While we were sleeping one of Thomas Eric Duncan's care givers tested positive for Ebola. The care worker saw Duncan on his second visit to the hospital and was fully geared up when administering to him. The difference between Ebola with the flu, Hepatitis B or measles is that although the flu, Hepatitis B and measles are far more contagious and do kill, Ebola has a much higher mortality rate and is absolutely unforgiving of any safety protocol errors. Hospitals see Hep B often and it's a devastating disease, but there's no pandemic of Hep B.
From HuffPo:
"We knew a second case could be a reality, and we've been preparing for this possibility," Dr. David Lakey, commissioner of the Texas Department of State Health Services, said in a statement Sunday. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."The Dallas response to Ebola is more than disappointing. All hospital systems have infection control protocols and plan for it.... but it looks like some ....complacency (for a lack of a better word) set in. I'll use my local hospital for an example. Memorial Healthcare Systems in Hollywood, Florida, added a question to their triage form asking patients if and where they traveled outside the U.S within the last 30 days months if not years ago, but no one really looked at that information unless they had a weird case and a lot of workers were unaware that it was on the triage form. That changed as of last week. Memorial runs infectious disease drills regularly and all personnel undergo regular PPE (Personal Protective Equipment) in-service training. Protocol mistakes are noted, but don't require more retraining. That's likely to change. I haven't heard from Jackson, University of Miami or Baptist hospital systems, but I suspect they are reviewing their readiness, too.
Interestingly, the emergency managers in South Florida have met regularly ever since Hurricane Andrew that showed just how unprepared we were for emergencies. Up until watching Dallas fumble their way through Ebola in their city, quarantine foibles, and biohazard decontamination mishaps, and now PPE mistakes; I am concerned that South Florida emergency management starts and ends with hurricane planning. Do we know how to humanely initiate a quarantine?
The U.S. knows how to contain infectious disease; detect, isolate, prevent, control, and protocol are drilled into medical personnel. For example, MRSA an antibiotic resistant staph infection is listed as a "never event" (a condition so egregious, that it should never occur). It was good training for our hospitals. The infection control mechanisms work and MRSA rates are dropping. Hep B rates are dropping. We do know how to control for infectious disease.
Despite the errors, there's no doubt in my mind that the U.S. health system is up to this challenge. Meanwhile, you can feel the fear mounting in the U.S. as it is fed by a media and politicos wanting to score points.
I went to Twitter to see how the world was reacting to the latest news about Ebola and as you can see below, the reactions run the gamut from the good, the bad, the absurd to the ugly.