Search

High-level isolation units (HLIUs) have been established by countries to provide safe and optimal medical care for patients with high-consequence infectious diseases. We aimed to identify global high-level isolation capabilities and determine gaps and priorities of global HLIUs, using a multiple method approach that included a systematic review of published and gray literature and a review of Joint External Evaluations and Global Health Security Index reports from 112 countries. A follow-up electronic survey was distributed to identified HLIUs. The landscape analysis found 44 previously designated/self-described HLIUs in 19 countries. An additional 33 countries had potential HLIUs; however, there were not enough details on capabilities to determine if they fit the HLIU definition. An electronic survey was distributed to 36 HLIUs to validate landscape analysis findings and to understand challenges, best practices, and priorities for increased networking with a global HLIU cohort; 31 (86%) HLIUs responded. Responses revealed an additional 30 confirmed HLIUs that were not identified in the landscape analysis. To our knowledge, this was the first mapping and the largest ever survey of global HLIUs. Survey findings identified major gaps in visibility of HLIUs: while our landscape analysis initially identified 44 units, the survey unveiled an additional 30 HLIUs that had not been previously identified or confirmed. The lack of formalized regional or global coordinating organizations exacerbates these visibility gaps. The unique characteristics and capabilities of these facilities, coupled with the likelihood these units serve as core components of national health security plans, provides an opportunity for increased connection and networking to advance the field of high-level isolation and address identified gaps in coordination, build an evidence base for HLIU approaches, and inform HLIU definitions and key components. [ABSTRACT FROM AUTHOR]

The article discusses the importance of international collaboration and preparedness in managing infectious diseases and health emergencies. It focuses on the Infectious Disease Emergency Specialist (IDES) training program in Japan, which was established after the Ebola outbreak in West Africa. The IDES program provides comprehensive training to Japanese physicians in responding to health emergencies, including a second-year international training component. The article also highlights the National Emerging Special Pathogens Training and Education Center (NETEC) in the United States as a model for collaboration and coordination in managing infectious diseases. The collaboration between NETEC and IDES has facilitated knowledge exchange and best practices in handling special pathogens and has contributed to Japan's readiness for future health crises. The article emphasizes the importance of international cooperation and the establishment of robust healthcare networks to strengthen global health security. [Extracted from the article]

A high-level isolation unit (HLIU) is a specially designed biocontainment unit for suspected or confirmed high-consequence infectious diseases. For most HLIUs, maintaining readiness during times of inactivity is a challenge. In this case study, we describe a checklist approach to assess HLIU readiness to rapidly operate upon activation. This checklist includes readiness criteria in several domains, such as infrastructure, human resources, and material supplies, that are required to safely activate the unit at any time. The checklist audit tool was derived from a novel activation readiness checklist published by the biocontainment unit at The Johns Hopkins Hospital in Baltimore, Maryland. It was then adapted for the Irish healthcare setting and implemented at the Mater Misericordiae University Hospital, Ireland's current isolation facility. Results from the audit were also used to inform recommendations for the construction of a new HLIU to open in 2025. The audit tool is user friendly, practical, and focuses on the essential elements of readiness to ensure a successful rapid operation. [ABSTRACT FROM AUTHOR]

In recent history, outbreaks of high-consequence infectious diseases (HCIDs) have raised health security concerns among the global community. As HCIDs continue to emerge, public health systems around the world experience the burden of implementing adequate preparedness and response measures to ensure the safety and security of their populations. HCID outbreak response efforts have highlighted the need for specialized training in safety and infection prevention and control for frontline workers who may encounter ill patients. The COVID-19 Mission Prep program for National Disaster Medical System personnel and the Deployment Safety Academy for Field Experiences (D-SAFE) program for US Public Health Service officers are 2 examples of virtual training programs that successfully provided foundational education on infection prevention and control and safety as well as deployable just-in-time training during HCID outbreak response efforts. The methods used to develop these training programs can be adopted by other countries to enhance the global outbreak response infrastructure for the next HCID event. The global outbreak response infrastructure demands investments in training as a preparedness measure, which will ultimately lead to safer, more coordinated outbreak response efforts with competent responders. [ABSTRACT FROM AUTHOR]

