The thing about this cyber attack that is frightening, is the reaction from the WH. Always the finger pointing to his "adversaries" not a plan to address our vulnerabilities. Preparedness is always a good thing, because your right, disruptions to our way of life can come in many forms. It takes very little time to get together extra water, batteries, a non digital list of emergency phone numbers, non perishable food. Not panic, planning, readiness for disruption.
Kristine Antonivich...you've nailed down the part that should concern people more than the intrusion itself.
An adversary rattling doorknobs is expected...that's what adversaries DO...(and so do WE)...and it's why the advisories exist.
What is NOT inevitable...is a response that treats the incident as a chance to assign blame...rather than a chance to close the EXPOSURE.
The FBI and CISA guidance is UN-ambiguous about the remedy: get the controllers OFF the public internet. Plain and f*cking simple.
That's an engineering problem...with a KNOWN fix...and a price tag...sitting in front of 152,000 public water systems. It isn't a partisan question and it doesn't get solved by identifying whose fault it was. None of that is helpful.
Your point about disruption cuts the same way.
The water in the closet doesn't ask what caused the outage. That's the whole argument for doing it; an afternoon's work that covers the ice storm...the main break...AND the doorknob-rattler alike.
Not panic... PLANNING. You said it better than I did.
Every article on emergency preparedness says keep an extra supply of essential meds. Pretty much all essential meds are prescription. Pharmacies are not allowed to fill early and insurance wouldn't pay for it if they did. How do I get an extra supply?
Marsha...there are legitimate ways to build a cushion...and none of them involve skipping doses. Don't do that one. Ever.
Rationing a working prescription to build a stockpile trades a hypothetical emergency...for a REAL one.
What actually works:
Move to 90-day fills.
Ask your prescriber to write for 90 days and use mail order...or a pharmacy that supports extended supply. Most plans allow the refill once you're around 75% through...so...a 90-day cycle refilled on schedule...naturally leaves you two to three weeks AHEAD.
Do that a couple of times...and you have a buffer you did NOT have to fight for.
Ask about a vacation override.
Insurers have a CODE for this. Most will authorize ONE early fill a year for travel; some allow MORE. Your pharmacist knows how to submit it... it's a phone call, not a favor.
Know your state's emergency refill law.
Most states let a pharmacist dispense an emergency supply without a current prescription...during a declared emergency...OR... when the prescriber can't be reached. Worth knowing the rule where you live before you need it.
Pay cash for the cheap ones.
Generic maintenance drugs on discount lists often run a few dollars a month. Insurance won't cover an early fill...but nothing stops you from buying one outright.
Two caveats.
Controlled substances are the EXCEPTION across the board; no early fills...no overrides... AND... it's not worth asking. Also...insulin, inhalers, and anything refrigerated have shelf-life limits that make a deep stockpile impractical anyway; so rotate what you have.
The other half of this is the part people skip: a printed list of your medications...doses... prescriber...and pharmacy. In a REAL disruption...that page does MORE work than the extra bottle.
Your pharmacist is the right person to walk you through which of these your specific plan allows. They field this question constantly.
This should give you a pretty good idea of the options available, Marsha.
Personally, and I recommend to my patients, using Cuban's CostPlus online pharmacy. Not that I love everything about Cuban, but they are legit and cheap - and your doc can send a rx that will be mailed to you, apart from normal refills that may be considered "early". You pay cash, but for most meds, it's quite reasonable. The problem is it's 1) only generics and 2) no "controlled" meds - so that puts limits on what you can get. But for e.g. an extra supply of antihypertensives, etc. - it can be very helpful.
Dr. Dave...this is the practical answer...and coming from someone who prescribes it ...carries more weight than my general list did. Thank you!
The MECHANISM you're describing is the key insight:
Paying cash outside the insurance channel sidesteps the whole "too early" problem... because the refill clock is an insurance CONTRUCT...not a legal one.
Nothing prohibits filling; the plan just won't pay. Remove the plan from the transaction...and the obstacle disappears.
