Today marks a triumphant moment for Texas as the last person being monitored for Ebola in the state has passed the 21-day incubation period. Yet the struggle with the deadly virus is far from over worldwide.
Sierra Leone is experiencing a sharp increase in Ebola cases throughout the past week, to the tune of 435 new people infected with the disease.
This comes as the United States acts boldly to step to up aid. The president has asked Congress for $6.18 billion to tackle the outbreak in Africa, and Facebook is adding a button to make it easier for its users to donate to charities battling the disease.
The social media company, in conjunction with the nonprofit NetHope, is also donating and installing 100 satellite communication terminals for Internet and phone services to affected areas in West Africa.
Nov. 6, 2014
Could your hospital become an Ebola treatment facility? If you are interested in learning more about how to ready your hospital for this designation, tune in to a one-hour webinar today at 4 p.m. ET.
The Centers for Disease Control and Prevention and the Health & Human Services’ Office of the Assistant Secretary for Preparedness and Response will host the session. Officials from the CDC and ASPR will deliver a synopsis of their policies for managing Ebola and will describe the activities of the CDC’s Rapid Ebola Preparedness Team, including evaluating the tool they use to measure hospital readiness, how to prioritize and lessons learned. They also will tackle personal protective-equipment use and supply questions. Participants can ask questions at the end of the session.
To connect, dial 800-779-9066 and enter access code 5213 to be connected to the audio portion.
The American Hospital Association advises you to organize a central listening location in your organization if multiple parties wish to participate in the call, as phone lines are limited.
Slides for the presentation will be streamed during the call here.
For the latest information, visit the AHA’s Ebola Preparedness Resources Web page.
Nov. 5, 2014
In striking contrast to the organized approach the United States took to managing Ebola at home, West Africa has been poorly equipped to control the spread of the disease. The region's dire state of affairs is all the more conspicuous given the fact that Ebola has been a problem in the area for more than 40 years and there is still no vaccine for it, which has cast a negative light on pharmaceutical developers' lack of progress.
Researchers have been working to change that disparity ever since the virus became a Western threat. But they are still confronted by obstacles as scientists work to understand how the disease mutates as it spreads. For example, researchers need continuous supplies of fresh, live Ebola specimens to assess these changes, and they are difficult to acquire.
In addition to the pharmaceutical community’s renewed investment in finding a cure for the virus, West Africa is getting brick and mortar aid from the British government, which is opening six Ebola treatment centers in Sierra Leone. The Royal Marines also are transporting food and supplies to help existing Ebola treatment centers. This is in addition to financial aid from the United States government and the World Bank.
Nov. 4, 2014
The Centers for Disease Control and Prevention urges leaders in designated or potentially designated hospitals to check the CDC website frequently for the latest assessment tools to determine hospitals’ preparedness in treating Ebola.
This is especially important because such information is subject to change as the scientific community continues to learn more about the disease.
As American hospitals continue to stay aware, there is cause for celebration in Texas: All 11 of those with established exposure to one of the three symptomatic Dallas Ebola patients now have passed the 21-day Ebola incubation period without having contracted the disease.
While we make progress at home, however, a new outbreak is raging in Koinadugu, Sierra Leone, which until very recently was known as the only area to have resisted Ebola by running a self-imposed quarantine system.
Nov. 3, 2014
A Maine judge lifted the 21-day mandatory quarantine ruling that nurse Kaci Hickox challenged last week, saying it wasn’t rational since the nurse tested negative for the disease. Hickox, who was isolated when she returned from treating patients with the virus in West Africa, says she hopes others who have treated those with Ebola will not face the same stigma she has.
This sentiment is echoed by the Society for Healthcare Epidemiology of America, which says the strict measures can inhibit future aid.
“Based upon the strong evidence that Ebola is not transmitted by those who do not have symptoms of EVD, we do not support mandatory quarantine of individuals, including healthcare personnel, who have provided care for patients with EVD,” says Daniele Diekema, M.D., president of the SHEA board of trustees. “These policies perpetuate unfounded fears about transmission in the absence of symptoms, and has resulted in other over-reactions (like day care centers and schools refusing to take children of healthcare personnel working with Ebola patients). All these over-reactions will inhibit healthcare personnel from stepping forward to help.”
