Army Public Health Weekly Update, 15 January 2021

Date Published: 1/15/2021
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​NOTICE: There will be no Army Public Health Weekly Update next week. Publication will resume on 29 January 2021.

The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link .

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Table of Contents


    COVID-19 Vaccination Information

    A safe and effective vaccine is an important tool for protecting yourself and those around you and ending the global pandemic. For more information visit APHC .

    Misinformation alerts

    8 January- Several stories have been trending around adverse reactions to the Pfizer and Moderna COVID-19 vaccines. Last week a story about a nurse who fainted after receiving her Pfizer vaccine was trending, and in the last 24 hours the story has escalated to claim that she has now died from the vaccine (which is false). A story about a physician at Boston Medical Center who went into anaphylactic shock after receiving the Moderna vaccine also caused a spike in claims that vaccine ingredients are unsafe. The CDC asks individuals with a history of severe allergies to vaccines to consult their physician before receiving the vaccine. Public Health Collaborative External Link 


    COVID presents new set of challenges for DOD environmental health

    12 January- Total Force Fitness is a fundamental element of the Department of Defense's National Defense Strategy. Helping to "Build a More Lethal Force," Total Force Fitness focuses on a service member's overall health over the duration of their career, including physical, environmental, spiritual, psychological, social, and financial components. One of the most important factors to take into account when maintaining one's overall fitness is physical environment, and the ability to perform tasks in a multitude of operational environments. That includes being provided with the correct equipment or reducing excessive exposure to natural elements, such as heat or cold, or chemical, biological, or radiological factors. Environmental health within the DOD includes monitoring factors including temperature, air, water, and soil, as well as identifying issues that may impact military and civilian employees both on base and within local communities. "Right now, we're obviously concerned about cold weather impacts to our workers, and we want to make sure they're using the right PPE (personal protective equipment) to be able to perform the mission. They have to be issued gloves and parkas and the types of equipment to be able to continue that mission," said Air Force Lt. Col. Elisa Hammer, Environmental Health Program manager for the Office of the Air Force Surgeon General. "Likewise, if it's hot weather, we want to make sure folks are implementing work-rest cycles, hydrating, and staying in the shade or maybe even recommend ice packs if that's not possible." Hammer explained how the COVID-19 pandemic has presented a new set of unique operational challenges. She cited the examples of airmen on the flight line or sailors on the flight deck, where social distancing may not always be possible, but "masking up" may be an issue as well. External Link

    DOD launches "My MilLife Guide" text message program to boost wellness

    11 January- Finding the right support to ease the stress of navigating daily COVID-19-related challenges can be a challenge itself. To support the military community, the Department of Defense recently launched -- My MilLife Guide. This new program that sends text messages designed to help the military community boost overall wellness while navigating stresses related to COVID-19. The program is only available for a limited time in early 2021, and will allow service members and spouses to directly receive motivational messages and helpful resources on their phones. My MilLife Guide was developed by one of the military's flagship support programs, Military OneSource, in partnership with the Military Health System. From now until Feb. 12, 2021, users can opt in to receive messages four times a week, for a total of eight weeks. To sign up, service members can text "MilLife SM" and spouses can text "MilLife Spouse" to GOV311, or they can visit My MilLife Guide starts each week with a text asking users to set a small goal, such as accomplishing a task on their to-do list or taking a small step to improve their sleeping habits. External Link

