hospitals, emergency medical services and other health care providers and have produced training videos and other informational resources about what to look for and how to appropriately respond to suspected cases, handle specimens and dispose of waste. The state has also purchased personal protective equipment for use in the most contagious scenarios and continues to participate in all relevant calls with federal partners.

The intensive monitoring protocols were recommended by public health experts, including the Division of Public Health Services and the Section of Infectious Disease and International Health at Dartmouth-Hitchcock. The policy and procedures are effective immediately and will be changed as necessary based on new information from the ongoing national efforts to prevent the spread of Ebola in the U.S.

For more information, visit the Department of Health and Human Services website at To learn more about Ebola, visit

Maine | Health Commissioner discusses Ebola protocols

Maine Department of Health and Human Services Commissioner Mary Mayhew met with members of the media on Tuesday to provide an update on Maine’s protocols.

Here are the Commissioner’s remarks:

Good evening.

I am Mary Mayhew, Commissioner of the Maine Health Department of Health and Human Services. I’m here today to give you an update on Maine’s response to the Ebola crisis, particularly as it relates to travelers and healthcare workers returning to Maine from West Africa.

Before I begin, I want to be very clear about our focus.

Every step that we are taking to prepare and plan for our response to Ebola is to protect the health of Maine people. There is no more critical function for government than to do everything possible to ensure the safety of its citizens – and we are focused on that at every point.

As you know, this terrible disease is widespread in the West African countries of Liberia, Sierra Leone and Guinea. As part of the worldwide response to the outbreak, there are health workers from our country that are doing brave work by traveling to the afflicted countries to assist in battling the outbreak.

These are important efforts and we commend those individuals who are assisting in this way. That good work also comes with very real risk. Recognizing the risk, the federal government has moved to establish screening protocols for those individuals returning to the United States from one of these countries.

However, we know this screening has limits in the effectiveness it provides. We know that a health worker in New York, who had no known breach in his protective equipment, unfortunately later developed symptoms and tested positive for this terrible disease. To ensure we are doing all we can to protect the health of Maine people, The Maine Department of Health and Human Services’ Center for Disease Control and Prevention continues daily post-arrival monitoring of travelers who came to Maine from an affected country.

Any traveler from West Africa who comes to Maine will be monitored for at least 21 days after the last possible exposure to Ebola. This is consistent with federal guidelines. This monitoring includes daily check-ins with a state epidemiologist for any signs of a fever or other Ebola related symptoms. If any symptoms develop, they will receive immediate medical care.

We have instituted additional protocols for ensuring that those individuals with a higher level of risk do not unnecessarily make contact with the public. These protocols include voluntary, in-home quarantine for someone who was known to have had direct contact with an Ebola patient.

I want to be sure everyone understands what quarantine means in this case. Stating it plainly, what we are asking for is that individuals who had direct contact with Ebola patients stay in their home and avoid public contact until the 21 days for potential incubation has passed.

We acknowledge that this protocol may go slightly beyond the federal guidelines, although the recent changes are very much more in line with Maine’s approach. We have made the determination that out of an abundance of caution, this is a reasonable, common-sense approach to remove additional risk and guard against a public health crisis in Maine.

If an individual who came in direct contact with Ebola patients has returned to Maine and is not willing to avoid public contact and stay in their home voluntarily during the period they are at some risk, we will take additional measures and pursue appropriate authority to ensure they make no public contact.

Our true desire is for a voluntary separation from the public. We do not want to have to legally enforce an in-home quarantine. We are confident that the selfless health workers, who were brave enough to care for Ebola patients in a foreign country, will be willing to take reasonable steps to protect the residents of their own country. However, we are willing to pursue legal authority if necessary to ensure risk is minimized for Mainers.

For any individual who must stay at home for a period of time for this reason, we will do all that we can to make sure that the person has everything necessary to be comfortable and receive the care that is needed.

I want to state again that we recognize the significant and brave contributions that are being made by healthcare workers each day, as they travel to West Africa and other regions of the world to provide critical care to those affected by disease. We are proud of our healthcare providers that continue to answer the call and are always ready to help others.

In closing, I encourage you and members of the public to visit the Maine CDC’s website at .

This website will be updated regularly with new guidance, updated protocols if warranted and easy-to-understand fact sheets.

Thank you

– See more at:

Maine | Ebola – Negotiations fail – Governor to exercise full extent of his authority to protect public health and safety

Governor Paul R. LePage announced today that negotiations with a healthcare worker who had been quarantined in New Jersey and is now in Fort Kent have failed despite repeated efforts by State officials to work with an individual.

