Novel infectious agents recently emerged overseas, grabbing headlines in America. They triggered concern because they do not respect traditional barriers such as national borders, the poverty line, and healthy behavior. With globalization, the likelihood of importing new germs into the country is increasing.
In the last year, man-made and natural catastrophes, from the terrorist bombing in Boston to Superstorm Sandy, have highlighted the potential disruption in our healthcare delivery capability - underscoring the limits and fragility of our healthcare infrastructure.
In the event of a pandemic, the stress placed on the healthcare system will be enormous. The 2012 Trust for America’s Health report states “we are not sufficiently prepared to address [health threats] as a nation ...”
Our greatest peril, offering potentially devastating consequences, is a new airborne pathogen with no treatment or prevention currently available. The problem is it will strike at the system core, affecting hospital physicians, nurses, and support staff. Knowing the only question is when, are we prepared?
From the 2003 SARS experience, we can infer the worst-case: Victims go to a hospital, where they infect healthcare providers, personnel, visitors, and fomites.
All they interact with becomes infectious and contagious, generating huge amounts of unsafe medical waste. The new germ is then spread throughout the community and onward. As seen with SARS, hospitals will be “Ground Zero” of this new pandemic.
Noting the terrible outcomes in Hong Kong, we must absolutely avoid closing facilities. On the contrary, hospitals, especially physicians and nurses, must be protected at all cost, as they are the first and last line of defense. Fail to achieve this, and the whole healthcare delivery system implodes.
Where do we stand now in terms of preparedness? Poorly. In the aftermath of Hurricane Sandy, hospital “red bags” containing infectious waste were seen floating in storm water, while others were stored in unsecured places.
What if they had released their content? What if they had been stolen?
The World Health Organization, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, and the Occupational Safety and Health Administration have prepared recommendations to protect hospital personnel and the public in case of an airborne pathogen outbreak, but they are not sufficient.
We must tackle many questions: What do we need to be best prepared? Are these guidelines sufficient? What about infectious medical waste? What are the big loopholes in readiness? How do we maximizing current resources? And many more questions.
We must begin a national effort to address emergency preparedness planning. Best practices must be created for managing a major surge in demand for emergency medical care.
We must review the point of outside hospital suppliers and the treatment of medical waste. We must consider the need for onsite sterilization, as well as quarantine procedures, including pop-up quarantine wards.
As a nation, it is our duty to protect healthcare professionals who daily risk their lives. Pandemic risk management should not elicit partisan stances. We should all agree upon the role of government here, which is to facilitate necessary precautions.
Remember, during the 1918-1919 influenza pandemic approximately 675,000 Americans died. Worldwide, it killed more people than did World War I.
It is clear that current practices in our hospitals and clinics are not the best way to protect the health and safety of the entire medical staff and patients, or the surrounding community.
Developing new best practices is of paramount importance, and we have a tremendous task ahead of us. We cannot allow our healthcare system – ourselves – to be vulnerable. Too many lives are at stake.Yann A. Meunier , MD, is CEO of HealthConnect International, LLC a healthcare consulting firm based in Silicon Valley, CA.