    Get into fighting weight with the 2021 Total Force Fitness Challenge

    12 January- Weight gain around the holiday season is common. However, this year's ongoing social distancing restrictions due to COVID-19 could present new challenges for those trying to stay in shape. On Jan. 4, 2021, the Uniformed Services University's Consortium for Health and Military Performance (CHAMP) launched the 2021 Total Force Fitness Challenge: Get Into Fighting Weight. This campaign will help Military Service Members recommit to their fitness and weight goals by taking on challenges that promote aspects of health and performance that can impact their weight. "Embracing the Total Force Fitness framework is essential for weight loss, which means taking a holistic approach," said Dr. Patricia Deuster, a professor at the Uniformed Services University and executive director of CHAMP. "This translates into forming healthy eating behaviors, making sure to get the right amount of exercise, having a positive outlook, being connected socially, committing to a realistic goal, and being ready. Success is more likely with a TFF approach than focusing on only one behavior." Human Performance Resources by CHAMP highlights strategies and resources from their Get Into Fighting Weight: A Total Force Fitness Guide. This guide takes an integrative approach to weight loss that is safe and sustainable. The five challenges detailed in the guide will help you learn how to set your own goals to meet your Service's readiness standards. Each week on various social media platforms, HPRC will post resources, including live video discussions around that week's challenge. Someone trying to lose weight might consider dietary supplements as a quick solution to lose weight. Supplements might seem like the easiest way, but they also might not be safe or effective. Operation Supplement Safety (OPSS) joins the Challenge to help Military Service Members and healthcare providers sort through information on popular ingredients and dietary supplement products marketed for weight loss. OPSS will also post updated articles and tools daily on social media, including live video discussions. External Link

    MHS Minute: December 2020

    23 December- See how MHS is leading a phased approach to offer 11.1 million Department of Defense personnel the first COVID-19 vaccines. To learn more about the safety and efficacy behind COVID-19 vaccines, go to: DVIDS External Link

    Remote sleep studies offered for Soldiers in Europe

    11 January- SEMBACH Kaserne - Army healthcare providers in Europe are now deploying new technology to remotely diagnose and help Soldiers suffering from sleep problems. This technology involves the use of at-home monitoring devices used to measure one's sleep and breathing patterns. "Home, or remote sleep testing, is one of the relatively new methods used to diagnose obstructive sleep apnea," said Lt. Col. Matthew Rodgers, officer-in-charge of the Sleep Disorders Center at Landstuhl Regional Medical Center. "Sleep apnea is a common and treatable medical condition that can cause poor sleep quality for patients and bed partners as well as cause or worsen other underlying medical conditions." Sleep complications are fairly common in the military community and are exacerbated by the early-rise culture that can disrupt normal sleep patterns. These complications include bouts of insomnia resulting from night operations, pre-dawn physical fitness workouts, sustained combat operations, and other such disruptions. According to medical experts, while the 'gold standard' for sleep testing is the in-lab polysomnogram, home or remote testing has been used as an option for a number of years in the civilian medical community and offers several benefits to the patient. "Remote, or home sleep studies offer the patient several benefits," added Rodgers. "Among those benefits are; convenience, comfort, and allowing patients to sleep in their own sleep environment/bedroom versus the artificial environment of a sleep laboratory." Faced with the COVID epidemic, social distancing requirements, limited bed space and lengthy wait times for an in-house sleep study, Army medical experts at Landstuhl Regional Medical Center were forced to think outside the box and be innovative in the way they conduct sleep studies. DVIDS External Link


    Feds 'overpromised and under delivered' on coronavirus vaccines, state health officials say

    7 January- The federal government "overpromised and under delivered" on coronavirus vaccine expectations, leaving states understaffed and without enough money to immunize their residents quickly, state health officials said Thursday. "We overpromised and under delivered as a nation," Dr. Steven Stack, commissioner of the Kentucky Department for Public Health, told a briefing sponsored by the Association of State and Territorial Health Officials (ASTHO). "We only got a third of what we thought we were going to get based on the initial modeling." The federal government confused states and the public by promising millions more doses than were actually delivered. Operation Warp Speed, Health and Human Services Secretary Alex Azar and other top officials initially promised 40 million vaccines would be delivered by the end of December, and first doses given to 20 million people by that time. It took until the first week of January to get 20 million doses distributed, and only about 6 million people have been vaccinated, according to the latest data from the US Centers for Disease Control and Prevention. Stack said the development of multiple vaccines in less than a year was a great achievement. "Had we just projected realistic quantities, the public wouldn't have seen this as a shortcoming -- we would have recognized it for the incredible accomplishment it was to have even this much vaccine this fast," Stack said. This gap between expectations and reality could have implications for public reception of the vaccine program, the officials said. CNN External Link

