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Ebola is raging again - and the U.S. is not ready

Health workers wearing protective gear begin their shift

Health workers wearing protective gear begin their shift at an Ebola treatment center in Beni, Congo on July 16, 2019. Photo Credit: AP/Jerome Delay

Five years ago, the Ebola virus broke through inadequate public health systems in West Africa and spread throughout the world. America was lucky. Only a few cases traveled here, but the U.S. government also did not respond as we had reason to expect.

Despite assurances that our country would be able to handle such a serious disease, our public health agencies and health care institutions made some serious mistakes.

The Centers for Disease Control and Prevention neglected to consult with the Occupational Safety and Health Administration when developing guidance for hospitals. It issued the guidelines and then had to reissue them because they had not adequately accounted for air-handling systems and missed the mark when it came to personal protective equipment.

Congress waited much too long to provide emergency supplemental funding to help our health care and public health infrastructure respond. And one governor quarantined a nurse only because she had provided humanitarian assistance in an area where the disease was prevalent. Communications to the public about what was happening were disorganized, confusing and unnecessarily frightening.

Today, the threat from Ebola is more serious. The World Health Organization has declared it to be a global public health emergency because Ebola has again defied controls and spread to the city of Goma in the Democratic Republic of Congo, where it could in turn spread throughout more densely populated urban areas and gain access to the global transportation system. We support this declaration and the additional resources and attention it should bring to the situation, but the WHO should have made it earlier. Ebola was an emergency long before it spread to Goma.

There are encouraging signs that some experimental Ebola drugs are working, and the CDC and U.S. Department of Health and Human Services seem to be more effectively tracking the disease. On the other hand, changes made previously to help local hospitals in the U.S. better prepare to treat those infected are not being implemented as designed. And that will have real human consequences the next time Ebola or another highly infectious disease — including a new highly pathogenic strain of influenza — reaches America.

During the outbreak five years ago, 56 hospitals across the U.S. were designated Ebola treatment centers, or ETCs. The idea was to increase national capacity to care for patients who contracted this highly infectious disease. These hospitals are mostly clustered around major airports where travelers from West Africa are likely to arrive, including Chicago’s O’Hare International Airport. They were initially equipped with dedicated clinical care resources, specialized infrastructure and trained staff to safely manage and treat patients suspected or confirmed to have Ebola. Since its inception in 2014, fewer resources have been allocated to this hospital network. As a result, the ETCs are having difficulty maintaining their ability to respond to Ebola cases that may come again to the U.S., and other infectious diseases that may follow.

Outbreaks are costly. Public health responses to Ebola, Zika, MERS, SARS and other diseases cost tens of billions of dollars, much of which can be avoided by taking preventive action. Congress can wait until Ebola or some equally deadly infectious disease arrives in our country, overwhelms state, local, tribal and territorial health care and public health capacity, and threatens lives and then provide billions in emergency supplemental funding. Or Congress can now recognize that these significant disease events will continue to occur and proactively take steps to ensure we can respond by creating a standing response fund.

In 2018, the bipartisan Blue Ribbon Study Panel on Biodefense, which we co-chair, issued a report called Budget Reform for Biodefense. In it, we recommended $2 billion for the Public Health Emergency Fund — a substantial increase over current funding levels — and which would be replenished with regular annual appropriations. Hospitals, other health care institutions and the public health community would have the funds they need, when they need it, to immediately protect our citizens. We hope that Congress will take up this recommendation soon, before Ebola — or another disease to which we are not paying as much attention — sickens and kills too many people here in the United States.

Former U.S. Sen. Joe Lieberman and former Pennsylvania Gov. Tom Ridge, the first U.S. secretary of Homeland Security, co-chair the bipartisan Blue Ribbon Study Panel on Biodefense. They wrote this for the Chicago Tribune.

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