Rebuilding for Tomorrow's Outbreak: The State of Special Pathogen Preparedness in the USA in the Wake of COVID-19

Purpose of ReviewSpecial pathogens require unique planning care capabilities within healthcare facilities and can pose significant public health threats. Outbreaks have continued to emerge through the COVID-19 pandemic and serve as reminders of the need to have tiered levels of readiness and resources supporting all healthcare settings.Recent FindingsRecent outbreaks of Marburg virus, Sudan virus, Lassa virus, and Nipah virus are examples of low-incidence pathogens that carry disproportionally high potential consequences for healthcare worker safety and public health. While the COVID-19 pandemic has increased awareness of the potential impacts of emerging infectious diseases on communities, it has also introduced new challenges in hospital special pathogen preparations, including high staff turnover, high patient volumes, fatigue, and financial challenges.SummaryAll healthcare organizations must act to ensure they can promptly identify suspected special pathogen patients using the "identify, isolate, inform" paradigm. A subset of healthcare facilities networked across the nation must have higher level special pathogen capabilities to ensure access to high quality and safe care is available to all. Preparing for special pathogens involves use of non-traditional personal protective equipment (PPE), specialized PPE doffing protocols, and complex resources and protocols supporting laboratory testing and waste management. Because of known and persistent gaps in special pathogen readiness, the US healthcare system continues to invest in the development of the National Special Pathogens System supported by the Administration for Strategic Preparedness and Response.