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ebola

October 14, 2014 - 3:14pm
posted by Howard B. Owens in batavia, health, medicine, UMMC, ebola.

It's been less than 10 days since new protocols related to Ebola were put in place at United Memorial Medical Center, but emergency room staff have already passed one key preparedness test.

In an unannounced drill, a man showed up claiming a fever and suffering from weakness and a headache, a staff member asked a newly implemented set of questions that included whether he had traveled recently from Western Africa.

He uttered, "yes," and within 60 seconds he was in an infectious disease isolation room.

"I was very encouraged by the outcome," said Dan Ireland, president of UMMC. "Any time we do an exercise, do a drill, we like to hear the positive feedback that things are working as they should be."

Following CDC guidelines, UMMC, the whole county's health and emergency response leadership, really, have been implementing Ebola protocols, even if it seems like a far-off, distant problem that may never reach Genesee County.

"We do a lot of things based on a long shot," Ireland said. "We prepare for the rare circumstances because those are the ones that can be really significant. Hopefully, it never happens, but we want to be prepared. I was here during the SARS era. We never had a SARS case in this facility, even while it was in Toronto, but we were ready. We have to be ready for those things or you're not doing the public the service that they need."

Ebola is a virus transmitted among mammals through contact with bodily fluid. Symptoms start with fever, sore throat, muscle pain and headaches, much like the flu. Death occurs in about 50 percent of the patients who contract it.  

The first known outbreak was in 1976 in South Sudan and there have been periodic outbreaks since. The latest outbreak started in March and currently about 10,000 people are believed to have the disease. But some scientists believe exponential growth (the number of people with the disease during an outbreak doubles about every 20 days) could mean as many as 500,000 in West Africa could be ill from Ebola (perhaps more than a million, if there is under reporting).

There is currently no Ebola-specific treatment or vaccine, though scientists are fast-tracking research.  

That's way isolation and quarantine are essential to controlling the disease.

Ireland said hospital officials are continuously communicating with staff about Ebola and CDC-recommended protocols.

It's a rapidly evolving situation, Ireland said, and directives and procedures sometimes change with little notice.

For example, today's identification protocol involves questions about travel. If the outbreak grows, that protocol could change.

"It could be very different story for you tomorrow," Ireland said. "That's health care and that's medicine. As new information comes out, health care evolves."

To help with the communication process, so essential to control of the disease should it ever reach Genesee County, the hospital hosted a meeting today of officials from UMMC, Genesee County Emergency Services and the County Health Department.

The word on how to deal with Ebola needs to get out to doctors and nurses throughout the local health community, including health workers at clinics and on ambulances, both paid and volunteer, as well as local law enforcement and fire chiefs.

Anybody who might come into first contact with an Ebola patient needs to know how to respond to the situation, since isolation and quarantine are so critical its control.

Tim Yaeger, emergency management coordinator for the county, said communication is already starting with the agencies his department deals with, and Ebola will be on the agenda of upcoming fire chief and fire service meetings.

"Our job is to maintain awareness and communication," Yaeger said. "We discuss it with our 9-1-1 center, emergency responders and law enforcement officers need to be aware and not make assumptions about how to protect themselves from people who might be infected. The common theme every day is that we're getting new information regarding Ebola and we need to coordinate that with emergency responders."

The county health department hasn't fielded any calls from concerned citizens about Ebola (there's been more calls about enterovirus, which has been reported in Rochester and Buffalo, but not Genesee County), but that doesn't mean county health officials aren't staying on top of the latest information, said Director Paul Pettit. 

The first person to contract Ebola in the U.S. is a Dallas nurse. She appears have been infected while treating a Dallas resident who contracted the disease in Africa.

Another health care worker in Spain contracted the disease after caring for a patient in that country.

In the case in Spain, it's been determined that the health care worker likely did not follow proper protocol for removing protective gear.

It's still speculation, but that may also have been the situation in Dallas.

Typically, health care workers are covered from head to toe in protective garb while interacting with Ebola patients (only those who have actually become sick can transmit the disease).  

The probable cause of health care workers in Spain and Dallas getting sick certainly has local nurses paying close attention to the proper procedures, said Mary Beth Bowen, vice president of nursing for UMMC.

"For the nursing staff, we practice infection protection every day," Bowen said. "It's now part of our training to practice for Ebola. We've put in a buddy system to monitor each other; video so they visually learn the procedures for putting on and removing protective gear. We're doing everything according to proscribed protocol. It's important to this organization that we minimize the risk of transmission."

There's even a place for chocolate syrup in the training.  

You see, if there's chocolate syrup on your protective gear and then you take it off and find chocolate syrup on your skin, you've done something wrong.

One reason Ireland wanted to talk about this issue, and bring these local experts together, is that he doesn't want anybody in the community to panic about Ebola.

He's concerned there's a lot of hysteria and misinformation in the media about the disease, and if panic sets in, it may lead to somebody avoiding medical treatment for other conditions, a decision that could be even more dangerous.   

If people understand more about the disease and what the hospital is doing to minimize any risk of transmission, he hopes it will eliminate any such panic in the community.

"We want to avoid any misinformation in the community," Ireland said. "We are doing everything by what the CDC advises."

Photo: Gathered at an office in UMMC to discuss Ebola are Tim Yaeger and Jim Bouton, Office of Emergency Management, Mary Beth Bown, VP of nursing, Paul Pettit, county director of health, and Dan Ireland, president of UMMC.

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