Health Sector Resilience Checklist for High Consequence Infectious Diseases

"Patients with Ebola Virus Disease (EVD) were treated in five US communities during the 2014- 2016 epidemic in West Africa. Many more US communities were involved in monitoring travelers from affected countries and other individuals with various levels of possible Ebolavirus exposure. In some cases, these monitored individuals required medical care necessitating the implementation of precautions similar to those needed for actual EVD patients. Extraordinary measures were required to respond to these patients (whether actually or just potentially infected with Ebolavirus) and the potential public health threat that they posed. There are important lessons to be learned from the lived experience of individuals who were involved in the response to patients with confirmed and potential EVD in the United States, and communities that face high-consequence infectious disease (HCID) events in the future would benefit from awareness of those lessons. To that end, the purpose of this project was to develop an evidence-informed checklist that outlines action steps for medical and public health authorities, in partnership with nongovernmental organizations and private industry, to assess and strengthen the resilience of their community’s health sector in the face of EVD or other HCIDs. For the purpose of this project, we define HCIDs as having all of the following characteristics: • Novel—or at least very rare—in the affected community • Moderately to highly contagious (by whatever route), at least during some stage of the disease • Moderately to highly lethal • Not easily controllable by medical countermeasures or non-pharmaceutical interventions • Causes exceptional public concern Examples include: viral hemorrhagic fevers (e.g., Ebola, Marburg, Lassa), smallpox, SARS, MERS, and H5N1 influenza A. The checklist is intended to apply to isolated cases or limited outbreaks of HCIDs. In a pandemic or widespread outbreak, the issues and recommendations may be substantially different."