Testing a State-of-the-Art Medevac Unit for a Flight You Hope to Never Take

From the outside, the Containerized Bio-Containment System (CBCS) looks like a huge, nondescript shipping container. But underneath this unassuming exterior is the next step in our fight against global epidemics. Inside you will find state-of-the-art medical and biological containment equipment that make it possible to fly multiple individuals with highly infectious diseases safely. On November 18, the State Department--in partnership with the Department of Health and Human Services (HHS), the Paul G. Allen Foundation, and MRI Global--practiced using this medevac capability in an exercise called Tranquil Surge.  

During the exercise, the CBCS was loaded onto a chartered 747 aircraft. The aircraft picked up willing participants role-playing as infected Ebola patients in Monrovia, Liberia and brought them to the University of Nebraska Medical Center. As part of the drill, participants from multiple countries, agencies, and local governments tested their procedures--everything from the mechanics of the actual container to the process for communicating across agencies and receiving clearances to bring the ill individuals across jurisdictions. Exercises like this one ensure we are prepared to respond immediately to an emerging infectious disease threat anywhere in the world.

Medical staff attend to a simulated patient in a CBCS unit during the Tranquil Surge training exercise. [State Department Photo]

Earlier this year, the international community breathed a collective sigh of relief when the World Health Organization officially declared an end to the Ebola outbreak in West Africa. The outbreak killed 11,000 people and sickened 28,000 others, and countless more suffered the social and economic repercussions of this outbreak--a tragedy that will leave a lasting mark on the world. 

Yet, the devastation could have been more widespread. The disease was contained thanks to the courage of doctors, nurses, and aid workers who put their own lives at risk as they rushed to the center of the epidemic. Despite taking all precautions, some of these lifesavers, including American citizens, became infected. And when this happened, the U.S. government had a commitment to protect and support our people involved in the outbreak response. We had to quickly figure out how to transport Ebola-stricken patients across borders without worsening their condition or exposing others to infection. To do so, the Department of State contracted a specialized plane with advanced equipment through Phoenix Air Group out of Cartersville, Georgia. The Department of State team--in partnership with HHS and the U.S. Centers for Disease Control and Prevention (CDC)--coordinated the evacuation of 46 people from multiple countries infected with or exposed to the Ebola virus. We brought these brave and dedicated individuals to the United States or to specialized treatment centers in one of six European cities, but we were often only able to transport one patient at a time. This medevac capability provided essential reassurance for healthcare workers from around the globe who volunteered for the fight against Ebola, but we also learned that these capabilities needed to be expanded.

A Containerized Biocontainment System (CBCS) unit is loaded onto a 747-400F charter jet in Monrovia, Liberia during the Tranquil Surge training exercise. [State Department Photo]

In our global health efforts, we are continually asking what we can do better to improve our processes. As you can imagine, developing a state-of-the-art biocontainment system was an incredibly complex challenge, but we met that challenge thanks to the continued hard work of the State Department and HHS teams, the vision of the Paul G. Allen Foundation, which provided a $5 million grant, and MRI Global’s design expertise. This team drew on years of bio-containment knowledge, lessons from the Ebola outbreak, and experience in custom fabrication to develop this highly specialized system. And then they figured out–-literally–-how to get it off the ground!   

Thanks to this innovative partnership, we can now safely transport up to four patients at a time, stop in several locations, and offer better in-flight medical support, all while preventing the spread of highly contagious pathogens.   

In our inter-connected world, infectious disease moves from person to person, community to community, and country to country incredibly quickly. One of the best ways to protect the American people is to be ready to respond as soon as an outbreak strikes--anywhere in world. The biocontainment system is one part of the multi-faceted U.S. government commitment to global health security. Another facet is the Global Health Security Agenda or GHSA, a growing partnership of over 50 nations, international organizations, and non-governmental stakeholders committed to helping countries build their capacity to prevent, detect, and respond to infectious disease threats. Through GHSA, we are building a responsive global coalition. To meet the complex challenges of tomorrow, the world needs diverse expertise and innovative solutions. We are using lessons learned from the recent Ebola outbreak to bring us one step closer to a world safer and more secure from epidemic threats.  

About the Author:  Heather Higginbottom serves as Deputy Secretary of State for Management and Resources and Dawn O’Connell serves as Senior Counselor to the Secretary of Health and Human Services.

Editor's Note: This entry also appeared on Medium.com.

For more information:

State Department and HHS Officials, including Heather Higginbottom, Deputy Secretary of State for Management and Resources (top left) join medical staff and their simulated patients during their tour of a CBCS unit. [State Department Photo]
November 28, 2016


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