Why your hospital may be unable to prevent spread of Ebola

October 17, 2014

Ebola particle (credit: National Institute of Allergy and Infectious Diseases)

Challenging reassurances by CDC director Tom Frieden, M.D. Thursday in congressional testimony, a group of infectious disease experts has suggested that conventional U.S. medical centers are unprepared and ill equipped to manage Ebola, in an open-access article published Thursday in Annals of Internal Medicine.

The authors recommend that a national network of specialized containment and treatment facilities tied to biosafety level-4 laboratories or airport quarantine stations.may be needed to reduce the virus’ spread.

Despite CDC efforts to prepare hospitals for Ebola, enormous challenges remain, the authors say. They express doubt that conventional settings can adequately prepare and train staff to meet the challenge of a virus that requires significant attention to every detail of care from the safe donning and doffing of personal protective equipment (PPE) to waste disposal.

The Annuals authors explain that with no margin for error, “policies and procedures must be reinforced through repetitious training. This level of readiness may be more than traditional medical centers are equipped to handle.”

The ‘nurse-killer disease’

In full agreement is the 185,000-member National Nurses United, which “has for weeks been decrying the lack of protective measures at the Dallas hospital where an Ebola patient had been treated,” according an article Thursday in the Washington Post.

“On Tuesday’s call, nurses from all over the country described their fears about going to work at hospitals without state-of-the-art protections.. . One nurse on the line called Ebola the ‘nurse-killer disease.'”

In developing countries, the situation is even worse. According to a blog post Wednesday by the University of Colorado Cancer Center, “a study recently published in the Journal of the American Academy of Dermatology shows that for Ebola, measles, syphilis and many other conditions with skin manifestations, the mortality rates are hundreds of times higher in developing countries than they are in developed countries.

The paper highlights the “importance of monitoring disease burden in the developing world even when the burden is low.”

UPDATE Oct. 17, 4:06 EDT: Is the United States Prepared for Ebola? from JAMA (online, open access), just published.