As Ebola permeates the conversation about our state and federal rights, it has also begun to affect how hospitals manage their electronic medical record systems. Now, a hospital in Boston can flag in its EMRs when an inbound patient has been to West Africa and has symptoms suggesting Ebola.
To reacquaint yourself with those symptoms, as well as guidance on how to treat those with the virus, please see the guidelines from the Centers for Disease Control and Prevention.
Oct. 31, 2014
One month after the first Ebola patient was diagnosed in the United States, we remain vigilant and cautious about guarding against the spread of the virus.
On that note, let's revisit some best practices for how to deal with treating Ebola.
According to the Healthcare Coalition for Emergency Preparedness, the following actions are effective and can be implemented in short order, should an emergency arise:
“We know that some hospitals simply are not prepared or shouldn't treat such exotic infectious diseases for various reasons and that our current system would be stressed if dozens of patients or more were infected,” Darrell Henry, executive director of the HCEP, said in a statement. “Instead, it would be smarter to route patients to predesignated health care facilities (or large centralized facilities in the event of a larger outbreak) that have the proper protocols in place, a highly trained staff, complete on-site Ebola disinfection and necessary biocontainment units to treat and contain Ebola and similarly infectious, lethal diseases.”
To learn more about protecting health care worker health and safety, participate in the Health & Human Services Ebola preparedness call at 3 p.m. ET today. The call will feature officials from the HHS Office of the Assistant Secretary for Preparedness and Response, Centers for Disease Control and Prevention, Department of Transportation and HHS Office of Intergovernmental and External Affairs.
To access the call, dial (800) 857-0664. The passcode is 8614132. Audio streaming also will be available here.
The Joint Commission and the CDC hosted a webinar on Ebola yesterday. You can listen to a replay of the call here.
Oct. 30, 2014
Maine nurse Kaci Hickox says that she will ignore her quarantine restrictions and go to court if her Ebola quarantine is not lifted today. On Oct. 24, Hickox returned to Liberty International Airport in Newark, N.J., from working on Ebola patients in Sierra Leone and showed no symptoms of the virus and then was sent to University Hospital in the same city and put under quarantine. New Jersey Gov. Chris Christie had imposed mandatory quarantines last week, and while he had her privately transported to her home in Maine, the quarantine has not yet been removed, as Maine also upholds the quarantine policy.
The quarantine issue might be less polarizing than it seems. While the Centers for Disease Control and Prevention oppose the mandatory quarantines and President Obama has spoken out against them, a new "CBS News" poll finds that 80 percent of Americans support quarantine for travelers arriving from West Africa. Just 17 percent think they should be permitted to enter if they do not show symptoms of Ebola.
Extra precaution is being taken on behalf of the U.S. military, as Defense Secretary Chuck Hagel said Wednesday that the military men and women helping to fight Ebola must undergo 21-day quarantines, which is more time than is required for many civilian health care workers.
Let the facts show that dozens of Ebola-treatment volunteers, 47 out of 150, have come back from West Africa’s “hot zone” without symptoms.
Oct. 29, 2014
With Texas Nurse Amber Vinson’s release from the hospital on Tuesday, America is now home to seven survivors of Ebola. American patients have gotten some of the best care in the world, often at hospitals with specialized biocontainment units. In regions such as West Africa, many patients struck with the virus don’t even make it to hospitals, let alone ones with personal protective equipment.
Guinea, Liberia and Sierra Leone are together struggling with more than 10,000 cases of the virus. Even as the United States makes careful progress, Liberian President Ellen Johnson Sirleaf told NBC News that it is more important than ever to stop the outbreak where it began, saying that if disease spreads, “we’re all in trouble.”
Amid these developments, we continue to develop a better understanding of how the virus is spread. The Centers for Disease Control and Prevention posted information on Friday that acknowledges the virus can be spread by air for a limited amount of time. For example, Ebola can be contracted by contact with an object contaminated by droplets from a sneeze from an infected person.
To remain as informed as possible about the CDC’s understanding of this virus, be sure to check its Ebola page for updates.
Oct. 28, 2014
Newly issued guidelines from the Centers for Disease Control and Prevention have adapted recommendations for travelers based on their levels of risk.