Your two limits are the right ones to flag...and they map EXACTLY onto where the trouble is.
Generics-only covers most of what a household actually needs; a buffer of antihypertensives...statins...metformin...thyroid. Controlled substances remain off the table everywhere...by design...and no workaround should be attempted there.
For anyone reading who wants to try it: this still routes through your PRESCRIBER...so the conversation to have is with your own doctor about whether a separate cash-pay supply makes sense for your specific medications.
Grateful to have clinicians in the readership. Seriously. This is the kind of correction that improves the file!
One thing that reassures me is that for convenience, my doctors "over-prescribe" my dosage, and a 90-day supply. There's only one controlled drug that I take, so that one's tricky. I can usually refill it one day prior to using the last one, and as a result, I've got a couple extra tucked away usually - I'm always afraid I'll drop one and can't find it.This helps when I'm not up to going that one day early to pick up. I've made an extra effort in recent months to go get ASAP. I've also heard it's sometimes successful to claim international travel to get an advance refill - and decline to tell insurance company your destination bc it's none of their business. Your doctor will need to be cooperative, however!
Exactly my thought. (This is one way the "medical profession," the pharmaceutical industry & the insurance industry arrange to control you. & there's more to it than just "how do I stockpile my medicine?" But that's a rant for another time.)
Federal government gutted the office that monitors foreign cyber intrusions, so I’m not the least bit surprised someone started poking around. There’s long been a concern that our public water supplies are open to intrusion. I’ve long been grateful for being on a private well, but I know there are other parts of our local infrastructure that are likely vulnerable. Your preparedness list is a good one.
And as Kristine noted, our fearless leader immediately started pointing fingers at his political rivals. This tells me there won’t be a lot of pushback to this little session of poking around. Probably tells the pokers the same thing.
If the response to a probe... is to blame a governor...the probe has ALREADY answered its own question...not "can we get in," but "what happens when we do."
A finger pointed sideways...is the most USEFUL intelligence they collected all week...and it was FREE.
On the well: it buys you the water...and it's worth having. But...you're right that it doesn't buy you the substation...the pump station downstream...or the hospital. SAME exposure... different building.
The advisory is about a class of device sitting on the public internet...and water... is just where it surfaced...FIRST.
I'd hold the staffing question a little more loosely than the rest of your note...I haven't verified the specifics of what was cut...and when...so I don't want to build on it until I have.
BUT... the general shape holds: the fix here is unglamorous...expensive...and local...AND ...NOTHING about the current posture suggests anyone is racing to fund it.
Glad the list was useful. Thanks for reading, Faith!
I grew up out in the sticks… we had a big garden… all of us kids had to help with the garden, same with the canning and freezing. We raised meat animals. Heated with a combo of wood and kerosene. I can fault my Depression era folks for a lot - but - we sure learned about preparedness and it’s stuck with me. Plus I live in an area that gets snow….
The ordered stand down of the security and terrorism folks has bothered me since it happened (after t 2.0 took office). Our infrastructure is aging, needs to be upgraded. We are vulnerable. Not trying to scare anyone - and - we do need to prepare for possible outages. Jack is absolutely correct on the security. People WILL get into your systems. The real game is catching them quickly, not always easy especially if you have less personnel looking at it.
There are experts talking about the necessity of developing a plan for an internet outage since our lives are online these days…. We pay bills online, get money from the atm, tap our credit cards for gas, groceries and a whole lot of everything. Never hurts to have some cash tucked away for emergency situations.
Based on Jack's recent article about possible attacks, I expected an ‘incident’. I see this one as a warning shot, a notice if you will that they CAN do something if they choose. Prepare, don’t panic!
