Ebola: Most US hospitals not prepared for deadly disease

Sept. 30, 2014: A vehicle drives up the driveway to the Texas Health Presbyterian Hospital in Dallas. A patient in the hospital is being teated for Ebola. (AP Photo/LM Otero)

Thomas Frieden, director of the Centers for Disease Control and Prevention, announced on Tuesday that a man who flew from Liberia to Dallas last week is infected with Ebola and being treated at Texas Presbyterian Hospital.

The CDC should discourage panic. But Frieden went overboard. Listening to him,you’d think C-D-C stands for Centers for Denial and Confusion.

Frieden flatly rejects limiting commercial air traffic from Ebola-stricken African countries, claiming it would cripple their economies and recovery efforts. Perhaps,but what about the risks to Americans? From the outbreak’s start, Frieden has predicted that patients infected with Ebola will fly to the U.S. and seek care in hospitals here.

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Whether -- or how many -- Americans die of Ebola will depend on what hospitals do when travelers carrying the disease arrive in the emergency room. Frieden claims hospitals are well prepared. The truth is, some are but many are not.

Cities like Dallas and New York are home to enclaves of Liberians and other West African newcomers, making it all the more likely that visitors from West Africa could be headed there.

In Dallas, the infected traveler, Thomas Eric Duncan,went to the emergency room on Sept. 25.He told one nurse he had just come from Liberia, but that critical fact was ignored, and he was sent home with antibiotics instead of being put into isolation and tested.

The hospital’s epidemiologist, Dr. Edward Goodman claims “we have had a plan in place for some time now for a patient presenting with possible Ebola.” Not a very good plan, obviously. After leaving the hospital, Duncan grew sicker over the next few days, and returned by ambulance. The emergency staff who originally treated him and the three ambulance personnel are now under observation for Ebola.

The infection control mistakes at Texas Presbyterian are reminiscent of what ended up killing44 people in Toronto when SARS (severe acute respiratory syndrome) struck therein March, 2003.

A patient who had unknowingly picked up the virus from an Asian traveler went to a Toronto hospital for help and was left sitting in a crowded emergency room for 16 hours, infecting others, before the staff realized he might have SARS and isolated him.

In contrast, when a SARS-infected traveler sought care at a Vancouver hospital with rigorous infection control, he was isolated within five minutes, and not one other person there contracted the disease.One hospital averted an outbreak. The other hospital failed.

Most hospitals in the U.S. lack the rigor and discipline to control Ebola. That’s why common infectious diseases such as MRSA and C. diff are racing through these hospitals, killing an estimated 75,000 patients every year. Ebola is even deadlier. Yet the CDC has done little to equip hospitals, other than send around memos.

At the Tuesday announcement, Frieden said “I have no doubt we will control this case of Ebola so that it does not spread widely.” Those are weasel words.

As an example of “control,” he pointed to what Nigeria did when another infected Liberian,Patrick Sawyer, flew there on July 20, collapsed, was hospitalized and died. Twenty Nigerians, mostly health care workers who treated Sawyer, contracted the virus, and 8 have died. So when Frieden promises “control,” of the Dallas case, does he mean it’s OK for 8 Texans to die?

Frankly, if even one Texan dies, Frieden should lose his job.

Frieden understates the difficulty of dealing with Ebola. On Tuesday,when he was asked about the deaths of the Nigerian health care workers, he dismissed the question,claiming“that hospital had zero infection control” and a nurse exposed to Sawyer’s blood failed to wash her hands

Maybe one nurse was careless. But Frieden left out half the story. Dr. Ada Igonoh, who wrote an extensive report about contracting Ebola at Sawyer’s bedside and surviving it, explained that she double gloved the one and only time she touched him to check his pulse, and caught the virus anyway.

We all hope for the best for the doctors and nurses at Texas Presbyterian and any other hospitals hit with Ebola. But hope and spin will not be enough to stop Ebola.