Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 May;46(5):533-537.
doi: 10.1016/j.ajic.2017.11.001. Epub 2017 Dec 15.

Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases

Diane Meyer  1 , Tara Kirk Sell  2 , Monica Schoch-Spana  2 , Matthew P Shearer  2 , Hannah Chandler  3 , Erin Thomas  4 , Dale A Rose  4 , Eric G Carbone  4 , Eric Toner  2
Affiliations

Lessons from the domestic Ebola response: Improving health care system resilience to high consequence infectious diseases

Diane Meyer et al. Am J Infect Control. 2018 May.

Abstract

Background: The domestic response to the West Africa Ebola virus disease (EVD) epidemic from 2014-2016 provides a unique opportunity to distill lessons learned about health sector planning and operations from those individuals directly involved. This research project aimed to identify and integrate these lessons into an actionable checklist that can improve health sector resilience to future high-consequence infectious disease (HCID) events.

Methods: Interviews (N = 73) were completed with individuals involved in the domestic EVD response in 4 cities (Atlanta, Dallas, New York, and Omaha), and included individuals who worked in academia, emergency management, government, health care, law, media, and public health during the response. Interviews were transcribed and analyzed qualitatively. Two focus groups were then conducted to expand on themes identified in the interviews. Using these themes, an evidence-informed checklist was developed and vetted for completeness and feasibility by an expert advisory group.

Results: Salient themes identified included health care facility issues-specifically identifying assessment and treatment hospitals, isolation and treatment unit layout, waste management, community relations, patient identification, patient isolation, limitations on treatment, laboratories, and research considerations-and health care workforce issues-specifically psychosocial impact, unit staffing, staff training, and proper personal protective equipment.

Conclusions: The experiences of those involved in the domestic Ebola response provide critical lessons that can help strengthen resilience of health care systems and improve future responses to HCID events.

Keywords: Ebola; Preparedness; health care; resilience; response.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None to report.

References

    1. Chevalier MS, Chung W, Smith J, Weil LM, Hughes SM, Joyner SN, et al. Ebola virus disease cluster in the United States—Dallas County, Texas, 2014. MMWR Morb Mortal Wkly Rep 2014;63:1087–8. - PMC - PubMed
    1. Yacisin K, Balter S, Fine A, Weiss D, Ackelsburg J, Prezant D, et al. Ebola virus disease in a humanitarian aid worker—New York City, October 2014. MMWR Morb Mortal Wkly Rep 2015;64:321–3. - PMC - PubMed
    1. Lyon GM, Mehta AK, Varkey JB, Brantly K, Plyler L, McElroy AK, et al. Clinical care of two patients with Ebola virus disease in the United States. N Engl J Med 2014;371:2402–9. - PubMed
    1. Varkey JB, Shantha JG, Crozier I, Kraft CS, Lyon GM, Mehta AK, et al. Persistence of Ebola virus in ocular fluid during convalescence. N Engl J Med 2015;372:2423–7. - PMC - PubMed
    1. Smith PW, Boulter KC, Hewlett AL, Kratochvil CJ, Beam EJ, Gibbs SG, et al. Planning and response to Ebola virus disease: an integrated approach. Am J Infect Control 2015;43:441–6. - PubMed

Publication types

MeSH terms