| USA TODAY | - |
A
national nurses group says that a Dallas hospital's sloppy handling of
the nation's first Ebola case put both healthcare workers and patients
at risk of infection from the deadly virus.
Liz Szabo, USA TODAY
Frontier Airlines confirms the day before a second Dallas health
care worker began showing symptoms of Ebola, she took a flight from
Cleveland to Dallas. The CDC now wants to hear from anyone who was on
that same flight.
VPC
At a press conference Wednesday, leaders from National Nurses United recited mutliple examples of how Texas Health Presbyterian Health in Dallas mishandled the care of Thomas Eric Duncan, the first person with Ebola diagnosed in the USA.
The group called on President Obama to use his executive authority to issue uniform standards for treating Ebola patients.
Two healthcare workers in Dallas who cared for Duncan before he was diagnosed with Ebola have been diagnosed with Ebola. A Spanish nurse caring for an Ebola patient in Madrid also has been diagnosed with Ebola.
In Dallas, nurses assigned to care for Duncan, who died last week, weren't given proper training or proper personal protective equipment, said Deborah Burger, copresident of the nursing group, who said she has spoken to nurses at Texas Presbyterian. These nurses also assigned to care for other patient, potentially exposing them to Ebola. Duncan was left in an area with other patients for hours after he was diagnosed, rather that immediately isolated, she said.
Blood samples taken from Duncan were sent through the hospital's general tube delivery system, rather than hand-delivered to a lab, Burger quoted the nurses as saying. That could potentially contaminated the entire tube system, which could infect blood shipped around the hospital.
The hospital failed to promptly remove waste contaminated with Ebola, which was stacked "to the ceilings," Burger said.
"We want to make sure this does not happen ever again," Burger said.
In a statement, Wendell Watson, a spokesman for the Dallas Hospital said that, "patient and employee safety is our greatest priority and we take compliance very seriously. We have numerous measures in place to provide a safe working environment, including mandatory annual training and a 24-7 hotline and other mechanisms that allow for anonymous reporting. Our nursing staff is committed to providing quality, compassionate care, as we have always known, and as the world has seen firsthand in recent days. We will continue to review and respond to any concerns raised by our nurses and all employees."
Secretary of Health and Human Services Sylvia Burwell said Wednesday that the country is devoted to making sure that nurses and other staff are safe.
In the future, the Centers for Disease Control and Prevention will send "go teams" of Ebola experts to any hospital with an Ebola case, within hours of the diagnosis, according to Thomas Frieden, the agency's director.
Frieden said CDC staff observed some problems at the Dallas hospital.
"Some healthcare workers were putting on three or four layers of personal protective equipment," or PPE, Frieden said. "Other things were done such as taping part of the gear in the belief that this would be more protective."
While workers were operating in good faith, Frieden said that, "by putting on more layers of gloves and other layers of clothing, it becomes much harder to put them and much harder to take them off. So the risk of contamination gets much higher."
Using a routine procedure helps reduce the risk of infection, Frieden said. "Healthcare workers who are using familiar PPEs in familiar ways are more likely to do it right," he said.
The nursing group also released results of a survey of nurses nationwide. According to the survey, 85% said their hospital has not provided education on Ebola in a way that lets nurses interact and ask questions.
In the survey, 40% say their hospital has insufficient current supplies of eye protection, including face shields or side shields with goggles; 38% said there are insufficient supplies of fluid resistant/impermeable gowns in their hospital.
In the nursing group's letter to Obama, the group asked for all hospitals to follow the guidelines used at the Nebraska Medical Center in Omaha, one of four in the USA speically designed to treat patients with the most dangerous infectious diseases. That hospital treated and released on Ebola patient, who survived, and is currently treating a second American with Ebola.
Among their demands, the nurses asked for full-body hazardous material suits that meet certain high standards.
Nurses caring for patients with Ebola are "our first line of defense," the group wrote to Obama. "We would not send soldiers to the battlefield without armor and weapons."
The group added, "not one more patient, nurse, or healthcare worker should be put at risk due to a lack of health care facility preparedness. The United States should be setting the example on how to contain and eradicate the Ebola virus."
Some groups have a good track record at safely caring for Ebola patients.
Doctors Without Borders has had 21 Ebola infections among its 3,000 staff on the ground in Liberia, Sierra Leone and Guinea. Twelve of its workers have died, six have recovered and three are in isolation.
Very few of those infections occurred in the hospital, said spokesman Michael Goldfarb. "The vast majority of cases occurred outside (its) medical structures, among local/national staff members," Goldfarb says. "While there isn't zero risk of exposure in our health facilities, the main threat to our staff lies in the communities they return to after working hours."
According to the World Health Organization, at least 8,997 people have been infected with Ebola and 4,493 people have died. Those numbers likely underestimate the epidemic's true reach because many overwhelmed health workers are no longer able to keep with regularly reporting new cases and deaths.
According to the WHO, 236 of 427 healthcare workers infected with Ebola have died.
Ebola does not spread through the air and can be transmitted only through close contact with the bodily fluids of someone who is showing symptoms of Ebola, according to the CDC. In the early stages of the disease, people are not very contagious because their bodies have relatively low levels of virus. That means that the general population is not at high risk from casual contact with Ebola patients.
Health workers, however, are at extremely high risk of Ebola, because the virus makes many copies of itself as the disease progresses, says infectious disease expert Peter Hotez. People with late stages of Ebola often bleed profusely, vomiting blood, making them contagious to those caring for them, such as health workers or family members, who take care of many Ebola patients in West Africa.
Some scientists are urging health officials to acknowledge what they don't know. At a meeting on Ebola Tuesday, one infectious disease researcher told an audience at Johns Hopkins University in Baltimore that scientists should get comfortable with uncertainty and be honest with the public about gaps in knowledge about Ebola.
"We're making this up as we go," said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. "We have to be mindful that we're making it up. One of the worst enemies we can have today is dogma."
Osterholm said he's concerned about migrant workers spreading Ebola to new parts of West Africa. Many men and teen boys work at home in the summer while harvesting crops, but leave their home country to take temporary jobs in October.
"The rest of Africa is a tanker truck waiting for a match to hit it," Osterholm said.
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