Nurses Voice Concerns Over Hospital Preparedness as US Responds to Ebola Patient

The White House wants you to "get the facts" on Ebola. In the 24 hours or so since the news broke that the US had its first case of Ebola diagnosed inside its borders — but imported from Liberia — the White House has been instagramming and tweeting to make sure Americans are up to speed on Ebola facts, precautions, and news updates.

With the White House involved directly in the situation — beyond just a social media campaign — and the US Center for Disease Control and Prevention (CDC) taking the reins in coordinating control efforts, it appears all hands are on deck to make sure patient zero is the only patient.

Don't panic, yet: We asked an Ebola expert about the possibility of a pandemic. Read more here.

"Ebola is relatively easy to contain as long as you isolate any suspected cases and maintain good clinical practices to prevent onward transmission," David Heymann, an infectious disease professor at the London School of Hygiene & Tropical Medicine, said in a statement on Wednesday. "US hospitals have good infection control measures in place, which involve isolating fevers of unknown origin, and using good clinical practices."

But questions have arisen about whether the patient was initially treated with proper precautions, and what kind of gaps exist within our healthcare system for handling infectious disease outbreaks.

The CDC announced Tuesday evening that a man at Texas Health Presbyterian Hospital of Dallas had tested positive for Ebola. Some details have since emerged on the specifics of the patient and how he contracted the hemorrhagic fever.

The man, identified by the Associated Press and Health officials in Liberia as Thomas Eric Duncan, is a Liberian national who had been living in Monrovia before traveling to the US to visit family. He possibly became infected September 15 when he assisted in taking his landlord's daughter to a hospital after she fell ill. The daughter died the following day.

— The White House (@WhiteHouse)October 1, 2014

Duncan left Liberia on September 19 and arrived in the US the next day. He reportedly did not exhibit symptoms on the flight, an important detail because Ebola can only be transmitted once an infected individual becomes symptomatic.

Why don't West Africans believe Ebola is real? Read more here.

According to officials, his symptoms first began four days later on September 24, and he made his first attempt to seek medical care on Friday, September 26. Despite telling a nurse at the hospital that he had recently been in Liberia, Duncan was initially turned away. He was not placed in isolation, where he currently remains, until he returned the ER two days later on Sunday, September 28. This is where concern begins over how seriously the case was treated.

Hospital spokesman Dr. Mark Lester said the details about Duncan coming from Liberia, where Ebola has taken nearly 2,000 lives during the current outbreak, were "not fully communicated" to the medical team at the hospital.

Out of the 12 to 18 individuals that officials believe came in contact with Duncan during the period in which he could have infected others, some of them appear to have been exposed in the two days between hospital visits — including five schoolchildren who came in contact with Duncan over the weekend.

According to National Nurses United (NNU), a nurses union, the handling of Duncan's case is just one indication that nurses and other hospital staff in the US may not be prepared to handle Ebola.

Liz Jacobs, a spokesperson for the group, which represents more than 180,000 nurses across the country and has assisted in Ebola response efforts in West Africa, told VICE News that NNU's concerns about hospital preparedness for a potential Ebola epidemic is not new. But a preliminary survey recently found that 60 percent of nurses and their hospitals were not prepared to handle the virus.

"We knew it was only a matter of time before we would see this occurring in the US, this is international," she said, adding that, when it comes to developing plans and training, hospitals need to "involve the people on the frontlines putting their lives at risk and that's the nurses."

According to Jacobs, some areas of concern include insufficient supplies of Personal Protective Equipment (PPE), lack of isolation accommodations, and an increased need for staff members when a patient is isolated. Some nurses have also reported that they have not been informed of any emergency measures or precautionary plans for handling Ebola in their facilities.

While preparing healthcare workers for dealing with infectious diseases and outbreaks is a concern, the mass spread of Ebola in the US is widely considered unlikely. Close body contact and exchanging bodily fluids are the only ways the virus can be transmitted.

Video shows Liberian Ebola patient escaping a treatment center. Read more here.

Basic universal precautions and supportive care (such as electrolyte repletion) are considered sufficient for treating Ebola in a modern healthcare system. As World Bank President and former World Health Organization Official Jim Yong Kim pointed out in a recent statement, an Ebola outbreak has never truly faced a modern health care system.

"Any hospital in the United States could deal with Ebola very easily, because it's really straightforward interventions," he told VICE News in a previous interview about the virus.

Public health officials and virologists seem to agree that, in terms of hospital care and facilities, Ebola is up against a tough fight if it wants to take hold in the US.

"For better or worse, at the moment America has the best record of treating Ebola patients safely, with three successfully treated and three safe in hospital at the moment," he said. "Ebola patients in America will be in state of the art facilities, and in the safest, best hands."

According to Neuman, in treating a person with Ebola, the most important thing is to make sure that nobody else catches the virus. With officials already keeping tabs on at least a dozen potential contacts, Heymann said tracing any of these individuals would be "fairly easy and straightforward for US authorities."

"As long as these systems are maintained, we don't need to worry about a major Ebola outbreak occurring in the US," Heymann said. "The same activities that will contain Ebola in the US will also stop the outbreaks in Africa if applied effectively."

Follow Kayla Ruble on Twitter: @RubleKB

Photo via Flickr