Abstract
The inextricable link between infectious disease preparedness and healthcare continues on full display as we move through the third year of the COVID-19 pandemic. At the forefront of this link are the organizations, hospitals, and health systems that have built infectious disease preparedness and response into the fabric of their day-to-day activities. In 2015, during the height of the West Africa Ebola outbreak of 2014-2016, the US Department of Health and Human Services established a 4-tiered structure for response to special pathogen diseases across the United States. 1 This structure forms an intricate fabric of healthcare facilities that have the ability to diagnose and care for patients with potential or confirmed special pathogens. 2 This fabric has created a nationwide system of readiness, ready to act at the earliest signs of an emerging infectious disease outbreak. Its growth will allow healthcare systems time to make capacity expansion plans, create networks of researchers ready to stand up novel clinical trials, and provide training and education on the personal protective equipment that have become a ubiquitous part of our lives. This network, led by the National Emerging Special Pathogens Training and Education Center (NETEC), with Regional Emerging Special Pathogens Treatment Centers (RESPTCs) in each US Department of Health and Human Services region of the country, has built and maintained a state of readiness since 2015 (Figure). 3
US Regional Emerging Special Pathogens Treatment Centers. Abbreviation: HHS, US Department of Health and Human Services.
While NETEC and RESPTCs maintained a state of readiness, the COVID-19 pandemic has exposed the far broader reaching impacts of a healthcare system unprepared for major special pathogen outbreaks. As evidenced by the ongoing pandemic, special pathogen outbreaks can have consequences on all facets of society—devastating loss of life, crippling economic ramifications, and a disproportionate impact on traditionally underserved communities. As leaders of NETEC, it is our view that the nation cannot build back long-term stability if we do not strengthen the healthcare systems that underlie special pathogen preparedness and response and protect the health of millions of Americans every day. This call for strengthened special pathogen systems of care has happened as recently as 2018, just 1 year before the onset of the COVID-19 pandemic. We must maintain our structures of preparedness even when not in the midst or immediate wake of an emergency. Building back resilient healthcare systems, with strong emerging infectious disease preparedness and response capabilities, is critical as we look with hope to a post-COVID-19 world.
As of May 4, 2022, more than 81.5 million cases and just under 1 million deaths of COVID-19 had been reported in the United States. 4 Many states across the country are having historic case counts even as more and more people are vaccinated and boosted every day. Hospitals and health systems have made extraordinary contributions to the fight against a disease that was unknown less than 2.5 years ago. Many of these contributions have come from RESPTCs, which have been instrumental in the COVID-19 response in a variety of ways. From isolating the first patients with COVID-19, rapidly conducting clinical research on COVID-19 therapeutics, and translating emerging science for rapid optimization of patient care and healthcare worker safety strategies, RESPTCs have been at the forefront of the US response to the pandemic.
This supplement is a collection of papers that highlight the work of NETEC and the national network of RESPTCs from the earliest days of the COVID-19 pandemic. It is the story of how RESPTCs made incredible efforts toward special pathogen education and training preparedness that buttressed the US healthcare system's operational response and clinical research capabilities. These papers underscore how sustained RESPTC operations through the COVID-19 pandemic will contribute to the changing landscape of pandemic preparedness and response, globally. This collection provides a vision for the future—where a stronger, more integrated, special pathogen system of care will improve the nation's response in anticipation of the next high-consequence infectious disease outbreak.
Footnotes
Acknowledgments
We are immensely grateful to the healthcare workers across the globe and most especially to the staff and faculty at NETEC and RESPTCs who have given so much of their lives and livelihoods to respond to this pandemic and all of the other needs of their patients and communities that do not disappear simply because there is a global emergency. We are thankful for the opportunity to care for and support the patients and families affected by COVID-19 and for all of the patients who have participated in research to help us fight the pandemic. We are also grateful to all of the public health leaders around the world and in our own back yards, building and maintaining public health infrastructure that keeps our communities safe even during times of adversity. The work of preparedness is an unbelievably challenging and often times a thankless job, and we thank colleagues at the Office of the Assistant Secretary for Preparedness and Response and the US Centers for Disease Control and Prevention who we continue to learn so much about health system preparedness and response from, especially the tireless Dr. Rick Hunt. We are exceptionally thankful to Dr. Eric Toner and Ms. Diane Meyer, our co-guest editors, for their input and support in conceptualizing this special issue of Health Security; to the NETEC Quality Committee members, Dr. Laura Evans and Dr. Chris Kratochvil; and, above all, the journal's managing editor, Ms. Kathleen Fox, and the Special Pathogens Research Network Program Manager, Ms. Rachel Prudhomme, for their unending support in making this supplement a reality. This special issue was supported by the Office of the Assistant Secretary for Preparedness and Response contracts 6U3REP150549-05-14, 4UREP150549-05-12, 6U3REP150549-05-03, 6U3REP150549-05-08, and 6U3REP170552-04-05.