John T. Fox is president and chief executive of Emory Healthcare in Atlanta.
The appointment of Ebola czar Ron Klain is an important initial step in mobilizing a coordinated national effort to confront this deadly virus.
As the first U.S. hospital to successfully treat Ebola patients, Emory University Hospital has a unique perspective on the scope of the effort and skill required to care for such patients while also protecting the staff and public. One key lesson learned has been that training and strictly following protocol are paramount. Although that may sound simple, it takes an enormous amount of dedication, resources and planning.
The staff at Emory Healthcare is committed to sharing our knowledge with the Centers for Disease Control and Prevention, as well as hospitals around the world, including through a new Web site listing our protocols. Sharing information in this way is critical, but it will not be enough. The new czar and other officials must create a long-term local, regional and national strategy to tackle not only Ebola, but also other life-threatening infectious diseases that we will face in the future.
This is not a time for finger-pointing. We need to grasp this opportunity to put a system in place that can serve as a model moving forward. The existence of four specially designed isolation units, including Emory’s, has helped buy some time, but we are operating with a razor-thin margin. Even a modest surge of 10 to 20 patients would strain the capacity of these centers. The U.S. health-care system has the resources and talent to deal with a larger challenge, but it must move immediately to build a truly scalable model.
The federal government should create a national medical infrastructure. We can start by establishing several National Ebola Support Centers, beginning with ones at Emory, Nebraska Medical Center and the National Institutes of Health, to serve as clinical training bases for other hospitals around the country.
At the same time, we need to:
• Require every major metropolitan area to help prepare its two or three largest health-care systems to care for Ebola-infected patients and give them the needed resources and training. These regional care centers must have significant sub-specialty support capabilities, including critical care expertise and capacity, particularly for nursing. Appropriate training must be provided to establish a culture of safety.
• Require all U.S. hospitals to undergo a prescribed level of preparedness based on their size, location and other factors. Establishing a common approach to classification of patients potentially at risk will help immensely in treating and controlling Ebola, as well as in preparing for future outbreaks of other infectious diseases.
• Establish regional and national standards and mechanisms for coordination of transportation services, supply distribution, specimen handling and waste management. The logistics involved in safely caring for patients with Ebola are extraordinary and must be a priority for any health-care system.
These measures sound daunting — and they are. But our national experience with Ebola has revealed vulnerabilities in our public health preparedness that must be addressed. Getting this right will serve us well into the future.
We cannot be a country ruled by fear. We must care for those in need. But a few hospitals cannot combat this public health threat alone. We need government leadership to provide the resources necessary to implement a coordinated, scalable national plan. It can be done.
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