Correct I got a Brita water bottle with filters to stop buying bottled water saved money and time do not have to deal with all those empty water bottles anymore
Also store extra medication for same reason
I live in a city/county/state that only cares themselves and not their citizens/constituents
Be prepared it could be storm damage or wind damage that could shut everything down
I like backups for my backups
You can’t always depend on neighbors if they are dealing with the same problems
It becomes everyone for themselves
Sadly to say this
Put your own mask on 1st
If you have extras then you can help your neighbors
I live in Florida, so about this time of year, I check my storm prep supplies. I have solar chargers for my phone (and small fans that run on USB cable), water purifying tablets and special filters, extra propane for my grill, a solar shower bag, and so on. I also get a few new outdoor solar (garden) lights that can be used indoors instead of flashlights or lanterns. I keep an extra toilet seat around, and at least one empty 5-gallon bucket + extra tp!
Thanks for the reminder. I’ve just been going through my preparedness things and found that I need to check the charges on my chargers. Not all full. And more water would be a good idea. Getting the extraneous “stuff” out of here that’s piled up and replacing what needs updating has been my spring/summer project. I’ll be happy if we finish by autumn.
The US has been bombing the bejeezus out of them, including civilian infrastructure. The Iranians are smart. They are adept at the use of asymmetric warfare and they have every incentive to use any means at their disposal. Straits of Hormuz, anyone? They have cyber warfare capabilities. So, the question isn't are they going to go after our systems, it is when? And the psychological impact of penetrating the US mainland can't be minimized. The Great Superpower, like its flaccid leader, has been found to be less than invincible.
Regarding our own preparedness, it has never been more important to take matters into our own hands. While one could never delegate all facets of preparedness to the government, this government is run by fools who have emasculated our defenses against cyber warfare, intelligence capabilities and more. Dearest Leader has made it abundantly clear, the welfare of the people is nonexistent on his priority list.
Thank you for sharing Jack!! Glad the water system was not tainted but these cyber attacks are scary bc we rely on the internet and power grid for everything these days!
The thing about this cyber attack that is frightening, is the reaction from the WH. Always the finger pointing to his "adversaries" not a plan to address our vulnerabilities. Preparedness is always a good thing, because your right, disruptions to our way of life can come in many forms. It takes very little time to get together extra water, batteries, a non digital list of emergency phone numbers, non perishable food. Not panic, planning, readiness for disruption.
Kristine Antonivich...you've nailed down the part that should concern people more than the intrusion itself.
An adversary rattling doorknobs is expected...that's what adversaries DO...(and so do WE)...and it's why the advisories exist.
What is NOT inevitable...is a response that treats the incident as a chance to assign blame...rather than a chance to close the EXPOSURE.
The FBI and CISA guidance is UN-ambiguous about the remedy: get the controllers OFF the public internet. Plain and f*cking simple.
That's an engineering problem...with a KNOWN fix...and a price tag...sitting in front of 152,000 public water systems. It isn't a partisan question and it doesn't get solved by identifying whose fault it was. None of that is helpful.
Your point about disruption cuts the same way.
The water in the closet doesn't ask what caused the outage. That's the whole argument for doing it; an afternoon's work that covers the ice storm...the main break...AND the doorknob-rattler alike.
Not panic... PLANNING. You said it better than I did.
-Jack
Every article on emergency preparedness says keep an extra supply of essential meds. Pretty much all essential meds are prescription. Pharmacies are not allowed to fill early and insurance wouldn't pay for it if they did. How do I get an extra supply?
Marsha...there are legitimate ways to build a cushion...and none of them involve skipping doses. Don't do that one. Ever.
Rationing a working prescription to build a stockpile trades a hypothetical emergency...for a REAL one.
What actually works:
Move to 90-day fills.
Ask your prescriber to write for 90 days and use mail order...or a pharmacy that supports extended supply. Most plans allow the refill once you're around 75% through...so...a 90-day cycle refilled on schedule...naturally leaves you two to three weeks AHEAD.
Do that a couple of times...and you have a buffer you did NOT have to fight for.
Ask about a vacation override.
Insurers have a CODE for this. Most will authorize ONE early fill a year for travel; some allow MORE. Your pharmacist knows how to submit it... it's a phone call, not a favor.
Know your state's emergency refill law.
