Cyber Vulnerability Grows Along With COVID-19 Pandemic Stresses

As the COVID-19 pandemic rages, demand for telehealth services has also grown, increasing the vulnerability that medical operations have to cyberattacks and hacks, according to Laura Hoffman, AMA assistant director of federal affairs.

Hospitals and medical practices must always take steps to protect their networks from cyberattacks on patient records and other data, but as hospitals and physician practices have adjusted to provide more care virtually, while also devoting significant resources to treating patients with COVID-19 and managing the increased number of cyberattacks on health care providers, security can become stressed, she said during a recent episode of the “AMA COVID-19 Update.”

“In the pandemic, we rightfully have a lot of resources focused on caring for patients with COVID. So, you’ve got a lot of additional personnel maybe working in different areas of the hospital that they aren’t accustomed to, maybe their access controls have had to change in terms of who’s allowed out into what portions of the electronic health records, and that can contribute to insider threats,” Hoffman said.

“We’ve got people continuing to work from home and continuing to receive treatment from home. So, the landscape of the vulnerabilities and entry points during the pandemic are increased as compared to a regular health care system where a lot of the care is delivered inside your secure clinic or hospital.”

Telehealth creates vulnerabilities

Hoffman also pointed to a growing reliance on telehealth and how more patients are receiving care from home using different telehealth platforms. The use of the technology has been “a wonderful way for us to promote social distancing and preserve” personal protective equipment (PPE), she said.

“But at the same time, what is good for the health care system and patients presents an opportunity, unfortunately, for cyber criminals. So, they see this now as an opportunity to perhaps exploit these increased use of telehealth systems and the fact that people are working in an environment that they may be less familiar with, and they are going to town in terms of trying to infiltrate different systems,” Hoffman said.

Ransomware, a long-standing problem for individual internet users, is also on the rise for institutions. “In the beginning [of the pandemic] we saw a lot of attacks via phishing and ransomware. Having people click on links for additional PPE that they might be trying to find … actually would then infect computers and systems,” she said.

Ransomware criminals then demand money from affected institutions to release infected software and locked up data. “It’s not just something that happens in a back room where the IT staff then gets busy to work and trying to fix the ransomware that has infected the system,” Hoffman noted. “It really is a system-wide impact when your systems are shut down. You can’t pull up distinct patient records to learn what medications they’re on or even what their diagnoses are.”

Beware of insider threats

One of the newest and biggest threats is called “Ryuk ransomware,” she explained, which has been released into the open internet for use by any malicious criminal.

The ransomware has created an opportunity for insider attacks by individuals who recognize an opportunity to exploit weaknesses in an institution’s technology.

“We’re seeing a lot of insider threats, unfortunately, where folks may recognize that their systems aren’t patched as strongly as they should be or completely as they should be, and they’re able to just insert this software right into some unsecured systems. One of the biggest examples we’ve actually seen recently is with the UHS [Universal Health Services Inc.] health care system where computers were infected, and many practices had to shut down. Hospital systems were without their EHR for some time,” Hoffman said.

It’s not just hospitals and large institutions that are affected. Small practices or individual physicians working from home may be storing less data, “but they may not have the same kinds of robust cybersecurity protections in place, and so it’s easier to infiltrate that network and maybe link it to a larger network,” she said.

Keep software up to date

Hoffman recommends IT staff check that software is up to date and make sure software patches for all technology are completed regularly—even personal computer operating systems and internet browsers that link to bigger data management systems.

“One thing to consider is giving all of your employees a really serious refresher about the kinds of links they should be clicking on when they review their emails inside the hospital system. Maybe have everybody change their passwords more frequently, make the requirements more complex.

“I know it just adds one more thing for everybody to remember, but you can use password managers to help with that and come up with complex passwords that you don’t need to actually remember every time,” she said

(By Len Strazewski, a Contributing News Writer at AMA)

UN Special Session on COVID-19 To Begin This Week

The UN General Assembly is holding a Special Session on the Covid-19 pandemic at the level of Heads of State and Government on 3 and 4 December.. It took more than a year of discussions to overcome the opposition of certain states, notably the United States and President Donald Trump.

