Lessons from the reestablishment of Public Health Laboratory activities in Puerto Rico after Hurricane Maria

Margaret C. Hardy, Rita C. Stinnett, Kristine J. Kines, Danisha M. Rivera-Nazario, David E. Lowe, Alexandra M. Mercante, Nathalie Gonzalez Jimenez, Rosa I. Cuevas Ruiz, Héctor I. Rivera Arbolay, Rafael L. Gonzalez Peña, Mayra Toro, Alma A. Trujillo, Claudia L. Pappas, Anna C. Llewellyn, Francisco Candal, María Burgos Garay, Gerardo A. Gomez, Jeniffer Concepcion Acevedo, Marisela Ansbro, Hercules Moura, Michael W. Shaw, Atis Muehlenbachs, Lovisa C. Romanoff, Brittany J. Sunshine, Dale A. Rose, Anita Patel, Craig N. Shapiro, S. Carolina Luna-Pinto, Satish K. Pillai and Eduardo O’Neill ()
Additional contact information
Margaret C. Hardy: Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention
Rita C. Stinnett: Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention
Kristine J. Kines: Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention
Danisha M. Rivera-Nazario: National Center for Environmental Health, Centers for Disease Control and Prevention
David E. Lowe: Laboratory Leadership Service Fellowship, Centers for Disease Control and Prevention
Alexandra M. Mercante: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Nathalie Gonzalez Jimenez: National Center for Environmental Health, Centers for Disease Control and Prevention
Rosa I. Cuevas Ruiz: Public Health Laboratories, Puerto Rico Department of Health
Héctor I. Rivera Arbolay: Public Health Laboratories, Puerto Rico Department of Health
Rafael L. Gonzalez Peña: Public Health Laboratories, Puerto Rico Department of Health
Mayra Toro: Public Health Laboratories, Puerto Rico Department of Health
Alma A. Trujillo: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Claudia L. Pappas: National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention
Anna C. Llewellyn: Center for Global Health, Centers for Disease Control and Prevention
Francisco Candal: Office of Technology and Innovation, Office of Science, Centers for Disease Control and Prevention
María Burgos Garay: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Gerardo A. Gomez: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Jeniffer Concepcion Acevedo: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Marisela Ansbro: Center for Preparedness and Response, Centers for Disease Control and Prevention
Hercules Moura: National Center for Environmental Health, Centers for Disease Control and Prevention
Michael W. Shaw: Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention
Atis Muehlenbachs: Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention
Lovisa C. Romanoff: National Center for Environmental Health, Centers for Disease Control and Prevention
Brittany J. Sunshine: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Dale A. Rose: Center for Preparedness and Response, Centers for Disease Control and Prevention
Anita Patel: National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention
Craig N. Shapiro: Center for Preparedness and Response, Centers for Disease Control and Prevention
S. Carolina Luna-Pinto: Center for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention
Satish K. Pillai: National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention
Eduardo O’Neill: Office of the Deputy Director for Infectious Diseases, Centers for Disease Control and Prevention

Nature Communications, 2019, vol. 10, issue 1, 1-8

Abstract: Abstract Public Health Laboratories (PHLs) in Puerto Rico did not escape the devastation caused by Hurricane Maria. We implemented a quality management system (QMS) approach to systematically reestablish laboratory testing, after evaluating structural and functional damage. PHLs were inoperable immediately after the storm. Our QMS-based approach began in October 2017, ended in May 2018, and resulted in the reestablishment of 92% of baseline laboratory testing capacity. Here, we share lessons learned from the historic recovery of the largest United States’ jurisdiction to lose its PHL capacity, and provide broadly applicable tools for other jurisdictions to enhance preparedness for public health emergencies.

Date: 2019
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DOI: 10.1038/s41467-019-10776-y

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