An interview with Darrell Henry, Executive Director
of The Healthcare Coalition for Emergency Preparedness,
based in Washington, D.C.
The Healthcare Coalition for Emergency Preparedness (HCEP) was formed in an effort to raise awareness and educate people about often overlooked issues in plans to maintain healthcare facility operations during a crisis and evelop efficient methods to reduce healthcare costs.
As such, the HCEP has repeatedly requested the Centers for
Disease Control and Prevention (CDC) to clarify standards related to
healthcare facility protocols for the safety of workers, specifically relat-
ed to the disinfection and transportation of medical waste. As spelled
out in a recently released fact sheet, the HCEP believes CDC standards
should follow international standards in regards to the handling and
disposal of medical waste, to protect health-
care workers as well as the public at large.
HCEP is pleased that CDC has now
clarified Ebola waste as a Category A infectious material, which the Department of
Transportation (DOT) determines is capable of posing an unreasonable risk to health,
safety, and property when transported in
commerce, and should not be treated like
normal regulated medical waste (RMW).1
Which CDC standards must be upheld when clean-
ing and disinfecting cleanrooms and controlled
The CDC is the national public health institute of the United
States that is a federal agency under the Department of Health
and Human Services (HHS). The CDC recommends hospitals to
be prepared to follow certain infection control and worker safety
CDC’s recommendations (guidelines) for infection protection
include avoiding contact with blood and bodily fluids of an infected
person and not handling any items that may have come in contact
with an infected person’s blood or body fluids.
Like the CDC, World Health Organization (WHO), and other
health policy experts, the Coalition recognizes and agrees that the
practice of inactivating cultures and stocks of microorganisms onsite
during medical waste treatment is a best practice.
It is important to acknowledge and remember that international
Ebola infection control standards should be followed precisely. You
cannot pick and choose which regulations to follow; all must be
Can you talk a bit about personal protective
equipment (PPE) and personnel procedures?
With healthcare workers on the front lines in the battle to contain
Ebola, the need for proper personal protective equipment and infection
control protocols is paramount. We know that there is not much information and research on disease transmission in the healthcare setting,
including the potential for infectious particles to be suspended in the air
around a symptomatic patient. Thus, it only seems appropriate to adopt
more conservative measures to protect healthcare providers.
What must the CDC do in order to contain further
outbreak of Ebola in the USA?
Properly handling and disposing of Ebola waste is an often-misunder-stood danger and public risk that we must responsibly and realistically
address if we are to implement a complete “creation to sterilization”
infection control process on-site where such patients are treated. In
essence, it is vital that on-site sterilization of Ebola waste be performed
before it is removed from the facility. Likewise, liquid waste must be disinfected before it is put into a municipal sewer system. Utilizing autoclave sterilization and bleach solutions works best, as the CDC notes.
We hope that Congress, along with the CDC, National Institutes
of Health (NIH), Assistant Secretary for Preparedness and Response
(ASPR), medical trade associations such as the American Hospital
Association (AHA), State and County Health Officials, and HCEP, can
all work cooperatively toward implementing simple, effective solutions using readily available technologies to implement appropriate
protocols, establish designated treatment centers, and utilize the best
American and international guidelines regarding infection control
procedures and preparedness in our hospitals.
Here are a few simple solutions that the CDC can ensure are
implemented in a hurry: utilize mobile triage centers; establish protocols for patient movement; disinfect solid and liquid waste on-site and
as close to the source as possible; and deploy mobile waste sterilizers
to medical centers. We should also rout patients to designated health
care facilities that have the proper protocols, highly trained staff, and
necessary bio-containment units to treat and contain Ebola and similarly infectious, lethal diseases.
Promoting Preparedness and Standards
in the Wake of Infectious Disease
Recent cases of Ebola in the United States have raised concern about CDC regulations and clean procedures.