Health care workers regularly practice dealing with disasters, but one would expect them to know how to deal with infectious diseases without regular drills. However, given the terrible breaches of public health safety protocol that led to the spread of Ebola in Texas this past month, it is a safe bet that hospital and others like it are reviewing protocols for patient and worker safety with everyone to avoid.
In today’s day and age, with all the attention the Ebola outbreak in Africa has gotten, it seems unbelievable that the hospital personnel in Texas did not take every precaution. The handling of infectious diseases changed considerably since AIDS and Ebola first emerged in Africa. So, did the protective gear medical personnel wear in those situations. However, something was mishandled in Texas, which had better make medical personnel everywhere re-visit their handling of patients with highly infectious diseases.
When the news first emerged this weekend that a hospital staffer who cared for Thomas Duncan, the Ebola patient who died there Oct. 8, became ill, the assumption was that the new Ebola case arose in one of the 48 people who had contact with Duncan prior to his diagnosis. The U.S. Centers for Disease Control and Prevention (CDC), however, has since said that is not the case.
The CDC has confirmed that the new case arose in a female hospital staffer who was among those at Texas Health Presbyterian Hospital who wore full protective gear in treating Duncan. “At some point there was a breach in protocol,” admitted CDC head Thomas Frieden. He also acknowledged that his agency is evaluating whether any other healthcare workers were exposed like this person was.
Dr. Anthony Fauci, director of the National Institute of Allergy of Infectious Diseases, said that there had to have been “an inadvertent, innocent breach of the protocol” for someone wearing personal protective equipment to be exposed. He indicated that such an occurrence extremely rarely happens.
The federal agency is working to identify other health care personnel who also might have also come in contact with Duncan and were exposed. It is also ensuring the woman, who developed a fever on Friday and tested positive for Ebola the next day, is receives appropriate care.
Additionally, the CDC is, once again, reviewing procedures for health care workers to use in treating Ebola patients and those with other highly contagious viruses. “This (situation) tells us there is a need to enhance training and to make sure protocols are followed,” Frieden acknowledged. The CDC will study ways of reducing the number of health care workers involved in treatment, reducing medical procedures, such as kidney dialysis, that could increase risk of exposure and, he indicated, having someone on site to monitor that protocols are followed.
“If this individual was exposed … it is possible that other individuals were exposed,” Frieden warned. Until the source of the exposure is determined, the CDC will limit the health care workers who treat potential Ebola patients.
The hospital has defended the care it provided Duncan, which many have labeled as incompetent. Even though he informed them he had just come from West Africa, where the epidemic has killed more than 4,000 people, they did not suspect Ebola and sent him home with antibiotics two days before he was later admitted and ultimately died.
It should not be needed, but the CDC clearly does need to require that hospitals start reviewing protocols to avoid breaches, such as the one in Texas that allowed Ebola to spread. Frieden stated Sunday that “We have the ability to prevent the spread of Ebola by caring safely for patients,” but ensuring that hospitals review protocols will help ensure against future spread.
By Dyanne Weiss