On April 1, 2024, a dairy farmer working in close contact with cattle in Texas was diagnosed with highly pathogenic avian influenza (HPAI) A(H5N1) virus, commonly referred to as H5N1 Bird Flu. This represents only the second case of diagnosed H5N1 Bird Flu in the United States (US), but the first in which the virus potentially jumped from a mammal to a human. According to the World Health Organization (WHO), transmission of H5N1 Bird Flu to humans is rare and there have been 868 documented infections over the last 27 years since the virus was first detected. Of those cases, 457, or 53 percent, resulted in fatality. With confirmed viral infections in cattle at dairy farms in Texas, Kansas, New Mexico, Michigan, and Idaho, there is growing concern that H5N1 Bird Flu may evolve to become more transmissible between people.
Whether H5N1 Bird Flu will evolve to infect more humans is unknown, but one thing is for certain: infectious disease outbreaks caused by viruses, bacteria, fungi, and parasites are on the rise, so it is crucial for our healthcare systems to be prepared for potential outbreaks. Effective preparations involve a multi-faceted approach that encompasses various aspects of public health, healthcare, and emergency management. Below are some key steps that can be taken by healthcare leaders, public health departments, and emergency managers to enhance our public health readiness nationwide.
Advocate and Allocate Increased Healthcare Preparedness Funding
While the US Senate committee responsible for pandemic preparedness requested $1.14 billion, only $335 million was authorized for the 2025 Budget. It is important to invest in mitigation efforts such as vaccine and therapeutic research and development, healthcare capacity building, training, drills and exercises, supply stockpiles, and staffing to protect human lives. The Federal Emergency Management Agency (FEMA) Public Assistance (PA) program and the Department of Health & Human Services (HHS) Health Resources and Services Administration (HRSA) Provider Relief Fund served as a lifeline to the US healthcare system and public health departments during the COVID-19 pandemic response. These sources may once again be useful in funding the mitigation measures needed to stay ahead of a potential H5N1 Bird Flu outbreak in humans.
Develop and Enhance Emerging Infectious Disease Plans
Healthcare providers and public health departments should develop and regularly update emergency preparedness plans that outline procedures for responding to pandemics and other public health emergencies. This includes establishing protocols for surge capacity, resource allocation, and coordination with local, state, and federal agencies. As part of an Emerging Infectious Disease (EID) Plan, organizations should consider developing stand-by contracts with vendors to provide staffing, emergency management, and supply chain logistics support in real time as needed for potential disease outbreaks and subsequent patient surge. Plans should outline specific actions to be taken in the event of an outbreak, including measures to control the spread of the virus in your organization and community, how resources will be allocated, and detailed measures to protect healthcare workers.
Implement Surveillance and Monitoring Systems
Robust, integrated surveillance and monitoring systems are crucial for all states, public health departments, and healthcare systems that collectively detect and track patients presenting with an infectious disease at the local level. The information collected by these sectors, when shared in real-time, can help to inform efficient coordination across the country and internationally.
Create Diagnostic and Testing Capacity
During the onset of COVID-19, testing capacity was limited, amplifying the importance of resource availability and trained personnel within laboratories. Building upon the lessons learned from rapidly scaling up COVID-19 testing, health systems, and public health departments should take steps to ensure the availability of diagnostic tests for detecting H5N1 Bird Flu, as well as the ability to rapidly ramp up capacity or partner to test for other potential infectious diseases.
Strengthen Healthcare Infrastructure and Capacity Building
Healthcare organizations today face significant challenges regarding the staffing and capacity necessary to handle potential surges in patient demand in an outbreak. This includes the ability to increase hospital bed capacity, stockpiling medical supplies and personal protective equipment (PPE), and training healthcare workers in infection control measures. With the growth of ambulatory care centers across the country, public health professionals must think creatively about where patients could be treated in the event of another pandemic as inpatient beds contract and ambulatory capacity grows.
Conduct Ongoing Training, Drills, and Exercises
Drills, training, and exercises help familiarize healthcare facilities and public health department staff with their roles and responsibilities in the event of an infectious disease outbreak, as well as build confidence among employees. This includes understanding of patient screening, isolation, treatment protocols, and communication/coordination procedures with other agencies. Drills and exercises allow organizations to practice working together in a simulated environment, identifying strengths and weaknesses, and areas for improvement in their response coordination. Following drills and exercises, debriefing sessions or after-action sessions are conducted to evaluate performance, identify lessons learned, and make recommendations for improvement to be incorporated into an enhanced EID Plan.
Educate and Engage with the Community
Restoring community trust in our public health systems and providers is critical. This begins with education outreach on how infectious diseases are spread, symptoms, modes of transmission, and preventive measures. Additionally, promoting behaviors such as hand hygiene, respiratory etiquette, ventilation, vaccination if appropriate, and the proper handling of food supply is crucial to this effort. Now is the time to develop communication strategies that are ready for dissemination and identify ways to provide accurate information and address concerns during a disease outbreak. By taking these steps, healthcare operations leaders and public health departments can better prepare for and mitigate against the potential public health and economic impacts of H5N1 Bird Flu, or any other future Disease X outbreak.
Hagerty Can Help
Hagerty Consulting can help your healthcare system or health department with developing preparedness plans for EIDs, including the identification and management of federal funding to support mitigation and offset expenses for response. In addition, Hagerty provides ongoing contracted emergency preparedness support and stand-by contracted staffing for rapidly scaling up your team during an emergency response. At Hagerty, our expert professionals have supported over 100 hospitals and more than 95 COVID-19 response missions across 25 states, helping state, local, non-profit, and private sector organizations increase their operational resilience amid a major health emergency. We can do the same for your organization.
Jeff Bokser is Hagerty Consulting’s Vice President of Healthcare Programs with strategic expertise in all aspects of healthcare operations, finance, organizational resiliency, institutional preparedness, and recovery. Jeff has over 20 years of experience as a senior leader at NewYork-Presbyterian and Yale New Haven Health and served as Incident Commander guiding 40,000+ employees through numerous internal and external emergency response and recovery operations.