With two infected aid workers lying in isolation in Emory University Hospital, the Ebola virus that's ravaged parts of western Africa has made its way to our shores. With the arrival of the deadly virus, can we expect a certain level of hysteria from the media, public and even health care workers? Perhaps, but hospital leaders can do their part to quell fears. Oh, and be extremely vigilant in following proper infection-prevention protocols.
During an hour-long call yesterday with media and hospital officials, the CDC's David Kuhar, M.D., continually reminded callers about the few ways Ebola is transmitted, none of which is airborne. Several callers commented that their facilities aren't equipped with a special isolation ward like the one at Emory and worried that they won't be able to effectively manage infected patients should the need arise.
"Any U.S. hospital able to isolate a patient in a single patient room and follow CDC guidance is capable of safely managing a patient with this disease," said Kuhar, medical officer, division of health care quality promotion at the CDC's National Center for Emerging and Zoonotic Infectious Diseases.
The CDC has issued several alerts, including guidance for evaluating patients suspected of having the disease. Still to come is critical guidance on handling lab specimens and disinfecting lab equipment.
Other callers wondered why they are seeing images of health care workers in Africa dressed head-to-toe in hazmat-looking garb, yet here, CDC recommendations call for less obtrusive use of personal protective equipment. It's about circumstances, explained Kuhar. In many of the African settings, clinicians do not have access to water or other disinfectants. Some hospital floors are made of dirt; health care workers in the field may have various duties, including attending to a corpse. When appropriate, he said, U.S. hospitals should activate more advanced protections.
To prepare for the inevitable questions from staff, hospital leaders should develop thorough communication plans, suggests Laura Seng, a partner at Barnes & Thornburg LLP and vice chair of the firm's health care department. She recommends:
- Script your communications to ensure that managers are delivering a consistent message and communicate policies in person if possible.
- Follow up with written highlights to staff.
- Provide a central number or email address for staff to submit questions.
- Communications regarding infection control issues and personal protective equipment should come from a trusted staff physician. "Explanations and communications from a local trusted physician are often received better than those from a state or federal agency," Seng wrote me in an email. "The local trusted physician can then reference CDC recommendations and refer staff to certain CDC statements — again, consistency is the key for all communications."
Some hospitals also may have staff traveling to Africa on aid missions. CDC officials recommend monitoring their health for 21 days upon their return to the states. Those who were in health care settings should be evaluated for potential exposure and the CDC should be consulted.
Seng points out that there are also some human resources and legal issues to consider. For instance, will staffers be put on paid leave while awaiting screening results, or will they have to use their own vacation time? What do your labor contracts say about return-to-work decisions?
"The hospital also needs to consider the human aspect — providing emotional support and counseling, if needed, for health care workers returning from stressful environments so they are prepared to take on new clinical responsibilities," she adds.