One man, Thomas Eric Duncan, has died in the U.S. from Ebola. Two healthcare nurses who attended to Duncan—two of at least 50 people who helped care for him at Texas Health Presbyterian Dallas hospital—are also believed to have contracted the disease. In theory, this is not possible because Ebola patients in the U.S. are treated in sterile isolation units. Now everyone who worked in the isolation unit on Duncan, according to Center for Disease Control director Dr. Thomas Frieden, is considered “at-risk” and is undergoing further evaluation.
Nurse Nina Pham, 26, fell ill over the weekend. Nurse Amber Joy Vinson developed a fever on Tuesday, after returning to Dallas from Frontier Airlines flight to Cleveland—a clear breach of protocol—where she was allegedly planning for her upcoming wedding. Vinson’s condition has worsened and she has been flown to a biocontainment unit at Emory University. The family she visited in Ohio has been instructed not to return to work. All 132 passengers of the airplane have been asked to contact the CDC, though Frienden says the risk of infection is diminished because Vinson was asymptomatic at the time of the flight.
Meanwhile, people with Ebola-like symptoms have been popping up all over North America—from a sheriff’s deputy in Texas, where Mr. Duncan was treated, to patients in Seattle, Ottawa and Ontario and elsewhere. This is understandable because symptoms are very common. They include stomach pain, redness of eyes, fever, diarrhea and bleeding. The incubation period for the disease is two to 21 days.
The current epicenter of the Ebola outbreak—the worst outbreak in history—is West Africa, principally Sierra Leone, Guinea and Liberia. (There is a concurrent Ebola breakout in the Democratic Republic of the Congo, but Congo is believed to have protocols and resources in place to wipe this smaller outbreak out quickly.) Mortality is 70% once infected. Laurie Garrett at ForeignPolicy.com says that as many as one million Africans could die by February 2015.
Meanwhile, the CDC says it will “stop [Ebola] in its tracks” in the U.S. The infection of the two nurses, however, is clearly proof of our vulnerability to infectious disease.
A rapid, point-of-care Ebola diagnostic is in a rushed development with the FDA, which will be far more effective than the temperature taking that is occurring at several U.S. airports. Lawmakers have called for a list to be provided to all hospitals of those who have travelled in areas with Ebola outbreaks. Others have called for an outright ban of travel to and from West Africa, which is highly unlikely to happen.
How many in North America are actually infected? Nobody knows for sure, but the official number is now two.
Hospitals across the U.S., according to experts, vary in their preparedness. Some have established thorough protocols for dealing with the disease in conjunction with the CDC. Others have only rudimentary preparedness and, presumably, some only an illusion of preparedness.
In the meantime, how should first responders respond?
The good news is that Ebola in the U.S. is extremely rare and it’s not an easy virus to contract, according to doctors. The virus should not be able to penetrate intact skin. Thorough hand washing can kill the virus. So, at a minimum, wash your hands often and be careful donning and doffing personal protective equipment as needed. Ask symptomatic subjects about their travel history and make sure this information makes it to the hospital staff in charge upon admittance.
Moreover, command staff at your department should be in routine contact with local medical centers. The Ebola outbreak is another topic to bring up, remembering that at present the threat is very low. Use this conversation as an opportunity to strengthen relationships with EMS, fire, hospitals and government and get on the same page.Remember: The flu kills thousands in this country each year. Historic flu pandemics, such as the Spanish Flu of 1918, kill many millions.
Hospital disaster preparedness funding since has been cut in half since 2004, according to Dr. Irwin Redlener, director of the National Center for Disaster Preparedness. We don’t know what the outcome of this outbreak will be. But in the meantime infectious diseases (remember Swine Flu?) happen and will continue to happen, and we need to prepare our officers, who will be in harm’s way, to do their jobs as safely as they can.