Pathogens Training Prepared Cedars-Sinai for COVID-19

Oren Friedman, MD; Nancy Salinas, RN; Jennifer Cuzzolina, RN; and Jonathan Grein, MD, engage in special pathogens training. (Photo by Ronnie Wong, MPH.).

Cedars-Sinai was as prepared as it could be for COVID-19 because staff participated in a federal training program focused on special pathogens.

Cedars-Sinai is one of 10 hospital systems in the U.S. that have been designated as National Emerging Special Pathogens Training and Education Centers. The U.S. Department of Health and Human Services and U.S. Centers for Disease Control and Prevention established this program in 2015 to prepare clinicians to care for patients with severe infectious diseases such as Ebola.

A paper recently published in the journal Health Security and co-led by Cedars-Sinai investigators describes the efforts these hospitals took prior to the pandemic that helped them respond to COVID-19.

"Many of the clinicians who treated the first COVID-19 patients at Cedars-Sinai had been undergoing regular special pathogens training," said Jonathan D. Grein, MD, first author of the paper as well as director of hospital epidemiology and instructor of Medicine at Cedars-Sinai.

Cedars-Sinai created a Special Pathogens Response Team in 2016 and continues to provide quarterly trainings. Doctors, nurses and other clinicians learn in a simulated lab with lifelike mannequins serving as patients. They're taught how to put on and remove personal protective equipment (PPE), how to isolate patients and how to prevent the spread of infectious agents. They also perform simulated intubations, central line placements and ultrasonography—all while wearing Ebola-level PPE, which is more extensive than what is typically used in a hospital and includes fluid-impermeable coveralls and head coverings.

In April 2019, the team hosted a Special Pathogens Symposium where experts who were involved with SARS-CoV-1, MERS-CoV and other outbreaks shared their knowledge. More than 100 clinicians from the region attended.

The preparation helped when COVID-19 hit and the Special Pathogens leadership team was able to train more than 1,200 Cedars-Sinai healthcare workers. Cedars-Sinai also shared COVID-19 best practices with other hospitals in the region.

"It really helped to calm anxiety because we had doctors and nurses who had trained to manage Ebola patients who served as ambassadors to COVID units," Grein said. "They already felt very comfortable with their PPE and the protocols we had in place."

The program, which typically involves about 50 clinicians, is currently adapting its approach to prepare to care for patients with monkeypox.

"The success of this program demonstrates the need to provide continuous special pathogen training to clinicians," said Jennifer Garland, PhD, RN-BC, co-author of the paper and Special Pathogens Program manager. "We need to be prepared not only for other COVID-19 variants but also for the next infectious disease outbreak."