A primary concern is the lack of readily available clinicians with the necessary specialized training to consult on the clinical diagnosis and treatment of unusual infectious diseases. Offering continuing medical education courses on such topics is not adequate to address this concern.
Given the unique nature of USAMRIID’s mission in dealing with special pathogens, additional measures should be taken to provide assurance that experienced medical professionals are readily available to consult on unusual infectious diseases. Serious consideration should be given to support an initiative that would provide experienced specialist physicians knowledgeable of diseases caused by organisms studied at the laboratories. This would include consultation as needed on a 24/7 schedule to see patients from the community. Such physicians should also serve to provide continuing communication and coordination between USAMRIID scientists and community physicians and public health personnel.
For medical and emergency response mechanisms, a senior authoritative management system is needed to ensure that USAMRIID works effectively with county government agencies, the local medical community, emergency preparedness and response initiatives, and Frederick Memorial Hospital. Such a system would include a clear chain of command with designated personnel to work directly with partners in the county and community. The Army should consider the use of permanent civilian staff for these positions to ensure continuity of relationships. Because USAMRIID will be part of the National Interagency Biodefense Campus, which will include biocontainment facilities of two other agencies, consideration should be given to delineating and coordinating emergency and medical response plans and resources for all facilities on the campus.