NMC prepares for Ebola

ER director: Facility takes virus seriously

Elodie Reed

By Elodie Reed

Staff Writer

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ST. ALBANS — Northwestern Medical Center (NMC) officials want Franklin County residents to know: There is little chance that the Ebola virus would make its way to Vermont, and in the unlikely event that it did, local hospitals, including NMC, are prepared.

According to Dr. John Minadeo, the medical director of NMC’s emergency department, ever since the Ebola outbreak began several months ago in West African countries like Sierra Leone, Guinea and Liberia, NMC has been working with the Vermont Department of Health and the Centers for Disease Control (CDC) of Atlanta, Ga. to update and enforce new protocol.

Ebola is an infectious disease that is transmitted through blood or bodily fluids from an infected person. It is not spread through air or water. Currently, there is no FDA-approved antibiotic for Ebola, though patients have recovered from the disease through careful monitoring and supportive care.

According to the CDC’s Web site, the World Health Organization has documented 8,997 total cases of Ebola and 4,493 deaths. Almost all of these cases have occurred in West African countries.

In light of two Texas Presbyterian health workers contracting the disease after caring for Thomas Eric Duncan, the first travel-associated Ebola patient in the U.S. who passed away on Oct. 8, the CDC has upped its rigor in its recommendations for Ebola patient care.

New measures include hospitals implementing a buddy system for healthcare workers when they put on protective gear to make sure skin is completely covered and a CDC Response Team that will be sent to any hospital with a confirmed Ebola patient within hours of diagnosis.

Five major airports that receive 94 percent of travelers from Sierra Leone, Liberia and Guinea to the U.S. have also implemented screening procedures. Airports in Montreal and Burlington are not included in that list.

“We’re monitoring it regularly,” Minadeo said of the CDC’s recommendations in regard to Ebola. “We’ve noticed that it is a moving target and that those recommendations are changing, and as they change we change our guidelines and policies.”

He added, “We are now adopting our guidelines for this specific virus.” NMC is also extending CDC recommendations to all EMS services in the area that work with the hospital.

What would happen

NMC has already begun a screening procedure related to the Ebola virus. Any patient coming in with a complaint of fever will be asked about their recent travel history, specifically whether they have been to West African countries in the past month or so.

“Everyday we see patients that come with a chief complaint of a fever,” said Minadeo. “Dozens a day.”

In the case that NMC received a patient that had fever and had recently traveled from Sierra Leone, Liberia or Guinea, Minadeo said everything would happen quickly.

“We would immediately place a mask on them and place them in our isolation room,” he said. Minadeo added that the number of healthcare workers in contact with the patient would be limited, and all would be dressed in protective gear.

“Using the protective equipment that we have, we would be able to continue giving the typical medical care,” he said. This would generally consist of IV fluids and monitoring.

“Supportive care is really the treatment for this,” said Minadeo.

In response to concerns about Ebola patients being treated differently, and perhaps less humanely, than other patients, Minadeo said, “There would be no compromise in the quality or the type of healthcare given. The difference would be we’d minimize the number of healthcare workers that are caring for the patients and we would restrict the number of visitors.”

Once a potential Ebola patient was stabilized and in isolation at NMC, the patient’s physician would be in contact with an infectious diseases specialist, and the patient would be transported to Fletcher Allen Health Care in Burlington. After the patient has a confirmed case of Ebola, the CDC Response Team would come in.

“That [all] may change, but that’s our current understanding of how it would work,” said Minadeo.

Quelling fears

While Minadeo said NMC is well prepared and confident in its ability to care for any potential Ebola patients, he also said Franklin County seeing Ebola patients isn’t likely.

“I’m confident in our response to any potential case that we would be able to identify and control it,” he said.

In an Oct. 16 Vermont Health Department press release, Dr. Harry Chen, the acting Secretary of Human Services and Tracy Dolan, Acting Health Commissioner, wrote an opinion stating that while there is always a risk for Ebola in the U.S. as long as it is in other parts of the world, “it’s important to understand how very small the risk is in this country.”

Chen and Dolan went on to point out the advanced health care and public health infrastructure in the United States and Vermont, something that has been lacking in places most devastated by Ebola.

The opinion piece concluded that the Vermont Department of Health is working with partners around the country to be informed on the most up-to-date information and protocols regarding Ebola.

Minadeo added, “The likelihood is very low. We have very few travelers to and from Africa. The only way you can contract Ebola is by contact with bodily fluids of someone who is infected.”

Minadeo said that people shouldn’t worry but just practice good preventative care to avoid all infectious diseases, like consistently washing hands, as usual.

“There’s certainly no reason to panic or worry,” he added. “People are not going to get it by walking around town.”

In the meantime, Minadeo said he and the NMC team will continue to have their daily meetings on the Ebola situation and prepare as best as they possibly can.

“We’ll be continuing to react and rethink our approach, and it’ll evolve every day,” said Minadeo.