BRUSSELS, Nov 30 2020 (IPS) – The holding of this Special Session (the 37th in the history of the UN) is of considerable importance. It is a unique opportunity to define and implement joint actions at the global level to fight the pandemic in order to ensure the right to life and health for all the inhabitants of the Earth. As the President of the UN General Assembly wrote in his letter of convocation: “Let us not forget that none of us are safe until we are all safe”.

This is a historic moment. The future of the UN is at stake, and above all the capacity of our societies to give life a universal value free from any subordination to market, economic and power “reasons”.

Health, life, is not a question of business, profits, national power, domination or survival of the strongest. The right to health for all is not only a question of access to care (medicines, vaccines….).

This special session is also very important because it represents a great opportunity for us citizens. It encourages us to express our priorities and wishes, to put pressure on our elected leaders so that their decisions comply with the constitutional principles of our States and with the Universal Declaration of Human Rights and the Declaration of the Rights of Peoples.

As the Agora of the Inhabitants of the Earth, we have already intervened in September with the UN Secretary General in defense of a health policy without private patents for profit and free of charge (under collective financial responsibility.

On 23 October, at the WTO (World Trade Organisation) level, the “rich” countries of the “North” (United States, European Union, Norway, Switzerland, United Kingdom, Australia, Japan…) rejected the request made by South Africa and India, supported by the WHO (World Health Organisation) and other countries of the South, to temporarily suspend the application of patent rules in the fight against Covid-19.

The suspension was intended to allow people in impoverished countries fair and effective access to coronavirus treatment. We deeply deplore it. With this rejection, the aforementioned countries have flouted the political and legal primacy of the right to health according to the rules and objectives set at the international level by WHO over the “logics” and market interests promoted by WTO. This is unacceptable.

Is humanity at the beginning of the end of any global common health policy inspired by justice, responsibility and solidarity?

Inequalities in the right to health have worsened as part of a general increase in impoverishment. According to the biennial Poverty and Shared Prosperity Report of the World Bank the COVID-19 pandemic is estimated to push an additional 88 million to 115 million people into extreme poverty this year, with the total rising to as many as 150 million by 2021.1

The vaccine market is valued at about $29.64 billion in 2018 and is expected to grow to $43.79 billion at a CAGR of 10.3% through 2020. The sector is marked by a high degree of concentration: four major pharmaceutical groups dominated in 2019 in terms of turnover generated by the marketing of vaccines.

Leading the way is the British company GlaxoSmithKline, followed by the American Merck and Pfizer, with 7.3 and 5.9 billion euros respectively, and then the French company Sanofi with over 5.8 billion euros last year.

The concentration of vaccine production is also impressive. Europe currently accounts for three-quarters of global vaccine production. The rest of the production is divided mainly between North America (13%) and Asia (8%). In Europe, there are pharmaceutical giants such as Roche, Novartis and Bayer.

The resulting social fractures from above-mentioned trends make it more difficult to implement measures and actions in line with common, shared objectives, in the interest of all, especially the weakest who are at risk.

The spirit of survival and nationalist, racist and class divisions have been reinforced. With a few exceptions, the commodification and privatisation of health systems have contributed to the transfer of decision-making powers to private global industrial, commercial and financial subjects.

National political powers, which are responsible for the processes of commodification and privatisation, are less and less able to design and impose a global and public health policy in the interest of the world’s population.

Mainstream narratives, values, choices and regulation practices must change

The world situation is dramatic. This does not mean that it’s impossible to reverse to-day’s trends. Here below we mention the solutions that Agora of the Inhabitants has submitted to the attention of the president of the UN General Assembly in view of the Special Session on Covid-19.

Our proposals were the subject of a consultation with associations, groups, movements and citizen networks during the month of November. We have received 1,285 signed personal emails of support from 53 countries.

First, the Special Session must strongly reaffirm the principle that the health of all the inhabitants of the Earth is the greatest wealth we possess. Health matters, health is a universal right. It should not belong only to those who have the power to purchase the goods and services necessary and indispensable for life. Our States must stop spending almost 2 trillion dollars a year on armaments and wars.

The health of 8 billion human beings and other living species is more important than the power of conquest and extermination. To this end, it is necessary to change the priorities of global finance by investing in the economy of global public goods (health, water, knowledge/education.

