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Operation Limelight – Raising Awareness of the Johns Hopkins Biocontainment Unit

A mock patient is cared for during an exercise
of the Johns Hopkins Biocontainment Unit.

Surrounded by a crowd of people, a male patient enclosed in an isopod was pushed onto the biocontainment unit at The Johns Hopkins Hospital on Wednesday, Aug. 29. The patient was a public health researcher who returned from an assignment in the Democratic Republic of Congo. The isopod, a stretcher covered in clear plastic, allowed him to see his surroundings while also safely preventing transmission of his unknown illness — potentially Ebola. The Lifeline team members transporting the patient were covered head-to-toe in an enhanced type of personal protective equipment. It was all part of an exercise to showcase the capabilities of the biocontainment unit and its team to media, congressional staff members and state officials.

Built in response to the 2014–2015 Ebola virus disease outbreak in West Africa, the Johns Hopkins Medicine biocontainment unit (BCU) is a state-of-the art unit designed to treat and care for patients infected with high-consequence pathogens such as Ebola. BCU operations and training are entirely funded through a $4.1 million federal grant over five years administered by the U.S. Department of Health and Human Services Assistant Secretary of Preparedness and Response (ASPR). This fiscal year is the fourth year of the five-year grant funding.

“The funding the BCU receives will terminate in 2020 unless permanent funding is secured,” says Brian Garibaldi, medical director of the BCU and assistant professor of medicine at the Johns Hopkins University School of Medicine. “Highlighting the BCU’s unique capabilities is an important aspect of further promoting the great work our team does in safely caring for patients with a range of highly infectious diseases.”

The BCU is staffed by dedicated providers with special training in infection control and can provide care for up to four patients in an environment that ensures the safety of health care workers, patients and their families. When not active for patient care, the BCU serves as a site for research and training for high-consequence pathogens such as Ebola, SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus), as well as functioning as a venue for hospital training for disciplines ranging from nursing to environmental care services.

The August exercise also served as a trial run for staff members. Objectives for this drill aimed to test protocols for patient acceptance to the BCU, handling and management of waste, and processing of laboratory specimens. Overall, drill organizers say the exercise was a great success. One highlight noted by the team was the efficiency of the patient admission process, while maintaining appropriate infection prevention practices. The BCU team will use the successes and areas of improvement identified from the exercise to impact practice and protocols to ensure a constant state of readiness.

As a regional treatment center, the BCU works in collaboration with the National Ebola Training and Education Center (NETEC). NETEC was established by Congress with emergency appropriations after the 2014–2015 Ebola outbreak in West Africa as the defense against future infectious disease threats to U.S. citizens. NETEC is seeking permanent funding of $9.5 million annually beginning in 2020 to support all 10 of its regional treatment centers, including the Johns Hopkins BCU.

“It’s unclear what the next outbreak will be, but securing permanent funding will allow us to continue to be prepared and do what we do best — that is caring for patients while protecting our staff,” says Lisa Maragakis, senior director of infection prevention for the Johns Hopkins Health System and CEPAR’s senior adviser and subject matter expert for infectious disease, epidemiology and public health.