In 1736, Benjamin Franklin warned Philadelphians that “an ounce of prevention was worth a pound of cure.” Franklin wasn’t speaking of illness; rather, he was warning against another dangerous contagion — fire. Nonetheless, his words have become a cornerstone concept of public health.
In December, the delivery of the first approved COVID-19 vaccines in the U.S. provided a pivot point. Until the vaccine arrived, our most effective approach to combating COVID-19 was avoidance, not immunity. The tools and technologies needed for avoidance are medically old-school, including quarantine and isolation, social distancing, hand washing, and masking.
When the history of COVID-19 is written, it likely will mention the Pfizer, Moderna and Johnson & Johnson brands for their work on vaccines. It certainly will include the term “warp speed” — a concept that would have been foreign to Franklin, or anyone not familiar with modern science fiction. A fair telling would include the heroic tale of work done by all parts of the health care team as humankind moved toward immunity.
Certainly, the vaccines’ scientific breakthroughs are worth more than a historical footnote. But it is worth remembering, the science of prevention got us this far.
I recently read a column related to this combination of high-tech and low-tech approaches to pandemic response that was extremely thought-provoking. It suggested that these tools are necessarily complementary. While technology may create new ways of managing a crisis like COVID-19, uneven technology adoption also can create challenges to reaching those who aren’t “plugged in.” At the same time, quarantine and social distancing can leave those who aren’t connected out in the cold — with limited emotional support or ability to reach the world. Cutting edge isn’t a panacea. Old-school isn’t necessarily irrelevant.
In Ben Franklin’s time, when an occasional or seasonal disease outbreak occurred, the well-heeled could depart for the summer to their country estate to ride out the epidemic. Alternatively, the poor city dwellers were left nowhere to run. Today, we know that there are similar gaps — whether they be isolated seniors in rural communities or urban communities with limited health care access. Technology only will provide a partial bridge to delivering science into their arms through vaccination. Hospitals, public health and community stakeholder engagement will be needed to reach these populations — in the communities they live, work, worship, learn and play.
Hopefully, the heroes of the COVID-19 history will be many. This is a narrative that will include countless public health leaders working to manage the crisis, health care workers hidden behind PPE, scientists in remote labs and artsy citizens with a sewing machine and an Etsy account.
The pandemic has been an all-hands-on-deck response. Much like the transition after the attack on Pearl Harbor, and the U.S. entry into World War II, everyone had a role to play and a responsibility to contribute. We’ve seen scarcity — PPE shortages and runs on toilet paper stocks. We’ve also seen resilience — Zoom meetings and homemade masks are the modern “victory garden.”
What’s old is new. In part, that’s because what’s old still works. The story of COVID-19 should begin at the beginning. It’s a narrative that leads with prevention, not cures.
Soon, the supply and demand curves will meet for vaccines, and getting a place in line won’t feel like finding a golden wrapper in your Wonka Bar. Until then, we’ll use an ongoing mix of old school and cutting edge to preserve lives until we develop populationwide immunity.
Think about that while you stoke your Franklin Stove, carefully.
MLN Connects Provider eNews Available
St. Louis Regional Health Commission Releases Chronic Pain Workbook
CMS Announces IPFQR Program Webinar
Emergency Directive — New Attacks Against Microsoft Exchange Server
Center For Internet Security Offers No-Cost Malicious Domain Blocking And Reporting
Jeff Tindle Announces Retirement
The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.
The St. Louis Regional Health Commission released a Chronic Pain Workbook as part of its Chronic Pain Initiative, a regional effort to reduce the effect of chronic pain in the safety net patient population. The workbook is a free resource to help people with chronic pain understand and manage their conditions better. It combines learning and activities on the neuroscience of chronic pain, effective behavioral tips, and ways to process and live a fuller life with pain. The book specifically focuses on how thoughts, emotions and behavior change, such as goal setting and mindfulness, can affect chronic pain.
The RHC provides information and resources for patients and providers on multidisciplinary strategies to address chronic pain, as well as information on the convergence of trauma, emotional pain and physical pain.
An outreach and education webinar for participants in the Inpatient Psychiatric Facility Quality Reporting Program is scheduled at 1 p.m. Wednesday, March 17. The presentation describes how the inpatient psychiatric facility community can access publicly reported IPFQR Program data on the Medicare Care Compare and Provider Data Catalog websites. Registration is required.
The Cybersecurity and Infrastructure Security partners have observed active exploitation of vulnerabilities affecting Microsoft Exchange Server 2013, 2016 and 2019. Successful exploitation of these vulnerabilities allows an unauthenticated attacker to execute arbitrary code on vulnerable Exchange Servers, enabling the attacker to gain persistent system access, as well as access to files and mailboxes on the server and to credentials stored on that system. Successful exploitation may additionally enable the attacker to compromise trust and identity in a vulnerable network. Microsoft released out-of-band patches to address vulnerabilities in Microsoft Exchange Server. The vulnerabilities impact on-premises Microsoft Exchange Servers and are not known to impact Exchange Online or Microsoft 365 (formerly O365) cloud email services. CISA strongly encourages immediate patching of these systems.
The Center for Internet Security now offers its Malicious Domain Blocking and Reporting ransomware protection service free to private hospitals. The service, which blocks network requests from an organization to known harmful web domains, already is available free to public hospitals through the Multi-State Information Sharing and Analysis Center. It can help block malicious links and prevent malware contained in phishing emails from activating, even if clicked on by an unsuspecting user, providing an added layer of defense. This service may be especially useful for smaller, less-resourced hospitals, but certainly may have value as an added layer of defense for larger hospitals and health systems.
Jeff Tindle, CEO of Carroll County Memorial Hospital, announced his plans to retire, effective Wednesday, June 30. He has served as the CEO for nine years. The hospital currently is searching for his replacement.