The UNMC Global Center for Health Security: Serving Nebraska and the World

The UNMC Global Center for Health Security: Serving Nebraska and the World

JEFFREY P. GOLD, MD Chancellor UNMC & UNO & Chair, Nebraska Medicine

UNMC: Global Center for Health Security

A global resource strategically focusing our expertise in Clinical Care and Operations, driving innovations in Research andDevelopment, Training and Education that refine and strengthen our core 2

GCHS: Federal Partners

Not since the threat of global nuclear war first emerged has human-kind faced the risks of potential disasters at the scale that the 21st century brings.

Conclusions: Both the federal government and many localities in the United States have made substantial progress in preparing for some local forms of mass casualty events.

However, at this point, the US health care system is wholly unprepared for a wide range of 21st-century health threats. It lacks the will, coordinative mechanisms, habits of cooperation, governance agreements, and shared resource investments essential to preparedness.

Berwick & Shine; Feb 2020 JAMA

COVID -19 SARS COV-2

Coronavirus: COVID-19 Update

Coronavirus: COVID-19 Update

Coronavirus: COVID-19 Update

Coronavirus: COVID-19 Update

Coronavirus: COVID-19 Update

Coronavirus: COVID-19 Update

Coronavirus: COVID-19 Update

45

30,000

40

25,000

35 30

20,000

25

15,000

20 15

10,000

10

5,000

5 0

0 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44 46 48 50 52 54 56

Cumulative Cases by Date Reported

Cumulative Cases (Deaths, 41 Initial Cases)

Comparison of Cumulative Cases by Date of Symptom Onset for 37 Deaths and 41 Initial Cases to Date Reported for All Cases

Deaths 41 Initial Cases Cases Reported

Coronavirus: COVID-19 Update Social & Economic

Health & Wellness

DELICATE BALANCE

Coronavirus: COVID-19 Update Pandemic outbreak: No intervention Pandemic outbreak: With intervention

Daily Cases

Days since First Case

Coronavirus: COVID-19 Update Pandemic outbreak: No intervention

Daily Cases

Pandemic outbreak: With intervention

Days since First Case

Coronavirus: COVID-19 Update Social & Economic

Health & Wellness

DELICATE BALANCE

Coronavirus: COVID-19 Update Health & Wellness

Social & Economic

Health & Wellness

DELICATE BALANCE

Coronavirus: COVID-19 Update Key Mitigation & Response Actions Delicate Public Health-Social Economic Balance •

•

Real time data driven – Disease Regression – Health Care Capacity – Supply & equipment • Regionally determined • Multi-staged at 14+ days Scientifically based decisions – Testing, testing & testing – Genetic, antibody & viability

Coronavirus: COVID-19 Update NEBRASKA PRAM DAILY AGGREGATED ACCELERATION DASHBOARD PRAM Dashboard NEBRASKA

for PRAM TODAY BENCHMARK

PRAM TODAY METRIC

PRAM VELOCITY BENCHMARK

PRAM TODAY VELOCITY

PRAM PRAM TODAY ACCELERATION ACCELERATION BENCHMARK

Confirmed Case Index % Positive Test Index Confirmed Death Index

<19.3 <5.0 <0.39

350.0 13.5 1.3

<1.0 <1.0 <1.0

1.23 1.43 0.56

<0.20 <0.20 <0.20

0.038 0.083 -0.034

Hospital Beds Index ICU Beds Index Ventilator Use Index

<429 <146 <153

220.7 71.7 61.7

<1.0 <1.0 <1.0

1.04 0.97 1.00

<0.20 <0.20 <0.20

-0.006 -0.045 -0.028

<1.5 <1.5 <1.5 0.5-1.5

1.07 1.00 1.04 0.93

<1.0 <1.0 <1.0 <1.0

1.11 0.86 0.98 0.75

<0.20 <0.20 <0.20 <0.20

0.017 -0.021 -0.003 -0.037

Disease Trend Index Resource Trend Index Recovery Composite Index Recovery Ratio Index

Coronavirus: COVID-19 Update NEBRASKA PRAM DAILY DISEASE DASHBOARD

Coronavirus: COVID-19 Update NEBRASKA PRAM DAILY RESOURCE DASHBOARD

Coronavirus: COVID-19 Update NEBRASKA PRAM DAILY AGGREGATED HCC ACCELERATION DASHBOARDS

Coronavirus: COVID-19 Update Key Professional & Pharmaceutical Interventions 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

COVID Test Deployment & Deployment Antibody Test Deployment & Deployment Routine ILI Syndromic Surveillance Routine Contact Identification & Tracing Single Reliable Data Collection & Sharing Monitor for Secondary & Tertiary Rebounds Antiviral Development & Deployment Vaccine Development & Deployment Develop Specific Mitigation & Response Guides Advise on federal, state & community actions

Coronavirus: COVID-19 Update Key Professional & Pharmaceutical Interventions

Coronavirus: COVID-19 Update Key Professional & Pharmaceutical Interventions

Coronavirus: COVID-19 Update 1-Check COVID

Coronavirus: COVID-19 Update H. R. 6074 Coronavirus Preparedness & Response Act COVID-19 Supplemental #1

$8.3 BILLION

Approved 415-2 by House on March 4, 2020 Approved 96-1 by the Senate on March 5, 2020 Signed by President on March 6, 2020

H. R. 6201 Families First Coronavirus Response Act COVID-19 Supplemental #2

$112 BILLION

Approved 363-40 by House on March 14, 2020 Approved 90-8 by the Senate on March 18, 2020 Signed by President on March 18, 2020

H. R. 748 Coronavirus Aid, Relief, & Economic Security Act COVID-19 Supplemental #3 $2.2 TRILLION Approved 96-0 by the Senate on March 25, 2020 Approved by Voice Vote House on March 27, 2020 Signed by President on March 27, 2020

Coronavirus: COVID-19 Update Key NPI’s or Community Mitigation Actions • • • • • • • •

If you are ill, stay home; self isolate & notify hc providerc If someone in your household is ill, stay home & self isloate Reduce students density in school, childcare, & events Reduce close contacts in the community and at work Reduce gatherings, iuse telework, create social distancing Use face coverings routinely inside & outside the home Limit utilization of facilities, travel, workforce & supplies Participate in self screening & public health surveillance

So…In Summary Incredible Challenge & Opportunity for the Global Community -

Play a leadership role in our Nation’s Public Safety & Defense Strategy.

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Expand health security professional education, research & care

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Continually meet critical need for scalable all hazard 21st Century threats

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Grow the federal investment in research, education and clinical care.

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Build upon strong Federal interagency relationships (DOD, DHHS, DHS…)

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Bolster new national opportunities in establishing P3 relationships.

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Save lives and grow economic prosperity today and into the future!

Not since the threat of global nuclear war first emerged has human-kind faced the risks of potential disasters at the scale that the 21st century brings.

Conclusions: Both the federal government and many localities in the United States have made substantial progress in preparing for some local forms of mass casualty events.

However, at this point, the US health care system is wholly unprepared for a wide range of 21st-century health threats. It lacks the will, coordinative mechanisms, habits of cooperation, governance agreements, and shared resource investments essential to preparedness.

Progress will require unprecedented participation and contribution from an enormous range of stakeholders, including government, the nonprofit and private sectors, and professionals involved in all facets of health care.

Berwick & Shine; Feb 2020 JAMA

The UNMC Global Center for Health Security: Serving Nebraska and the World

JEFFREY P. GOLD, MD Chancellor UNMC & UNO & Chair, Nebraska Medicine