State On High Alert For Ebola Cases
Although there have been no cases of the Ebola virus reported in California as of yet, the death of one patient in Texas and the subsequent infection of two nurses who cared for him have placed the state's healthcare providers in a state of high vigilance.
The California Department of Public Health (CDPH) on Wednesday announced that it has activated the state's medical and healthcare coordination center and was negotiating with hospitals to act as designated facilities to treat patients in the state who might be stricken with Ebola.
“We're preparing in partnership as we continue to monitor the situation in Texas,” CDPH Director Ron Chapman, M.D., said during a lengthy news conference on Wednesday afternoon.
Chapman declined to name any hospitals or healthcare systems that might treat Ebola patients because discussions were ongoing, but added that their names would be released in the near future.
A pair of suspected cases of Ebola in California last month were quickly ruled out after testing. And while CDPH officials noted that the virus did not pose a significant threat, they reiterated that it was not out of the realm of possibility that cases might appear in the state in the future.
Two nurses who treated Nigerian national Michael Eric Duncan at Texas Health Presbyterian Hospital in Dallas contracted the disease and are currently in quarantine in Dallas and Atlanta receiving treatment. The first nurse to receive a diagnosis, 26-year-old Nina Pham, is being treated by her employer and her condition has been stable. The virus is fatal in about half of all cases, although that may be skewed by the often erratic delivery of healthcare in western Africa, where most outbreaks of Ebola have occurred.
The other nurse who was diagnosed with Ebola, 29-year-old Amber J. Vinson, flew a commercial flight from Cleveland to Dallas on Monday, the day before she was diagnosed. Although the federal Centers for Disease Control and Prevention (CDC) said on Wednesday she should have never been on the flight, Vinson maintains she had asked the agency and it had okayed her travel.
CDC officials said that given Vinson was all but symptomatic during her trip, the likelihood of her passing the virus to her fellow passengers or the plane's flight crew. The aircraft has been removed from service as a precaution.
Given that two hospital workers contracted the deadly virus while supposedly following protocols that should have ensured their safety, the CDC did change its guidelines this week on how nurses, doctors and other hospital employee should be dressed while treating or coming into contact with Ebola patients. They included a hood that covers the head all the way down to the neck, and fluid-resistant leg and shoe coverings. Neither had been required under prior CDC guidelines.
Hospitals in California appear to be taking extra precautions as well. UCSF Medical Center and Oakland-based Kaiser Permanente, which operates 32 hospitals statewide, began this week to provide extra training to frontline healthcare workers on how to prevent contraction or transmission of Ebola. Both providers are focused on training frontline workers in their hospital emergency rooms, while Kaiser is also training personnel at its outpatient clinics and call centers regarding how to respond to suspected cases of Ebola.
A spokesperson with the California Hospital Association did not immediately respond to a request seeking comment, so it remains unclear whether hospitals statewide are systematically providing additional training to their workers.
CDPH officials said that the agency was working with both the California Department of Industrial Relations and Cal-OSHA to ensure that not only hospitals were following appropriate safety measures, but to help pick the ones best prepared to treat Ebola patients.
Chapman also noted that the CDPH has contracted with a firm that was cleared by both state and federal authorities to transport Ebola specimens to specialized laboratories for testing, after some concerns had been raised about whether traditional lab courier services would be willing or capable of such a job. Inglewood-based World Courier is a subsidiary of AmeriSource Bergen.
How hospitals in California and elsewhere have prepped their workers for dealing with Ebola patients has become a point of friction in recent days, as the Oakland-based labor union National Nurses United claimed that Texas Health Presbyterian was not only ill-prepared to deal with treating Ebola patient Duncan, but that hospital managers refused to listen to concerns from nurses and other healthcare workers about his being swiftly isolated.
“Sadly, the problems expressed by the...Texas Health Presbyterian RNs was predictable in our fragmented, uncoordinated private healthcare system, and it mirrors concerns we’ve heard from nurses across the U.S.,” said NNU Executive Director RoseAnn DeMoro.
James Watt, M.D., who heads CDPH's communicable disease control division, noted Wednesday that the agency had met with a contingency from NNU earlier this week to hear their concerns, and would meet with them again soon.