New York City (NYC) was the nation’s first epicenter for Coronavirus Disease 2019 (COVID-19). NYC Health + Hospitals (NYC H+H), the largest public healthcare system in the United States, cared for a disproportionate number of COVID-19 patients, with many of our hospitals nearing capacity. On a daily basis, we provide essential inpatient, outpatient, and home- and community-based patient care to more than 1 million New Yorkers. With a workforce of over 35,000 employees, our healthcare system reaches New Yorkers at more than 70 locations across the city’s five boroughs – including 11 acute care hospitals, 5 post-acute/long-term care facilities, 7 Federal Qualified Health Centers, 60 community clinics, and NYC jails, as well as through home-based care. During the COVID-19 pandemic, within a 6-week time period, NYC H+H treated over 10,000 suspected and confirmed admitted COVID-19 patients.
As a major travel hub and home to an extremely diverse population, NYC must always prepare for looming infectious disease threats and potential outbreaks. The Systemwide Special Pathogen Program (SPP) within the Department of Emergency Management at NYC H+H oversees infectious disease preparedness and response across the healthcare system. Since 2015, the SPP has prepared for and responded to multiple emerging and reemerging infection disease threats such as Zika virus, Ebola, Candida auris, measles, seasonal influenza, Middle East Respiratory Syndrome (MERS), and COVID-19. SPP works hand in hand with frontline staff at all clinical care sites to prevent and control emerging and re-emerging infectious diseases. Prior preparedness work has focused on our 11 acute care hospitals, but other service lines including ambulatory care, long-term care/skilled nursing facilities, home care and correctional health need the same level of preparedness given the fact that infectious patients, visitors, or even healthcare workers may present at any type of facility or in the field.
With support from the CDC National Center for Emerging and Zoonotic Infectious Diseases, NYC H+H SPP will expand special pathogens infection prevention initiatives across all NYC H+H service lines. Support from this cooperative agreement will enhance preparedness, outbreak detection and response in collaboration with clinical and public health partners. We propose to implement the following four strategies: (1) disseminate and adopt, (2) inform and adapt, (3) target and train and (5) evaluate and improve the delivery of program activities related to public health guidance. The associated activities include, but not limited to, developing various types of infection prevention and control guidance from CDC resources; providing in-services training for frontline staff including clinicians, healthcare professionals, and ancillary staff; developing videos, job action guides, signage and toolkits; and conducting secret shopper exercises and drills across all facilities to assess preparedness and response.
The CDC funding will enable the SPP to increase capacity and offer special pathogen tactical educational and refresher training opportunities to directly engage frontline staff. It will allow H+H to engage frontline staff from all service lines including ambulatory care, long term care/skilled nursing facilities, acute care facilities, correctional health, and home care to ensure all staff understand the fundamentals of infection prevention and specific policies and procedures related to COVID-19, as all frontline staff are at risk for exposure to infectious diseases. The final outcomes of these infection prevention activities will include a decrease in (1) healthcare associated infections among patients and healthcare workers with COVID19; decrease in community-acquired infections with COVID19 across public and private settings and (3) improved clinical outcomes among patients with or who are at increased risk for emerging infectious diseases, like COVID19.