ArgumentOutbreaks of Lethal Diseases Like Ebola and the Wuhan Coronavirus Happen Regularly. The U.S. Government Just Cut Funding for the Hospitals that Deal with Them
The U.S. response to the 2014-2015 Ebola crisis has been to create a “tiered” hospital approach to the treatment of epidemics: Saskia Popescu writes that the expectations are that frontline facilities should be able to quickly identify and isolate potential patients and transfer them to an assessment or treatment hospital if necessary. But “many dangerous pathogens, including the disease now spreading in China, can be treated at run-of-the mill hospitals in the United States,” she writes. “The next epidemic could start with a patient checking in at a local urgent care clinic. Congress needs to ask if its current plan for special pathogen response prepares the country for that. It’s likely the answer is no.”
The U.S. response to the 2014-2015 Ebola crisis has been to create a “tiered” hospital approach to the treatment of epidemics: Saskia Popescu writes in the Bulletin of the Atomic Scientists that the expectations are that frontline facilities should be able to quickly identify and isolate potential patients and transfer them to an assessment or treatment hospital if necessary.
“At the top of the tiered structure, the 10 regional facilities have the capabilities to simultaneously treat at least two Ebola patients and to isolate at least 10 patients with a respiratory special pathogen like SARS or Middle East respiratory syndrome (MERS),” she writes.
The tiered approach ensures there are hospitals and healthcare workers equipped to handle special pathogen cases, but like many public health responses to infectious diseases, it’s a Band-Aid, meant to deal quickly with outbreaks before they spiral out of control.
The tiered structure addresses this problem by having some hospitals (i.e., the frontline facilities) prepare simply to assess a patient who might have a special pathogen. But this approach means maximum exposure of healthcare workers.
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To be clear, many dangerous pathogens, including the disease now spreading in China, can be treated at run-of-the mill hospitals in the United States. A cost of over a million dollars per treatment center is no easy pill for hospitals to swallow, even as many have adapted their specialized bio-containment units for uses other than the care of an Ebola patient. My own experience, echoed in surveys and studies, is that hospitals are unlikely to invest the necessary resources to prepare for somewhat improbable events like an Ebola epidemic in the United States. It’s easy to imagine administrators asking, “Why worry about Ebola when we are running out of influenza testing kits?”
The next epidemic could start with a patient checking in at a local urgent care clinic. Congress needs to ask if its current plan for special pathogen response prepares the country for that.
It’s likely the answer is no.
