by Anthony L. Kimery
The nation's defenses against emerging infectious diseases are insufficient
The already staggering number of Americans who die each year from merging and re-emerging infectious diseases could skyrocket during a worst case influenza pandemic or yet unknown disease outbreak, stated a new report by the Trust for America's Health (TFAH), “Germs Go Global: Why Emerging Infectious Diseases Are a Threat to America.”
More than two years ago, HSToday.us reported health authorities were concerned that hospital-acquired infections (HAIs) that kill an estimated 90,000 to 100,000 Americans each year during routine hospital stays could be expected to be rampant during a health crisis in which tens of thousands – or more – persons require emergency medical care under what will likely be less than sterile and sanitary conditions. Conditions primarily responsible for the transmission of HAIs.
Shortly before his recent death, the world renowned virologist, Dr. Graeme Laver, also expressed his concern to HSToday.us about the spread of HAIs during a pandemic and mass casualty events. He said "they would most assuredly spread" in overcrowded hospitals and temporary structures erected to treat the numbers of people who will need medical attention in a pandemic.
“We’re looking at a little known and largely ignored health crisis secondary to a pandemic or large-scale terrorist bombing like a nuke or something,” a source involved in federal emergency medical preparedness planning told HSToday.us a year ago.
HAI infections can cause serious illnesses and, in severe cases, death. Indeed, infectious diseases are a major cause of illness, disability and death, statistics and authorities point out.
A year ago the Journal of the American Medical Association (JAMA) reported that a strain of methicillin-resistant Staphylococcus aureus (MRSA) spreading around the country is causing more life-threatening infections than public health authorities had thought, and killing more people in the US each year than AIDS.
"Antimicrobial resistance undercuts the effectiveness of essential medicines and reverses years of progress made in the treatment of infectious diseases. Left unchecked, antimicrobial resistance is as destructive and deadly as any global health threat," said Senator Sherrod Brown (D-OH). "That's why I've introduced the Strategies to Address Antimicrobial Resistance (STAAR) Act. By accelerating efforts to combat antimicrobial-resistance, this bill would prevent further erosion in the effectiveness of critical medical treatments."
"Infectious diseases are not just a crisis for the developing world. They are a real threat right here, right now to America's economy, security, and health system," said TFAH Executive Director, Dr. Jeffrey Levi. "Infectious diseases can come without warning, crossing boarders, often before people even know they are sick. Americans are more vulnerable than we think we are, and our public health defenses are not as strong as they should be."
TFAH’s report also finds that the nation's defenses against emerging infectious diseases are insufficient, creating serious consequences for the US health system, economy, and national security.
Because of this possibility, and the fact that the spread of HAIs is already at an alarming level during non-catastrophic emergency conditions, HSToday.us noted that HAIs are viewed as a national security threat, according a National Intelligence Estimate (NIE), a fact the TFAH report also highlighted.
In Jan. 2000, the National Intelligence Council, the US Intelligence Community’s (IC) center for midterm and long-term strategic thinking which leads the effort to produce National Intelligence Estimates (NIEs), released an unclassified version of the NIE, “The Global Infectious Disease Threat and Its Implications for the United States,” which expresses alarm over the national security implications of HAIs. The NIE “represents an important initiative on the part of the IC to consider the national security dimension of a nontraditional threat.”
Indeed, the NIE “responds to a growing concern by senior US leaders about the Implications - in terms of health, economics, and national security - of the growing global infectious disease threat. The dramatic increase in drug-resistant microbes, combined with the lag in development of new antibiotics, the rise of megacities with severe health care deficiencies, environmental degradation, and the growing ease and frequency of cross-border movements of people and produce have greatly facilitated the spread of infectious diseases.”
A crisis will compound the problem. “Alone or in combination, war and natural disasters, economic collapse, and human complacency are causing a breakdown in health care delivery and facilitating the emergence or reemergence of infectious diseases,” the NIE emphasizes.
In this NIE, the IC stated that “hospital-acquired infections … will pose a threat” to national security, noting: “Inadequate infection control practices in hospitals will remain a major source of disease transmission in developing and developed countries alike.”
The TFAH report examines major vulnerabilities in the current US strategy for combating infectious diseases. One crucial area that is problematic is treatment.
“While the US government has invested significantly in treatments that could counter an intentional biological attack, new drugs to treat emerging diseases and new antibiotics to address growing antimicrobial resistance have received far less attention,” the TFAH report stated. “The development of new, improved therapies to treat drug resistant bacterial infections, as well as influenza and other viruses, is essential.”