It’s been said that fear travels faster than the virus.
This is true. Given that Ebola is less contagious than many other communicable diseases, it’s easier to catch Ebola panic than Ebola itself. But if you’re a health care journalist writing about Ebola or the Ebola response, it’s sometimes hard to tell the real stories from the sensationalism.
In light of the Ebola diagnosis of two Dallas health care workers and the CDC initially placing blame on a “breach in protocol,” the past couple of days have seen a flurry of inflammatory Ebola coverage that focuses on the negatives. One of these is a survey from National Nurses United, the largest nurses’ union in the U.S.: 80 percent of NNU nurses surveyed don’t feel they have received adequate Ebola training. New allegations have surfaced that nurses treating him “worked for days without proper protective gear and faced constantly changing protocols.” Additionally, there have been federal funding cuts to public health preparedness and response activities: $1 billion less in FY 2013 than in FY 2002, a year in which the nation dealt with 9/11 and the anthrax attacks, and anticipated the SARS epidemic of 2003.
All of this alarming info has fanned the flames of public fear – even though only three cases of the disease have occurred on American soil, more than two-thirds of Americans are worried about it. Moreover, it has led journalists, commentators and even health professionals to wonder: Are U.S. hospitals truly prepared for an Ebola outbreak?
Maybe, maybe not. But don’t issue dire predictions of worst-case scenarios to your audience just yet.
When you cover Ebola, remind your readers and listeners that an Ebola outbreak has not happened and is actually unlikely to occur on the same scale as in West Africa. Next, investigate the public health preparedness and response capacity of your local hospital or health department. The CDC has provided hospitals with a detailed checklist on how to handle a possible Ebola outbreak, so here are a few good questions to ask based on those recommendations:
- What is the hospital’s official protocol on infectious disease control?
- What procedures or protocols do triage staff and nurses follow in terms of notifying hospital leadership and state/local public health officials? (Ebola is “nationally notifiable,” which means it must be reported to local, state and federal public health authorities.)
- Is there a lead manager in place for coping with an infectious disease outbreak?
- Have all staff been trained on identifying signs and symptoms of Ebola? Are they getting patients’ travel histories?
- Is there enough personal protective equipment (PPE) for all personnel? What kind do they use? This can include fluid-impermeable gowns with hoods, gloves, boots, booties, shoe covers, eye protection (face shield or goggles), face masks, N95 respirators (to be used during aerosol-generating procedures, which stimulate coughing), and hand sanitizer/wash fluid.
- What kind of Ebola or other outbreak training exercises do hospital staff undergo? Do they know how to put on and remove PPE safely? How often is their training refreshed?
- Are hospital personnel vigilant about hand sanitization, sanitization of instruments, and general cleanliness?
- Where would an Ebola patient be isolated? If they don’t have any kind of isolation area, what space could be used as one?
- How should contaminated items to be handled? What are the environmental cleaning procedures?
- Do the staff maintain a situational awareness of Ebola and update the triage guidelines accordingly?
- What is the hospital’s communication plan in the event of an outbreak? Is there a health communications officer who creates appropriate signage or literature for posting within the hospital? Is there a spokesperson who formulates external messages for the public or the media?
Not every hospital can meet all of these guidelines. In fact, only four hospitals in the country (the National Institutes of Health in Maryland, Emory University Hospital in Atlanta, the University of Nebraska Medical Center, and St. Patrick Hospital in Montana) have special high-containment isolation units. But all hospitals can prepare to handle an outbreak in a variety of ways, and it’s important to investigate the specifics before assuming (or publishing) the worst.
Additional resources on public health preparedness:
- Public Health Preparedness Capabilities – National Standards, CDC
- Ebola Information for Public Health and Medical Professionals in U.S. Healthcare, USHHS
- Office of Public Health Preparedness & Response, CDC
- Public Health Preparedness, National Association of City and County Health Officials (NACCHO)
- 2013-14 National Public Health Preparedness Report – Background, PHPR Office (CDC)
- Detailed Hospital Checklist for Ebola Preparedness, CDC
- Evaluating patients for Ebola virus disease in New York City, New York City Department of Health and Mental Hygiene
- 2014 Ebola virus disease evaluation algorithm, New York City Department of Health and Mental Hygiene
More coverage:
- U.S. Hospitals Drill to Prep for Ebola But Real Outbreak Could Be Trickier, ABC News
- 5 Ways U.S. Hospitals Need to Get Ready For Ebola, Time
- Are U.S. Hospitals Really Prepared for Ebola?, New York Mag
- Who’s In Charge of Ebola at Hospitals?, Bloomberg Businessweek
- Why Deadly Ebola Virus Is Likely To Hit The U.S. But Not Spread, National Geographic
- What Would Keep Ebola from Spreading in the US? Investing in Simple Research Years Ago, SuperBug
(Special thanks to Kim Krisberg (@kimkrisberg) for inspiring this post with a message on AHCJ’s electronic discussion list about public health preparedness funding.)
