VCU news

By Carissa Etters

Gov. Terry McAuliffe toured the Unique Pathogens Unit at Virginia Commonwealth University last week and spent time talking to the highly trained and skilled team that staffs it. The purpose of the governor's visit was to garner his support and advocacy for VCU Medical Center to become one of 10 U.S. Department of Health and Human Services regional Ebola treatment centers.

VCU Medical Center is one of 55 Centers for Disease Control and Prevention Ebola treatment centers in the country. The medical center received the designation last fall after treating its first patient under investigation. During the treatment of the first PUI, the team recognized the need for a designated and secluded unit to offer the needed level of care when treating unique pathogens patients.

Once again, this shows the extraordinary leadership of Virginia. I want to commend VCU for putting this up. We don’t know what the next outbreak of some type of pathogen [will be]—we don’t know standing here today – but what I’m impressed with is that no matter what it is, we can deal with any situation here in Virginia.

The 5,130-square-foot unit is a complete self-contained biocontainment unit equipped with state-of-the-art video monitoring capabilities. It is able to sustain up to two patients at one time. Other features include areas for donning and doffing personal protective equipment, a clinical laboratory, a fully stocked pharmacy, a waste management area with an autoclave, and a control room to monitor patients and team members while providing care and communication mechanisms to provide an outlet for social and spiritual needs of the patient. The unit is also equipped with laptops to monitor vital signs of team members providing care.

The team worked closely with the Virginia Department of Health, the Virginia Hospital and Healthcare Association, the Centers for Disease Control and Prevention and emergency planners throughout the state in the creation of this self-contained unit. It has since been thoroughly vetted and endorsed by the CDC, the University of Nebraska and Emory University. The medical center now has about 100 highly trained, highly skilled team members that can be called upon at any time if a unique pathogen presents. All Unique Pathogens Unit team members volunteer to work in that capacity. If a patient presents, the unit can become fully operational within four hours of the initial call. Pharmacy and supplies can be stocked within one hour.

Why Ebola is truly a unique pathogen

In comparison to other infectious diseases, Ebola is less contagious than measles or mumps, meaning there is no airborne transmission. A person has to come into contact with bodily fluids such as blood or saliva to get the disease from another person. Also, Ebola is not contagious until a patient becomes symptomatic.

While Ebola is less contagious then measles or mumps, it is far more infectious. It takes only one viral particle to infect someone, whereas influenza takes 1,000 particles for infection and HIV takes 100 particles. Additionally, Ebola has a significantly higher mortality rate than other diseases. In Africa, Ebola has about a 40 percent mortality rate. However, in the United States the mortality rate is less because of the advanced care and treatment provided by medical centers such as VCU.

Cost of care

Providing such high-quality specialty care is expensive. To put it in perspective, one Ebola patient generates an average of 1,000 pounds of waste throughout the duration of their stay. That is equivalent to about eight 55-gallon drums filled per day, per patient. The estimated cost to dispose of that waste is more than $1 million. The estimated cost of the Tychem PPE including the suit, the hood and the battery pack is nearly $1,000.

The medical center is applying for federal funds to help cover some of the costs. If named one of the 10 regional Ebola treatment centers, VCU Medical Center could receive federal funding up to $2.4 million a year to keep the unit staffed and ready to respond. The HHS region coverage area includes:

• Virginia
• West Virginia
• Washington, D.C.
• Maryland
• Delaware
• Pennsylvania

World-class care

The governor, accompanied by John Duval, vice president for clinical services and chief executive officer of VCU Hospitals, and Michael Rao, Ph.D., VCU president, met with leadership and various members of the Unique Pathogens Unit on May 13 to see up close how the team is trained and prepared to provide world-class care to unique pathogens patients.

“Once again, this shows the extraordinary leadership of Virginia,” McAuliffe said. “I want to commend VCU for putting this up. We don’t know what the next outbreak of some type of pathogen [will be]—we don’t know standing here today – but what I’m impressed with is that no matter what it is, we can deal with any situation here in Virginia.”

Feature image at top: Gov. McAuliffe examines PPE demonstrated by a Unique Pathogens Unit team member.

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