Hospitals, reporters miss low-hanging fruit in response to Ebola cases

When something goes wrong at a hospital, there are often three responses: Blame the patient, blame the nurse, or blame some forces beyond their control.

All three of those things have happened in the wake of the recent cases of Ebola reported in Dallas, and reporters should be wary of those types of claims about Ebola and other infectious outbreaks. The truth is, we know what to do to stop Ebola. It requires more focus and patience than dealing with other diseases, but it can be done. We just haven’t been doing it well. Here are three tips for avoiding the trap of putting blame in the wrong place, with more to come on Monday.

1) Let’s stop saying that all the missed opportunities with Ebola “raise questions.”  

In the coverage of Ebola, headline writers and reporters love to raise questions. “Second US Ebola Case Raises Questions About Safety.” “Ebola Protocol Breach Raises Questions About Where to Treat Patients.” “Ebola Diagnosis for 2nd Texas Hospital Worker Raising Questions Over Virus Battle Plan.”

Let’s just say preventative measures were ignored. Basic steps that were low-hanging fruit on the tree of prevention were left to rot. (New reports say nurses didn’t wear protective suits for the first two days of treating the first Dallas Ebola patient.) And now two people are infected with likely more to come. It would have taken an hour for Texas Health Presbyterian Hospital in Dallas to deputize one person to come up with a plan specific to that first patient. That plan probably would have led to fewer than 100 people coming into contact with the patient, but, if the number did reach 100, the plan would have been specific on the types of directions to give to these people. Do you need to rent out a Holiday Inn and stick them all there? Perhaps. At a minimum, you need to tell them to avoid schools, airplanes, buses and other places packed with people. What kind of guidance have these patients received? Why did the CDC not tell the second nurse recently diagnosed with Ebola that she should not get on the flight she was about to board when she reportedly called the agency? (Note that other accounts say that the nurse called the hospital to ask abou the flight -- not the CDC.)

2) We have known for a long time how to stop Ebola. It’s essentially the same rule book we have been following for every highly infectious disease from the black plague to cholera to AIDS. Ebola did lead to highly specific recommendations about protective gear and disposal systems for infectious material, but the recommendations have been spelled out and successfully followed. So why isn’t everyone following that rule book? Peter Piot, now the head of the London School of Hygiene and Tropical Medicine, helped discover Ebola in 1976. As soon as they figured out what was killing people at such a rapid clip, they quarantined anyone with symptoms. As Piot told Rob Brown at the BBC in July:

We systematically went from village to village and if someone was ill they would be put into quarantine," says Piot. "We would also quarantine anyone in direct contact with those infected and we would ensure everyone knew how to correctly bury those who had died from the virus.

They also closed the hospital where the outbreak was first discovered and started communicating to people how to look for the signs and symptoms, how to handle bodies of people who died from the disease, and how to disinfect anything that may have come in contact with the virus. The epidemic ended with only about 300 people dead. Today, the death count is at 8,000 and growing.

3) Some people and organizations clearly are doing the right thing, and successes should be celebrated and emulated.

After a woman with Ebola flew on a Frontier Airlines flight, the airline put its flight staff on paid leave to keep them away from others and grounded the plane. They’ve controlled what they can control.

Emory University has treated two patients with Ebola. The patients recovered and no one else at Emory or in the vicinity has been diagnosed with the disease.

What did Emory know that Texas Health Presbyterian Hospital in Dallas did not? It followed the well-known guidelines, trained its staff, and prepared.  

The Washington Post's Mark Berman wrote on Oct. 14:

Two nurses who treated Ebola patients at Emory University Hospital have traveled to Texas to consult about using protective equipment and other infection control measures, Emory announced Wednesday.

Thankfully, Emory is sharing their knowledge with the less knowledgeable, and health reporters should do the same. I’ll have more tips on Monday.

Next: Tracking Ebola by the missed opportunities to stop its spread

Photo by Ted Eytan via Flickr.