Since the arrival of a healthcare worker to the State of Maine, State health officials have worked diligently and tirelessly to address the safety and needs of the individual healthcare worker and all Mainers.

The Governor’s chief legal counsel together with the Attorney General was in hours of negotiation Wednesday in an attempt to reach agreement on how healthcare workers in Maine should meet the CDC guidelines for those in the “some risk” category. That category includes anyone who has had direct exposure to persons infected with Ebola within a 21-day incubation period. The agreement sought to identify how healthcare workers should conduct themselves, given the threat of exposure to the public, should symptoms develop.

“I was ready and willing—and remain ready and willing—to reasonably address the needs of healthcare workers meeting guidelines to assure the public health is protected,” Governor LePage said.

CDC guidelines outlining what Maine considers an in-home quarantine require:
a. Direct Active Monitoring;
b. Any travel will be coordinated with the public health authorities to ensure uninterrupted direct active monitoring;
c. Controlled movement to include exclusion from long-distance commercial conveyances or local public conveyances;
d. Exclusion from public places and congregate gatherings;
e. Exclusion from workplaces for the duration of a public health order (except to receive necessary healthcare);
f. Non-congregate public activities while maintain a three-foot distance from others is permitted (for example, walking or jogging in a park);
g. Other activities should be assessed as needs and circumstances change to determine whether these activities may be undertaken.

These guidelines would allow an individual in the “some risk” category to go for walks, runs or ride their bicycle, but would prevent such a person from going into public places or coming within three feet of other people in non-congregate gatherings. Unfortunately, an agreement was not reached. The Governor remains willing to enter into such an agreement, on a case-by-case basis, with traveling healthcare workers who meet this definition.

As a result of the failed effort to reach an agreement, the Governor will exercise the full extent of his authority allowable by law.
Maine statutes provide robust authority to the State to use legal measures to address threats to public health.

Public health provisions contained at Title 22 of Maine’s Revised Statutes govern how the State may proceed to control diseases. There are multiple options provided in law. Specifics of the process or steps being taken by the State at this time may not be discussed publicly due to the confidentially requirements in law.

Delaware | Update on Ebola prevention and preparation efforts

Joined by the State’s top health officials, along with infectious disease and emergency response experts, Governor Markell today provided an update on ongoing statewide efforts in response to the Ebola virus epidemic.

“We are facing an unprecedented situation with the Ebola virus, making prevention and preparation efforts vital,” said Governor Markell. “While the risk of transmission in Delaware is low, the State has been preparing for the potential of any Ebola cases for months to ensure we are in the best possible position to keep the public safe.”

While there are no cases in Delaware and the risk of transmission is low, the Division of Public Health (DPH) in the Department of Health and Social Services (DHSS) is working to ensure the appropriate screening tools and disease prevention strategies are used to further reduce any chance of transmission. These tools and strategies are based on the best currently available science, which tells us that Ebola virus is only transmitted by infected patients who have symptoms. The risk of getting the disease through normal, everyday contact is extremely low.

DPH is working closely with hospitals, medical providers, EMS companies, and many other partners to prepare, coordinate care, and provide advice and guidance. Issues being addressed by this group include how to screen for the disease, safe ambulance transportation of potential Ebola patients, personal protective equipment guidance and availability, hospital readiness, infectious disease monitoring, and protocols for any doctor’s office that might see a case.

“Delaware’s hospitals know that the best way to address Ebola is to prevent its spread. The Division’s approach to doing that is sound, science-based, and will help protect both Delawareans and the health care professionals who care for them,” said Wayne Smith, President and CEO of the Delaware Healthcare Association.

In addition, the Governor has directed engagement from all cabinet-level agencies to ensure statewide efforts are coordinated and comprehensive.

“If a case is confirmed in Delaware, a Centers for Disease Control and Prevention rapid response team would be on the ground to assist us,” said Secretary Rita Landgraf. “They would support the Division of Public Health to trace any potential contacts who might need to be monitored, have activity restrictions or, although unlikely, be quarantined. The CDC also would work with the State and the hospitals to determine if the ill patient should be moved out of state for treatment.”

In coordination with the Centers for Disease Control (CDC), DPH is receiving notice of all travelers from the three West African countries, Sierra Leone, Guinea, and Liberia.

DPH is in daily contact with those persons to check their status and health, and will remain in daily contact throughout the 21-day period following their last potential Ebola exposure. If anyone shows symptoms of illness or a fever, they will be taken to the closest hospital for evaluation, and, if needed, isolation and testing. Currently there are 11 individuals in Delaware who are considered low risk that are being monitored. Eight live in New Castle County and three live in Kent County. “Low risk” is defined as having no known direct contact with a person infected with the Ebola virus.

