When it comes to bio-preparedness in America, Dr. Stephen Morse, a professor of epidemiology at Columbia University Medical Center in New York City, has mixed feelings.
Before the first case of Ebola in the United States, Morse said he would have considered the information provided by the Centers for Disease Control and Prevention and the reported false cases as signs that the United States was taking proper proactive steps to prevent an outbreak.
"Then we had the one actual case that came here," Morse said. "I would have to say after that that I think some places are prepared, some hospitals are prepared, but I can't give an answer for all of them because it's clear ... we have to learn quite a bit in order to be fully prepared."
Similarly, the cases with anthrax near the September 11, 2001, terrorist attacks represent a need for improvement.
"I'm not sure our record with anthrax was necessarily enviable," Morse said. "Not that it's easy, but the first case ... was recognized rather late."
Morse feels a key area for improvement lies in risk communication.
"What we call risk communication, which is basically what you tell the public and how do you do this in an effective way, is still an evolving field," he said. "You try to tell people what you know as promptly as you can and as accurately as you can."
Coupled with risk communication is a need to improve the public health system.
"It's really the function that ties all of these things together," Morse said. "Saying we need a stronger public health infrastructure also implies we need ... better surveillance, but as early warning systems that are consistent, that can actually operate with each other across state lines and that provide information in a timely and as accurate a fashion as possible, much like the risk communication."
In addition to his work as a professor, Morse works with the New York City Department of Health and Mental Hygiene to enhance emergency preparedness and serves on advisory boards related to public health and bioterrorism. He collaborates internationally with scientists on microbiology and virology research, as well as the development of early warning and response systems.