Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-19T23:09:19.163Z Has data issue: false hasContentIssue false

Current Capabilities and Capacity of Ebola Treatment Centers in the United States

Published online by Cambridge University Press:  08 December 2015

Jocelyn J. Herstein
Affiliation:
Department of Environmental, Agricultural & Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska
Paul D. Biddinger
Affiliation:
Division of Emergency Preparedness, Department of Emergency Medicine, Massachusetts General Hospital Boston, Massachusetts Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
Colleen S. Kraft
Affiliation:
Division of Infectious Diseases, Department of Pathology and Laboratory Medicine, Department of Medicine, Emory University, Atlanta, Georgia
Lisa Saiman
Affiliation:
Department of Pediatrics, Columbia University Medical Center, New York, New York Department of Infection Prevention and Control, New York-Presbyterian Hospital, New York, New York
Shawn G. Gibbs
Affiliation:
Nebraska Biocontainment Unit, Nebraska Medicine, Omaha, Nebraska Department of Environmental Health, Indiana University School of Public Health, Bloomington, Indiana
Aurora B. Le
Affiliation:
Department of Environmental, Agricultural & Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska
Philip W. Smith
Affiliation:
Nebraska Biocontainment Unit, Nebraska Medicine, Omaha, Nebraska Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
Angela L. Hewlett
Affiliation:
Nebraska Biocontainment Unit, Nebraska Medicine, Omaha, Nebraska Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
John J. Lowe*
Affiliation:
Department of Environmental, Agricultural & Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska Nebraska Biocontainment Unit, Nebraska Medicine, Omaha, Nebraska
*
Address correspondence to John J. Lowe, PhD, 985110 Nebraska Medical Center, Omaha, NE 68198 (jjlowe@unmc.edu).

Abstract

OBJECTIVE

To describe current Ebola treatment center (ETC) locations, their capacity to care for Ebola virus disease patients, and infection control infrastructure features.

DESIGN

A 19-question survey was distributed electronically in April 2015. Responses were collected via email by June 2015 and analyzed in an electronic spreadsheet.

SETTING

The survey was sent to and completed by site representatives of each ETC.

PARTICIPANTS

The survey was sent to all 55 ETCs; 47 (85%) responded.

RESULTS

Of the 47 responding ETCs, there are 84 isolation beds available for adults and 91 for children; of these pediatric beds, 35 (38%) are in children’s hospitals. In total, the simultaneous capacity of the 47 reporting ETCs is 121 beds. On the basis of the current US census, there are 0.38 beds per million population. Most ETCs have negative pressure isolation rooms, anterooms, and a process for category A waste sterilization, although only 11 facilities (23%) have the capability to sterilize infectious waste on site.

CONCLUSIONS

Facilities developed ETCs on the basis of Centers for Disease Control and Prevention guidance, but specific capabilities are not mandated at this present time. Owing to the complex and costly nature of Ebola virus disease treatment and variability in capabilities from facility to facility, in conjunction with the lack of regulations, nationwide capacity in specialized facilities is limited. Further assessments should determine whether ETCs can adapt to safely manage other highly infectious disease threats.

