The COVID-19 Pandemic: Priorities for Preparedness, Persistence and Prevention

By Kelly M. Pyrek

Editor’s note: We present a round-up of the latest information about COVID-19 at the time of publication in early April 2020.

The superpower status of the United States may not be reflected in its historic suboptimal levels of readiness and preparedness, which have not been addressed despite several additional outbreaks since the 2003 SARs pandemic – the so-called ‘dress rehearsal’ for the current COVID-19 pandemic.

That year, the General Accounting Office (GAO) released a report summarizing its findings after Congress directed it to examine the preparedness of state and local public health agencies and hospitals for responding to a large-scale infectious disease outbreak and the relationship of federal and state planning for an influenza pandemic to preparedness for emerging infectious diseases.

The GAO found that gaps in disease surveillance systems and laboratory facilities and that there were workforce shortages. As the report observes, “The level of preparedness varied across seven cities GAO visited, with jurisdictions that have had multiple prior experiences with public health emergencies being generally more prepared than others. GAO found that planning for regional coordination was lacking between states. GAO also found that states were developing plans for receiving and distributing medical supplies for emergencies and for mass vaccinations in the event of a public health emergency.”

The report continued, “GAO found that most hospitals lack the capacity to respond to large-scale infectious disease outbreaks. Most emergency departments have experienced some degree of crowding and therefore in some cases may not be able to handle a large influx of patients during a potential SARS or other infectious disease outbreak. Most hospitals across the country reported participating in basic planning activities for such outbreaks; however, few hospitals have adequate medical equipment, such as the ventilators that are often needed for respiratory infections such as SARS, to handle the large increases in the number of patients that may result. “

The GAO recommended that the public health response to outbreaks of emerging infectious diseases such as SARS could be improved by the completion of federal and state influenza pandemic response plans that address problems related to the purchase, distribution, and administration of supplies of vaccines and antiviral drugs during an outbreak.  As healthcare sector entities scramble in month three of the COVID-19 outbreak, the question is, aren’t healthcare systems better prepared?

As Janet Heinrich then-director of healthcare/public health issues for the GAO, observed, “…while the efforts of public health agencies and health care organizations to increase their preparedness for major public health threats such as influenza pandemics and bioterrorism have improved the nation’s capacity to respond to SARS and other emerging infectious disease outbreaks, gaps in preparedness remain. Specifically, we found that there are gaps in disease surveillance systems and laboratory facilities and that there are workforce shortages. The level of preparedness varied across cities we visited, with jurisdictions that have had multiple prior experiences with public health emergencies being generally more prepared than others. We found that planning for regional coordination was lacking between states. We also found that states were developing plans for receiving and distributing medical supplies for emergencies and for mass vaccinations in the event of a public health emergency. We found that most hospitals across the country lack the capacity to respond to large-scale infectious disease outbreaks. Most emergency departments have experienced some degree of crowding and therefore in some cases may not be able to handle a large influx of patients during a potential SARS or other infectious disease outbreak. Although most hospitals report participating in basic planning activities for such outbreaks, few have adequate medical equipment, such as ventilators that are often needed for respiratory infections such as SARS, to handle the large increases in the number of patients that may result.”

Read further from the April 2020 issue HERE