Recent events and emerging data are especially concerning to health care
providers. In 2003, 20% of all confirmed persons with Severe Acute Respiratory Syndrome (SARS) were health care workers; in Canada, that number was 43%.1 Then, and now with the Corona Virus (COVID-19), we look to the World Health Organization (WHO) and agencies such as the Centers for Disease Control and Prevention (CDC) for answers to a myriad of questions and for information on how they will help contain, and eventually stop, the spread of the virus.
Although the mortality rate of COVID-19 is lower than that of SARS,
the former spreads much more easily. The mortality rate of COVID-19 is estimated to range from 1% to 2.3%,2 but 1 descriptive study3 reports a rate of 11%; the SARS mortality rate was 9.6%.2 For perspective, the global mortality rate of seasonal influenza is estimated to be approximately
2.1 per 100 000 cases.4
Even though a prompt global response was generally credited for limiting the SARS epidemic, both the WHO and CDC are currently experiencing immense financial stress.5 Appropriations for CDC funding are approximately 10% lower than 2016 funding levels, in 2018 the White House disbanded its global health security team, and epidemic prevention
activities were curtailed in 39 out of 49 countries (including China) while $1.35 billion was cut over 10 years from the CDC’s Prevention and Public Health Fund.6,7 In the meantime, the WHO has been consistently underfunded. In the early 1980s, voluntary contribution dues from member states (the main source of support for WHO) were frozen, and a
zero-real growth policy was adopted. For 2021, the United States’ administration is proposing to cut its annual funding to WHO by 50%.8
Public health always has been the victim of its own successes. When immunizations are effective and the rates of a communicable diseases go down, their perceived threat diminishes along with the perceived importance of vaccinations. But scientists have long warned about increased risk of epidemics due to infectious pathogens “spilling over from animals to humans,” the development of antimicrobial resistance, the spread of infectious disease through global travel and trade, and a weak public health infrastructure. Unfortunately, measures to address these risks, such as improving our public health infrastructure and hiring qualified scientists, take time.
As such, health care facilities are doing all they can by providing personal protective equipment (PPE) and training, dispensing hand sanitizers and masks to visitors, and issuing regular updates for all employees. The situation is fluid, changing daily, and dependent on your geographical location.
We all need to be as vigilant as possible. We are ever grateful for the health care providers, scientists, and agencies on the front lines who care for infected persons and look for ways to prevent disease spread. Let’s hope the lessons learned from this and other similar events will not be forgotten. The importance of preparedness cannot be understated. You cannot wait to fix the fire truck until there is a fire. It needs to be ready to go.