infection prevention
By Phenelle Segal, RN, CIC, FAPIC
FPO
Outbreak Readiness:
How Prepared
is Your Facility?
F
Ebola proved
that if basic
systems had
been in place,
the epidemic
could have
been aborted
at almost
no cost,
compared
to the
$5.4 billion
that the U.S.
funded.
or at least two decades, the U.S. has been
planning for inevitable global pandemics,
as evidenced by the doubling of the National
Institutes of Health (NIH) budget for biomedical
research in 1998. The President’s Emergency
Plan for AIDS Relief (PEPFAR) was created to
stem the rising fear of devastation from Human
Immunodeficiency Virus (HIV). However, health
crises such as severe acute respiratory syndrome
(SARS) that emerged in 2002, and Ebola in
2014, the U.S. response, together with the rest
of the world, was considered slow and not well
organized. Ebola proved that if basic systems
had been in place, the epidemic could have been
aborted at almost no cost, compared to the $5.4
billion that the U.S. funded.
Curbing epidemics is complex and requires
a combination of money, additional manpower
and with modern technology, the ability to
diagnose, treat and prevent these diseases should
be simpler. 1
This article focuses on improvements nation-
wide for pandemic preparedness using Ebola’s
arrival in the U.S. in 2014. Ebola Virus Disease
(EVD) created an urgent need for pandemic prepa-
ration when the primary patient responsible for
introducing the virus into the country fell through
the cracks after his initial visit to a hospital in Texas.
Ebola preparedness placed a heavy financial and
human resource burden on healthcare facilities
across the nation. Acute-care hospitals were
provided guidance by the Centers for Disease
Control and Prevention (CDC) via their “Interim
Guidance for Preparing Frontline Healthcare
Facilities for Patients Under Investigation (PUIs)
for Ebola Virus Disease (EVD).” CDC guidance
also included a detailed checklist for hospitals
and specified that this could be used for Ebola as
well as other infectious diseases. The result was
much-improved awareness and preparedness for
the inevitable; however, the question remains
whether the healthcare industry can ever be
fully prepared?
Novel respiratory viruses including severe
acute respiratory syndrome (SARS Co-V) in 2003,
H1N1 influenza (swine flu) in 2009 and Middle
www.healthcarehygienemagazine.com • march 2020
East respiratory syndrome (MERS Co-V) in 2012
reminded the world that ongoing preparation
— particularly in the acute-care setting — is
vital to the success of preventing an outbreak of
major magnitude.
Once again, the U.S. currently faces the threat
of a respiratory virus outbreak with the novel
coronavirus known as COVID-19 that originates
from and has sickened tens of thousands of people
in China. The death toll has surpassed 1,500 at the
time of writing. Similar to SARS and MERS, most
often the virus spreads from respiratory droplets as
a person-to-person transmission, when a person
who is infected sneezes or coughs within the space
of approximately 6 feet of others. As this novel
virus has many unanswered questions to date, it
is not certain whether surface contamination can
infect mucus membranes including the mouth,
nose or eyes.
Are We Prepared?
In October 2018, the U.S. Department of
Health and Human Services (HHS), Office of In-
spector General (OIG) released a report, “Hospitals
Reported Improved Preparedness for Emerging
Infectious Diseases After the Ebola Outbreak.”
The OIG found that most acute-care hospitals in
the nation were unprepared for the outbreak of
Ebola in 2014, “…with 71 percent of hospital
administrators reporting that their facilities were
unprepared to receive Ebola patients. By 2017,
administrators from only 14 percent of hospitals
reported their facilities were still unprepared for
emerging infectious disease (EID) threats such as
Ebola.” Hospitals began updating their emergency
plans, provided education and training for staff,
particularly front-line staff, purchasing additional
supplies and the very important task of conducting
drills. HHS provided many resources, and these
are available to date. The greatest challenges
for hospitals to maintain preparedness includes
immediate and day-to-day priorities taking
precedence, preparing for natural disasters and
staff time. In December 2014 it was reported that
state health officials had designated 35 hospitals
as “Ebola centers” and were ready to accept
patients if necessary.
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