It’s Week 3 of Ebola headlines in Dallas, and everyone’s nerves are pretty well grated to their roots.
News that the virus has struck two health care workers who cared for Thomas Eric Duncan before his death from Ebola, is rattling even the sturdiest among us. After all, the latest exposures happened at a hospital on full alert, where they ought to know what they are doing, right?
The occasional panicky thought — We Must Do Something Dramatic! — is understandable. But take a breath. Let’s keep things in perspective.
What’s most important right now is for all medical facilities to learn how to handle Ebola so that when — not if — the next case emerges, medical staffs will be more ready than Texas Health Presbyterian Hospital Dallas was.
We can’t solve the problem by expecting every ailing individual to go to one of the nation’s four primo biocontainment units like those in Atlanta or Omaha. First, they have very limited space. Second, the next time someone, whether in Dallas or Duluth, becomes ill and suspects Ebola, he’ll head straight to the closest ER. Workers there must know how to respond. That’s why every hospital in the country must power up to learn and implement best practices.
Yet the last few days have exposed systemic shortcomings in the way U.S. hospitals are equipped to fight Ebola.
For more than two weeks, Presbyterian and its staff have been forced into learning how to fight a fire as the blaze burned around them. Mistakes have been made; PR efforts have been inept.
But now the hospital can do a world of good by helping the medical community learn from its experiences. This requires complete transparency and truth-telling.
The most crucial test that every hospital must know how to pass involves the first hour or so after an undiagnosed victim of Ebola comes through its doors. We’ve heard conflicting explanations about what happened during Duncan’s initial visit to the Presbyterian ER. We need to know the real story.
It’s also imperative that the hospital release all the details about how Duncan’s case was handled once he returned to the hospital two days later. What protocol for protective gear disposal was in place? Was an infection-control manager on the case, and, if so, what were his or her responsibilities? What work was assigned to the two health care workers who have since contracted the virus?
The answers are critical, because until the epidemic is stopped in the hardest-hit areas of West Africa — 6,000 miles and 4,400-and-growing deaths away — cases like Duncan’s and the exposed health care workers' will continue to crop up worldwide.
For now, getting clear answers from Presbyterian will allow the health care system, hospital by hospital, to build the strongest possible armor against this killer virus.
Smart care precautions
After Ebola was diagnosed in nurse Nina Pham, the Centers for Disease Control and Prevention announced these changes:
- CDC staffers will watch every procedure done for Pham and change protocol immediately when warranted.
- Retraining is underway for hospital staff on how to don and doff protective gear and on other infection-control procedures.
- Staffers will put gear on and off in pairs, watching each other to prevent mistakes.
- Anti-viral-agent spray might be added to protocol for anyone leaving the isolation unit.
- CDC is looking into better protective gear that is less cumbersome yet able to block the virus.
- CDC is increasing training, outreach and education nationally.
- Information about the Pham case will be made widely available as quickly as possible.