Infect. Control Hosp. Epidemiol. 2016;37(3):313–318

Type
Original Articles
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Liddell, AM, Davey, RT, Mehta, AK, et al. Characteristics and clinical management of a cluster of 3 patients with Ebola virus disease, including the first domestically acquired cases in the United States. Ann Intern Med 2015;163:8190.CrossRefGoogle ScholarPubMed
2. Smith, PW, Anderson, AO, Christopher, GW, et al. Designing a biocontainment unit to care for patients with serious communicable diseases: a consensus statement. Biosecur Bioterror 2006;4:351365.CrossRefGoogle ScholarPubMed
3. Bannister, B, Puro, V, Fusco, FM, Heptonstall, J, Ippolito, G, EUNID Working Group. Framework for the design and operation of high-level isolation units: consensus of the European Network of Infectious Diseases. Lancet Infect Dis 2009;9:4556.CrossRefGoogle ScholarPubMed
4. Interim guidance for US hospital preparedness for patients under investigation (PUIs) or with confirmed Ebola virus disease (EVD): a framework for a tiered approach. Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/hospitals.html. Updated 2015. Accessed May 20, 2015.Google Scholar
5. Interim guidance for preparing Ebola treatment centers. Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/vhf/ebola/healthcare-us/preparing/treatment-centers.html. Updated 2014. Accessed August 24, 2015.Google Scholar
6. Puro, V, Fusco, FM, Schilling, S, et al. Biosecurity measures in 48 isolation facilities managing highly infectious diseases. Biosecur Bioterror 2012;10:208214.CrossRefGoogle ScholarPubMed
7. Smith, PW, Boulter, KC, Hewlett, AL, et al. Planning and response to Ebola virus disease: an integrated approach. Am J Infect Control 2015;43:441446.CrossRefGoogle ScholarPubMed
8. Iwen, PC, Garrett, JL, Gibbs, SG, et al. An integrated approach to laboratory testing for patients with Ebola virus disease. Lab Med 2014;45:146151.CrossRefGoogle ScholarPubMed
9. Lowe, JJ, Gibbs, SG, Schwedhelm, SS, Nguyen, J, Smith, PW. Nebraska biocontainment unit perspective on disposal of Ebola medical waste. Am J Infect Control 2014;42:12561257.CrossRefGoogle ScholarPubMed
10. HHS selects nine regional Ebola and other special pathogen treatment centers. Health and Human Services website. http://www.hhs.gov/news/press/2015pres/06/20150612b.html. Accessed June 12, 2015.Google Scholar
11. Assistant Secretary for Preparedness and Response. Ebola Measures Technical Assistance Review. http://www.phe.gov/Preparedness/planning/hpp/meetings/Documents/ebola-measures-transcript.pdf. Accessed November 21, 2015.Google Scholar
12. Fusco, FM, Schilling, S, Puro, V, et al. EuroNHID checklists for the assessment of high‐level isolation units and referral centres for highly infectious diseases: results from the pilot phase of a European survey. Clin Microbiol Infect 2009;15:711719.CrossRefGoogle Scholar
13. US and World Population Clock. US Census Bureau website. http://www.census.gov/popclock/. Accessed June 12, 2015.Google Scholar
14. Hewlett, AL, Varkey, JB, Smith, PW, Ribner, BS. Ebola virus disease: preparedness and infection control lessons learned from two biocontainment units. Curr Opin Infect Dis 2015;28:343348.CrossRefGoogle ScholarPubMed
15. Boulter, K, Link, N, Mehta, A. Hospital Preparation and Team Development. http://netec.org/wp-content/uploads/2015/09/2-NETEC-Hospital-Preparation-Team-Development.pdf. Accessed November 21, 2015.Google Scholar
16. Jelden, KC, Gibbs, SG, Smith, PW, et al. Nebraska biocontainment unit patient discharge and environmental decontamination after Ebola care. Am J Infect Control 2015;43:203205.CrossRefGoogle ScholarPubMed
17. Lowe, JJ, Olinger, PL, Gibbs, SG, et al. Environmental infection control considerations for Ebola. Am J Infect Control 2015;43:747749.CrossRefGoogle ScholarPubMed
18. Maltezou, HC, Fusco, FM, Schilling, S, et al. Infection control practices in facilities for highly infectious diseases across Europe. J Hosp Infect 2012;81:184191.CrossRefGoogle ScholarPubMed
19. Heymann, D. ed Control of Communicable Disease Manual, 20th ed. Washington, DC: American Public Health Association, 2015.CrossRefGoogle Scholar
20. Middle East respiratory syndrome (MERS). Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/coronavirus/mers/. Accessed May 29, 2015.Google Scholar
21. Update 49–SARS case fatality ratio, incubation period. World Health Organization website. http://www.who.int/csr/sarsarchive/2003_05_07a/en/. Accessed May 29, 2015.Google Scholar
22. Severe acute respiratory syndrome (SARS). Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/sars/. Accessed May 29, 2015.Google Scholar
23. Update: CDC Ebola response and interim guidance. Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/media/releases/2014/t1027-ebola-response-interim-guidance.html. Accessed June 12, 2015.Google Scholar
24. Update: outbreak of severe acute respiratory syndrome—worldwide, 2003. MMWR Morbid Mortal Wkly Rep 2003;52:269–272. Centers for Disease Control and Prevention (CDC) website. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5213a1.htm. Published 2003.Google Scholar
25. Fusco, FM, Puro, V, Baka, A, et al. Isolation rooms for highly infectious diseases: an inventory of capabilities in European countries. J Hosp Infect 2009;73:1523.CrossRefGoogle ScholarPubMed