The meatpacking industry has faced significant challenges in maintaining a safe and healthy working environment for its employees during the COVID-19 pandemic, which has resulted in worker illness and death, temporary closures of facilities, reductions in production capacity, and consequences throughout the supply chain. We sought to explore the concerns and perceptions of COVID-19 among meatpacking workers in the Midwestern part of the U.S. We conducted an online survey of meatpacking workers in Nebraska, Iowa, Kansas, and Missouri between May 7 and 25, 2020. A total of 585 workers participated (M = 41.3 years, SD = 10.3). More than 72% of workers believed that they were at 'high risk' for contracting COVID-19, but less than one half had been tested (42%). Most workers (83%) reported that their employer had instituted some safety measures, but less than one half reported physical distancing on the line (39%), slowing down the line (34%), additional paid time off (28%), or restructuring of shifts (20%). Enforceable standards are needed in the meatpacking industry to reduce COVID-19 transmission. Culturally and linguistically tailored education, paid sick leave, and restructuring of work can reduce the risks of COVID-19 transmission. Transparency on workplace transmission rates is essential to developing strategies to mitigate occupational risks and foster worker trust., Introduction The meat processing (meatpacking) industry has faced significant challenges in maintaining a safe and healthy working environment for its employees. The culture within these plants prioritizes production (Ramos et [...]

In the early months of the coronavirus disease (COVID-19) pandemic, meat processing facilities became among the largest epicenters of COVID-19 outbreaks in the United States (1). Declared a critical infrastructure [...]

The article discusses the importance of high-level isolation units (HLIUs) in managing high-consequence infectious diseases (HCIDs). HLIUs are specialized facilities equipped with advanced infrastructure and highly trained staff to provide optimal care for HCID patients while minimizing risks to healthcare workers. HLIUs have played a crucial role in managing outbreaks of novel pathogens, such as COVID-19. However, HLIUs face challenges in recruiting and retaining staff and securing funding for operational readiness. The article emphasizes the need for global collaboration and research to address these challenges and improve high-level isolation practices. The special issue provides insights from HLIUs in different countries and regions, highlighting the importance of sharing experiences and establishing relationships to enhance HCID management. [Extracted from the article]

In 2014, a tiered network of facilities to manage patients with Ebola virus disease (EVD) was established in the United States (1). The Centers for Disease Control and Prevention designated [...]

During the 2014-2016 West Africa Ebola virus disease (EVD) outbreak, 56 hospitals in the United States were designated by the Centers for Disease Control and Prevention as Ebola treatment centers [...]

A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing. The Global Center for Health Security established an ethics advisory committee to support COVID-19 response efforts. The ethics advisory committee supported the development of guidance on infection prevention and control to promote justice, reciprocity, health, safety, and equity for workers in the meat processing industry. Our experience highlighted the fundamental role of ethical analysis in public health response efforts, but ethical analysis in this case required an interdisciplinary approach, including the need for effective community-relevant solutions. The integration of an ethics committee into public health emergency response efforts can address ethical concerns for workers in industries that must remain operational during public health emergencies. [ABSTRACT FROM AUTHOR]

To the Editor: The 2014-2015 outbreak of Ebola virus disease (EVD) in West Africa was unprecedented in scale and scope. During the outbreak, 11 patients with EVD were cared for [...]

During a highly hazardous communicable diseases (HHCD) outbreak, most patients are likely to be treated within the affected region. However, circumstances exist for which aeromedical evacuation high-level containment transport (AE-HLCT) [...]

Emerging infectious disease epidemics require a rapid response from health systems; however, evidence-based consensus guidelines are generally absent early in the course of events. Formed in 2017 by 5 high-level isolation units spanning 3 continents, the experience of the Global Infectious Disease Preparedness Network (GIDPN) early in the course of coronavirus disease 2019 (COVID-19) provides a model for accelerating best practice development and improving decision-making in health emergencies. The network served as a platform for real-time, open and transparent information-sharing during unknowns of an active outbreak by clinicians caring for patients, by researchers conducting clinical trials and transmission and infection prevention studies, and by teams advising local and national policy makers. Shared knowledge led to earlier adoption of some treatment modalities as compared to most peer institutions and to implementation of protocols prior to incorporation into national guidelines. GIDPN and similar networks are integral in enhancing preparedness for and response to future epidemics/pandemics. [ABSTRACT FROM AUTHOR]