Monday, December 30, 2019

Trump's wall will not stop a pandemic - Congress needs to fund the special pathogen network.

Earlier this month I blogged about how Trump ‘keeps topping’ science fiction author William Gibson. The present keeps getting stranger and stranger. I included “an excerpt from the recently published The Second Sleep: A novel by Robert Harris.”

The novel is set in a seemingly slightly post-medieval Britain. The central character is a priest who has discovered an ancient manuscript. The author of that manuscript belonged to a group of ancients who contemplate a post-apocalyptical world.

We have broadly identified six possible catastrophic scenarios that fundamentally threaten the existence of our advanced science-based way of life …

Among them was “A pandemic resistant to antibiotics.”

It’s no longer in the realm of science fiction. The thing is we may have the technological and medical means to prevent such a pandemic but lack the societal - -and particularly the political – will to prevent it.

At the Washington Post, Ronald A. Klain and Syra Madad warn us that A program protecting us from deadly pandemic is about to expire.

Five years ago, a man walked into a Dallas emergency room and became the first person diagnosed with Ebola in the United States. Suddenly, the nation was confronted with a rare, deadly and infectious disease whose containment required special procedures, training and equipment. When two nurses at that hospital got infected, the real scramble to respond began.

Three weeks later, the Obama administration proposed — and shortly thereafter, a bipartisan majority in Congress approved and funded — a major program to equip facilities and train staff on the front lines of our health-care system. As a result, when the United States confronts another challenge like the Ebola threat of 2014 — as it inevitably will — we will be prepared to quickly identify infected people, isolate them and provide them with care.

Unfortunately, this program expires in May 2020, and there is no indication that Congress intends to fully renew it. Without such continued funding, training will cease, specialized facilities will be shut down, and — as staff members move on to other jobs and opportunities — all Americans will be at greater risk.

The plan that the government put in place … had four tiers. First, most health-care facilities around the country were prepared to identify patients who might have a dangerous infectious disease like Ebola and refer them for testing. Second, in almost every major city, at least one “assessment center” was established to accept and test suspected cases. Third, more than 60 treatment facilities for Ebola and similar diseases were set up within existing hospitals from coast to coast, to treat patients with such a diagnosis. And at the apex of the system, 10 Ebola & Other Special Pathogen Treatment Regional Centers were established to handle the hardest cases.

Right now, Congress is considering funding for these most advanced facilities, but not the full network that protects our country. If it does not renew this entire program in the next five months, the system will begin to disintegrate. Equipment will get out of date or be cannibalized for other purposes. Drills and simulations will cease. We will return to nearly the state of unpreparedness that we had five years ago.

That would be disastrous.

Why? Because the day will come when a dangerous pathogen will arrive in the United States once again. …

Just as it takes only one patient to cause an outbreak, so too does it take only one unprepared health-care facility, in one city in the United States, to serve as an incubator for the spread of such a disease. We are only as strong as our weakest link.

Failure to act would be penny-wise but pound-foolish. The cost of keeping up the trained, equipped and prepared facilities is far less than the hundreds of millions of dollars it cost to start almost from scratch as we did in 2014. …

We do not know when the next dangerous pathogen will arrive in our country, or when a patient with such a disease will require isolation and treatment. We do not know where such an event will occur. But we do know that it will happen — sooner or later.

Congress should renew the entire treatment network for Ebola and other special pathogens, and fund it for another five years. We have already invested the time and money to be prepared for this eventuality. It will be a health-care and economic catastrophe if we squander that capacity now.

We are looking at the possibility of a pandemic like Ebola that is caused not by our technological sophistication, as contemplated by Harris in The Second Sleep, but by our collective political failure to act. Perhaps someone can make the case to Congress that funding Trump’s wall will not stop a pandemic.

Ronald A. Klain was the White House Ebola response coordinator in 2014–2015 and is an adviser to Joe Biden’s 2020 presidential campaign. Syra Madad is the senior director for the System-wide Special Pathogens Program for New York City Health + Hospitals.

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