Staying prepared for an outbreak

Meet the folks who staff Geisinger’s biocontainment unit, a first line of defense against contagious disease.

Imagine news has just broken. Someone in our region is suspected of carrying a new, contagious virus after traveling abroad.

Do you go into lockdown mode? Or do you say, “I’m ready to help”?

If you’re one of about 90 volunteers across Geisinger who are trained to work in the biocontainment unit at Geisinger Shamokin Area Community Hospital, you’d likely do the latter.

The unit, which celebrates its 10th anniversary this year, is part of a national network created in response to an African Ebola outbreak. The goal is to have self-contained spaces, staffed by people who’ve undergone extensive drills and training, ready for a public health threat involving any contagion.

The facility is carefully planned, with its own lab, a separate trash disposal process and an airflow and cleaning system that includes airlocks for certain spaces. Every detail, right down to pass-throughs for transferring things like lab specimens between rooms, is designed to reduce any chance for the spread of contaminants.

But the unit’s most important “safety features” are the people who staff it. While most folks might instinctively avoid getting close to invisible, dangerous pathogens, this team is eager to face these threats.

“We all work together,” says Katherine Kemberling, emergency management director. “Everyone wants to be here.”

Although most of the volunteers are scattered throughout Geisinger’s footprint and only meet in person for training, “We’re like family,” says nursing assistant Heidi Rupp.

The team includes Geisinger employees who hold all kinds of roles, including doctors, nurses and environmental services workers. But the nature of the work makes the team uniquely egalitarian. Cleaning — constant, careful, relentless cleaning — is done by everyone on the unit, from environmental service technicians to physicians.

And everyone is empowered to correct their teammates. “We have a culture of safety here,” says Ms. Kemberling. “If you see a safety risk, you say it.”

A compelling interest in contagion control

John Harahus, RN, emergency preparedness coordinator, jumped at the chance to work at the unit when it was in development.

His interest in public health emergencies started when he was a kid after watching the 1995 movie Outbreak, about the spread of a deadly virus. “I had my mom take me to a medical library to learn about Ebola,” he says. He worked on an EMS crew when he was young and later joined Geisinger’s nursing staff. “When I found out they were starting a unit here, I said, ‘Yes. Sign me up.’”

Ms. Kemberling and Ms. Rupp say Mr. Harahus is especially good at concocting substances that mimic bodily fluids for training. Using a cabinet full of items like cake mix, coffee grounds and oatmeal, he can replicate things like vomit — including its change in color and consistency as an Ebola case progresses.

It might sound odd, but the goal is serious. If a team member gets even a spattering of the substance on their personal protective equipment (PPE), they need to know how to handle the situation in a way that protects themselves and everyone around them.

COVID sets team in motion

Thankfully, the unit has yet to host a patient. But the team’s training was crucial to keeping Geisinger patients and staff safe during the pandemic, when members were deployed across the system as COVID safety site managers.

Rather than scaring off potential volunteers, the pandemic served as a recruiting tool. “When staff saw how effectively we reduced the risk of spreading COVID, people became passionate about the work we do,” Ms. Kemberling says. “When you do things the right way, you are safe.”

For example, the team follows strict protocols for donning, doffing and fitting PPE. The unit has several full-length mirrors, so team members can check and re-check their gear. And everyone, including staff who monitor team members using video cameras, watches to make sure PPE fits properly and doesn’t need adjustment.

Ms. Rupp is proud of her work during the pandemic and her ability to share her knowledge. “Not one person got COVID in the ER while I was a site manager,” she says.

Combating stress

Being ever vigilant about cleanliness and prepping endlessly to fight contagion might sound stressful. But Mr. Harahus says the endless training, both locally and with national partners, has the opposite effect.

“Training reduces stress,” he says. “It becomes second nature. That’s why we’re more like family than coworkers. We’re always looking out for each other.”

And if another outbreak happens?

“I would come in no matter what,” says Ms. Rupp. “I love this unit, and I want to help the patient. It’s all about training.”