Juliette Mullin, Senior Editor
Until this month, health authorities thought that any hospital in the United States was equipped to handle an Ebola case from start to finish. But the events in Texas have changed that.
Now, CDC says that future Ebola cases in the United States will be routed to selected hospitals for care. "There's a need for specialized centers when there is a patient with confirmed Ebola, or a number of patients if that were to happen in the future," says CDC Director Tom Frieden.
But which hospitals will serve as these Ebola centers?
Designated Ebola hospitals
Currently, just four U.S. hospitals have top-level biocontainment facilities, and three of them have already treated Ebola cases.
Although CDC has not released the complete list of hospitals that will serve as "Ebola centers," state officials are working with the agency to select area hospitals and get them ready.
In Illinois, the state health department says that Presence Resurrection Medical Center and Rush University Medical Center are being considered to serve as the area's specialized Ebola facilities.
To get ready, Rush has created a task force of doctors, nurses, and support staff that have volunteered to care for any Ebola patients that the hospital might receive. Last week, infection control experts trained the task force on how to put on and take off protective gear. Meanwhile, the facility is expanding a portion of its ICU so it has the appropriate biocontainment capacity.
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In Texas, Gov. Rick Perry (R) has designated The University of Texas Medical Branch at Galveston to serve as an Ebola treatment center. "In the event of another diagnosis, this facility will allow us to act quickly to limit the virus' reach and give patients the care they need in an environment where health care workers are specially trained and equipped to deal with the unique requirements of this disease," Perry says. (The state is also building a treatment center for Ebola and other infectious diseases in North Texas.)
In Pennsylvania, the Children's Hospital of Philadelphia (CHOP) is one of a handful of pediatric facilities designated for Ebola care. "The likelihood of an Ebola outbreak in the United States is extremely low, however, if a pediatric patient should need care for Ebola in this country, CHOP is one of the sites that has agreed to provide care," says Julia Shaklee Sammons, medical director of CHOP's department of infection prevention and control.
In New Jersey, Gov. Chris Christie (R) has named three hospitals to care for any Ebola patients: Hackensack University Medical Center and University Hospital in Newark, and Robert Wood Johnson University Hospital. Similarly, New York has named eight hospitals as designated Ebola facilities.
What about the facilities that are not named as dedicated centers?
Although dozens of hospitals have already been identified as specialized centers, experts emphasize that all hospitals must be prepared to screen and isolate potential cases.
"For the hospitals not designated as Ebola centers, the exact role they will play isn't one-size-fits-all," says Advisory Board senior consultant Julie Riley, explaining, "It depends a lot on local public health policy, and what other organizations in their region are tasked to do."
In New York, Riley says, "it sounds like... hospitals report suspected cases to the department of health, which helps with the coordination of lab testing to confirm the case. While waiting for results, that hospital might need to isolate that patient."
All New York hospitals—not just the eight designated centers—are being trained to recognize Ebola symptoms and respond effectively, according to Howard Zuker, the state's acting health commissioner. This week, the state health department held a massive training session for health care workers that included interactive demonstrations on protective equipment.
Other states are devising different systems. According to Riley, some are considering systems in which a hospital will immediately transfer a patient to a regional center once the patient is deemed "high-risk."
"So since the roles these facilities will be playing varies, the key is to make sure they are fully coordinated with other organizations and local officials," Riley advises.