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Richey TW, Fowler RL, Swienton RE, O'Neal JP, Harris CA. Review of Emergency Medical Services Vulnerability to High Consequence Infectious Disease in the United States. Front Public Health 2021; 9:748373. [PMID: 34676196 PMCID: PMC8523911 DOI: 10.3389/fpubh.2021.748373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/08/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose: Emergency medical services (EMS) responders are a group of medically skilled professionals who perform a wide range of essential medical services within a community including emergency response, patient transport, and mobile integrated healthcare. The proper functioning of the EMS system is paramount to the well-being of the medical system and public health. The intent of this paper is to review current EMS standards and practice to determine the danger a high consequence infectious disease (HCID) may pose to these healthcare workers and the community. Areas Addressed: Through the review of EMS practice several areas were identified as vulnerabilities to the EMS network. These vulnerabilities consisted of the lack of standardized licensing practice, inconsistent medical direction, and the inability to properly implement the use of personal protective equipment (PPE). The compounding of these vulnerabilities allows for HCIDs to pose a serious threat to EMS personnel with the possibility of devastating and crippling the EMS infrastructure within the US. Discussion: The vulnerabilities identified must be addressed both to protect EMS providers and to enhance the resilience of the US healthcare system. Ways to address the identified vulnerabilities should focus on improving the EMS curriculum and increasing minimum levels of education for first responders. Targeting minimum education and training standards could be the most effect method of reducing the dangers of HCIDs to EMS systems.
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Affiliation(s)
- Thomas W Richey
- Institute for Disaster Management, College of Public Health, University of Georgia, Athens, GA, United States
| | - Raymond L Fowler
- Emergency Medicine Center at Dallas, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Ray E Swienton
- Emergency Medicine Center at Dallas, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - James Patrick O'Neal
- Institute for Disaster Management, College of Public Health, University of Georgia, Athens, GA, United States
| | - Curtis A Harris
- Institute for Disaster Management, College of Public Health, University of Georgia, Athens, GA, United States
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Phillips V, Njau JD, Edison L, Brown C. The Cost and Public Health System Effects of Active Monitoring and Illness Response for Ebola Virus Disease: A Case Evaluation of Georgia. Health Secur 2020; 18:164-176. [PMID: 32559157 PMCID: PMC11151352 DOI: 10.1089/hs.2019.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In August 2014, the World Health Organization declared the Ebola virus disease epidemic in West Africa a public health emergency of international concern. After 2 imported cases of the disease were identified in the United States in autumn 2014, the Centers for Disease Control and Prevention recommended that all jurisdictions begin active monitoring of travelers at risk of developing Ebola virus disease for 21 days from the last day of a potential exposure to minimize the risk of disease transmission. Here we describe the infrastructure development, monitoring processes, total planned expenditures, and effects on the public health system in Georgia associated with active monitoring and illness response of all travelers from Ebola-affected West African countries from October 2014 to March 2016. We conducted qualitative interviews with Georgia Department of Public Health (GDPH) staff. We identified state active monitoring and illness response infrastructure investments and monitoring activities and state and federal funds spent in both areas. And, we evaluated whether active monitoring and illness response enhanced Georgia's ability to respond to future infectious disease outbreaks. Developing the infrastructure to support the monitoring and response required investment in information technology, training of public health and medical personnel, increasing laboratory capacity, and securing personal protective equipment. Estimated total expenditures were $8.25 million, with 76% spent on infrastructure and 17% on daily monitoring. The GDPH leveraged internal resources and partnerships to implement active monitoring and illness response. Infrastructure investment increased surveillance capacity, strengthened relationships between the GDPH and medical providers, and led to the creation of infectious disease transport and hospital networks. Active monitoring and illness response increased outbreak preparedness, but it warrants comparison with other possible responses to determine its overall value.
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Affiliation(s)
- Victoria Phillips
- Victoria Phillips, DPhil, is an Associate Professor, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, and a consultant to the Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch, Centers for Disease Control and Prevention, Atlanta, GA
| | - Joseph D Njau
- Joseph D. Njau, PhD, is a Staff Fellow, Food and Drug Administration, White Oak Campus Federal Research Center, Silver Spring, MD
| | - Laura Edison
- Laura Edison, DVM, is in the Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness Response; and Clive Brown, MD, is Chief, Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch; both at the Centers for Disease Control and Prevention, Atlanta, GA
| | - Clive Brown
- Laura Edison, DVM, is in the Career Epidemiology Field Officer Program, Division of State and Local Readiness, Center for Preparedness Response; and Clive Brown, MD, is Chief, Division of Global Migration and Quarantine, Quarantine and Border Health Services Branch; both at the Centers for Disease Control and Prevention, Atlanta, GA
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Cáceres VM, Goodell J, Shaffner J, Turner A, Jacobs-Wingo J, Koirala S, Molina M, Leidig R, Celaya M, McGinnis Pilote K, Garrett-Cherry T, Carney J, Johnson K, Daley WR. Centers for Disease Control and Prevention's Temporary Epidemiology Field Assignee program: Supporting state and local preparedness in the wake of Ebola. SAGE Open Med 2019; 7:2050312119850726. [PMID: 31205697 PMCID: PMC6537056 DOI: 10.1177/2050312119850726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 04/22/2019] [Indexed: 11/17/2022] Open
Abstract
Objectives: The Centers for Disease Control and Prevention launched the Temporary Epidemiology Field Assignee (TEFA) Program to help state and local jurisdictions respond to the risk of Ebola virus importation during the 2014–2016 Ebola Outbreak in West Africa. We describe steps taken to launch the 2-year program, its outcomes and lessons learned. Methods: State and local health departments submitted proposals for a TEFA to strengthen local capacity in four key public health preparedness areas: 1) epidemiology and surveillance, 2) health systems preparedness, 3) health communications, and 4) incident management. TEFAs and jurisdictions were selected through a competitive process. Descriptions of TEFA activities in their quarterly reports were reviewed to select illustrative examples for each preparedness area. Results: Eleven TEFAs began in the fall of 2015, assigned to 7 states, 2 cities, 1 county and the District of Columbia. TEFAs strengthened epidemiologic capacity, investigating routine and major outbreaks in addition to implementing event-based and syndromic surveillance systems. They supported improvements in health communications, strengthened healthcare coalitions, and enhanced collaboration between local epidemiology and emergency preparedness units. Several TEFAs deployed to United States territories for the 2016 Zika Outbreak response. Conclusion: TEFAs made important contributions to their jurisdictions’ preparedness. We believe the TEFA model can be a significant component of a national strategy for surging state and local capacity in future high-consequence events.
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Affiliation(s)
- Victor M Cáceres
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jessica Goodell
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julie Shaffner
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alezandria Turner
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jasmine Jacobs-Wingo
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samir Koirala
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Monica Molina
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robynn Leidig
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martín Celaya
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kara McGinnis Pilote
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tiana Garrett-Cherry
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jhetari Carney
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kym Johnson
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - W Randolph Daley
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
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