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Hackers’ health care siege

The ideas and innovators shaping health care
Jan 05, 2023 View in browser
 
Future Pulse

By Ben Leonard, Ruth Reader, Carmen Paun and Erin Schumaker

TECH MAZE

NEW YORK, NY - APRIL 15:  A hacker using a laptop computer at the Hacked By Def Con Press Preview during the 2016 Tribeca Film Festival at Spring Studios on April 15, 2016 in New York City.  (Photo by Rob Kim/Getty Images for Tribeca Film Festival)

Hackers have compromised over 40 million patients' data.

The toll of ransomware attacks on the health care sector is mounting.

Attacks on health care providers doubled between 2016 and 2021, leaving 42 million patients' data vulnerable, according to a new study in JAMA Health Forum. The attacks are now more often hitting large organizations that have more than one facility than before.

"Ransomware attacks on health care delivery organizations are increasing in frequency and sophistication," the researchers from the University of Minnesota and the University of Florida wrote. "Disruptions to care during ransomware attacks may threaten patient safety and outcomes."

A chart featuring how health care organizations have been affected by ransomware attacks.

More than 2 in 5 (44.4 percent) attacks, the researchers found, hindered delivering health care to patients. Electronic systems went down 41.7 percent of the time, while care was canceled in 10.2 percent and ambulances were diverted in 4.3 percent of attacks.

Some other findings: 

— Nearly one in five attacks involved attackers making protected health data public, typically via the dark web.

— Clinics and hospitals were the most frequently targeted health care organizations.

— About 16 percent of attacks disrupted operations for a week or more.

The researchers noted that their findings are likely underestimates due to underreporting.

They found that about 20 percent of attacks weren't reported to HHS' Office for Civil Rights, which ensures that health care organizations safeguard patient records.

And more than half of ransomware attacks weren't reported in a timely way. The authors suggested that could be due to the relative toothlessness of HHS' enforcement.

Why health care is vulnerable:

— Care disruptions can significantly impact patients, which could compel health care organizations to pay a ransom.

What Congress could do:

— Tighten rules for reporting attacks.

"Missing attacks and delayed reporting suggest opportunities for legislators who wish to strengthen data collection around cyberattacks, particularly ransomware, so as to shape an informed and well-targeted policy response," the researchers wrote.

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Share any other thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com, or Erin Schumaker at eschumaker@politico.com.

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Today on our Pulse Check podcast:
Lauren Gardner talks with Carmen about the World Health Organization's warning that the new Omicron subvariant XBB.1.5 — which has become the dominant Covid-19 strain in the U.S. — could drive a new wave of cases.

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Listen to today's Pulse Check podcast

THE LAB

BURIEN, WASHINGTON - APRIL 17: Sea Mar Burien Well Woman Day provides breast and cervical cancer screenings for Seattle women on April 17, 2021 in Burien, Washington. (Photo by Suzi Pratt/Getty Images for Hologic)

The American Cancer Society recommends women get tested regularly for cervical cancer. | Getty Images for Hologic

48

The percentage of women who say guidance about recommended Pap test frequency is confusing, according to a new Harris Poll survey

At-home testing to screen for cervical cancer could help prevent deaths from the disease, public health officials believe.

The National Cancer Institute is about to begin a self-sample screening trial for human papillomavirus, or HPV, a sexually transmitted infection that is the leading cause of cervical cancer. The study is called the "Last Mile Initiative," and the cancer institute will work with private companies that develop the tests. The trial is expected to get underway in the first quarter of 2023.

HPV screening at home is gaining popularity in Europe, Africa, South America, Southeast Asia and Australia.

While screening rates fell in much of the world during the pandemic, Sweden increased its rates by sending 330,000 HPV test kits to women. Test coverage increased from 75 percent to 85 percent. Now, the at-home kits, available from primary care doctors, are an option for regular HPV testing in the country.

This method of sample collection is also likely to pave the way for screening of other kinds of cancer at home, said Jeff Andrews, vice president of medical affairs at BD, a New Jersey maker of cervical cancer tests.

Why it matters: One in 10 women have never been tested for cancerous or precancerous cells in their cervix, raising their risk of contracting cervical cancer, according to a new Harris Poll survey commissioned by BD.

The mid-November survey of 872 U.S. women between the ages 18 and 64 found that more than 70 percent had delayed tests. And Hispanic and Black women were less likely to get screened than white women. Overall, most women said they didn't know how regularly they should be screened.

The American Cancer Society recommends that women ages 25 to 65 get a test for human papillomavirus, or HPV, the leading cause of cervical cancer, every five years or a screening for potential cervical cancer every three years, known as a pap test.

Some 4,000 women die in the U.S. from cervical cancer annually, even though it is largely preventable by vaccination and screening.

Almost a quarter of women were past due for a cervical cancer screening before the Covid-19 pandemic, and testing plummeted after the coronavirus arrived, according to an American Cancer Society analysis.

HPV vaccination to help prevent cervical cancer is on the rise, but still lags below optimal levels. While in 2021, more than three quarters of adolescents in the U.S. received at least one dose of the three-dose vaccine, only 62 percent were up to date on their vaccination schedule, according to the most recent CDC data.

PANDEMIC

 Maria Van Kerkhove

The WHO's Maria Van Kerkhove | Martial Trezzini/Keystone via AP

"We are concerned about its growth advantage, in particular in some countries in Europe and the Northeast part of the United States, where XBB.1.5 has rapidly replaced other circulating sub-variants."

– Maria Van Kerkhove, the WHO's Covid-19 technical lead

The coronavirus Omicron strain XBB.1.5, which has become the dominant strain in the U.S. in just a matter of weeks, could drive a new wave of cases, Maria Van Kerkhove, the World Health Organization's Covid-19 technical lead, said Wednesday.

Still, Van Kerkhove and other top health officials are unsure whether that means more people will go to the hospital or die because vaccines and prior infection have built up their immunity.

What we know: In the U.S., the subvariant increased from 4 percent of sequenced cases to 40 percent in just a few weeks, White House Covid-19 response coordinator Ashish Jha tweeted Wednesday.

But the United States is suffering far less from Covid than it did a year ago. Death rates were about seven times higher at this time last year, and hospitalizations were almost three times as high. Both categories have been lower at various points in the pandemic, however, and hospitalizations in New England, where XBB.1.5 is spreading fast, are rising and at about 40 percent of last year's levels.

Van Kerkhove said the increase in hospitalizations in the Northeast can't be attributed to XBB.1.5 because other respiratory illnesses, including flu, could be partially responsible.

What's next: Jha warned that Americans' immunity against XBB.1.5 "is probably not great" if a prior infection was before July or if they haven't received the bivalent shot that became available in September.

He advised people to get their bivalent booster, test for Covid before attending large gatherings and before meeting with the elderly or people who have weakened immune systems and wear a high-quality mask in crowded indoor spaces.

 

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