Most states let a pharmacist dispense an emergency supply without a current prescription...during a declared emergency...OR... when the prescriber can't be reached. Worth knowing the rule where you live before you need it.
Pay cash for the cheap ones.
Generic maintenance drugs on discount lists often run a few dollars a month. Insurance won't cover an early fill...but nothing stops you from buying one outright.
Two caveats.
Controlled substances are the EXCEPTION across the board; no early fills...no overrides... AND... it's not worth asking. Also...insulin, inhalers, and anything refrigerated have shelf-life limits that make a deep stockpile impractical anyway; so rotate what you have.
The other half of this is the part people skip: a printed list of your medications...doses... prescriber...and pharmacy. In a REAL disruption...that page does MORE work than the extra bottle.
Your pharmacist is the right person to walk you through which of these your specific plan allows. They field this question constantly.
This should give you a pretty good idea of the options available, Marsha.
Thanks for the question!
-Jack
Personally, and I recommend to my patients, using Cuban's CostPlus online pharmacy. Not that I love everything about Cuban, but they are legit and cheap - and your doc can send a rx that will be mailed to you, apart from normal refills that may be considered "early". You pay cash, but for most meds, it's quite reasonable. The problem is it's 1) only generics and 2) no "controlled" meds - so that puts limits on what you can get. But for e.g. an extra supply of antihypertensives, etc. - it can be very helpful.
Dr. Dave...this is the practical answer...and coming from someone who prescribes it ...carries more weight than my general list did. Thank you!
The MECHANISM you're describing is the key insight:
Paying cash outside the insurance channel sidesteps the whole "too early" problem... because the refill clock is an insurance CONTRUCT...not a legal one.
Nothing prohibits filling; the plan just won't pay. Remove the plan from the transaction...and the obstacle disappears.
Your two limits are the right ones to flag...and they map EXACTLY onto where the trouble is.
Generics-only covers most of what a household actually needs; a buffer of antihypertensives...statins...metformin...thyroid. Controlled substances remain off the table everywhere...by design...and no workaround should be attempted there.
For anyone reading who wants to try it: this still routes through your PRESCRIBER...so the conversation to have is with your own doctor about whether a separate cash-pay supply makes sense for your specific medications.
Grateful to have clinicians in the readership. Seriously. This is the kind of correction that improves the file!
-Jack
Very good question.
One thing that reassures me is that for convenience, my doctors "over-prescribe" my dosage, and a 90-day supply. There's only one controlled drug that I take, so that one's tricky. I can usually refill it one day prior to using the last one, and as a result, I've got a couple extra tucked away usually - I'm always afraid I'll drop one and can't find it.This helps when I'm not up to going that one day early to pick up. I've made an extra effort in recent months to go get ASAP. I've also heard it's sometimes successful to claim international travel to get an advance refill - and decline to tell insurance company your destination bc it's none of their business. Your doctor will need to be cooperative, however!
Exactly my thought. (This is one way the "medical profession," the pharmaceutical industry & the insurance industry arrange to control you. & there's more to it than just "how do I stockpile my medicine?" But that's a rant for another time.)
Federal government gutted the office that monitors foreign cyber intrusions, so I’m not the least bit surprised someone started poking around. There’s long been a concern that our public water supplies are open to intrusion. I’ve long been grateful for being on a private well, but I know there are other parts of our local infrastructure that are likely vulnerable. Your preparedness list is a good one.
And as Kristine noted, our fearless leader immediately started pointing fingers at his political rivals. This tells me there won’t be a lot of pushback to this little session of poking around. Probably tells the pokers the same thing.
Pokers pay attention.
Faith Senie..yes.
If the response to a probe... is to blame a governor...the probe has ALREADY answered its own question...not "can we get in," but "what happens when we do."
A finger pointed sideways...is the most USEFUL intelligence they collected all week...and it was FREE.
On the well: it buys you the water...and it's worth having. But...you're right that it doesn't buy you the substation...the pump station downstream...or the hospital. SAME exposure... different building.
