There is a ton of Ebola fear and controversy in the media. Blame is being placed on the CDC, the Hospitals, the Nurses. When HIV/AIDS broke out in the 80’s we as a society experienced many of the same things that we’re seeing today with Ebola. Fear, Panic, Media sensationalism.
The NY Times has a run-down of the news from that time-period that you might say is being replicated now with Ebola
The AIDS Epidemic:1981-1987
1981: Unusual Outbreaks
June 5
The Centers for Disease Control and Prevention’s newsletter Morbidity and Mortality Weekly (MMWR) makes a reference to five cases of an unusual pneumonia in Los Angeles.
July 3
Rare Cancer Seen in 41 Homosexuals
The C.D.C.’s MMWR publishes its first description of a outbreak of 41 cases of Karposi’s Sarcoma, a rare skin cancer.
August 29
2 Fatal Diseases Focus of Inquiry
Two rare diseases have struck more than 100 homosexual men in the United States in recent months, killing almost half of them, and a medical study group has been formed to find out why.
December 10
Researchers report in The New England Journal of Medicine that harmless viruses and bacteria can often cause fatal illnesses in homosexual men.
By the end of 1981: 121 deaths
1982: Anxiety, Confusion
447 deaths
May 11
New Homosexual Disorder Worries Officials
A serious disorder of the immune system that has been known to doctors for less than a year – a disorder that appears to affect primarily male homosexuals – has now afflicted at least 335 people.
August 8
A Disease’s Spread Provokes Anxiety
The New York Times reports about the growing anxiety among gay men.
December 10
Infant Who Received Transfusion Dies of Immune Deficiency Illness
The C.D.C. reports that an infant died of acquired immune deficiency syndrome (AIDS) after receiving multiple transfusions.
The Ebola Fear
This fear is real and warranted. Hospitals are being criticized for not providing proper PPE (Personal Protective Equipment) and nurses are being criticized for not utilizing the equipment properly or not following protocol. i.e. the recent discussions of the Dallas Nurse diagnosed with Ebola after flying commercially.
In July of this year TedTalks had a conversation about the drawbacks of the US being a ‘reactive society’. Being reactive isn’t necessarily the right way to respond but it is a response. Fortunately, here in the US we at least have this option. As policies and procedures are modified, staff are being trained and proper equipment is being provided. These are all late in coming but they are coming and for this, we should be thankful. It’s not the pro-active response that many of us would have hopped for or expected but there are things being done. There are several items that can be addressed that take some of the ‘blame’ away and put information and education in the hands of those on the frontline dealing with this deadly virus and we are now beginning to see hospitals and health care facilities begin to implement and deal with these items.
Positive Responses and Implementation of Change
In a recent discussion via the Gypsy Nurse Network on Facebook, the question on ‘positive response’ was asked. What are hospitals and health care facilities doing to manage this virus? We got some great responses and proof that the Hospitals and Health Care systems are beginning to work on the issues at hand. (Note: The following quotes are from actual nurses working in the mentioned hospitals)
EQUIPMENT, TRAINING, SUPPORT, EDUCATION
“I work in an ED, we have a new cart with all the equipment on it that would be needed. It includes instructions for putting on the PPE and removal of it, and we have all been oriented to this cart. The 2 isolation rooms in this ED are also the first 2 rooms closest to the lobby.”
– North Shore Medical Center in Salem, MA
“I’m in ER. We have had frequent updates in our shift change huddle for a couple of months. Inserviced on isolation transport module. Maps of Africa and information posted in all triage rooms. Recently because of circumstances have increasing education including donning and doffing equipment and PAPPER respirators.”
“At John Peter Smith hospital in Fort Worth, TX we have now added a question on the triage and admission assessment asking about recent travel. I don’t work in ED but I know that they have been doing drills in case of a case coming to us.”
“At St. Louis university hospital a town hall meeting was held . Protocol set up for the Ebola pts. A strict PPE with N95 and suits not plastic gown will be wore special training for the nurse only two MD will handle all the cases.”
– St Louis University Hospital, St Louis , MO
“Policy in place, memos posted, online training including how to take special PPE on & off. Hazmat suits ordered by Infection Control. new “first contact” screening tool (specific questions about travel & symptoms) house wide. And this is an HCA hospital! Designated area of care here in Reston that includes most remote room, limited staff, & ICU goes to them with portable equipment should the need arise. We’re as ready as anyone can be, I think!”
“Also at an HCA in LaFayette, Louisiana. Had a mandatory meetings Mon and Tues where we got handouts and questions answered, online review of donning PPE and focusig on the taking off. Implemented a “buddy system” if/when working with EVD patients to help hold each other accountable with keeping precautions clear. Special carts created. And HCA is having pts being treated as air born and staff is to wear n-95’s instead of just surgical masks.”
– HCA Hospital Lafayette, LA
“Numerous CEUs on Ebola and new policies in place on PPE, discussed contamination of the OR equipment and how an isolation area being set up on another floor, ready for the worst. Doubt very much the OR stuff will come into play since unlikely a pt would survive any procedures when hemorrhaging is a key component of the disease.”
– Undisclosed Hospital in Miami, FL
“We had a staff meeting today to discuss how to properly wear PPE and we are wearing the gear they wear when doing total joints and will have a buddy watch us put it on and take it off to help prevent accidental contamination”
Education is Key
For those of us in the medical field, education is KEY! Not only to educate ourselves but our patients, families and communities.
The Following guidelines are copied from: http://www.cdc.gov/vhf/ebola/
Guidance & Recommendations
Infection Prevention and Control of Ebola Virus Disease in US Hospitals
Posting date: Wednesday, August 20, 2014
Faculty: David T. Kuhar, MD
- Infection Prevention and Control for Hospitalized Patients with Known or Suspected Ebola in U.S. Hospitals
- Environmental Infection Control in Hospitals for Ebola Virus – Interim Guidance
- Safe Handling of Human Remains of Ebola Patients in U. S. Hospitals and Mortuaries
- Medical Waste Management
Patient Evaluation
- Algorithm – Evaluating Returned Travelers for Ebola, US[PDF – 1 page]
- Checklist for Patients Being Evaluated for Ebola in the U.S.[PDF – 1 page]
Laboratory (specimen collection, transport, testing, submission)
- Specimen Collection, Transport, Testing, and Submission for Persons Under Investigation for Ebola in the U.S. – Interim Guidance
- Frequently Asked Questions for U.S. Clinical Laboratories
- Compliance with Select Agent Regulations for Laboratories Handling Patient Specimens that are Known or Suspected to Contain Ebola Virus – Interim Guidance
Protecting Healthcare Workers
- Sequence for Putting On and Removing Personal Protective Equipment (PPE)[PDF – 3 pages]
- Tools for Protecting Healthcare Personnel
Diagnosis
General Information
