How COVID has prepared Illinois for the next pandemic

CHICAGO (WLS) -- The world wasn't ready for the current pandemic; more than 3 million dead is proof COVID-19 took us by surprise.

And now, as the COVID-19 pandemic cautiously begins to wind down, new precautions are already underway to prevent the next bio-threat.

Chicago now plays a pivotal role as scientists and emergency experts work on the front defensive lines.

The Advanced Emergency Response Center at Rush University Medical Center was conceived after the 9/11 attacks and built in 2012. It was conceived by Emergency Medicine Chair Dr. Dino Rumoro.

When the center was built, SARS CoV-2, the virus that causes COVID-19, was not on the radar.

"No, it wasn't but you know we saw Ebola. You know, we had SARS, I mean there were other things that we saw, said Rumoro.

The emergency department and distinctive butterfly-shaped hospital tower were built to perform specific functions in a large-scale health crisis. Rumero refers to it as CBRNE: Chemical, Biological, Nuclear and Explosive response center.

There are three main components to the center: mass decontamination, surge capacity and respiratory isolation units with contained circulation known as negative air flow.

There is a separate and contained ambulance entrance, and bay right off it to form a special decontamination area with multiple shower heads. The room has a massive water system underneath to capture the contained water so it does not go into the sewer system.

The hospital, and its ER, wait for the unexpected.

Specialized treatment rooms can secure patients and contaminated air. Nearby a supply area with high tech equipment is stocked, briefly tested on suspected Ebola patients in 2014, and now wrapped and ready for the next contagion.

Among the specialized medical supplies stored in a locked area are air hoods and helmets called Powered Air-Purifying Respirators, or PAPRs. The equipment allows medical staff to breath easily and protects against any infected droplets that might be aerosolized.

Registered Nurse Jean Flaws-Chervinko worked in the hospital when a suspected Ebola patient was brought in from O'Hare International Airport in 2014. She said the hospital is still geared up for whatever may be coming next.

"We're ready, we just are ready," said Flaws-Chervinko. "This unit was ready for the respiratory part which would have been COVID, and we're ready for anything else like Ebola."

As a safety precaution, in the sub-basement of the distinctive tower a fleet of robots is deployed daily to ferry everything from food to medical supplies.

Early in the design for the emergency department the decision was made to not locate the loading dock near the ambulance bay for fear that terrorists could drive up and pretend to be making a delivery.
The robots move freely in the tunnels and they even have their own elevator.

A once-futuristic novelty, the center has been paying off in the pandemic.

"Since COVID started we've changed the way we process patients, the way we intake them, screen them decide who might be infected," said Rumoro.

The ambulance bay was turned into a triage unit for rapid COVID testing. And the atrium, originally built for quick change into a treatment area, has been used for the first time to provide oxygen to coronavirus patients.

In the I-beams of the atrium are hook-ups for air, oxygen and electrical so ventilators could be used. Rumoro said it's the first time this area was put to the test.

"This obviously came in handy for COVID because this is an area where the ER expanded into if someone was short of breath we could just hook them up to the oxygen," she said.

Hospitals across the country are now being urged to invest in pandemic preparedness infrastructure, including the ability to provide surge capacity.

Policymakers, academia, industry and medical experts around the world now re-accessing what needs to happen to prepare for the next health threat.

The federal government just pledged $3 billion to prepare for the next pandemic including the creation of "Epidemic Intelligence Officers," described by the CDC's Dr. Rochelle Walensky as elite disease detectives.

"It will create new programs intended to increase staffing at our nation's laboratories and build preparedness for the future," she said.

One glaring mistake in Illinois and elsewhere was inadequate personal protective equipment, PPE.

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Taming the "Wild West" of medical supplies and personal protection equipment consumed Illinois government in the early days of the pandemic.



At the height of the supply crunch Illinois arranged under the radar deliveries to bring in millions of masks and gloves from China.

"The big problem was that there was no centralized or unified, you know, governmental intervention. And so, everybody was competing with everybody else for PPE," said Fegan.

"Initially, you know, the highest dollar got the supplies and that really squeezed our folks who didn't have the immediate cash available and so that was a huge problem."

As a result, there's now a focus on expanding PPE stockpiles.

"We're already talking about the preparation, what sort of things we need to maintain, you know, so we are maintaining our supplies of PPE right now, we are rotating them out to make sure that we don't have expired product." Fegan said.

The race is also on to stop the next pandemic before it starts.

In the Regional Innovative Public Health Lab virus hunters are working to intercept COVID variants before hot spots emerge. The Chicago Department of Public Health awarded Rush the $3.5 million contract to create the lab partnership.

"The primary focus right now is on surveillance," said Stefan Green.

Green, a 25 year microbiologist, is the co-principal investigator of the $3.5 million partnership and director of the Genomics and Microbiome Core Facility at Rush. Inside the lab scientists test positive specimens from hospitals across the city.

"I think people realize public health has been underfunded," he said. "We can't afford not to have facilities just like this so you'll see these I think in every, in every state in multiple locations."

Another partnership, aimed at derailing future viral outbreaks, is the Abbott Pandemic Defense Coalition.

"We're a hub for traffic across the world. It really does provide a great opportunity to identify and find the next pandemic," said Alan Landay, principal investigator at Rush.

Rush University Medical Center was one of the first in the United States to join the effort. The first of its kind global network, managed by Illinois-based Abbott, seeks to identify pathogens in real time and quickly deploy diagnostic testing.

"All of the information will be shared with our collaborators with the community because this information is really powerful," said Gavin Cloherty, the head of infectious disease research at Abbott.

Cloherty explained that the sequences of viruses that are found will be published in a public database that can be accessed by health officials and laboratories around the world.

"We've learned from COVID-19 the importance of global collaboration, the importance of diagnostic testing, the importance of speed, speed to respond," he added, "This information is what the public health community needs to inform them of the level of risk of anything that we find, and really to enable them to respond quickly."
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