May 17, 2020

[PHOTOS] Why American Ebola Containment Procedures are Destined to Fail

Patient Care
Patient Care
3 min
Could the Ebola Crisis Cause Sierra Leone to Diversify from Mining?
The current number of Ebola cases worldwide is in the upwards of 9,000, with the first two homegrown cases of Ebola in the United States being a pair of...

The current number of Ebola cases worldwide is in the upwards of 9,000, with the first two homegrown cases of Ebola in the United States being a pair of nurses who got sick after treating Thomas Duncan, the first person ever diagnosed with Ebola in the U.S.

Both Nina Pham and Amber Joy Vinson were among the staff who encountered Duncan during his 10-day stay at Dallas’s Texas Presbyterian Hospital. However, several staff on Wednesday, Oct. 15 anonymously told reporters that the nurses were not given sufficient protection against the risk of Ebola.

National Nurses United released the results of a survey that revealed 85 percent of nurses do not feel prepared to deal with the deadly virus. And according to experts, caretakers who feel unprepared and unappreciated are far less likely to show up to work during a pandemic.

This is an appropriate response, as a disproportionate number of people who were diagnosed with Ebola in West Africa were health care workers, too.

Doctors Without Borders this week said that 16 of its staff had contracted Ebola in the current outbreak, and nine had died from the disease. Dr. Sheik Umar Khan, the doctor who heroically led Sierra Leone’s fight against Ebola, got sick and died in July.

Around the globe, about 400 health care staff have contracted Ebola, and more than 230 have died, reported Forbes.

Caring for Ebola patients is complicated; the patients are highly acute and need constant monitoring from health care staff. The CDC still does not know how the latest Ebola patient contracted the virus, but it is clear that even extremely minor oversights while following hospital protocols can increase the risk of getting Ebola.

CNN’s Dr. Sanjay Gupta illustrated how a health care worker would suit up and then remove his or her protective gear when following CDC’s guidelines in a recent video, noting flaws in the process. He used chocolate sauce to represent the Ebola disease.

First, Gupta dressed in a full-body protective suit.

Next, someone pours chocolate sauce into his hands to represent the Ebola virus.

Rubbing his hands together, Gupta notes that gloves would be the most likely contaminated area.

The front of the gown can also be easily contaminated if the worker smears his or her hands across it.

Gupta then demonstrates how the gown would be removed by ripping it off in one motion.

If part of the glove brushed his arm as he was removing the suit, then that could be a potential exposure, he says.

If his face-shield were contaminated, then the virus could be transferred to his neck as he lifts it over his head.

Removing the face mask poses the same risks.

Once all protective clothing is removed, Gupta points out chocolate sauce (Ebola) on his arm.

And on his neck.

Gupta says this method may work in many hospital situations but that three things "really jumped out at him" as being problematic. 

First, not all of his skin was covered, which could be an issue "if there was some splattering from a patient who was sick." Second, Gupta says that in pictures provided by the CDC, there is no "buddy system," or someone who checks workers when they put on their protective clothing and when they remove it. Lastly, he notes that there's no specific requirement for cleaning one's hands before taking off the gloves. 

“This month has been a nightmare,” NNU Executive Director RoseAnn DeMoro told Buzzfeed. “We’ve been lied to in terms of the preparation in the hospitals. We are putting nurses in physical danger.”

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Jun 13, 2021

How healthcare can safeguard itself against cyberthreats

Jonathan Miles
6 min
Jonathan Miles, Head of Strategic Intelligence and Security Research at Mimecast, tells us how the healthcare sector can protect itself from attacks

One of the most fundamental lessons from the COVID crisis is that health should always be a priority.  In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.

The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics. 

From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world. 

Going digital 

The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years. 

This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate. 

Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.

To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care. 

Strengthening defences

Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change. 

It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device. 

These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.

Despite this, there are fundamentals that any organisation should implement: 
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.

In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.

Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents. 

Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.

This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents. 
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.

Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.

As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.  

Fighting future threats

With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.

To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced. 

This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.

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