Health
Dallas Police Department / Reuters
A second Texas health worker who contracted Ebola from a sickened patient flew on a commercial domestic flight with an elevated temperature before being diagnosed, health officials said on Wednesday, raising new concerns about U.S. efforts to control the disease and the guidelines given to health care professionals.
Chances that other passengers on the plane were infected are very low, but the nurse should not have been traveling on the flight, U.S. Centers for Disease Control and Prevention (CDC) director Thomas Frieden told reporters. Echoing concerns that the U.S. has not been sufficiently stringent in its efforts to keep the disease's spread in check, President Barack Obama said Wednesday that the country needed to monitor Ebola "in a much more aggressive way."
The latest hospital employee to come down with symptoms of the virus, Amber Vinson, 29, was isolated immediately after reporting a fever on Tuesday, Texas Department of State Health Services officials said. She was among those who treated Liberian patient Thomas Eric Duncan at a Dallas hospital. Duncan, who flew from Liberia via Europe, later died.
Vinson, a health care worker at Dallas’ Texas Health Presbyterian Hospital, flew from Dallas to Cleveland, Ohio, last week. On Oct. 13 she returned on a Frontier Airlines flight to Dallas/Fort Worth International Airport, officials said. CDC officials are now contacting the 132 passengers on her return flight.
The latest revelation raises questions about the preparedness of health care workers in the U.S.
Addressing some of those concerns, Obama told reporters Wednesday after meeting with Cabinet officials that he had directed the CDC to step up its response to new cases.
"We want a rapid response team, a SWAT team essentially, from the CDC to be on the ground as quickly as possible, hopefully within 24 hours, so that they are taking the local hospital step-by-step through what needs to be done," he said.
Earlier, nurses from the United States, Liberia and Spain expressed outrage at the way hospitals have trained and protected nurses treating Ebola patients, accusing hospitals have having lax standards and inadequate guidelines.
The CDC will transport Vinson to Emory University in Atlanta, where several Ebola patients have recovered from the disease.
“What happened in Dallas could happen anywhere,” said RoseAnn DeMoro, executive director of National Nurses United (NNU), on a phone conference with health care workers around the world. More than 11,000 nurses listened in on the call, the NNU said.
DeMoro called promises of safety a “facade” and said employers tell nurses who want training to “look it up on a website.”
“This shouldn’t be on us to have to picket individual hospitals” to get safe working conditions, she said, calling Ebola a “nurse killer disease,” having taken the lives of over 230 health care workers in West Africa.
The NNU on Tuesday conveyed the stories of nurses at Texas Health Presbyterian who said improper hospital safety protocols and lack of training are endangering lives.
The union has written an open letter addressed to Obama, demanding that the White House take executive action to standardize and improve safety standards at hospitals treating Ebola patients.
The nurses want training, hazmat suits, isolation rooms and better procedures for disposing of infectious fluids from patients in the final stages of the illness.
“We have bargaining demands,” DeMoro said on the call. “Those will escalate to possible pickets with the public.”
Nurses who dialed in to the conference call Wednesday afternoon described scarce safety procedures at their hospitals.
“It’s just an accident waiting to happen,” said Donna Flemming Covey, a nurse at Providence Hospital in Washington, D.C. She accused her employers of not providing her or her colleagues with goggles because they were “too expensive.”
“The major problem is we do not have a national, integrated health care system,” Covey told the conference call, describing it as a patchwork of private hospitals’ policies. “What is needed is a uniform national standard” for equipment and training.
On the basis of what CDC officials saw when they arrived at Dallas’ Texas Health Presbyterian Hospital, Frieden said health care workers might have put themselves at greater risk for contracting Ebola by overzealously donning multiple layers of protective equipment.
“By putting on more layers of personal protective equipment — it makes it harder to put on and take off — the chance of contamination becomes higher,” he said, stressing that the health care workers who might not have taken proper precautions were not reckless.
“There’s fear and the anxiety, and it’s understandable. These are good, dedicated people who were trying to protect themselves and their families,” Freiden said.
Authorities decontaminated the worker’s apartment complex and went door to door before dawn to inform neighbors about the situation.
Frieden said the CDC would take steps to prevent the use of public transportation by people who have been near those with Ebola.
Meanwhile, Dallas County Judge Clay Jenkins told reporters Wednesday morning that doctors have upgraded the condition of the first infected Dallas health care worker, Nina Pham, from stable to good.
“Like Nina Pham, this is a heroic person, a person who dedicated her life and is dedicating her life to helping others,” Jenkins said of Vinson.
The situation “may get worse before it gets better, but it will get better,” said Dallas Mayor Mike Rawlings, who said that the city made “reverse 911” phone calls to Vinson’s neighbors to inform them of the appearance of Ebola in their area.
“Dallas is anxious about this, and with this news this morning, the anxiety level goes up a level,” he said. “But we are not fearful.”
Ebola spreads by contact with bodily fluids of infected patients, with blood, diarrhea and vomit the most infectious fluids.
Health care workers said through the NNU that they treated Duncan for days without the correct protective gear as hazardous waste piled up and supervisors changed safety protocols. The union said the nurses want to remain anonymous in order to avoid retaliation from their employer.
Daniel Varga, the chief clinical officer with Texas Health Resources, the owner of Texas Health Presbyterian, said the quick isolation of the second worker shows their response to the disease is working. He said that there was no “systemic” problem that led to the transmissions and that workers had appropriate protective clothing.
“No one wants to get this right more than our hospital,” he said, adding that he would not comment on the allegations the union has made but that health care workers have proper protective gear and procedures.
Ebola has killed 4,500 people, almost all of them in the West African countries of Liberia, Sierra Leone and Guinea. In this outbreak, the disease has proved fatal for about 70 percent of patients.
With reporting from Wilson Dizard
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