- The Washington Times - Monday, May 18, 2009

ANALYSIS/OPINION:

The H1N1 swine flu and previous issues, such as SARS, have highlighted the vulnerability our health care system faces from serious tests of preparedness in the area of operational sustainability in a crisis.

The ability of our health care facilities to maintain operations during times of crisis is a matter of interest for every American and should be a priority for federal and state policymakers.

The bipartisan Pandemic and All-Hazards Preparedness Act of 2006 has helped us prepare for the current crisis and deal with future ones. Many sectors of hospital operational sustainability desperately need experienced solution management, but the disposal of infectious waste is not addressed adequately by health care emergency-preparedness planning, best practices and guidance and resources.

A 2003 Government Accountability Office study concluded that many hospitals lack the capacity to respond to large-scale infectious-disease outbreaks and most hospitals lack adequate equipment for a patient surge on a medical facility. Furthermore, many reports cite the challenges of medical supply chains, both inbound and outbound, to deal with waste products that would accumulate in a pandemic or natural disaster.

Ninety percent of our hospitals since the mid-1990s have chosen to export their infectious waste through their local communities and over our roads and highways. However, during a pandemic, infectious waste should not be allowed to leave the realm of the clinical experts on disease control at our nation’s hospitals.



Unfortunately, a majority of hospitals rely on outsourcing their infectious waste to an off-site provider. Current practices usually involve removal, transportation and off-site disposal of waste.

With real threats of pandemics, transporting infectious and contagious medical waste is no longer prudent. Modern, affordable technologies can cleanly, safely and economically sterilize infectious and contagious waste on the premises of health care facilities. Treating hazardous materials on-site is also a cleaner, greener, less costly and, most important, safer option.

The Centers for Disease Control and Prevention staff and other federal health officials have recognized that the best practice for emergency preparedness and pandemic response is inactivating amplified cultures and stocks of micro-organisms on-site during medical waste treatment.

Taking an on-site sustainability approach helps address this looming issue of hospital preparedness in the case of a pandemic or other crisis. Under such a scenario, the volume of hazardous materials would increase dramatically when a large population suddenly contracted a contagious disease or incurred a disaster and surged a hospital’s capacity.

Our country has begun to apply stringent actions across the board in order to avoid catastrophic health threats. The Department of Agriculture demands that food waste be sterilized at ports of entry to avoid agriculture contamination. A logical next step in our efforts to polarize waste and keep our country healthy would argue that we should sterilize medical waste at the point of generation as well - especially in a crisis such as the one we face today.

We remain vulnerable in the area of management of contagious waste, and the threat of pandemics, bioterrorism and natural disasters is very real. There appears to be no logic for hospitals not to sterilize their infectious waste on-site during a pandemic other than the lack of equipment and a lack of incentive to install such equipment. We must ensure that the burden of safer and greener waste-disposal options doesn’t fall solely on the hospitals.

Newly confirmed Health and Human Service Secretary Kathleen Sebelius should adopt on-site sterilization capacity as a best practice for sustaining health care facility operations in a crisis - and dedicate the resources necessary to improve on-site infectious-waste treatment capacity.

The federal government has invested billions of dollars in the Hospital Preparedness Program, in which funds have been spent mostly on perishable items in addition to worthy planning and training drills, as opposed to real equipment and capacity enhancements. Expenditures for on-site treatment of infectious waste are perhaps the only costs for preparedness that would begin to pay for themselves from the day of installation.

The scope of the pandemic threat is global. An outbreak would dwarf our already strained resources, which is why it should be a priority for the federal government to address common-sense solutions and resources for on-site treatment of infectious waste now in order to help ensure the health and safety of every community throughout the nation.

Darrell Henry is executive director of the Healthcare Waste and Emergency Preparedness Coalition.

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