U.S. and regional health officials are considering establishing "dedicated" hospitals in each state that would treat any potential Ebola infections in the area—even those diagnosed at other hospitals in the state.
The move comes days after Dallas nurse Nina Pham, who cared for the first U.S. Ebola patient, tested positive for the deadly virus, marking the first known Ebola transmission on U.S. soil and heightening concerns about the health system's ability to contain its spread.
Background on the Dallas Ebola cases
The nurse was on the team at Texas Health Presbyterian Hospital that treated Thomas Eric Duncan, a Liberian national who died last week after spending 10 days at the hospital battling Ebola.
Dallas hospital explains how it treated the first U.S. Ebola case
The woman wore protective gear while caring for the patient and was considered to be at low risk for infection. She cared for Duncan during his second admission to Texas Health Presbyterian. According to CDC Director Tom Frieden, the nurse had "extensive contacts with" Duncan on "multiple occasions."
Top health officials say that the infection was likely a result of a breach in protocol at the facility. There was "an inadvertent, innocent breach of the protocol of taking care of a patient within the personal protective equipment," says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, adding, "That extremely rarely happens."
Fauci says CDC is working to identify the breach in question. Freiden says the agency is focusing on possible breaches made during dialysis and respiratory intubation.
However, some health care workers say that the case doesn't highlight a protocol breach so much as a lack of adequate training for hospital workers. Infection control experts say hospital workers must be coached through treating Ebola cases.
Initially, the health workers who interacted with Duncan were considered "low-risk" because they were dressed in protective gear. However, Pham's diagnosis raises questions about whether hospitals are adequately prepared. As such, all of the medical staff who treated Duncan at the Dallas hospital will now be monitored, in addition to a person who had close contact with Pham.
Dedicated Ebola hospitals needed
As a result, CDC and other health authorities say each state should have at least one hospital capable of handling an Ebola case. Abbigail Tumpey, a CDC official in charge of education outreach says, "We'd like to have at least one hospital in every state that does feel they could manage a patient from start to finish."
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Currently, just four hospitals in the United States have specially created bio-containment units to address Ebola infections. The hospitals are: Emory University Hospital in Atlanta, NIH in Bethesda, Maryland, the University of Nebraska Medical Center, and St. Patrick Hospital in Missoula, Montana. Three of those hospitals have already treated confirmed or suspected Ebola cases.
The dedicated hospital strategy is only in the discussion stage, according to Bloomberg. Tumpey says, identifying such hospitals is "going to be a long process" that will "not happe[n] overnight."
CDC will ramp up infection control efforts
In the meantime, CDC will "double down on training, outreach, education, and assistance" to help control the virus in the United States, according to Freiden.
According to Bloomberg, the agency is setting up numerous calls and webinars with infection control experts and communication specialists to train health care workers in screening and treating infected patients. Such outreach efforts will include training on the proper use of protective equipment and how to set up an isolation unit.
What happens to the rest of the hospital when an Ebola patient is admitted?
"The events in Dallas in the last 24 hours have made it a lot scarier for frontline health care workers," Tumpey says, adding, "We want to make sure they feel fully prepared and confident."
If another hospital receives an Ebola patient, Tumpey says, "We would make sure they understand what it'd look like long term, and if they didn't feel like they could handle a patient, we would help them figure out how to safely transfer the patient" (Chen/Gilblom, Bloomberg, 10/14; Yan, CNN, 10/14).
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