Update on Ebola Treatment Center Costs and Sustainability, United States, 2019

Jocelyn J. Herstein; Aurora B. Le; Lily A. McNulty; Sean A. Buehler; Paul D. Biddinger; Angela L. Hewlett; John J. Lowe; Shawn G. Gibbs


Emerging Infectious Diseases. 2020;26(5):1007-1009. 

In This Article

Abstract and Introduction


We surveyed 56 Ebola treatment centers (ETCs) in the United States and identified costs incurred since 2014 ($1.76 million/ETC) and sustainability strategies. ETCs reported heavy reliance on federal funding. It is uncertain if, or for how long, ETCs can maintain capabilities should federal funding expire in 2020.


In 2014, a tiered network of facilities to manage patients with Ebola virus disease (EVD) was established in the United States.[1] The Centers for Disease Control and Prevention designated 56 hospitals as Ebola treatment centers (ETCs), each equipped with specified capabilities to provide safe high-level isolation care for patients with EVD. This network was enhanced with the later designation of 10 regional Ebola and other special pathogen treatment centers (RESPTCs) with enhanced capabilities to care for patients with other highly hazardous communicable diseases (HHCDs). Since that time, efforts have been made to expand existing ETC capabilities beyond EVD in preparation for treating the next HHCD outbreak.

Previous assessments of these 56 ETCs by our team found average costs incurred to train teams, enhance physical infrastructure, and acquire advanced resources totaled nearly $1.2 million/facility.[2] Despite these major investments, only 15–18 months after initially establishing their ETCs, by 2016 most hospitals reported challenges in sustaining ETC capabilities, and 3 centers reported they no longer maintained preparedness for EVD care.[3]

Now, 3.5 years after our last ETC assessment, these specialized units face intensified threats to their sustainability because federal funding of these centers through the Hospital Preparedness Program (HPP) Ebola Preparedness and Response Activities is set to expire in 2020.[4] We aimed to determine whether additional costs for ETCs have incurred since our assessment in 2015, as well as to assess hospitals' sustainability plans for maintaining capabilities after federal funding ceases.