Oct 26, 2009 (CIDRAP News) – In a measure designed to help hospitals respond more quickly to surging numbers of pandemic H1N1 cases, President Barack Obama on Oct 24 signed an emergency declaration that will help facilities establish alternative care sites and protocols for triage and transport.Pandemic H1N1 flu activity is now widespread in 46 states, according to a recent status update from the US Centers for Disease Control and Prevention (CDC). National indicators point to intensifying pandemic activity that could overwhelm local hospitals and emergency departments.At least two hospitals that experienced a surge of flu patients have already had to alter their flu triage and treatment by setting up tents adjacent to the emergency departments: Memorial Hospital in Bakersfield, Calif., in mid October and Dell Children’s Memorial Hospital in Austin, Tex., in mid September.The emergency H1N1 declaration fulfils one of two conditions that would be needed for the Department of Health and Human Services (HHS) to grant a waiver of section 1135 of the Social Security Act, which would ease certain restrictions on healthcare facilities in an emergency.The waiver still requires individual requests from facilities and would only apply to a specific emergency area and period and within 72 hours of when a hospital has instituted its disaster protocol.In the past, section 1135 waivers have been made for events including Hurricanes Katrina, Ike, and Gustav, Obama’s inauguration, and North Dakota flooding.The waiver affects requirements in several government health programs that provide certain patient protections that also may impair the ability of healthcare institutions to fully implement their disaster medical plans. The government programs include Medicare, Medicaid or the Children’s Health Insurance Program (CHIP), the Emergency Medical Treatment and Active Labor Act (EMTALA), and the Health Insurance Portability and Accountability Act (HIPAA).In background materials on the HHS’s flu.gov Web site, federal officials said the waiver doesn’t suspend HIPAA privacy rules. It said, however, that the president’s emergency declaration and an HHS secretary waiver could temporarily shield affected hospitals against sanctions for not complying with some provisions such as securing patient approval for the medical team to speak with family or friends involved in their care.Paula Steib, a spokeswoman with the Association of State and Territorial Health Officials, told CIDRAP News that Obama’s signing of the emergency declaration wasn’t unexpected.”It was a continuation of similar actions taken this past spring to ensure all authorities are in place so the federal government and the states have the flexibility to respond to needs should they arise,” she said.”It was not related to any specific events or vaccine supply issues, but an effort to be as prepared as possible.”In late April after the first novel H1N1 illnesses were identified, federal officials declared a public health emergency, which they said was a routine measure that allowed the government to free up resources to respond to the outbreak and deploy antiviral medications from the Strategic National Stockpile to states.See also:Oct 24 background information on Obama’s H1N1 emergency declarationhttp://www.flu.gov/professional/federal/h1n1emergency10242009.htmlOct 25 White House blog posthttp://www.whitehouse.gov/blog/2009/10/25/president-obama-signs-emergency-declaration-h1n1-fluOct 23 CIDRAP News story “Spikes in US indicators point to intensifying pandemic”Apr 26 CIDRAP News story “US swine flu cases rise as feds call health emergency”
JAY LAPRETE/Associated PressThe Big Ten’s hope of placing a team in the national championship game took a huge hit when the conference’s top three teams, Ohio State, Michigan and Iowa, all lost this past Saturday.While some college football analysts and writers have already written off the Big Ten, most coaches have yet to hit the panic button.”I don’t think any team is out of anything unless you have two losses,” Michigan head coach Lloyd Carr said.Wisconsin’s Barry Alvarez isn’t worried about the Big Ten yet either.”It’s very, very early to make those kinds of statements,” he said. “The voters recognize the best teams at the end of the year.”It will be a tough road for any of those three teams to make it to the championship game, judging from last year, when Auburn finished undefeated and was left out of the Orange Bowl. Furthermore, all three teams will also have to face each other before the end of the season.Iowa head coach Kirk Ferentz doesn’t like to talk about the BCS at any point of the season, but especially not this early.”I never worry about the BCS and I hope our players don’t either,” Ferentz said.Many of the Big Ten coaches echoed Ferentz’s comments, saying they let other people worry about the race for the National Championship and simply concentrate on winning the games in front of them.”There’s a lot more people outside of this building that talk about it than inside our building,” Ohio State head coach Jim Tressel said. “Right now you can’t worry about what will go on at the end of the year.”Big Ten elite look to bounce back: Last weekend’s losses have left Ohio State, Michigan, and Iowa in the unfamiliar position of having to recover from an early season loss.”You win, you lose, you still have to move on to your next opponent,” Ferentz said. “The worst thing you can do is let the loss carry over to the next game.”Carr said the key is to forget about last week’s game.”The most important thing is to stay focused and be ready to play,” Carr said. “You can’t sit around and feel sorry for yourself because no one else will.”Tressel said his team simply needs to get back to winning games, but with the structure of the college football season, needs to do so quickly.”This isn’t baseball,” Tressel said. “We only get a certain amount of opportunities.”Wildcats claim two Big Ten honors: The Northwestern Wildcats, off to a 2-0 start this season, claimed the offensive and co-special teams players of the week after defeating Northern Illinois last weekend.True freshman running back Tyrell Sutton was named offensive player of the week after rushing for 214 yards and four touchdowns, including the game-winning score.Junior defensive back Marquice Cole earned co-special teams honors after returning two punts for 101 yards, including an 81-yard touchdown scamper.Ohio State linebacker A.J. Hawk was named defensive player of the week for his work in the Buckeyes’ loss to No. 2 Texas. Hawk had 12 tackles, two sacks, an interception, a forced fumble and a fumble recovery.Wisconsin senior wide receiver Brandon Williams shared the co-special teams honors with Cole following the Badgers’ 65-0 blowout win over Temple. Williams returned one kickoff for 38 yards, and four punts for 105 yards, including a 66-yard touchdown.