The Special Session should: – propose the creation of a public cooperative financial fund for health, as an integral part of a Global Deposits and Consignments Fund for Global Public Goods; – commission UNIDIR or a commission of independent experts to submit a study report on immediate reductions in military expenditure and the reconversion of its allocation to the development, production and distribution of public goods and services in the health and related fields of water, agro-food and knowledge.

Second, universal rights to life imply that the goods and services indispensable for life should no longer be subject to private appropriation nor to exclusive collective appropriation. Therefore it is necessary to build the common future of all the inhabitants of the Earth by promoting and safeguarding the common public goods and services indispensable for life.

Water, health, seeds, housing and knowledge and education, are the most obvious common public goods. They cannot be dissociated from universal rights. Patents on life (and artificial intelligence) are a strong example of the dissociation between goods that are indispensable for life, such as medical care goods (infrastructure, medicines, and so on) and the right to life.

Hence, we propose:

  • to recognise that health (goods and services) is a global common public good that must be safeguarded, protected and valued by the community, under the responsibility of democratically elected public authority institutions, at the different levels of societal organisation of human communities, from the local to the global community of life on Earth;
    • approve the abandonment for the period 2021-2023 of application of the rules concerning patents on living organisms, in particular on all the tools for combating the Covid-19 pandemic (diagnostics, treatment, vaccines). The monopolies left to patent holders have no relevant social, ethical, economic and political value. To this end, the Member States of the United Nations and its specialised agencies, representatives of all the peoples and citizens of the Earth, commit themselves, for want of anything better, to use as of now existing instruments of international law such as compulsory licensing;
    • decide to set up a global Task Force, under the aegis of the UN, to revise the legal-institutional regime of intellectual property in the Anthropocene, the aim of which would be to abandon the principle of the patentability of living organisms for private and profit-making purposes and to define a new global regime on intellectual property in the light also of the experience accumulated in recent years in the field of artificial intelligence.

Third, it is of fundamental importance to abandon submission to the dictates of “In the name of money”. “You are not profitable? You are not indispensable. In any case, your life is not a priority”. It is not because a person is not profitable for the capital invested that he or she is no longer indispensable. Being without purchasing power does not mean becoming without rights. Life is not money. Living beings are not commodities, resources for profit.

To this end, the Special Session should:

  • highlight the need for the re-publicization of scientific research (basic and applied) and technological development. The pooling of knowledge and health protocols, medicines and vaccines must be part of the immediate measures to be taken. In this perspective;
    • propose the approval of a Global Compact on Science for Life and Security for all the inhabitants of the Earth;
    • to convey in 2022 a UN world conference on the global common public goods and services. The current mystifying use of the concept of ‘global public goods’ in relation to Covid-19 vaccines underlines the urgency and importance of the proposal.

Fourth, a global health policy requires a global political architecture capable, above all, of outlawing predatory finance. The “global security” of the global public goods in the interests of life for all the inhabitants of the Earth can be achieved by creating global institutions with corresponding competences and powers.

The Earth inhabitants do not need new winners, new global conquerors. They need world leaders and citizens who are convinced that the future of life on Earth requires a new and urgent Global Social Pact for Life. In 25 years’ time, the UN will celebrate the centenary of its founding.

The Special Session must make it clear that there can no longer be a debate on small adjustments to the global regulatory model known as “multilateralism”.

The Special Session should:

  • recognise Humanity as an institutional subject and key actor in the global politics of life. The opening of a Global Common House of Knowledge, based on the existing pooling of knowledge, experiences, technical tools (case of Costa Rica concerning health…) will be a significant concrete step forward;
    • propose the urgent creation of a Global Public Goods and Services Security Council, starting with health, water and knowledge.

It is time for governments and citizens to get or regain common control of health policy. The Special Session must set the record straight. The right to health for all is not only a question of (economic) access to care (medicines, vaccines…) but, more, a question of building the human, social, economic (such as employment…), environmental and political conditions that shape an individual and collective healthy state.

(By Riccardo Petrella from IPS, an Italian national living in Belgium is Emeritus Professor, Catholic University of Louvain (Belgium), with Honorary Degrees (Honoris Causa) from eight universities in Sweden, Denmark, France, Canada, Argentina and Belgium. His research and teaching fields have been regional development, poverty, science and technology policy and globalization.)

