cover story
The COVID-19 Pandemic:
Priorities for Preparedness
and Prevention
By Kelly M. Pyrek
T
he superpower status of the United
States may not be reflected in its
We present
historic suboptimal levels of readiness
a round-up
and preparedness, which have not been
of the latest
addressed despite several additional
information
outbreaks since the 2003 SARs pan-
about COVID-19
demic – the so-called ‘dress rehearsal’
at the time of
for the current SARS-CoV-2 /COVID-19
publication in
pandemic.
early April.
That year, the General Accounting
Office (GAO) released a report summa-
rizing its findings after Congress directed it to examine the
preparedness of state and local public health agencies and
hospitals for responding to a large-scale infectious disease
outbreak and the relationship of federal and state planning
for an influenza pandemic to preparedness for emerging
infectious diseases.
The GAO found that gaps in disease surveillance systems
and laboratory facilities and that there were workforce
shortages. As the report observes, “The level of preparedness
varied across seven cities GAO visited, with jurisdictions
that have had multiple prior experiences with public health
emergencies being generally more prepared than others.
GAO found that planning for regional coordination was
lacking between states. GAO also found that states were
developing plans for receiving and distributing medical
supplies for emergencies and for mass vaccinations in the
event of a public health emergency.”
The report continued, “GAO found that most hospitals
lack the capacity to respond to large-scale infectious disease
outbreaks. Most emergency departments have experienced
some degree of crowding and therefore in some cases
may not be able to handle a large influx of patients during
a potential SARS or other infectious disease outbreak.
Most hospitals across the country reported participating in
basic planning activities for such outbreaks; however, few
hospitals have adequate medical equipment, such as the
ventilators that are often needed for respiratory infections
such as SARS, to handle the large increases in the number
of patients that may result. “
The GAO recommended that the public health response
to outbreaks of emerging infectious diseases such as SARS
could be improved by the completion of federal and state
influenza pandemic response plans that address problems
related to the purchase, distribution, and administration of
supplies of vaccines and antiviral drugs during an outbreak.
As healthcare-sector entities scramble in month three of
Editor’s note
14
SARS
ID
-CoV-2
image courtesy of NIA
the COVID-19 outbreak, the question is, aren’t healthcare
systems better prepared?
As Janet Heinrich, then-director of healthcare/public
health issues for the GAO, observed, “…while the efforts
of public health agencies and healthcare organizations
to increase their preparedness for major public health
threats such as influenza pandemics and bioterrorism have
improved the nation’s capacity to respond to SARS and other
emerging infectious disease outbreaks, gaps in preparedness
remain. Specifically, we found that there are gaps in disease
surveillance systems and laboratory facilities and that
there are workforce shortages. The level of preparedness
varied across cities we visited, with
jurisdictions that have had multiple
prior experiences with public health
We found that emergencies being generally more
prepared than others. We found that
most hospitals
planning for regional coordination
across the
was lacking between states. We also
found that states were developing
country lack
plans for receiving and distributing
the capacity
medical supplies for emergencies
to respond
and for mass vaccinations in the
event of a public health emergency.
to large-scale
We found that most hospitals across
infectious disease the country lack the capacity to
respond to large-scale infectious
outbreaks."
disease outbreaks. Most emergency
departments have experienced some degree of crowding
and therefore in some cases may not be able to handle a
large influx of patients during a potential SARS or other
infectious disease outbreak. Although most hospitals report
participating in basic planning activities for such outbreaks,
few have adequate medical equipment, such as ventilators
that are often needed for respiratory infections such as SARS,
to handle the large increases in the number of patients that
may result.”
Fast-forward to 2020. Healthcare systems are scram-
bling to address PPE and equipment shortages as if SARS
never happened. As the 2003 GAO report noted, “Most
hospitals lack adequate equipment, isolation facilities, and
staff to treat a large increase in the number of patients for
an infectious disease such as SARS. To prevent transmission
of SARS in healthcare settings, CDC recommends that
healthcare workers use personal protective equipment,
including gowns, gloves, respirators, and protective eyewear.”
The report continues, “In the seven cities we visited, hospital,
april 2020 • www.healthcarehygienemagazine.com