More Training On the Way—and Needed—for U.S. Health Care Workers Expected to Treat Ebola Patients

Oct 13, 2014, 12:48 PM

Tomorrow, the U.S. Centers for Disease Control and Infection (CDC) will hold a conference call for medical personnel. The call will review and underline safeguards needed to help protect health workers who will be called on to help with care for U.S. Ebola patients, should more cased be diagnosed.

The first patient diagnosed with Ebola in the United States died in Dallas last week; a second, a nurse who looked after that patient, was confirmed yesterday by the CDC to have the virus. She is in isolation in a Dallas hospital.

CDC director Tom Frieden, MD, MPH, said the infected nurse may have contracted the disease through a “breach in protective gear protocol.” However, Ezekiel Emanuel, MD, a bioethicist and professor at the University of Pennsylvania, said this morning on MSNBC that he thought the problem was not so much a breach as the need for greater implementation. Medical checklist guru Atul Gawande, MD, agrees. In a short piece titled “Ebola is Stoppable” in The New Yorker last week, Gawande wrote “The main challenge is taking off the protective personal equipment—that’s when it is easiest to contaminate yourself.”

Public health experts are assessing what changes to make to reduce the chance of transmission without making suiting up so cumbersome that health workers are tempted to skip steps. At yesterday’s press conference, Frieden said that there have been reports out of West Africa of health workers who contaminated themselves when they pricked themselves with a clean needle that came in contact with contaminated gloves. For now, the procedures laid out in posters from the CDC on how to don and remove protective clothing remain in place.

>>Bonus Link: Over the weekend, an article in the Los Angeles Times questioned a key component of assessing people who may be infected with Ebola—assuming that they are not contagious if they don’t have fever. The study, funded by the World Health Organization and published online last month in the New England Journal of Medicine, analyzed data on 3,343 confirmed and 667 probable cases of Ebola, finding that thirteen percent did not have a fever. U.S. public health experts told the Times that they continue to view fever as the key indicator that the virus is transmissible to other people.

This commentary originally appeared on the RWJF New Public Health blog.