U.S. Hospitals Not Prepared To Deal With Ebola

Hospitals are not fully prepared to handle waste from Ebola and other deadly viruses on-site, according to the Healthcare Coalition for Emergency Preparedness.

Hospitals in the U.S. have been instructed to ramp up their preparedness plans, but many of these facilities still aren’t able to sterilize medical waste from Ebola or other deadly diseases on site, according to the Healthcare Coalition for Emergency Preparedness.

medical waste disposal
(Photo: Adobe Stock by Robert Kneschke)

Late last month, the U.S. Department of Health and Human Services’ (HHS) Administration for Strategic Preparedness and Response (ASPR) awarded $21 million to 13 healthcare facilities to serve as leading providers of care within their regions to sustain and improve healthcare system preparedness for emerging special pathogens.

“New or emerging special pathogens are a significant threat to the nation’s health, economy, and national security. Our responses to Ebola, COVID-19, and Monkeypox have highlighted a need to increase our readiness to respond to these threats,” said  ASPR Assistant Secretary Dawn O’Connell. “We are taking this critical step to award new funding to our regional healthcare partners to strengthen the capabilities of their special pathogen programs and make our healthcare system better prepared to respond to these infectious diseases.”

The awards will help integrate clinical and healthcare systems’ operational expertise into existing preparedness and response structures at the regional, state, jurisdiction, and local levels. These healthcare facilities will be better prepared for medical surge capacity and to respond to and treat infectious diseases caused by special pathogens during public health and medical emergencies.

Regional Emerging Special Pathogen Treatment Centers (RESPTCs) are hospitals with enhanced capability and capacity to care for highly infectious diseases, such as Ebola or COVID-19, and serve as regional hubs for the National Special Pathogen System. These hospitals are continuously ready and available to care for a special pathogen patient medically evacuated from overseas or diagnosed within the U.Ss.

ASPR selected three new healthcare facilities to serve as RESPTCs, providing $3 million each to Washington Hospital Center, Washington, DC; University of North Carolina at Chapel Hill, Chapel Hill, NC; and Spectrum Health System, Grand Rapids, MI. In addition, ASPR awarded funding to the 10 existing RESPTCs, providing $1.2 million each to:

  • Massachusetts General Hospital, Boston, MA
  • New York City Health and Hospitals Corporation/HHC Bellevue Hospital Center, New York, NY
  • Johns Hopkins Hospital, Baltimore, MD
  • Emory University Hospital and Children’s Healthcare of Atlanta/Egleston Children’s Hospital, Atlanta, GA
  • University of Minnesota Medical Center, Minneapolis, MN
  • University of Texas Medical Branch at Galveston, Galveston, TX
  • Nebraska Medical Center, Omaha, NE
  • Denver Health & Hospital Authority, Denver, CO
  • Cedars-Sinai Medical Center, Los Angeles, CA
  • Providence Sacred Heart Medical Center and Children’s Hospital, Spokane, WA

Treating Medical Waste Waste On-Site

Five of these 13 special pathogen centers are not prepared to treat such waste on-site, according to the Healthcare Coalition for Emergency Preparedness. Overall, most large hospitals lack on-site treatment capability, even after CDC Chief Dr. Frieden told Congress in 2015 that “Funding will go to hospitals to strengthen their waste management systems…Where we are supporting hospitals to deal with Ebola, we would want that done onsite.”

“New or emerging special pathogens are a significant threat to the nation’s health, economy, and national security. Our responses to Ebola, COVID-19, and Monkeypox have highlighted a need to increase our readiness to respond to these threats.”

ASPR Assistant Secretary Dawn O’Connell

One of the greatest challenges hospitals faced during the last Ebola outbreak was handling waste. According to the U.S. Department of Transportation (USDOT), Ebola waste is classified as Category A, which is “an infectious substance in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to it occurs.”

Recently, a hospital in the Pacific Northwest ran a table-top exercise to handle an Ebola patient. It found no local Regulated Medical Waste (RMW) transportation service provider to dispose of Category A waste, and the nearest available hauler was more than 1,000 miles away. It would have cost the facility nearly $100,000 per day to dispose of the Ebola waste from just one patient.

“The federal government needs to ensure that Ebola/Special Pathogen Centers have the ability to safely treat such waste on-site to protect workers and communities from exposure to the virus and mitigate the enormous costs of sending the waste off-site for treatment,” said Darrell Henry, Senior Advisor to the Healthcare Coalition for Emergency Preparedness. “With reports of 140 people arriving in the United States from Uganda daily, we know that an outbreak in the U.S. is only a plane flight away.

“Federal Agencies, including CDC, HHS, OSHA, and USDOT, suggest that Ebola/special pathogen waste be sterilized on-site at the hospital to minimize the public threat,” added Henry. “We also can’t overlook the need to deploy on-site sterilization technologies to Veterans Administration Medical Centers, which, per the VA’s own analysis, would save the federal government millions of dollars in every day operating costs.”

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As recently as 30 years ago, most hospitals had on-site technology (incineration) to destroy any contagious waste, but that was discontinued due to EPA regulations to reduce toxic emissions. Today, just 20% of hospitals have on-site technology, mostly large steam autoclaves. While most outsource the treatment of medical waste, nearly all of the top ranked medical institutions— including Hopkins, Stanford, Cleveland Clinic, Mayo, UCLA, and others — utilize on-site sterilization technology, according to the Coalition.

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