Moderna Seeking US, European Regulators To Approve Covid-19 Vaccination

Moderna Inc, which has reported its Covid-19 vaccine is 94 per cent effective, on Monday announced it is filing with US and European regulators for emergency use authorization. Moderna follows barely a week after Pfizer and its German partner BioNTech filed for US regulatory approval. By the end of 2020, Moderna expects to have approximately 20 million doses of its mRNA-1273 vaccine available in the U.S and is “on track to manufacture 500 million to 1 billion doses globally in 2021.

Moderna created its shots in collaboration with the U.S. National Institutes of Health and got a final batch of results over the weekend which show the vaccine is more than 94% effective. Moderna’s efficacy results are based on 196 Covid-19 cases in its huge U.S. study with more than 30,000 participants. Of the 196 cases, 185 were in participants who received the dummy shot and 11 who got the vaccine. Severe cases and one death were reported in participants who got the dummy shot.

Moderna expects to present its data to the US Food and Drug Administration on December 17. First up will be Pfizer and BioNTech, on December 10. Both Pfizer and Moderna are two-shot vaccines.

The US government’s vaccine management chief has said all systems are ready to deliver the vaccines to priority groups within 24 to 48 hours of FDA approval.  Government Model Suggests U.S. COVID-19 Cases Could Be Approaching 100 Million

The actual number of coronavirus infections in the U.S. reached nearly 53 million at the end of September and could be approaching 100 million now, according to a model developed by government researchers.

The model, created by scientists at the Centers for Disease Control and Prevention, calculated that the true number of infections is about eight times the reported number, which includes only the cases confirmed by a laboratory test.

Preliminary estimates using the model found that by the end of September, 52.9 million people had been infected, while the number of laboratory-confirmed infections was just 6.9 million, the team reported in the Nov. 25 issue of the journal Clinical Infectious Diseases.

“This indicates that approximately 84% of the U.S. population has not yet been infected and thus most of the country remains at risk,” the authors wrote.

Since then, the CDC’s tally of confirmed infections has increased to 12.5 million. So if the model’s ratio still holds, the estimated total would now be greater than 95 million, leaving about 71% of the population uninfected. The model attempts to account for the fact that most cases of COVID-19 are mild or asymptomatic and go unreported.

Scientists used studies looking for people who have antibodies to the coronavirus in their blood – an indication that they were infected at some time — to estimate how many infections went undetected. Some of these antibody studies have suggested that only about one in 10 coronavirus infections is reported.

The goal in creating the model was to “better quantify the impact of the COVID-19 pandemic on the healthcare system and society,” the authors wrote. The model also estimated that official counts do not include more than a third of the people hospitalized with COVID-19.

NPR (11/26, Hamilton) reported “the actual number of coronavirus infections in the U.S. reached nearly 53 million at the end of September and could be approaching 100 million now, according to a model developed by” Centers for Disease Control and Prevention researchers. The model “calculated that the true number of infections is about 8 times the reported number, which includes only the cases confirmed by a laboratory test.” NPR added, “Preliminary estimates using the model found that by the end of September, 52.9 million people had been infected, while the number of laboratory-confirmed infections was just 6.9 million, the team reported in…Clinical Infectious Diseases.”

Your Phone Can Send You An Alert If You Were Near Someone Who Has Coronavirus

As new coronavirus cases explode nationwide, health officials are turning to cell phones to help slow the spread of infections. Thanks to technology available on Apple and Google phones, you can now get pop-up notifications in some states if you were close to someone who later tested positive for Covid-19. The alerts come via state health department apps that use Bluetooth technology to detect when you (or more precisely, your phone) has been in close contact with an infected person’s phone.

While these apps can’t keep you safe — they only let you know after you’ve been exposed — they could prevent others from getting infected if you take precautions, such as self-quarantining, after receiving an alert.

Millions of people are signing up, although these apps aren’t yet available in many states. Health officials believe the alerts could be especially helpful in cases where an infected person has been in contact with strangers — for example in a bus, train or checkout line — who wouldn’t otherwise know they were exposed.

How the notifications work

iPhones and Android devices contain constantly changing anonymous codes that ping nearby phones via Bluetooth — a process that starts once the user opts to get the notifications.

For the exposure notifications to be effective, Android users must turn on Bluetooth and download their state’s Covid-19 notification app. On iPhones, the system is already baked into settings, although users must go to exposure notifications and make sure availability alerts are on.  A close-contact alert from the Covid-19 exposure notification app made by the Nevada Department of Health and Human Services.

