MMWR News Synopsis

Hurricane Evacuation Laws in Eight Southern U.S. Coastal States — December 2018

CDC Media Relations
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Analysis of evacuation policies in eight southern U.S. coastal states found that all have laws to execute evacuation orders. However, only half have laws that related to community outreach, delivery of public education programs, and public notice programs. Policies that support hurricane evacuations that require informing those with limited English proficiency or persons with disabilities and functional needs of emergency evacuation plans can help minimize harm by protecting people at risk. Expanded communication efforts to the whole community through alerts and warnings and community outreach may result in fewer direct and indirect hurricane-related injuries and deaths. Each of these eight jurisdictions has a plan and the authority to issue a hurricane evacuation. Every September, the Centers for Disease Control and Prevention (CDC), along with global, national, regional, and local governments, as well as private and public health institutions, supports emergency preparedness efforts and encourages Americans to take action before, during, and after an emergency. This year it is especially important to have a plan in place that allows for a safe evacuation while also taking into account COVID-19 precautions. Knowing your nearest evacuation route, including items such as hand sanitizer and masks in your go kit, and ensuring all of your prescriptions are filled before you leave are some steps you can take to ensure your safety. Findings suggest the need to consider translating evacuation procedures into multiple languages other than English to address the needs of all community residents. CDC has translated ‘Be safe after a hurricane’ into 10 languages (Arabic, Chinese, Dari, Farsi, French, Haitian Creole, Pashto, Swahili, Tigrinya, and Vietnamese). To learn more about how to navigate disaster planning visit: https://www.cdc.gov/cpr/readiness/hurricane_messages.htm and #PrepYourHealth on Twitter.

Frequent Mental Distress Among Adults, by Disability Status, Disability Type, and Selected Characteristics — United States, 2018

CDC Media Relations
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An estimated 17.4 million U.S. adults with disabilities report experiencing frequent mental distress – nearly five times that of people without disabilities. Nearly a third of adults with disabilities (32.9%) reported experiencing frequent mental distress, which includes stress, depression, and problems with emotions, compared with 7.2% of adults without disabilities. Mental distress is associated with health risk behaviors such as cigarette smoking, insufficient sleep, and physical inactivity. Frequent mental distress is defined as 14 or more mentally unhealthy days in a 30-day period. Targeted interventions and policy changes that ensure adults with disabilities receive mental health screening, health care, and support services could help reduce mental distress.

Prevalence of Underlying Medical Conditions Among Selected Essential Critical Infrastructure Workers — Behavioral Risk Factor Surveillance System, 31 States, 2017–2018

CDC Media Relations
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Extra efforts to minimize exposure risk and prevent and treat underlying conditions are important to protect workers whose jobs increase their risk for exposure to infectious diseases. Many essential workers are at increased risk for being exposed to COVID-19 because their jobs require close contact with patients, the public, or coworkers. Having certain underlying medical conditions puts people at increased risk of severe illness from COVID-19. To assess how common underlying conditions were among workers in six essential occupations and seven essential industries, CDC investigators analyzed data from the 2017 and 2018 Behavioral Risk Factor Surveillance System (BRFSS) surveys. In 2017 and 2018, many essential workers had underlying medical conditions, particularly two groups of healthcare workers: home health aides and nursing home workers.

Delay or Avoidance of Medical Care Because of COVID-19–Related Concerns — United States, June 2020

CDC Media Relations
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Even during the COVID-19 pandemic, people experiencing a medical emergency should seek and be provided care without delay. During June 24–30, 2020, a web-based survey of a nationwide representative sample of U.S. adults aged 18 years and older was used to examine the percentage of adults delaying or avoiding medical care. As of June 30, 2020, an estimated 41% of 4,975 U.S. adults reported having delayed or avoided medical care because of concerns about coronavirus disease 2019 (COVID-19), including 12% who reported having avoided urgent or emergency care. Urgent or emergency care avoidance was more common among unpaid caregivers for adults, people with two or more underlying medical conditions, Black adults, Hispanic adults, young adults, and people with disabilities. These findings align with emerging data revealing that hospital admissions, overall emergency department (ED) visits, and the number of ED visits for heart attack, stroke, and hyperglycemic crisis have declined since the start of the pandemic. Avoidance of emergency and urgent medical care may be harmful, and in some cases, life-threatening. Sustained avoidance of routine care may lead to missed opportunities for management of chronic conditions, receipt of routine vaccinations, or early detection of new conditions, which might worsen outcomes. Avoiding medical care can be especially problematic for people with underlying medical conditions. While detailed reasons for avoiding care remain unclear, increasing accessibility of medical and telehealth services might help prevent people from delaying needed care.

Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults >18 years in 11 Outpatient Health Care Facilities — United States, July 2020

CDC Media Relations
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Implementing protective steps to reduce exposures to COVID-19 during on-site eating and drinking should be considered to protect customers, employees, and communities. Identifying possible exposures to COVID-19 in the community is difficult when there is widespread transmission, especially when some people don’t show symptoms. This study assessed differences in community and close contact exposures between adults who showed symptoms and tested positive for COVID-19 with adults from the same medical facility of similar age and sex that showed symptoms and tested negative. Findings from this investigation show that participants with and without COVID-19 reported generally similar exposures, with the exception of going to locations with on-site eating and drinking options. Adults with COVID-19 were more than twice as likely to report dining at a restaurant in the 14 days before getting sick compared to adults without COVID-19. In addition to dining at a restaurant, those who tested positive were more likely to report going to a bar/coffee shop, but only among those who did not report close contact with persons with known COVID-19 before getting sick. Exposures and activities that make it difficult to wear masks and maintain social distancing, including going to locations that offer on-site eating and drinking, may increase the risk for getting COVID-19. This study did not ask whether dining was done inside or outdoors.

Infants with Congenital Disorders Identified Through Newborn Screening — United States, 2015–2017

CDC Media Relations
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Newborn screening continues to be one of the most successful public health interventions, offering early detection and intervention to all infants. Approximately 12,900 U.S. infants are predicted to be identified each year through newborn screening with one of the disorders included in this report. Newborn screening identifies infants at risk for congenital disorders for which early intervention has been shown to improve outcomes. Hearing loss, hypothyroidism, sickle cell disease, and cystic fibrosis were the most common disorders identified in the study. Newborn screening continues to be a great public health achievement, offering early detection, intervention, and potential for improved outcomes to all infants, regardless of geographic, ethnic, or socioeconomic differences.

Newborn Screening Practices and Alpha-Thalassemia Detection — United States, 2016

CDC Media Relations
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Findings from this analysis indicate that there are differences among states in newborn screening practices for alpha-thalassemia.  The development of more uniform alpha-thalassemia testing and reporting procedures for state newborn screening (NBS) programs could help better our understanding of how many people are born with alpha-thalassemia in the United States. Future data can be used to better understand the impact of alpha-thalassemia on the health of Americans. Thalassemia is an inherited blood disorder caused when the body doesn’t make enough of a protein called hemoglobin, an important part of red blood cells. There are two type of thalassemia – alpha or beta which refers to the specific part of hemoglobin that isn’t being made. If either the alpha or beta part is not made, there aren’t enough building blocks to make normal amounts of hemoglobin. In the United States, public health data on alpha-thalassemia are lacking and the data that are collected indicate a lot of variation across states. Alpha-thalassemia is not a core condition on the United States Recommended Uniform Screening Panel (RUSP) for state NBS programs. However, many states screen for alpha-thalassemia using similar methods as those that detect sickle cell disease (which is a core RUSP condition). This study describes the first nationwide survey to understand alpha-thalassemia screening and reporting practices in NBS programs across the United States. Among state NBS programs that responded to the survey, 93% conduct alpha-thalassemia screening on newborn infants. However, some state programs use more rigorous testing practices than others and there are differences across states in what constitutes a positive alpha-thalassemia screening result and how these results are reported back to families. The survey findings highlight an opportunity for NBS programs to re-evaluate their screening practices and their strategies for reporting screening results to families. In addition, the development of more uniform alpha-thalassemia testing and reporting procedures for state NBS programs could help better our understanding of how many people are born with alpha-thalassemia in the United States. Future data can be used to better understand the impact of alpha-thalassemia on the health of Americans.

• Age-Adjusted Lung Cancer Death Rates, by State — National Vital Statistics System, United States, 2018

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

CDC works 24/7 protecting America’s health, safety and security. Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC responds to America’s most pressing health threats. CDC is headquartered in Atlanta and has experts located throughout the United States and the world.