The recommendations categorize people into four groups: "high risk," "some risk," "low risk" and "no risk," based on how much they’ve been exposed to Ebola. Here is the CDC’s fact sheet about recommended monitoring procedures, and here is our summarized breakdown of what each classification entails (please see the fact sheet for all details):
- The high-risk category includes health care workers who have clearly, directly come into contact with the virus or who have not worn personal protective equipment while treating an Ebola patient who is showing symptoms. These workers should steer clear of public transportation, working outside the home, public gatherings and more for at least 21 days, although it’s OK to leave the home in limited situations.
- The some-risk category includes a health care professional who works in an active Ebola treatment center, such as in West Africa, but who consistently wears PPE, or a person who was in close contact with someone showing symptoms of Ebola and was not wearing PPE. This person should be frequently monitored by local health officials, with his or her temperature taken twice a day. These officials can decide whether to restrict this person’s travel.
- Those at low risk include people who have traveled to an Ebola-heavy country but who have not had contact with Ebola patients, or who have otherwise been around a symptomatic Ebola patient (such as on a plane) but still have not been in direct contact with him or her. The guidelines say those people should monitor their own temperature and symptoms, but their travel is not to be regulated.
- Someone who has no risk has been in contact with a person who is not showing symptoms after that person was in contact with a person with Ebola; someone who has been in contact with a person with Ebola before this person showed symptoms; and having been in a country with an Ebola outbreak more than 21 days ago without showing symptoms.
These guidelines were issued Monday amid national controversy over New York and New Jersey’s mandatory quarantines of all health care workers who have treated people with Ebola, regardless of their medical conditions.
More information about Ebola Preparedness can be found on the American Hospital Association’s Ebola resource page.
Oct. 27, 2014
Some states – such as New York and New Jersey – are quarantining all health care workers who have treated people with Ebola, regardless of their medical conditions. Nurse Kaci Hickox is making headlines after being quarantined in New Jersey even when she tested negative for the virus. Recent reports indicate that an exception is now being made to this rule for her.
This enhanced regulation was put in place not long before Hickox arrived in Newark on Friday. The new procedures command a mandatory 21-day quarantine, as opposed to the 21-day monitoring that the CDC declared earlier in the week.
The mandatory quarantine has been criticized by the Society for Healthcare Epidemiology of America.
“SHEA believes that mandatory quarantine will lead to fewer volunteers and increased difficulty in assembling care teams in West Africa and in other countries, including the United States, preparing to care for EVD patients,” SHEA said in a statement.
In other news today, The Healthcare Laundry Accreditation Council is recommending that health care laundries follow the current guidelines offered by the Centers for Disease Control and Prevention regarding the handling of linens that have been used in the care of alleged or confirmed patients with Ebola.
On Nov. 14, HLAC will host a webinar on Ebola preparedness from a laundry viewpoint. More information will be available soon and published on HLAC's website.
More information about Ebola Preparedness can be found on the American Hospital Association’s Ebola resource page.
Oct. 24, 2014
Karen DeSalvo, M.D., who has led the Office of the National Coordinator for Health IT since last December, has been named acting assistant secretary at HHS. In the new role, she'll be a key member of the Obama administration's Ebola response team.
DeSalvo has a background in public health. Before joining ONC, she was health commissioner of New Orleans and helped to modernize that city's health care system following Hurricane Katrina. In June 2013, we talked to DeSalvo about her efforts to build a strong primary care network in the Crescent City.
For more on how DeSalvo's move may impact health IT, check out Matthew Weinstock's blog.
In other news today, the Association for Professionals in Infection Control and Epidemiology released a survey assessing hospital readiness to receive a patient infected with Ebola. The study, conducted Oct. 10–15, suggests that only 6 percent of U.S. hospitals are well-prepared to handle such cases. The association suggests that hospital leaders focus on three aspects of infection prevention:
• adequate infection prevention staffing;
• training health care workers on safety protocols so they are prepared to the utmost;
• investing in infection tracking and monitoring technology.
APIC officials say that a broader goal of the survey is to draw attention to how infection prevention departments are funded and staffed.
"We have to drop so many other things to take this on," Jennie Mayfield, APIC president said during a press briefing this morning. "Nobody wants a flu epidemic in their facility."
The American Hospital Association seeks to arm hospitals with resources to maintain ultimate preparedness, including a scope of official Ebola treatment guidelines, diagnosis information and more.