    It's essential to understand why some health care workers are putting off vaccination

    11 January- Some hospitals around the country are reporting that 40 percent or more of their health care workers who could be getting a Covid-19 vaccine are not immediately signing up for it. Other health facilities have had so many extra doses from employees who declined the vaccine that people outside the first priority group — including a sheriff's deputy and a Disney employee — have ended up getting shots. It's a troubling development, especially since health care workers are at higher risk of contracting the virus and are essential in our efforts to treat record numbers of Covid-19 patients. Some public health experts also hoped this group would be relatively easy to vaccinate — and could help pave the way for broader vaccine acceptance. "I am definitely concerned that health care workers are electing to wait to get vaccinated," Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the US Centers for Disease Control and Prevention, said in a briefing last week. "We want them not only to protect themselves, but we also want them to be educating their patients so that everyone across the United States understands that these vaccines are available, that they have a good safety profile, that they are working." A December survey by the Kaiser Family Foundation found health care workers overall were about as likely to be hesitant about getting the vaccine as the general population (29 percent and 27 percent, respectively), with these respondents saying they would probably not or definitely not get the vaccine. VOX External Link

    Tennessee mom warns of coronavirus-related illness in children after son hospitalized: 'I felt helpless'

    9 January- A mom whose son was hospitalized after developing the coronavirus-related multisystem inflammatory syndrome in children (MIS-C) is warning others to be wary of the condition should their child battle COVID-19 or be exposed to the virus. "I felt helpless, I couldn't do anything to help him," said Amber Allen, of Nashville, of her 5-year-old son Matthew who was recently treated for the inflammatory condition at Monroe Carrel Junior Children's Hospital at Vanderbilt. "His feet and his knees and his hands were all swollen and I just knew something more was wrong," she told local news outlet WKRN. "His health just started declining," she added, noting that Matthew required hospitalization for five nights and six days. He is now recovering, however. Fox News External Link 

    Two more life-saving Covid drugs discovered

    7 January- Two more life-saving drugs have been found that can cut deaths by a quarter in patients who are sickest with Covid. The anti-inflammatory medications, given via a drip, save an extra life for every 12 treated, say researchers who have carried out a trial in NHS intensive care units. Supplies are already available across the UK so they can be used immediately to save hundreds of lives, say experts. There are over 30,000 Covid patients in UK hospitals - 39% more than in April. The UK government is working closely with the manufacturer, to ensure the drugs - tocilizumab and sarilumab - continue to be available to UK patients. As well as saving more lives, the treatments speed up patients' recovery and reduce the length of time that critically-ill patients need to spend in intensive care by about a week. Both appear to work equally well and add to the benefit already found with a cheap steroid drug called dexamethasone. BBC News External Link

    WHO director calls for easing of vaccine hurdles for developing nations

    8 January- The World Health Organization's (WHO's) director-general today called on vaccine makers and countries to take steps to ensure that low- and middle-income countries aren't shut out of receiving vaccine supply. The move comes amid news of a European Union deal with Pfizer, announced by the European Commission today, that would give countries in the region nearly half of the company's COVID-19 vaccine output for 2021. CIDRAP External Link