Delaware is also designating “high risk” and “some risk” categories for those who have had direct contact with a person or people symptomatic with the Ebola virus. (See attached) These individuals will receive direct active monitoring for the 21-day incubation period by Division of Public Health staff, including daily visits. “High risk” individuals must also be quarantined at home and “some risk” individuals must limit their activities, including avoiding public transportation and large gatherings, and seeking approval from DPH to travel.

DHSS urges people not to make assumptions that someone might be infected based on their accent, background or skin color, and it is important to remember how hard the disease is to transmit.

If you wish to discuss a suspected case, you may contact DPH 24/7 at 888-295-5156, including weekends and holidays. If you have general questions, the CDC has a 24/7 line available for information on the Ebola virus at 800-CDC-INFO (800-232-4636).

For further Ebola information and resources visit the Delaware Public Health homepage:

Ebola Monitoring Fact Sheet

Connecticut | State’s guidelines for monitoring travellers from Ebola-affected nations more stringent than CDC requirements

Governor Dannel P. Malloy today issued the following outline of how the state is monitoring the health of any individual returning to Connecticut after traveling from one of the countries in West Africa affected by the Ebola outbreak.
Earlier this month, the Governor announced that the state was utilizing its authority under the order signed by the Governor granting the Department of Public Health (DPH) Commissioner the discretion to quarantine people who have met the threshold for such action.  As of last week, the department has issued four quarantine orders in the state involving nine people.  One order involving one person has been rescinded based on a review of additional information related to travel activities.  Currently, there are eight people in quarantine in Connecticut.
“We have taken this situation very seriously for months,” said Governor Malloy.  “With the news of a recent traveler with Ebola in neighboring New York, it is critical that we look at each case on an individual basis.  The protocols outlined here will ensure that we have the ability to take preventative action that will protect public health, utilizing the best information we have and the expertise of our public health officials.  DPH will continue to err on the side of caution in each and every circumstance.”
Under these protocols, DPH is working with federal authorities and is being notified of travelers arriving in Connecticut from the three West African countries impacted by the Ebola virus: Guinea, Liberia and Sierra Leone.  All such travelers will be subject to 21 days of active mandatory monitoring, and Connecticut’s DPH will review each case and determine if additional steps beyond monitoring are necessary based upon a review of the person’s travel history and potential exposure.  Under active monitoring, local health directors contact individuals daily to obtain their temperatures and determine whether they have developed any symptoms of illness.
Discussing the state’s procedures, DPH Commissioner Dr. Jewel Mullen said, “Once the traveler has arrived in Connecticut, they are interviewed by local health department staff or by an epidemiologist from the Connecticut DPH.  Detailed information is obtained by these public health officials about the person’s travel and whether they potentially could have been exposed to Ebola.  Epidemiological experts at DPH assess this information, including the quality of the information collected.  We then discuss, and decide on the appropriate steps to protect the public’s health — erring always on the side of caution.”

If the Commissioner deems it necessary based on information gathered during the screening process, a quarantine will be required.  Under these guidelines, a person held under quarantine is not sick, but is kept away from other people because they may have been exposed to an infectious or contagious disease.

The state’s isolation procedure will be implemented once a person is exhibiting symptoms, so that further infection of other people can be prevented.
For more information, please visit the state’s Ebola website,


Europe | ECDC tutorial on ‘Critical aspects of the safe use of personal protective equipment’

Today, ECDC published a tutorial covering the fundamental concepts of personal protective equipment (PPE) and barrier nursing to support preparedness in hospitals across Europe.

The document provides practical information on the use of PPE at the point of care, including technical requirements and procurement aspects.

The focus of the tutorial is on an extended set of PPE components, which includes goggles, respirators, gloves, coveralls and footwear.
The topics covered start with procurement and technical requirements as mandated by EU regulation, followed by critical aspects and known pitfalls in the donning (putting on)  and doffing (taking off) of PPE. As effective staff protection never depends on the protective equipment alone, the tutorial also identifies operational basics of barrier management and nursing, including waste management, disinfection and incident management.
It is extremely important that those involved in barrier nursing, especially with cases of an infectious diseases of high consequence, are trained in protective equipment use. This tutorial is meant to support, not replace, practical training and regular refresher courses held by experienced PPE instructors.
Read more:

Finland | Govt to send protective equipment to Ebola-affected countries

The Finnish Ministry of the Interior will have 325,000 protective masks delivered to Ebola-affected countries through the EU Civil Protection Mechanism. The masks are provided by the National Emergency Supply Agency.