When someone who uses the feature tests positive for coronavirus, he or she gets a PIN from a health official to enter into their phone. Any other phone that was nearby in the previous two weeks — usually within six feet or less, for at least 15 minutes — will get an alert telling the user to quarantine and notify a health provider.

The apps assess your risk on the strength of the Bluetooth signal (how close you were to the other person) and the duration of your contact with them.

Where you can get them

At least 15 states are taking part in this Covid-19 exposure notification system.  They include Alabama, Colorado, Connecticut, Delaware, Michigan, Minnesota, Maryland, Nevada, New Jersey, New York, North Carolina, North Dakota, Pennsylvania, Virginia, Wyoming and the nation’s capital, Washington, DC.

Some states reported a flurry of sign-ups within weeks of launching the program. Maryland launched its notification system on November 10 and more than 1 million people have already signed up, said Charlie Gischlar, a spokesman for the state health department. He described the app as “a complement to traditional contact tracing and another tool in the toolbox” to combat coronavirus infections.

Colorado, where coronavirus cases and hospitalizations have surged in recent weeks, has also seen more than 1 million people sign up for alerts since the system launched on October 25. The state is one of several conducting massive campaigns to educate residents about their exposure notification service.

Some states have launched apps to alert residents when they may have been exposed to coronavirus.  “We are at a pivotal moment in this pandemic, and opting in to this service helps keep our families and communities safe and our economy running,” Colorado Gov. Jared Polis said in a statement.

Other states, including California and Oregon, have launched pilot programs but their notification systems are not yet available to everyone.

Questions about privacy

Is information from the apps anonymous? Experts say it is.  The apps don’t collect data on users or their locations, and there is no way to link Covid diagnoses and alerts to names and identities on phones, Gischlar said.

Unlike a previous notification system widely touted at the beginning of the pandemic that used GPS, which tracks a person’s location, the Bluetooth system helps maintain privacy and anonymity among users.

“The fact that they use Bluetooth to bounce signals off other phones close to you, as opposed to tracking your location, does make them less invasive, and people shouldn’t worry their location is being tracked — it isn’t,” said Steve Waters, founder of Contrace Public Health Corps, which provides guidance on Covid-19 contact tracing.

“The process is entirely anonymous and doesn’t collect any personally identifiable information, addressing the privacy concerns of earlier more invasive contact tracing apps.”

Earlier versions that sparked privacy concerns were created by third-party developers. This coronavirus notificiation alert technology is provided by Apple and Google, and users can opt out from using it at any time, Gischlar said.

The alerts can reduce Covid-19 infections

The more people who sign up for the alerts, the more effective they are. Right now only a small percentage of the roughly 100 million Americans who live in the 15 states use the apps.

But health officials say even these minimal numbers are making a difference. In Colorado, officials cited studies that show even a 15% use of exposure notification technologies leads to a significant decrease in coronavirus infections and deaths. The state says usage of their app is now at 17%.

Some states have grouped together to enable pop-up notifications across state lines, according to Tony Anscombe, a global expert for internet security company ESET. This is especially important in places near state borders where people work in one state and live in another.

The alert system only works on phones that are less than five years old. For example, New York, New Jersey, Pennsylvania and Delaware have formed a regional alliance that uses a similar system that allows their apps to work across state lines, Anscombe said.

States face some challenges in spreading them. The alert system is designed to complement traditional contact tracing, not work alone.  But technology brings its own set of challenges. For starters, the notification system only works on Google and Apple phones that are less than five years old, Anscombe said. Not everyone has a newer smartphone, and only a small percentage of those who do are using the notification system.

The software on iPhones and Android devices detects when people — or rather their phones — get close to one another.

In addition, not all states are using the notification system. Many state health departments are already overwhelmed by the virus’ resurgence, and some may not have the resources to develop and maintain an app, Anscombe said.

The earlier, GPS-based notification system caused an outcry among privacy advocates and has created skepticism about contact tracing in general, Waters said.

“States need additional funding, currently stuck in Congress, to help battle disinformation and increase adoption of this critical tool in the battle against Covid,” Waters said. The coronavirus pandemic also has become a political issue, with some Americans taking it less seriously than others. For that reason, Waters said, some are also reluctant to use Covid exposure apps.

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