    Why water quality matters for health

    11 January- Since we were young, our parents and teachers have taught us that we need to consume eight glasses of water every day to keep healthy and be able to go on for the day. Water is vital in everyone's life. We all know this back then and probably have been reminded by numerous commercials and statements from doctors. However, many people are wondering if the water they consume is safe and most of them drink whatever is available. Well, to be honest, we should always think about the water quality we are drinking every day. Low-grade water quality can create a big impact on our health in general. The possibility of getting ill from drinking water from a polluted area is very high. Drinking water with contaminants can also cause serious health implications such as amoebiasis and the like. That is why doctors recommend you should think about the quality of water you drink and take the necessary actions and precautions to make sure the water you are consuming is safe and clean. Tech Times External Link


    CDC: Weekly U.S. Influenza Surveillance Report

    Key Updates for Week 53, ending January 2, 2021-

    Influenza-Associated Hospitalizations: The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. A total of 118 laboratory-confirmed influenza-associated hospitalizations occurring between October 1, 2020, and January 2, 2021, were reported by FluSurv-NET sites. This number is lower than average for this point in the season and comparable to counts seen at this point during the 2011-12 season. Hospitalization rates will be presented once case counts increase to a level that produces stable rates. In the interim, case counts will be reported each week.

    Influenza-Associated Pediatric Mortality: No influenza-associated pediatric deaths were reported to CDC during week 53. One influenza-associated pediatric death occurring during the 2020-2021 season has been reported to CDC. CDC External Link 

    WHO: Influenza update

    04 January 2021, based on data up to 20 December 2020-

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic has influenced to varying extents health seeking behaviors, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission have likely played a role in reducing influenza virus transmission.

    - Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year.

    - In the temperate zone of the northern hemisphere, influenza activity remained below inter-seasonal levels, though sporadic detections of influenza A and B viruses were reported in some countries.

    - In the temperate zone of the southern hemisphere, influenza activity was reported at inter-seasonal level.

    - In the Caribbean and Central American countries, no influenza detections were reported. Severe acute respiratory infection (SARI) activity, likely due to COVID-19, was elevated in some reporting countries.

    - In tropical South America, there were no influenza detections in this reporting period.

    - In tropical Africa, influenza activity continued to be reported in Western Africa.

    - In Southern Asia, sporadic influenza detections were reported in India.

    - In South East Asia, influenza detections of predominately influenza A(H3N2) continued to be reported in Lao People's Democratic Republic (PDR) and Viet Nam.

    - Worldwide, influenza B detections accounted for the majority of the very low numbers of detections reported. WHO External Link


    Concerns about mold prompt nationwide recall of yogurt

    11 January- The parent company of Lavva brand yogurt has initiated a recall of a lot of product because testing showed possible mold contamination. The yogurt is available at retailers nationwide, including Whole Foods Market, Sprouts, Kroger and local natural food stores. Although the single lot of implicated blueberry yogurt "cleared strict quality assurance protocols, recent testing indicates a potential mold contamination," according to a company recall notice from EVR Foods Inc., which was posted by the Food and Drug Administration. The lot of recalled yogurt has an expiration date of Feb. 21, so there is concern that consumers may have unused servings of the product in their homes. The 5.3-ounce containers of blueberry plant-based Lavva brand yogurt were produced at a manufacturing facility in Norwich, NY, and has only been linked to the single date code, the company reported in the recall notice. As of the posting of the notice, no confirmed illnesses had been reported. The yogurt containers are plastic cups with foil lids. The bottom of the cups are marked with "lot #022121." The lot number is also the expiration date, according to the company's statement. Food Safety News External Link

    Weis recalls ice cream after consumer finds extraneous metal material

    11 January- Weis Markets is recalling ice cream from almost 200 stores across seven states because a consumer found metal pieces in a container of it. The company reports the recall includes 10,869 containers of Weis Quality Cookies and Cream Ice Cream and 502 bulk containers of Klein's Vanilla Dairy Ice Cream, according to a notice posted by the Food and Drug Administration. According to the recall notice, the implicated Weis Quality Cookies and Cream Ice Cream in 48-ounce containers has been removed from sale. It was sold in 197 stores in Pennsylvania, Maryland, Virginia, New Jersey, New York, Delaware and West Virginia. There is concern that consumers and retailers may have unused portions of the recalled ice cream on hand because of its long shelf life. Food Safety News External Link 


