The Senate Committee on Homeland Security and Government Affairs’ roundtable yesterday highlighted the challenges faced by epidemiologists in hospitals and public health, who are working to contain the outbreak of novel coronavirus (COVID-19), treat patients, protect the healthcare environment, and track down exposures and cases of mild and moderate infection that are capable of spreading. These on-the-ground efforts to stop the spread and protect all of us are at risk of being undermined by several factors: inconsistent federal funding for preparedness and response, incomplete investment in development of vaccines, inadequate funding to spur development of anti-infectives for drug-resistant pathogens, and complacency in the aftermath of a crisis.
The Society for Healthcare Epidemiology of America (SHEA) agrees with the urgent need expressed by Dr. Julie Gerberding, former Director of CDC, to move away from “herky-jerky” and “reactionary” funding, which weakens efforts of those responsible for preparing for and stopping infectious diseases threats. Unpredictable funding forces scaling back of critical prevention efforts – from vaccine development to effective communication from the federal to local workforce – resulting in a cycle of “complacency, crisis, complacency, crisis.” The Government Accountability Office’s Nikki Clowers voiced her concern over the U.S.’ pattern of pulling funding from preparedness when the crisis no longer seems as urgent, and then pulling from routine care to ramp it up again, with timing that does not adequately support either type of effort.
In addition to the emergence of new pathogens like COVID-19, which have the ability to spread quickly with high mortality, Dr. Gerberding spoke about the shortage of effective antibiotics to treat antibiotic-resistant secondary infections that often prove deadly to these patients. She described the market failure to encourage development of the antibiotic pipeline while multidrug-resistant organisms become increasingly common. Pharmaceutical companies have little incentive to invest in the development of these drugs, which yield little to no profit.
Likewise, the experience with the SARS-CoV outbreak demonstrates the weaknesses in following through on vaccine development. A vaccine for SARS-CoV that showed promise was shelved after funding was withdrawn when the initial outbreak tapered off. Had funding been sustained through completion, we would have a vaccine ready in our National Stockpile.
Finally, the expert witnesses all emphasized that activity needs to be sustained, as the arrival of warmer weather provides no guarantee that cases will decline. Singapore is seeing community spread, despite warm weather. Additionally, COVID-19 causes lower respiratory disease, rather than infection in the upper respiratory tract most common in cold and flu season. All the witnesses expressed reluctance to pin hopes on a reprieve in spring.
Sustained federal investments during and between infectious disease outbreaks allow public health professionals, healthcare epidemiologists, and their teams to prepare for surge capacity, as well as engage in routine preparedness. Through continuous support, clinicians can maintain a constant state of readiness and our federal systems can move to a proactive model of supporting these efforts to ensure preparedness.
The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society’s work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at www.shea-online.org, www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.
Contact: Tamara Moore | 202-868-4008 | firstname.lastname@example.org
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