This autumn marks 5 years since the first case of Ebola entered the emergency department doors in Dallas, Texas. Unexpected, Thomas Duncan and the Ebola virus disease infection that he would succumb to, would change the face of US health care and biopreparedness forever. For many of us, the memory is still fresh—the rapid race to acquire the necessary personal protective equipment (PPE) implementing measures in the face of changing guidance from the US Centers for Disease Control and Prevention (CDC), and ensuring we were ready should another unanticipated case of Ebola enter our hospital.
This was a lesson in not only stamina, but gaps and opportunities within health care preparedness. The fear associated with the disease raised unnecessary red flags anytime a patient with travel to any part of Africa sought care. This was a time when we learned that such levels of readiness are not sustainable across all hospitals. Ultimately, we need to maintain a constant state of training and education as to avoid going from nothing to a biocontainment unit in a matter of days. NYC Health + Hospitals is one organization that has taken this level of preparedness to new heights. While the health care system encompasses a designated treatment facility, it also includes several frontline facilities, requiring a range of support, funding, and coordination.
On Friday, November 1, NYC Health + Hospitals celebrated the 5 year anniversary
of their work in special pathogens preparedness and in urging the continuity of federal funding for hospital preparedness. This celebration and reminder of the importance of hospital preparedness is critical as the Hospital Preparedness Program funding is set expire early next year. This funding supports 10 regional special pathogens hospitals/treatment facilities around the United States, which are unique in their ability to safely care for patients with special pathogens like Ebola and other viral hemorrhagic fevers. For their preparedness efforts, the public health system has received $11 million of the $213 million that are available. This funding supports education and coordination efforts across public health, emergency medical services, and law enforcement in addition to health care.
The events on November 1 underscored not only the work done since 2014, but also the reality that an Ebola case is only a flight away. As the Democratic Republic of the Congo (DRC) continues to fight an ongoing Ebola outbreak that has over 3000 confirmed cases, there is a critical need for hospitals to maintain vigilant preparedness for infectious diseases.
During the event, many hospital representatives spoke to their efforts, including William Hicks, chief executive officer, NYC Health + Hospitals/ Bellevue, Machelle Allen, MD, chief medical officer, NYC Health + Hospitals, and Syra Madad, DHSc, MSc, MCP, senior director for system-wide special pathogens program. Ronald Klain, the designated Ebola-Czar
during the 2014 outbreak, was also present at the event, stressing the critical nature of hospital preparedness and federal support for such programs.
Underscoring the importance of their efforts and the need for continued funding, Madad noted that “because New York City is a gateway to the world, travel-associated diseases, such as Ebola, Lassa fever and MERS, could present at any time, and our facilities are trained and prepared for such an eventuality.”
As NYC Health + Hospital representatives emphasized, hospitals represent a unique vulnerability and yet opportunities to build a more prepared critical infrastructure. Unfortunately, the existence and continued resilience of special pathogens treatment facilities is dependent upon federal funding and unless renewed next year, will expire and leave us vulnerable to high-consequence infectious diseases.