In the news:
- New York doctor tests positive for Ebola
- AAMI releases joint statement on biohazardous medical waste
- Mali reports first Ebola case
Oct. 23, 2014
The Ebola crisis appears to be lessening in the United States and beyond. Two infected Americans are cured, Ebola patient and Texas nurse Amber Vinson is being moved from isolation and Texas nurse Nina Pham is also showing signs of improvement after being treated for the virus. President Obama has expressed cautious optimism over the containment of the outbreak, even as Connecticut quarantines nine people, incoming airplane passengers are hospitalized for potential symptoms of the virus and the United States steps up Ebola monitoring for incoming West African passengers.
While the number of people in West Africa with Ebola is almost at 10,000, it could be much worse, officials say. Time says that Ebola hasn’t caught fire the way it could have in West Africa because of the robust health systems in place.
When it comes to treating the virus, health innovators are making immediate strides: A trial vaccine is set for rollout in January, and scientists are even considering using robots to treat the virus. Brainstorming meetings are planned for early next month.
In times like these, the onus is on all of us to stay calm, prepared, and open to potential solutions. For information on basic Ebola facts and treatment tools, visit the CDC’s Ebola resource page. The American Hospital Association also has a good variety of reference information available here.
Oct. 22, 2014
While certain, highly experimental Ebola drugs appear to have been effective in some cases, a cure-all for the virus has not yet been established. Drug companies are racing to develop pharmaceuticals to treat the virus, and are planning to start trials as early as next month.
All this comes on the heels of very recent Ebola-related optimism. A Red Cross official predicted the virus could be contained within six months and, according to news reports, current Ebola patients are recovering or improving from the virus.
This good news doesn’t mean that health officials are necessarily lessening their vigilance. Emory Healthcare has launched an Ebola Preparedness website to serve as a resource for health care organizations, helping them access and download best practices information about diagnosis, treatment and screening for the virus.
The American College of Emergency Physicians Conference will also make room to discuss Ebola readiness at its October conference, ACEP14, from Oct. 27 – 30 in Chicago.
Oct. 21, 2014
The Center for Disease Control and Prevention has intensified its guidelines for the treatment of Ebola. Hospital workers treating Ebola patients are advised to wear double sets of gloves, one-use hoods with full-face protection and specific types of masks, and to follow other strict procedures, the agency says. Ultimately, no skin should be uncovered when personal protective equipment (PPE) is worn.
The CDC has also updated its information about how the PPE should be removed, and has expressed the importance of supervised PPE removal, as well as rigorous training before staff works with an Ebola patient.
Rich Umbdenstock, CEO and president of the American Hospital Association, says the AHA welcomes these updated guidelines.
"The AHA is urging hospitals to use the resources at their disposal to continue to train their nurses and staff and drill again and again on the entire course of care from diagnosis to final waste disposal, using the same equipment on which they will rely in order to safeguard their staff, patients and communities," Umbdenstock says. "Hospitals will protect patients and staff while achieving the ultimate goal: caring for patients. This includes on proper procedures for putting on and taking off personal protective equipment under the watchful eye of a trained observer."
While these changes may seem clearly spelled out, front-line workers should be vocal about any apprehensions that they may have when it comes to executing them. Any questions raised can be valuable down the line, says Linda Greene, manager of infection prevention at the University of Rochester (N.Y.) Highland Hospital, and a member of the Association for Professionals in Infection Control and Epidemiology’s regulatory review panel.
“If front-line staff have concerns, they need to bring them to their managers,” Greene says. “If there is something perhaps management has overlooked, than who better than the front-line workers to point that out?”
Greene notes that we’re relying on these workers to notice what could be subtle, but ultimately important, issues.
“Often we come from the 30,000-foot view when we’re looking at policies specific to an organization,” Greene says. “There may be specific nuances to those policies or guidelines that need to be developed. That’s when front-line staff really need to point out what they see and ask questions.”
No matter what your vantage point is, you can find the most up-to-date information about treating the Ebola virus here, and you can get best practices about dealing with Ebola from the American Hospital Association’s Ebola reference page.
Oct. 20, 2014
As fear about Ebola has spread through the media and our personal lives, the need for communication and scientific awareness is paramount. Whether officials in Dallas are pleading with us to move past our stigma as the 43 contacts of Ebola victim Thomas Eric Duncan emerge from their 21 days of isolation, or schools and public buildings close en masse as a response to the virus, we are reminded that it is more important than ever to listen to the experts and know the facts before reacting viscerally.