The protective masks, which have been approved by the World Health Organisation (WHO), are due to arrive in the Netherlands early next week. They are intended for use by local health staff and international humanitarian workers in Ebola-affected countries.

This material assistance from Finland, which is coordinated by the Ministry of the Interior, is provided as part of a massive logistics operation funded by the European Commission. In this operation, the equipment requested by the WHO and other UN organisations is collected from the Member States and shipped on board a Dutch military vessel to West Africa. The vessel will depart from the Port of Den Helder on 6 November 2014.

Italy | Ebola, question time del Ministro

Il Ministro della Salute Beatrice Lorenzin ha risposto al Question time del 29 ottobre su Ebola ed eventuale diffusione della tubercolosi. Di seguito le parole del Ministro.

“Questa è un’occasione per non fare allarmismo e dare una corretta informazione in un’Aula così autorevole e di fronte al Paese. Ad oggi come voi sapete sono pervenute al Ministero della salute diverse segnalazioni di casi sospetti, che però sono state tutte gestite secondo i protocolli previsti dalle circolari ministeriali emanate sull’argomento e tutti i casi sospetti hanno avuto esito negativo e anche per quanto riguarda la questione di Vicenza si stanno applicando i protocolli internazionali e per i militari di Vicenza vale esattamente quello che vale per i cooperatori italiani.

Per quanto riguarda le misure di prevenzione concordate da ultimo nella riunione straordinaria del 16 ottobre dei Ministri della salute che ho convocato insieme al Commissario Borg, comunico che vengono aggiornati sistematicamente i protocolli di screening, valutazione clinica, assistenza medica infermieristica a favore degli operatori umanitari italiani e del personale civile e militare, di rientro dai periodi di servizio svolti nei Paese in situazione epidemica.

Noi abbiamo chiesto che ci sia una informazione, una comunicazione omogenea in tutti i Paesi europei. Tale procedura si attua anche per tutte le grandi manifestazioni convegnistiche di rango internazionale, pensiamo soltanto alla nostra nazione con gli eventi della FAO o gli eventi legati al Semestre europeo. Ho proposto un sistema di tracciatura dei movimenti e dei contatti di soggetti a rischio nei singoli Paesi con la possibilità di geolocalizzare i viaggiatori internazionali che abbiano come meta Paesi terzi rispetto all’aeroporto di entrata come misura cautelativa ulteriore rispetto agli screening sanitari effettuati in uscita dagli aeroporti locali.

Viene mantenuto uno stretto contatto con le autorità federali statunitensi, britanniche e francesi oltre che con l’OMS a cui sono stati affidati i coordinamenti delle operazioni dei tre Paesi africani coinvolti dell’epidemia. Stiamo inoltre collaborando alla stesura delle linee di sperimentazione dei candidati vaccini e dei candidati farmaci per la prevenzione e la terapia della malattia. Ho proposto un coordinamento tra i Ministeri competenti e ricordo che è stato anche nominato un Coordinatore UE per l’ebola nella persona di Christos Stylianides.

Comunico che nel DDL stabilità del 2015 abbiamo ottenuto lo stanziamento di risorse adeguate per l’acquisto di ulteriori dispositivi di protezione individuale per il personale medico e paramedico. Quanto alla tubercolosi evidenzio che nel nostro Paese il tasso annuale di incidenza della TBC è pari a 6,99 casi per centomila abitanti nell’anno 2012. L’Italia è pertanto ben al di sotto del limite che definisce la classificazione di Paese a bassa prevalenza: 10 casi per centomila. Stiamo comunque lavorando per migliorare la qualità della sorveglianza, della diagnosi e del trattamento della malattia specie tra i soggetti più svantaggiati.

Quanto all’operazione Mare nostrum ricordo che il Ministero della salute ha collaborato con propri medici all’attività della marina militare e colgo l’occasione per annunciare che il mio dicastero sta lavorando proprio in questi giorni ad un protocollo di intesa con i Ministri dell’interno e della difesa per assicurare anche dopo la fine della predetta operazione tempestivi controlli sanitari sui migranti. Da ultimo, per quanto riguarda le esigenze evidenziate dagli interroganti che sia assicurata una adeguata informazione al fine di evitare un inutile allarmismo non posso che condividere e assicurare anche per il futuro l’impegno del mio dicastero a continuare a fornire elementi di formazione completi. Approfitto di un ultimo minuto per dire che c’è l’attivazione di un numero verde che stiamo facendo presso il Ministero, oltre al fatto che presso il sito del Ministero ci sono informazioni aggiornate costantemente sull’andamento del virus, sui luoghi e sulle domande che vengono rivolte dai cittadini”.

Be well. Practice big medicine.