    'A pandemic of broken toes': How life at home has been painful for feet

    12 January- The coronavirus hasn't been satisfied with unleashing a serious, contagious disease that has altered everyday life around the planet. In its overachieving way, it is also responsible for increases in anxiety and depressionteeth-grindingangersleeplessnessmigraines and another physical ailment being noted by orthopedists and podiatrists: "There's a pandemic of broken toes," said John Keeling, an orthopedic surgeon in Chevy Chase, Md. He estimates the number of broken toes seen at his office has tripled or quadrupled. Ben Pearl, a podiatrist whose practice is Arlington Foot and Ankle, said he has "absolutely" seen an increase in broken toes, "and the short reason is that with the pandemic, people are spending more time at home." Jane Andersen, a podiatrist with Chapel Hill Foot & Ankle Specialists, said she has also been treating more patients with plantar fasciitis, tendinitis and even ingrown toenails. "There are little trickle-down effects from pandemic and isolation that are happening," Andersen said, "and broken toes is only one of them."...Keeling has implicated Zoom meetings and online school — he has also seen an increase in broken toes among kids — for some of the breaks. Whatever his patients' age, "they're going around with either stocking or bare feet, and in the haste to get to the next meeting, they bump into the furniture." The Washington Post External Link


    Plague in the Democratic Republic of the Congo: Nearly 300 cases in Ituri since August

    2 January- According to a recent UNICEF Humanitarian Report, in Ituri province in northeastern Democratic Republic of the Congo (DRC), officials have reported 286 cases of bubonic plague, including 27 deaths were reported since August. Rethy and Biringi health zones have the highest number of cases, with 210 registered cases, including 15 deaths. In a letter to ProMED mail published Thursday, officials with EcoHealth Alliance also report on the bubonic plague outbreak in Biringi health zone reporting some 150 suspected cases from mid-November to mid-December. Of the total, overall, women and men are equally affected; however, adolescents (under 17 years old) seem the most at risk, representing 78.9% of the sick people, they write in the letter. Outbreak News Today External Link


    Pakistan: Measles outbreak in Jacobabad leaves two children dead

    10 January- A measles outbreak in the city of Jacobabad in Sindh province, Pakistan has left two children dead and many others hospitalized, according to a report in the news source, The News.  As many as 20 children of village Lakhmir suffered serious complications of measles and were admitted to taluka Hospital Gharhi Hassan, Jacobabad. Two children, ages one and seven died from complications due to measles. Outbreak News Today External Link


    France reports death due to rabies–European bat Lyssavirus type 1, a 1st for the mainland

    9 January- According to a retrospective analysis, the Institute Pasteur has reported the death of a 60-year-old Limoges man had died from European bat Lyssavirus type 1 in August 2019. It is believed the victim was bitten or scratched by a bat nesting in the attic of his house. In August 2019, he died encephalitis, the cause of which was not known. A partnership established between the Necker hospital and the Pasteur Institute, aimed at identifying the causes of undocumented encephalitis, led to the genetic analysis of post-mortem samples. These analyzes at Necker Hospital in Paris showed that he had contracted a lyssavirus, European Bat Lyssavirus type 1 (EBLV-1). "It's been 35 years since such a death happened in the world. And in mainland France it's really the first. In Russia, in 1985, only one other case of human encephalitis caused by this strain was confirmed, and two more cases of rabies were described in Finland in 1985 and in Scotland in 2002. They were caused by a different species of bat lyssavirus, and killed two scientists specializing in bats research," Laurent Dashe, deputy head of the Pasteur Institute's national rabies reference center told AFP. He suggested that "the patient had contact with bats nesting in his attic." Dashe said rabies has been officially eradicated in France since 2002, adding that "the last death related to non-flying animals in France occurred in 1998." Outbreak News Today External Link


