Back in August, it only took Mt. Sinai Hospital workers in New York seven minutes to isolate and start treating a man who they suspected of having Ebola. Other U.S. hospitals have also speedily screened and tested suspected Ebola patients, all without incident.
The contrast between those other hospitals' responses and the actions of workers at at Texas Health Presbyterian Hospital Dallas, who recently mistook a Liberian man's symptoms for a common illness and didn't properly communicate his travel history to other colleagues, can be explained with training and drills, explained Dr. Brian Koll, the executive director of infection prevention for Mt. Sinai Health System.
“We first started preparing quite a while ago, when small pox was a concern, then we had the anthrax attacks in New York City, and then most recently for H1N1, MERS, bird flue and for SARS,” said Koll in a phone interview with the Huffington Post. “This is really just part and parcel of infectious diseases -- once someone has a fever and had traveled to an endemic area, automatically our protocols for isolation and treatment begins.”
A week before encountering the first Ebola patient diagnosed in the U.S., officials at Texas Health Presbyterian Hospital Dallas had held a meeting about what to do in the event that someone with suspected Ebola shows up at the hospital. In attendance were “all the stakeholders that might be involved in the care of such a patient,” according to Dr. Edward Goodman, Texas Health's hospital epidemiologist.
That may not have been enough, considering the lapse in care for their Ebola patient, Thomas Eric Duncan. He returned to the hospital two days later, but in an ambulance and, at that point, “critically ill."
Koll suggested that educational efforts and drills for everyone -- not just healthcare providers -- who worked in the hospital could create the conditions for immediate isolation and treatment. For instance, Mt. Sinai officials met with the hospital’s engineers, receptionists, security guards, transportation staffers and environmental services in addition to healthcare workers in order to prepare for a potential Ebola patient.
“I would strongly encourage meeting with everybody who is in the facility, from leadership all the way down to frontline staff,” advised Koll. “You don’t know who is going to come into contact with a patient.”
Education starts, Koll explained, with a primer on the science of Ebola -- how it’s passed on and how it progresses. Hospitals should also train staffers on how to properly wear and take off protection like gloves, masks, fluid-impermeable gowns and shoe protectors, as well as keep the gear accessible. For healthcare workers specifically, Koll has helped institute a protocol in which first contact with patients starts with testing for a fever, and then broad questions about travel.