- Dr. Thomas FreidanDirector, Center for Disease Control and Prevention
Center for Disease Control: Update Influenza Prevention for Homeless Shelters and Jails
Existing resources pertain to the 2009 Pandemic and may confuse homeless services personnel.
The website of the CDC provides this guide to prevent influenza, which is useful only to persons able to translate its concerns from 2009 to 2013.
http://www.cdc.gov/h1n1flu/guidance/homeless.htm (now a dead link) and
Just a few people joining me in a letter to Dr. Frieden, which would obviously be handled by his staff, might actually succeed in provoking the Center for Disease Control and Prevention into assigning some of its technical writers to revise the existing guidelines. Most of the information is already there, but today we have the 2012-2013 H3N2, not the 2009 H1N1.
It only stands to reason that CDC(P) would do this. But like anything else, they are slammed with work to do and tend to spend their time "putting out fires". They need public support and even outright pressure in order to convince their Congressional auditors of the need for diversion of resources to any given task.
A wise use of their time would be if they would spend "manpower" now, disseminating usable infection control precautions, specifically tailored to homeless shelters and jails, under 2013 conditions.
Consider the alternative: much higher rates of disease. Not just influenza, but pneumonia, whooping cough, RSV and other ruthless diseases which have appeared this season among children and adults. There is also the emergence of XDR-TB in recent years - extremely drug resistant tuberculosis. In today's jet set environment, we are even witnessing the re-emergence of diseases we thought we were finished with, such as polio, and mutations leading now to actual H5N1 disease outbreak in humans in Vietnam and other places. There is never a guarantee that the anonymous warming centers will not be a site of transmission from a distant part of the planet, in which case our resources would be diverted to containing yet another such outbreak. Wth proper hygiene, barrier and traffic controls and other known methodologies, infection transmission can be dramatically reduced.
It is very time consuming to deal with dozens, scores, hundreds, thousands of people with advanced influenza. And it can progress to pneumonia, and worst.
We don't want that.
Act now, before it is too late. Help get the jail commanders and homeless services agencies running the way they should.
- Director, Center for Disease Control and Prevention
Dr. Thomas Freidan
RE: Please Update Influenza Prevention for Homeless Shelters and Jails
The website of the CDC provides this guide to prevent influenza for "emerency shelters".
It is designed for a broad class of shelters such as Red Cross emergency shelters and does not have the kind of content which would be directly applicable to management of chronic and short-term homeless individuals in an epidemic environment.
Furthermore, it is, like most such material, pertinent to the 2009 swine flu situation. Professional infection control specialists might be able to translate as they go, and use this guide, but as more people become sick, out of work, and potentially homeless, there will be manpower shortages as we have seen in every serious epidemic in years past.
The material in its current form is useful only to persons able to translate its approach from a 2009 outlook to a 2013 outlook.
Surely, it makes more sense for one team at the CDC in Atlanta to quickly review the guidelines, revise them for current conditions, and then propagate them via the CDC website and other means, as opposed to each state and each county having its own local health department perform essentially an identical translation job. Inevitably, corners would be cut, and that would translate into higher mortalit and morbidity rates.
We all want to assure that very few people transmit and receive pathological infectious disease microbes while seeking shelter in emergency shelters, particularly when they are funded by HUD Emergency Solutions Grants. This can be handled with a simple revision of existing protocols. The CDC is well equipped for the job of managing the revision process. Please enable you staff to allocate sufficient human and material resources to get it done.
Thank you for your overall leadership in the field of disease control and prevention over the many years. Our nation can only be grateful to its corps of top medical scientists, who are our main line of defense.
It is therefore respectfully requested that the CDC update this information and information similar to it reflecting the conditions of seasonal flu epidemic.
Thank you for your expeditious consideration hereof.
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