    Japan PM issued Declaration of the State of Emergency due to COVID-19

    10 January- In a follow-up on the COVID-19 situation in Japan, on Friday, Japan's Prime Minister Yoshihide Suga implemented a state of emergency due to rises in COVID-19. PM Suga said: The state of emergency has entered into effect from today. We intend to implement thoroughgoing measures, such as shortening the operating hours of dining and drinking establishments and having 70% of workers teleworking. In each area nationwide, the number of new cases of infection has made record highs. We take this extremely seriously. We would like to overcome this pressing situation at all costs, with the cooperation of the citizens. I ask for your cooperation in this regard. (On the necessity of expanding areas subject to the state of emergency to include Osaka and Aichi) The four prefectures of Saitama, Chiba, Tokyo and Kanagawa accounted for more than half the new cases of infection over the New Year's holiday period. In other prefectures (such as Osaka and Aichi), under the state of emergency it is still possible to implement measures in the same way we did in those four prefectures. Also, we intend to take thorough measures by confirming the situations in and closely collaborating with such prefectures. Outbreak News Today External Link


    Canada: Alberta reports first case of the South African variant of COVID-19

    9 January- Alberta's Chief Medical Officer of Health, Dr. Deena Hinshaw announced the first case of the South African variant of COVID-19. According to her tweet Friday: Alberta has detected its first case of the South African variant of COVID-19. This case involved a recent traveler. The individual is in quarantine & there's no evidence at this time that the virus has spread to others. I know any new case is concerning, but we are actively monitoring for these variants & working to protect the public's health. Our current measures in place for #COVID19AB are protective against this variant, so we must all keep staying safe & protecting each other. To date, Alberta has reported 109,652 total COVID-19 cases, including 1241 deaths. Outbreak News Today External Link

    U.S.: Legionnaires' disease outbreak in Portland: 1 dead; 4 hospitalized

    7 January- A bacterial pneumonia outbreak, known as Legionnaires' disease has hit a Portland-based senior housing complex, leaving 1 dead and 4 hospitalized as more than 100 residents were evacuated from the housing complex. A report released by the Multnomah County Health Department said that the outbreak is caused by contaminated water that has entered the Rosemont Court senior living complex. Health authorities further say that people that have increased risk, including senior members of the community, have a greater risk for Legionnaires disease, albeit being not contagious in nature. "This is a unique and concerning situation," said Dr. Jennifer Vines, Multnomah County Health Officer, "and we are working with our partners as quickly as we can to determine if other properties or water sources are affected." As the number of sick are yet to be verified, temporary housing at motels and provided bottled water, handwashing stations and other amenities are being handed out by Multnomah authorities for people who have relocated after the outbreak. Outbreak News Today External Link 


    Brazil: Minas Gerais reports big decrease in dengue in 2020

    10 January- The State Department of Health (SES) in Minas Gerais, Brazil reported 58,126 confirmed dengue fever cases (84,529 probable cases- confirmed and suspected) in 2020, a significant decrease compared to the previous year when the state saw 483,733 probable cases. The Epidemiological Bulletin published last week also shows  there were 13 dengue-related deaths and another 57 suspect deaths. This compares with 171 confirmed deaths in 2019. Mining towns recorded the most cases to include Belo Horizonte (5,703) and Pará de Minas (3,640) seeing the most. The Mosquito: A Human History of Our Deadliest Predator. In addition to dengue, other diseases transmitted by the Aedes aegypti mosquito were recorded in the bulletin: 3,123 probable cases of chikungunya were found, of which 1,689 were confirmed and three suspected deaths. Regarding Zika, 479 probable cases were registered. Of these, 144 were confirmed for the disease. In 2020, Brazil recorded more than 1.4 million dengue fever cases, including nearly 1000 deaths. Outbreak News Today External Link