As Fischer and Wohl Fight Disease in Sub-Saharan Africa, the U.S. Department of Health and Human Services’ Administration for Strategic Preparedness and Response (ASPR) Selects UNC to be a Regional Emerging Special Pathogen Treatment Center (RESPTC). Read press announcement.
Many courageous infectious disease specialists and other clinicians have not shied away from caring for those in need, even in the hot zones. These efforts require clever and creative work, like the kind demonstrated during the COVID-19 pandemic. A pop-up Respiratory Diagnosis Clinic (RDC) went up over a weekend, travel down North Carolina’s back roads took COVID testing into rural areas, and as remarkable, UNC’s state of the art Surveillance Laboratory was built in 9 weeks, becoming Carolina’s frontline defense again Covid.
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Now, UNC will become a regional expert in civilian biodefense, joining Emory University, as the only two RESPTCs in the Southeast. William Fischer, MD, the director of the Emerging Pathogens Program at the Institute for Global Health & Infectious Diseases (IGHID) and associate professor of pulmonary diseases and critical care medicine, and David Wohl, MD, professor of medicine and Lead of the IGHID Global Infectious Diseases Clinical Research Unit at Chapel Hill, with UNC colleagues, will lead a Regional Emerging Special Pathogen Treatment Center (RESPTC) funded through the U.S. Department of Health and Human Services’ Administration for Strategic Preparedness and Response (ASPR). UNC is one of three sites selected to expand beyond 10 existing RESPTC sites across the US. Two other new centers will be established at Washington Hospital Center in Washington, D.C. and Spectrum Health System in Grand Rapids, Michigan. Read more.
What does it mean to be a Regional Emerging Special Pathogen Treatment Center (RESPTC)?
William Fischer, MD:
“Over the past two decades we have witnessed a rise in the number of emerging and re-emerging infectious disease outbreaks – this is an important opportunity to strengthen local, regional and national preparedness, response and recovery. This has been a total team effort, including support from each state in our region, local public health officials, and emergency medical professionals.
“Becoming a RESPTC will bolster the country’s preparedness and capacity to respond to emerging pathogens during medical and public health emergencies. UNC is perfectly situated to take on this responsibility, and has been at the forefront of caring for infectious diseases patients for decades, starting with the HIV epidemic in the 1980s.
“Right now, UNC Medical Center is what is called an assessment hospital. If someone were to land at RDU with an emerging pathogen, we are one of eight assessment hospitals in North Carolina that could be designated to care and manage that person for 96 hours until we could transfer them to Emory or John Hopkins or another special pathogen site in the US.”
David Wohl, MD:
“With this grant we can become the terminal hospital where we would no longer need to send a patient somewhere else for care. Our already existing capacity to accept, stabilize and transfer someone with a special infection will now expand to being able to accept, manage, and complete care here without having to move a patient elsewhere. The grant is a recognition of our current capabilities and our potential to move to the next level to be able to provide all the necessary care such that there’s no place else that could provide any better care.
“A large part of this grant will help us become a training and education center not only for North Carolina but for the southeast in partnership with Emory, which already has an established special pathogens unit. UNC infectious disease and infection control experts will be able to train and educate staff at UNC, other hospitals, and clinics in urban areas and rural communities across the Southeast.”
What should the community know about UNC’s infection control management?
David Wohl, MD:
“It’s important that we be really clear. UNC has very strict infection control measures in place and was already an assessment hospital capable of taking care of an individual who may have been exposed to an emerging pathogen. It has been for years.
“This grant is about being prepared and preparing others. We may never see a special pathogens case, we may not ever see anything like monkey pox or Ebola, or COVID emerge again. But it’s very likely we will. Being a designated center of excellence means we will be better prepared to take care of whatever comes our way. And there will be no better place to receive this special care than at UNC.”
How did this come about?
David Wohl, MD:
“UNC Hospitals in Chapel Hill was already one of eight North Carolina healthcare facilities designated as an assessment hospital to identify, isolate, and care for a patient infected with an emerging pathogen for up to 96 hours before transfer to a RESPTC.
“We had five weeks after the call for applications. Billy and I were slated to go to Liberia, and then I had an HIV conference in London. We knew there would be time constraints, we had to decide if we could do this. We also needed buy-in from UNC Health leadership and support from key stakeholders from each of the eight states in our region. All this while we were abroad. Basically, we put this grant together with tremendous help from our colleagues at UNC Infection Control and Prevention while we were on three different continents, which was really remarkable.”
What does this mean for North Carolina?
David Wohl, MD:
“This award will bolster the country’s preparedness and capacity to respond to emerging pathogens during medical and public health emergencies. We’re at a very crucial literal crossroads here in Chapel Hill, the confluence of I-40 and I-85 plus nearby I-95.
“North Carolina also has a large military presence often stationed overseas and a citizenry dedicated to missionary and nonprofit work abroad, where new pathogens have historically emerged. Because of our proximity to Fort Bragg and one of the largest, if not the largest concentration, of service members in any state, we have a huge number of service members. It’s really important to be able to offer this for our service people. There are also quite a few missionary groups who do a lot of work in Africa and Asia. This is something that’s going to be available not only for our state and region, but also for our country.
“Our long history and dedication to treating special pathogen patients in Africa, around the world, and at home, as well as our strong partnerships with North Carolina public health leaders, has prepared us to handle whatever might come our way.
“Outreach through our UNC Health Care System will be important as we engage with partners who can guide us to community stakeholders, including those in underrepresented or vulnerable populations, so that if there were an outbreak, people will know how to access us. It’s really high on our list to make sure that we offer training in rural areas. We also want to work with those who provide services to agricultural workers. During Covid, we went out to farms and engaged those working in meat processing plants to offer testing and vaccinations. That’s what we do and are still doing. We have this history and we’re not going to stop.”
Please explain how you are collaborating with UNC Hospitals?
David Wohl, MD:
“We are collaborating with UNC Hospitals and campus leadership, the medical intensive care unit, as well as our infection prevention experts at UNC, including Emily Sickbert-Bennett, PhD, Brooke Brewer, RN, MS, David Weber, MD, and their teams.
“It will take a year to get the treatment center in place. Our charge is to be able to accept up to two people within eight hours of notification. We’re going to designate in a really innovative way what Billy Fisher has envisioned. Two rooms of our MICU will become special pathogen treatment rooms, another room will handle all the laboratories with a modular laboratory in place for set-up, and another room will handle waste. Four rooms of the MICU would become a ‘pop-up’ special pathogens unit.
“Another important point is that Billy’s in Uganda. I think this is one of the reasons we were awarded the grant, in addition to all of the other things we talked about. We go into Liberia, we go into the Lassa fever unit. Billy is a world expert on Ebola management. We jumped in right away to see patients exposed to monkey pox. And when COVID started and people were scared, we helped, with many others, to lead the way. We know how to do this. This is what we do.”
-Kim Morris, APR