Earlier today, emergency medical workers rushed 33-year-old doctor Craig Spencer to Bellevue Hospital in Manhattan after he developed a fever of 103 F and nausea, potential Ebola symptoms.
Spencer had recently returned from Guinea, where he was treating Ebola patients while working with Doctors Without Borders.
Ever since Thomas Eric Duncan was diagnosed with Ebola in Dallas, there have been fears that another case will be imported from West Africa and that the disease could spread.
As of Oct. 6, New York City had already investigated 88 suspected or potential Ebola cases, according to the Centres for Disease Control and Prevention. The New York Times reports that about one person a day has been put into isolation in a city hospital over the past six weeks.
That’s a lot of scares, but no one has turned up with the virus yet. Doctors ruled out all but one suspected case without even a blood test for Ebola. The city health department is expected to release Spencer’s test results by 3 a.m. EDT.
While fears have not yet panned out, many fear an outbreak in a large, global, dense city. Fortunately, health officials are on high alert — they have been preparing for possible cases like Spencer’s for a while.
How They’re Preparing For A Case
At JFK, the entry point for about half of the 150 people who arrive in the US each day from Guinea, Sierra Leone, or Liberia, travellers coming from or who passed through those countries are questioned and checked for illness, and their temperatures are measured using an infrared temperature gun. They also receive a special kit to help them self-monitor symptoms, with a thermometer and information about Ebola symptoms.
People who may have been exposed to Ebola will be referred to the CDC. If sent to a hospital, they will probably go to Bellevue, which has been designated as the go-to place for dealing with the illness in New York City. That’s where Spencer is currently being evaluated.
The hospital has four isolation rooms set up to deal with Ebola patients, and they say they could set up nine more rooms if needed.
Failures to stop infections in Spain and Dallas show that containing the virus requires what CDC director Tom Frieden called “meticulous attention to detail.” The smallest error could have fatal consequences.
One criticism of those cases is that hospital staff didn’t receive adequate training on how to put on and take off gear that could be easily contaminated while dealing with the virus.
Anne Bové, a representative from the New York State Nurses Association, told WNYC that in New York “people are being trained on how to put the personal equipment on and take it off … It’s something that’s done more than once or twice.”
Additionally, the city’s Department of Health has sent “patients” pretending to have Ebola symptoms and with a plausible travel history into all 11 city hospitals to evaluate their performance.
They have noticed that staff have a harder time removing protective suits correctly than putting them on in the first place, and they’re trying to eliminate inconsistent behaviour.
Any healthcare workers who see a certain set of symptoms is supposed to immediately call the Department of Health. The city wants to know if a hospital sees anyone who has been to a country experiencing an Ebola outbreak who has a fever over 101.5 degrees F and has other symptoms including a severe headache, abdominal pain, bleeding, or diarrhoea.
These procedures were communicated to New York City hospitals by the CDC and put into place on Aug. 11. This means that, in theory, if someone showed up with the same symptoms that Thomas Eric Duncan had when he first went to the emergency room in Dallas, it should prompt an immediate Ebola investigation.
The CDC says that there have been delays in diagnosing some suspected cases because healthcare workers have been hesitant to examine potential Ebola patients and handle their laboratory specimens.
The Virus Can Be Stopped
Based on the experience of Nigeria, it’s clear that with the proper approach, Ebola’s spread in an urban area can be stopped. Ebola cases were successfully treated in Atlanta and Nebraska without any additional infections, which is another sign that hospitals can safely treat the disease.
But it is possible that we’ll see other cases show up before the epidemic in West Africa is under control.
Until then, the CDC is telling hospitals to take a travel history of patients, and if there’s any chance they have been exposed to “think Ebola.”
“We’re ready for anything,” New York Mayor Bill de Blasio told reporters on Oct. 13.
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