P3A218: Beyond Ebola and COVID-19: Transitioning to a High-risk Pathogen Response Plan

Background: The Ebola outbreak of 2014/2015 spurred the rapid development of emergency preparedness and response plans for hospitals nationwide. In addition, the COVID-19 pandemic prompted rapid establishment of protocols to identify and treat patients as well as ensure adequate protection for staff. As globalization and climate change continue to expose humans to known and unknown high-risk pathogens, hospitals must establish a flexible response plan that emphasizes rapid identification and treatment of potentially infected patients as well as staff protection.

Methods: During the 2014 Ebola outbreak, Children’s National Hospital (CNH) was designated as a National Ebola Treatment Center, one of 35 hospitals in the nation. In 2022, CNH was named a Regional Emerging Special Pathogen Treatment Center as the pediatric partner with Washington Hospital Center (WHC) through funding from the U.S. Department of Health and Human Services' (HHS) Administration for Strategic Preparedness and Response (ASPR). Building on our hospital’s prior response plans for Ebola and COVID-19, our team created a new “High-Risk Pathogen” plan incorporating a wide variety of divisions, including Emergency Medicine, Infectious Diseases, Intensive Care Services, Laboratory, Social Work, Environmental Services, Nutrition, Security, Pre-Hospital/Transport and Telemedicine. In addition, we formed a partnership with WHC , collaborating on family centered care as well as sharing protocols and best practices. We streamlined testing protocols with our local Department of Health to ensure efficient identification of high-risk pathogens and will perform outreach to regional partners and hospitals.

Results: The newly formed CHiRP (Children’s High Risk Pathogens) group established a new high-risk pathogens response plan, led by a multidisciplinary team that allows for rapid response to potential suspect cases. The plan includes a rapid notification system for the team with immediate establishment of an online virtual command center, enabling all involved divisions to be updated in real time and to provide input in a collaborative fashion. New innovations include the expansion of telemedicine capabilities, which decreases potential staff exposures while allowing for enhanced communication for a patient in isolation. We plan to test our plan in tabletop drills to ensure hospital readiness.

Conclusion: Building on established hospital preparedness plans for both Ebola and COVID-19 as well as the collaborations formed during these crises, hospitals can leverage this existing effort to create a more flexible, “all high-risk pathogen” approach that can be rapidly modified based on the current outbreak scenario. Other hospitals should consider the same approach to develop their own infectious disease disaster plans. We all need to be prepared for when, not if, another outbreak occurs.