Saturday, August 16, 2014

Ebola Virus Preparedness in US Hospitals- An Emerging Disconnect

As the Ebola outbreak continues to evolve and as US hospitals prepare for the imminent arrival of additional cases stateside, a disconnect is emerging between recommendation and practice. 

For example, the Centers for Diseases Control recommends that health care workers treating Ebola patients need only wear gloves, a fluid-resistant gown, eye protection and a face mask to prevent becoming infected with the virus. Patients should also be placed on contact and droplet precautions.

Where I work, and elsewhere, the fear of Ebola infection by HCWs is driving more aggressive infection prevention measures. The phenomenon is nicely summarized in the NY Times article. In addition to the isolation of patients in airborne and contact precautions, we have dedicated personal protective equipment for the care of Ebola infected patients, this includes Tychem suits, double gloves, PAPRs and fluid resistant booties over the Tychem suit.

Although the minimal standards for isolation and personal protective equipment set by the CDC for the care of Ebola infected patients is likely sufficient, the cross transmission of Ebola from a patient to a HCW in a US hospital would, in my opinion, result in near mass hysteria.

A heightened infection prevention strategy for the care of Ebola infected patients may not be unreasonable.