A United States healthcare worker here in Dallas has contracted Ebola from an infected patient. A “breach in protocol” according to the Center for Disease Control and Prevention (CDC) is the cause for spread of the deadly disease. This nurse is one of up to 416 healthcare workers reported by the World Health Organization (WHO) who have contracted the deadly Ebola virus since the start of spread this year. In their recent release, the WHOclaim 233 healthcare workers have died in the line of fire on the Ebola war thus far.
In the United States, we have the CDC, local and state government jumping in to control the spread of Ebola. For our health care leaders and general population, this deadly disease is more understood than it has been in under-served populations and in past generations. For high-risk individuals, strict isolation protocols are in place at our hospitals and clinics. Here in Dallas, the emergency response (911) and disaster preparedness system has specially prepped ambulances in the ready.
From this most recent disturbing news surrounding our own Dallas healthcare worker, we are learning (the hard way) that containing the spread of Ebola can be difficult and no “breach of protocol” is acceptable.
Historically, healthcare workers have been at high risk for developing Ebola in Guinea, Liberia, Nigeria and Sierra Leone (for example). The difference with this Ebola outbreak is that this year’s sickness spread beyond remote rural areas of Africa where containment is more easily and successfully performed. Instead, Ebola is reaching Africa’s larger cities where (according to WHO),”neither doctors nor the general public are familiar with the disease”.
In addition, several infectious diseases in these regions initially appear similar to the Ebola illness. Common African illnesses such as malaria and typhoid fever may share similar early signs and therefore the healthcare providers in these regions may not have high suspicions for Ebola. When unprotected healthcare providers (without medical gloves, gowns, etc) rush to aid critically ill patients, bodily fluid contact between provider and patient may occur.
As I was assisting an unconscious (but breathing) gentleman in a Las Vegas show, I did take time to ponder these questions, “Will I have to begin mouth to mouth resuscitation?” If he had stopped breathing (as were CPR protocols at that time), the answer would have been “Yes.”
At unexpected times, I (among other physicians, nurses, etc.) have rushed into taxicabs and parking lots to deliver babies with bare hands. Even before and during the AIDS epidemic, we were not always properly prepared or over-sighted on the need for gloving and gowning when attending an emergency. Whether the emergency was in or out of the hospital, unexpected critically wounded patients or laboring woman required our immediate medical care. In addition, I am not alone in assisting motor vehicle injury patients on the roadside. Acting on my own at a roadside emergency, I don’t take the time to ask a wounded accident victim if they have HIV, hepatitis or any other infectious disease before beginning medical intervention. Many medical personnel would agree, that caring for the wounded and sick carries a degree of personal risk.
The WHO reports that the loss of so many doctors and nurses has made it difficult for them to provide sufficient numbers of foreign medical staff in Ebola-afflicted countries. For the unfortunate Ebola-afflicted healthcare workers, the innate need to serve people sometimes has them putting patients’ needs over their own safety.
In the medical field, contagion is an understood risk; however, healthcare providers’ falling victim to exposed diseases is upsetting. Best prevention methods need to be available, implemented and followed.