24 �e Costco Connection JANUARY 2015

INFORMEDdebate

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Is the United Statesadequately preparedfor contagious diseases?CONTAGIOUS DISEASES LIKE Ebola have people concerned. But many are, nevertheless, confident in America’s ability toact quickly, effectively and humanely in controlling the spread of disease and caring for those who may become afflicted. However, others point out weaknesses in our health-care system that need immediate correcting.

What do you think? 

Find out more about this topic on the Web:• cdc.gov/ebola• osha.gov/SLTC/ebola/• aha.org/advocacy-issues/emergreadiness/ebola• dash.harvard.edu/handle/1/8852098

Find out more about this topic on the Web:

24 �e Costco Connection JANUARY 2015

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Lawrence HarrisI will never worry about being

infected with the Ebola virus because all my treatment comes from the

Veterans Administration. I feel that should be adaquate enough to determine if I am infected should I feel ill.

Daniel RouseI think there should be federal

guidelines governing all 50 states for how to deal with [conta-gious diseases].

Douglas Handley There were missteps by the

hospital in Dallas, the Texas Board of Health and the CDC early on with Ebola.

It appears that it is under control here. With the growing interna-tional response, it is getting better in Africa.

Clifton HangerLook how overwhelmed a

hospital was when they had only one Ebola case. Now imagine 50.

Lisa AnnApparently so, we’re healing

them, aren’t we? America has the fin-est scientists and physicians of any

other country. Get a grip, people!

Pam NateNot as long as we have nurses

and other health-care people who think they are above the rules and put

themselves above the healthof the public.

JANUARY 2015 �e Costco Connection 25

YES

NO

Opinions expressed are those of the individuals or organizations represented and are presented to foster discussion. Costco and The Costco Connection take no position on any Debate topic.

DECEMBERDEBATE RESULTS:Should airlines banseat-reclining onshorter flights?

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67% YES33% NO

Dr. Amesh Adalja is a member the Public Health Committee, Infectious Diseases Society of America (idsociety.org).

Jean Ross is an acute-care nurse and co-president of National Nurses United (nationalnursesunited.org).

JANUARY 2015 �e Costco Connection 25

AS A REGISTEREDnurse, I have taken care of patients with infectious life-threatening viruses, from tuberculosis and HIV to hepatitis and H1N1 [swine flu]. Now there is Ebola, a virus with

a frighteningly high mortality rate and no cure.The exposure of nurses and others to the

virus in a Dallas hospital last year illustrates the clear and present danger to the front-line caregivers and ultimately to the public that this virus poses.

Our nation’s response to Ebola exposes the broader problem: the reality of a fragmented, uncoordinated private health-care system that puts profit margins ahead of public and care-giver safety, including access to protective equipment.

Amber Vinson, one of the nurses who contracted Ebola while treating patient Thomas Eric Duncan, is a case in point. She received little training from her hospital, and the first time she put on the personal protec-tive equipment, which left her neck exposed, was when she was heading in to take care of the patient.

Sadly, Dallas is not unique. According to an overwhelming majority of nurses surveyed by

National Nurses United at facilities across the United States, many hospitals are unprepared: Eighty-four percent of nurses say they haven’t been adequately trained.

While other countries—notably Canada, which took action after its vulnerabilities were exposed by the 2003 SARS (severe acute respi-ratory syndrome) epidemic—have empowered their public health agencies to coordinate local, provincial and federal detection and response efforts for pandemics, the U.S. cut funding. Funding for public health preparedness and response activities was $1 billion less in fiscal 2013 than in 2002.

We look to the Centers for Disease Control and Prevention (CDC) for guidance, but the CDC, whose budget was cut by 20 percent in recent years, is not a regulatory agency. It has no authority to compel hospitals to comply with any guidelines.

Congress and the White House must mandate that all hospitals meet optimal, uni-form, national standards of equipment, such as hazmat suits, and training in order to safely protect patients, health-care workers and the public.

We all count on nurses to be there for us when we’re at our sickest and most vulnerable. It’s everyone’s problem if nurses are not pro-tected. C

THE UNITED STATES,despite well-publicized missteps that occurred with the Ebola patient in Dallas, is well prepared for contagious disease outbreaks.

A big thrust of pre-paredness came in more recent years and was prompted by two events: the anthrax attacks in 2001 and the threat of a new influenza pan-demic. The anthrax attacks, in which 22 people were deliberately infected, exposed vulnerabili-ties and prompted a renewed interest in pre-paredness. Public health emergency prepared- ness and hospital preparedness were signifi-cantly augmented. Additionally, research into certain pathogens, which heretofore had attracted little to no interest, was spurred.

Cities began to prepare to mass-dispense medications and vaccines should the need arise. The Strategic National Stockpile, which ware-houses essential medications and vaccines, was developed, and a whole new branch of the Department of Health and Human Services, led by the Assistant Secretary for Preparedness and Response, was created. In the name of bio-terrorism preparedness, the nation became more prepared for all hazards.

Soon after the anthrax attacks, avian influ-enza cases accruing in Asia highlighted the per-petual threat of pandemic influenza. Many felt this threat was the most likely to occur. Influenza preparedness is multifaceted and requires coor-dination of many elements, such as vaccine pro-duction, surveillance, hospital preparedness and antiviral-medication stockpiling.

Preparedness for influenza even stretched to chicken farms—a vital asset, as most of our influenza vaccines are chicken-egg-based—to ensure robust year-round flock numbers. New domestic vaccine plants to supplant chicken-egg-based vaccines also were constructed.

It can’t be denied that there are shortcom-ings in our preparedness. Many local health departments do not have adequate resources to devote to infectious diseases, as their missions have morphed to handle myriad noninfectious disease problems that divert scarce resources from what was once their primary purpose.

The threat of infectious diseases will not abate, and preparedness at all levels remains paramount. The current Ebola outbreak under-scores this fact and, though stressing our sys-tem, will ultimately show just how inhospitable the U.S. is to this virus, given the foresight reflected in our prior preparations coupled with the resiliency of our nation. C

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