Remember when the official word was that Ebola in the United States was completely under control? Two weeks ago, the public was told that Thomas Eric Duncan, the country's first Ebola patient, was immediately quarantined after he went to Texas Health Presbyterian the second time with Ebola symptoms. Still, back then it seemed believable that officials in Dallas and the state had Ebola covered.
Flash-forward to today: Duncan died of the disease last week and now two of the nurses who treated him have tested positive for Ebola. Other nurses are now telling the public that conditions at the Dallas hospital were anything but safe.
An unspecified number of nurses told reporters in a conference call on Tuesday that they were "unsupported and unprepared" to handle an Ebola patient, according to the New York Daily News.
See, the initial impression from officials was that Duncan and his family were clapped into quarantine as soon as they arrived back at the hospital on September 28 and told doctors that he'd just come from Liberia and that they suspected Ebola. But Dallas nurses say that wasn't what happened. In fact, Duncan wasn't isolated until hours after he arrived at the hospital, and only after a supervising nurse demanded it. Up until then, Duncan was sitting near seven other patients.
The Centers for Disease Control advises impermeable gowns that cover the entire body and all exposed skin, but nurses claim staff was provided with "flimsy" gowns that didn't cover the neck, head or lower legs, according to the Daily News. They tripled their gloves to handle the patient, but had to close the gloves with surgical tape.
The CDC also advises healthcare workers to wear face shields for protection, but the nurses say they were only given surgical masks. Some wore face masks with plastic shields to protect their eyes, but that wasn't standard at the hospital, according to the Associated Press. Healthcare workers didn't receive full-body gear until Duncan's second day in the intensive care unit. Even worse, Duncan's lab samples were sent through the same hospital tube system used by the entire hospital without any warnings or precautions taken.
All of this was communicated through National Nurses United, the largest nursing union in the country. The nurses listened to questions and emailed answers. RoseAnne DeMoro, director of the union, refused to disclose how many nurses spoke on the issue, because Texas Health Presbyterian has explicitly banned its staff from talking to the media. The nurses who spoke aren't members of the union and there's no protection for their jobs should their identities be disclosed.
The nurses reportedly chose to speak out after nurse Nina Pham tested positive for the disease, according to the Daily News. Pham cared for Duncan his first day in the intensive care unit, before any of the safety gear was provided. Now another nurse has tested positive for the disease -- though she was only diagnosed the day after she flew from Cleveland to Dallas, according to the Washington Post.
Texas Nurses Association is naturally concerned about all of this, particularly the CDC's initial claim that Pham contracted the disease through a "breach of protocol," which is basically a fancy way of saying that it was her mistake, director Cindy Zolnierek stated on Tuesday. CDC Director Dr. Thomas Friedan hastily backed off that claim, admitting that the CDC should have done more when Ebola was confirmed, and it is starting to look more and more likely that, despite our much vaunted healthcare system and the public infrastructure that was held up as protectively superior compared to that of West Africa, we may not have been as ready to handle this disease as officials claimed. (Shocking, we know.)
In fact, nurses across the United States are reporting that they still aren't being prepared to handle another Ebola patient -- and despite airport screenings, the odds are good that there will be another case, according to a release issued by National Nurses United. Of more than 2,000 RNs surveyed in 46 states, 85 percent said that they have not been provided education about Ebola in a setup that allows them to ask questions. When it comes to gear, 40 percent say their hospitals don't have enough face masks and other supplies to protect their eyes, and about the same percentage report they don't have enough impermeable gowns to protect their skin from the highly contagious bodily fluids of an Ebola patient.
And the thing is, Ebola isn't just any virus. Despite all the reassurances about how it doesn't spread that easily, the bodily fluids of an Ebola patient who is showing symptoms are highly contagious, and the healthcare workers dealing with such patients probably aren't used to observing this level of caution, Diana Mason, a professor of nursing at Hunter College and president of the American Academy of Nursing, told NPR.
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When dealing with an Ebola patient, healthcare workers shouldn't gown and de-gown in the same place. However, most hospitals simply don't have the space for that, Mason said. The process is also specific enough that Mason said you would want someone watching you gown and de-gown because it's so easy to make a mistake.
Meanwhile, Houston officials are intent on not going the way of Dallas on handling Ebola. On Wednesday morning, the Houston City Council and Mayor Annise Parker were briefed by the directors of Houston Emergency Medical Services and the Houston Department of Health and Human Services on the disease. Officials with both organizations reported they've been meeting with representatives from schools, local hospitals and first responders about how to deal with a potential Ebola patient, according to KPRC. Basically, anyone suspected of having Ebola needs to be immediately quarantined and hospitals need to, you know, actually have the proper gear to protect their healthcare workers from contracting the disease while caring for a patient.
Gov. Rick Perry is still in Europe, but he led the pack, issuing a statement on the second locally transmitted Ebola case in Texas:
"This is the first time that our nation has had to deal with a threat such as this. Everyone working on this challenge - from the medical professionals at the bedside to the public health officials addressing containment of the infection - is working to end the threat posed by this disease. These individuals are keeping the health and safety of Texans and the needs of the patients as their most critical tasks. Every relevant agency at the local, state and national levels is working to support these individuals."