May 17, 2020

Scared of Ebola? This Measles Outbreak is Far More Dangerous.

Patient Care
4 min
The measles virus as seen under a microscope.
Just a few short months ago, the United States was terrified of Ebola. Even though an outbreak never materialized, the panic that was running through Am...

Just a few short months ago, the United States was terrified of Ebola. Even though an outbreak never materialized, the panic that was running through Americans was leading to haste accusations – 80 percent of Americans even wanted doctors and nurses that treated Ebola patients to be locked into quarantines, despite lack of medical evidence, according to The Washington Post.

But as the United States continued to treat the few Ebola victims and return them to proper health, that fear dwindled down, and eventually, disappeared.

Back in December, a measles outbreak was linked to visitors to the Disneyland Resort Theme Parks in Orange County, California. Sixty-seven people from California and six other states were sickened, according to the latest count from the Centers for Disease Control and Prevention.

The measles outbreak, which unlike Ebola that never had a proper foothold in the country, is here to stay; and it’s only going to get worse.

[READ MORE] This Ebola Outbreak Might Not Go Away For A Very Long Time

So far this year there have been 84 measles cases in 14 states – that’s more than U.S. typically sees in an entire year, Dr. Anne Schuchat of the CDC said on Thursday.

“This is a wake-up call to make sure measles doesn’t get a foothold back in our country,” she said.

“We have had, in two and a half weeks, as many cases [in California] as we had in all of last year,” Dr. Gil Chavez, state epidemiologist for California, said. “From this particular outbreak, we can expect to see additional cases.”

What is measles?

Measles is caused by the measles virus. It begins with a fever that lasts for a couple of days, followed by a cough, runny nose, and conjunctivitis (pink eye). The illness starts with a runny nose, watery eyes, cough, and high fever. After 2 or 3 days, tiny white spots appear in the mouth. After 2 more days, a raised, red rash starts on the face and spreads down the body and out to the arms and legs. The rash usually lasts 4 to 7 days. Symptoms start about 10 days after exposure and last from 1 to 2 weeks. After about five days, the rash fades in the same order it appeared.

Measles is highly contagious. Ninety percent of people who aren't immune get sick after being around an infected person. Vaccination against the virus is highly effective. Schuchat said the current outbreak is happening because people haven't been vaccinated — not because the measles vaccine isn't working.

The latest wave of cases and potential infections to be identified is in Arizona. Health officials there said 1,000 people may have been exposed to measles from seven people confirmed to have been sick with measles there. Four of those cases were in an unvaccinated family that visited Disneyland.

"This is a critical point in this outbreak," wrote Will Humble, director of the Arizona Department of Health Services, in a blog post Wednesday. "If the public health system and medical community are able to identify every single susceptible case and get them into isolation, we have a chance of stopping this outbreak here. However, if we miss any potential cases and some of them go to a congregate setting with numerous susceptible contacts, we could be in for a long and protracted outbreak."

As Chris Ingraham’s Wonkblog graphic above illustrates, the number of measles cases in the United States has been skyrocketing for months. Why?

According to Forbes, there are three major reasons:

1. More parents are deciding not to vaccinate their kids, and then choosing to live in clusters near like-minded people.

2. There’s a growing opt-out rate for those vaccinations, which is as high as 13 percent in parts of California.

3. Some doctors are even parroting their patients’ false fears about vaccines.

Widespread vaccination led to a decline in measles, and the disease was declared eliminated in the U.S. in 2000. Vaccination has kept the illness at bay, but the disease remains common in many countries, and travelers bring cases back to the U.S.

Measles is also an aggressive and unrelenting disease, and someone infected with measles can infect 12 to 18 additional people (someone with Ebola, on the other hand, may only infect one or two more people). Even someone who’s been vaccinated against measles runs a low risk of getting infected. Notably, about a half-dozen of the people infected in the Disneyland outbreak had been vaccinated against measles.

[READ MORE] The Coming Crisis of Antibiotic Resistance

The "overall picture has been getting better, not worse" for vaccination, Schuchat said. But pockets where many people haven't been vaccinated, such as the Amish communities in Ohio back in 2014, provide fertile ground for the measles virus.

America fussed over Ebola and clamored for a non-existent Ebola vaccine, and yet many last year admitted to not vaccinating their children for measles, mumps and the flu.

The world ignored Ebola until it came to America, and then we panicked. The measles outbreak is self-created but we aren’t panicking enough.

While the Ebola virus has a higher death rate (50 percent as opposed to the measles’ 10 percent), a preventable disease such as the measles continues to worsen in America. And there’s only one thing keeping it alive: willful ignorance. 

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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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