The utility and sustainability of US Ebola treatment centers during the coronavirus disease 2019 (COVID-19) pandemic

Abstract

Objective: In response to the 2014-2016 West Africa Ebola virus disease (EVD) epidemic, the Centers for Disease Control and Prevention (CDC) designated 56 US hospitals as Ebola treatment centers (ETCs) with high-level isolation capabilities. We aimed to determine ongoing sustainability of ETCs and identify how ETC capabilities have impacted hospital, local, and regional COVID-19 readiness and response. Design: An electronic survey included both qualitative and quantitative questions and was structured into two sections: operational sustainability and role in the COVID-19 response. Setting and Participants: The survey was distributed to site representatives from the 56 originally designated ETCs; 37 (66%) responded. Methods: Data were coded and analyzed using descriptive statistics. Results: Of the 37 responding ETCs, 33 (89%) reported they were still operating while 4 had decommissioned. ETCs that maintain high-level isolation capabilities incurred a mean of $234,367 in expenses per year. All but one ETC reported that existing capabilities (e.g., trained staff, infrastructure) before COVID-19 positively affected their hospital, local, and regional COVID-19 readiness and response (e.g., ETCs trained staff, donated supplies, and shared developed protocols). Conclusions: Existing high-level isolation capabilities and expertise developed following the 2014-2016 EVD epidemic were leveraged by ETCs to assist hospital-wide readiness for COVID-19 and support response for other local and regional hospitals However, ETCs face continued challenges in sustaining those capabilities for high-consequence infectious diseases.

Creation and impact of containment units with high-risk zones during the coronavirus disease 2019 (COVID-19) pandemic

“…During the Ebola outbreak, the US government invested substantial amounts of money in a small number of treatment facilities who would be dedicated to care for high-consequence pathogen patients 16 . We show here that multidisciplinary collaboration at a facility not designated to care for patients with high-consequence pathogens could provide effective care while maintaining HCP safety.…”

Challenges and Approaches to High-Level Isolation Unit Staffing and Just-in-Time Training: A Meeting Report

“…Some noted finding success in identifying HLIU “champions” to advocate on behalf of the unit, emphasizing the importance of preparedness and limiting the burden on the institution. Attendees also emphasized the need to show the return on investment to the institution during periods between outbreaks or activations (eg, through dual use of the physical unit for training staff, conducting research, utilizing HLIU experts to train staff in other departments [ 11 , 12 ]). Other approaches, including the integration of the HLIU into educational programs (eg, nursing education) and partnering with the emergency department, show the institution the value of the HLIU program beyond HCID care and management.…”