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U.S. Department of Health and Human Services


Preparing for a Potential Domestic Ebola Outbreak

Author: Robert Kadlec, MD, Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services
Published Date: 3/15/2019 2:11:00 PM
Category: Hospital Preparedness; Exercises & Trainings; Public Health Preparedness;

Enhancing U.S. Healthcare System Preparedness and Public Health Emergency Response Capabilities

Blog Series:  Battling the Ebola Epidemic

An Ebola outbreak that began more than seven months ago continues to claim lives in the Democratic Republic of the Congo (DRC). Although international response efforts are underway to contain the outbreak at its source and prevent the spread of the disease to other countries, we must always be prepared for the possibility of an Ebola case in the United States.

The U.S. Department of Health and Human Services (HHS) is working with its partners to prepare healthcare systems and enhance response capabilities so we are ready to protect American communities. To prepare the nation to face rapidly evolving and complex health threats, the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) is enhancing regional preparedness, developing response plans, conducting exercises to ensure those plans can be implemented effectively, and training medical responders from the National Disaster Medical System (NDMS). 

Enhancing Regional Preparedness in the United States

To strengthen regional highly infectious disease response capabilities in the U.S., HHS/ASPR and the Centers for Disease Control and Prevention (CDC) have worked with state health departments and the private sector to develop a tiered approach to prepare U.S. healthcare facilities to safely and rapidly identify, isolate, evaluate, and manage travelers or patients with possible or confirmed cases of Ebola.

ASPR provided hospitals with approximately $214 million from the 2014 Ebola emergency supplemental funds to establish a nationwide, regional treatment network for Ebola and other highly infectious diseases. The funding established the foundation required for the nation’s healthcare system to safely and successfully identify, isolate, assess, transport, and treat patients with suspected cases of Ebola virus disease or other highly infectious disease.

To prepare clinicians to provide safe and supportive care for patients with Ebola or other highly infectious diseases, HHS awarded funding to establish the National Ebola Training and Education Center (NETEC). NETEC is a consortium of three U.S. healthcare facilities – Emory University in Atlanta, Georgia; University of Nebraska Medical Center/Nebraska Medicine (UNMC) in Omaha, Nebraska; and the New York City Health and Hospitals Corporation/HHC Bellevue Hospital Center in New York, New York. All three of these hospitals have treated Ebola patients successfully. NETEC offers training, resources, readiness assessments, and expertise to help prepare for emerging threats related to infectious disease outbreaks, including Ebola.

By leveraging the best practices established from investments made with the Ebola supplemental appropriations, ASPR is developing innovative, tiered, regional demonstration projects that can serve as models for building a Regional Disaster Health Response System across the country.

Developing Protocols and Exercises to Save Lives

Immediately after the Ebola outbreak in 2014, ASPR collaborated with the Department of State and other federal departments and agencies to develop protocols and capabilities to address potential U.S. cases of Ebola, including transport systems and a network of domestic hospitals that could activate biocontainment units on short notice.

In order for the protocols to be useful, healthcare providers need to understand how to use them. Saving lives requires preparation and training. Partners across the healthcare system need to work together to ensure that patients are safely transported and treated in an emergency – and that requires practice and tremendous coordination.  

In 2018, ASPR led an exercise called Tranquil Terminus, the largest bio-containment patient movement exercise in HHS history. The exercise focused on moving seven people acting as patients with Ebola symptoms within different regions of the country.  During the event, partners exercised notification processes, worked together to make critical decisions, and used resources to move highly infectious disease patients by ground and by air transport. 

Training NDMS Responders

To ensure our responders are able to support future infectious disease outbreaks, ASPR is utilizing Ebola supplemental funding to provide enhanced training to NDMS personnel. These medical professionals come primarily from private sector and are called into action by HHS as intermittent federal employees to respond to public health emergencies and disasters. 

NDMS has partnered with the University of Nebraska Medical Center to support two specific training courses for personnel:

  • Isolation, Simulation and Quarantine Training provides situational awareness, preparedness and planning, infection prevention and control, and crisis and risk communications
  • Highly Infectious Disease Patient Transport Training trains personnel to transport highly infectious patients to appropriate facilities, use personal protective equipment, and implement infection control practices while avoiding excessive delays in care

Both of these training courses provide NDMS personnel with the appropriate skills and general awareness to treat highly infectious disease patients without becoming infected or spreading infection within the impacted area. 

The Path Forward

Ebola is just one of many potential national health security threats our nation faces. We are working with our partners across government and industry to accomplish a single, critical goal:  saving lives in an emergency. By making smart investments, establishing strong partnerships, and creating comprehensive plans, we will be better prepared to fight Ebola or other highly infectious diseases and save lives.   

This is the second blog in a two-part series on battling the Ebola epidemic.  This series is designed to highlight the actions that ASPR is taking to protect health and save lives during current Ebola outbreak.  To stay up to date as new blog posts are published, follow us on TwitterFacebook or LinkedIn.


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