The advisory is about a class of device sitting on the public internet...and water... is just where it surfaced...FIRST.
I'd hold the staffing question a little more loosely than the rest of your note...I haven't verified the specifics of what was cut...and when...so I don't want to build on it until I have.
BUT... the general shape holds: the fix here is unglamorous...expensive...and local...AND ...NOTHING about the current posture suggests anyone is racing to fund it.
Glad the list was useful. Thanks for reading, Faith!
-Jack
I grew up out in the sticks… we had a big garden… all of us kids had to help with the garden, same with the canning and freezing. We raised meat animals. Heated with a combo of wood and kerosene. I can fault my Depression era folks for a lot - but - we sure learned about preparedness and it’s stuck with me. Plus I live in an area that gets snow….
The ordered stand down of the security and terrorism folks has bothered me since it happened (after t 2.0 took office). Our infrastructure is aging, needs to be upgraded. We are vulnerable. Not trying to scare anyone - and - we do need to prepare for possible outages. Jack is absolutely correct on the security. People WILL get into your systems. The real game is catching them quickly, not always easy especially if you have less personnel looking at it.
There are experts talking about the necessity of developing a plan for an internet outage since our lives are online these days…. We pay bills online, get money from the atm, tap our credit cards for gas, groceries and a whole lot of everything. Never hurts to have some cash tucked away for emergency situations.
Based on Jack's recent article about possible attacks, I expected an ‘incident’. I see this one as a warning shot, a notice if you will that they CAN do something if they choose. Prepare, don’t panic!
Thanks Jack. Holding very steady here!
Correct I got a Brita water bottle with filters to stop buying bottled water saved money and time do not have to deal with all those empty water bottles anymore
Also store extra medication for same reason
I live in a city/county/state that only cares themselves and not their citizens/constituents
Be prepared it could be storm damage or wind damage that could shut everything down
I like backups for my backups
You can’t always depend on neighbors if they are dealing with the same problems
It becomes everyone for themselves
Sadly to say this
Put your own mask on 1st
If you have extras then you can help your neighbors
TY
I live in Florida, so about this time of year, I check my storm prep supplies. I have solar chargers for my phone (and small fans that run on USB cable), water purifying tablets and special filters, extra propane for my grill, a solar shower bag, and so on. I also get a few new outdoor solar (garden) lights that can be used indoors instead of flashlights or lanterns. I keep an extra toilet seat around, and at least one empty 5-gallon bucket + extra tp!
Lived there about half my life. You definitely learn how to be prepared.
Thanks for the reminder. I’ve just been going through my preparedness things and found that I need to check the charges on my chargers. Not all full. And more water would be a good idea. Getting the extraneous “stuff” out of here that’s piled up and replacing what needs updating has been my spring/summer project. I’ll be happy if we finish by autumn.
Of course, Iran is testing our systems.
The US has been bombing the bejeezus out of them, including civilian infrastructure. The Iranians are smart. They are adept at the use of asymmetric warfare and they have every incentive to use any means at their disposal. Straits of Hormuz, anyone? They have cyber warfare capabilities. So, the question isn't are they going to go after our systems, it is when? And the psychological impact of penetrating the US mainland can't be minimized. The Great Superpower, like its flaccid leader, has been found to be less than invincible.
Regarding our own preparedness, it has never been more important to take matters into our own hands. While one could never delegate all facets of preparedness to the government, this government is run by fools who have emasculated our defenses against cyber warfare, intelligence capabilities and more. Dearest Leader has made it abundantly clear, the welfare of the people is nonexistent on his priority list.
Very important piece. I don't think most Americans realize the danger we are in.
And you’re sure it wasn’t Elon ‘testing the water’ before November election… with the felon prez’s under the table blessing?
Thank you for sharing Jack!! Glad the water system was not tainted but these cyber attacks are scary bc we rely on the internet and power grid for everything these days!
We know how to solve this problem, globally and permanently, and it wouldn’t be too difficult. Modern cryptography almost comes in a box these days.