Ebola outbreak reminds us that we need pandemic preparedness

Ebola outbreak reminds us that we need pandemic preparedness
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Smallpox virus caused an estimated half-billion deaths in the 20th century before the World Health Assembly declared it eradicated in 1980. Our ability to diagnose and treat infectious diseases has advanced tremendously over the last century, but they continue to pose significant threats to public health. For example, the current Ebola outbreak in the Democratic Republic of Congo has become one of the worst in decades. Congress has already made substantial investments to guard against these threats and should ensure continued funding before the current authorization expires in 2020.

In recent decades, new dangers — including the emergence of lethal pathogens, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), the increase in viral hemorrhagic fever outbreaks such as Ebola and Lassa fever and the rapid rise of antibiotic-resistant bacteria — threaten to outpace our ability to develop effective treatments. Overcoming these new and challenging obstacles — and protecting the public from a 21st century pandemic — requires preparation and resources.

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In response, Congress supported an effort in 2014 by the U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) to create 10 regional Ebola and special pathogen treatment centers (RESPTCs).

Located within existing hospitals, these state-of-the-art bio-containment units have enhanced capabilities to ensure patients with highly infectious diseases can be safely isolated and treated. ASPR also helped to create the National Ebola Treatment and Education Center to assist with education and preparedness at all health care facilities and provided needed resources to state health departments to bolster state and regional networks for infectious disease preparedness.

These preparedness initiatives provide a tremendous resource, allowing our nation to better respond to threats from highly infectious diseases. The RESPTCs have increased the number of beds available to provide care for patients infected with highly contagious pathogens nearly twentyfold. Further, the efforts have greatly increased the nation’s collective knowledge and preparedness regarding infection prevention measures that keep health care workers, patients and the public safe.

This regional network of treatment centers and assessment hospitals, along with key public health, emergency medical services and other stakeholders, has also had an immeasurable impact on health system preparedness by strengthening relationships between hospitals and health departments as well as coordination among local, state and federal agencies.

In Maryland, for example, the collaboration between the Johns Hopkins Hospital bio-containment unit, Maryland Department of Health and five area hospitals prepared to receive, isolate and care for potential patients with Ebola or other high-consequence pathogens until transfer, promises to greatly strengthen overall preparedness across the region. This reflects the vision set forth by Robert Kadlec, assistant secretary of preparedness and response, to create an all-hazards, tiered, regional disaster health system based, in part, on the success of the RESPTC network.

Nationally and regionally, we are far better prepared to respond to an infectious disease threat, such as Ebola or pandemic respiratory virus, because of these dedicated federal resources. The preparedness capabilities may be put to the test at any time considering the ongoing Ebola outbreak in the Democratic Republic of Congo, recent cases of monkeypox in the U.K., persistent reports of MERS throughout the Middle East and the constant threat of novel, pandemic respiratory viruses.

We have an opportunity to build upon the infrastructure that has been put in place and continue strengthening our capabilities to meet these and other biologic threats. Congress can help achieve these goals by re-authorizing and appropriating investment in infectious disease preparedness.

Brian T. Garibaldi, M.D., directs the bio-containment unit at Johns Hopkins Hospital. He is also an associate professor of medicine and physiology at the Johns Hopkins University School of Medicine. Lisa L. Maragakis, M.D., M.P.H., is the senior director of infection prevention for the Johns Hopkins Health System. She is also an associate professor of medicine, epidemiology and health, policy and management at the Johns Hopkins University School of Medicine and the Bloomberg School of Public Health.