A program protecting us from Ebola will soon expire
Without proper funding for this disease treatment program, Americans will be at greater risk
Five years ago, a man walked into a Dallas emergency room and became the first person diagnosed with Ebola in the United States. Suddenly, the nation was confronted with a rare, deadly and infectious disease whose containment required special procedures, training and equipment. When two nurses at that hospital got infected, the real scramble to respond began.
Three weeks later, the Obama administration proposed — and shortly thereafter, a bipartisan majority in Congress approved and funded — a major program to equip facilities and train staff on the front lines of our health care system. As a result, when the United States confronts another challenge like the Ebola threat of 2014 — as it inevitably will — we will be prepared to quickly identify infected people, isolate them and provide them with care.
Unfortunately this program expires in May of 2020, and there is no indication that Congress intends to fully renew it. Without such continued funding, training will cease, specialized facilities will be shut down and — as staff members move on to other jobs and opportunities — all Americans will be at greater risk.
A related program was established shortly after the anthrax attacks of 2001, when Congress funded a small number of highly specialized facilities to cope with “special pathogens.” But that effort funded only three facilities nationwide, none of them located in the 15 most populous cities. By 2014, when the Ebola epidemic raged in West Africa, the U.S. system was capable of treating a handful of patients specially brought from overseas — but it was not ready for someone to walk into a hospital off the street with the disease.
The plan that the government put in place that fall had four tiers. First, most health care facilities around the country were prepared to identify patients who might have a dangerous infectious disease like Ebola and refer them for testing. Second, in almost every major city, at least one “assessment center” was established to accept and test suspected cases. Third, more than 60 treatment facilities for Ebola or similar diseases were set up within existing hospitals from coast to coast, to treat patients with such a diagnosis. And at the apex of the system, 10 Ebola & Other Special Pathogen Treatment Regional Centers were established to handle the hardest cases.
Right now, Congress is considering funding for these most advanced facilities, but not the full network that protects our country. If it does not renew this entire program in the next five months, the system will begin to disintegrate. Equipment will get out of date or be cannibalized for other purposes. Drills and simulations will cease. We will return to nearly the state of unpreparedness that we had five years ago. That would be disastrous. Why? Because the day will come when a dangerous pathogen will arrive in the United States once again. Besides the lingering threat from a current Ebola outbreak in Congo, there are numerous other highly infectious disease outbreaks happening around the world today — Lassa fever in Nigeria, Middle East respiratory syndrome in Saudi Arabia, Crimean-Congo hemorrhagic fever in Pakistan, to name a few. Preparedness efforts developed for Ebola will aid the response to other diseases like these.
Just as it takes only one patient to cause an outbreak, so too does it take only one unprepared health care facility, in one city in the United States, to serve as an incubator for the spread of such a disease. We are only as strong as our weakest link.
Failure to act would be pennywise but pound-foolish. The cost of keeping up the currently trained, equipped and prepared facilities is far less than the hundreds of millions of dollars it cost to start almost from scratch as we did in 2014. For a fraction of that, we can keep the frontline and treatment centers and their teams up-to-date and ready. Moreover, the principles applied by this specialized program are also useful as our health care system responds to less dangerous infectious disease threats that also come knocking at its door.
We do not know when the next dangerous pathogen will arrive in our country, or when a patient with such a disease will require isolation and treatment. We do not know where such an event will occur. But we do know that it will happen — sooner or later.
Congress should renew the entire treatment network for Ebola and other special pathogens, and fund it for another five years. We have already invested the time and money to be prepared for this eventuality. It will be a health care and economic catastrophe if we squander that capacity now.