- November 20, 2014
Although only five cases of Ebola have been confirmed in the U.S., the staff at Health Central Hospital in Ocoee has taken precautions beyond the recommendations of the Centers for Disease Control and Prevention.
“We have a team throughout the hospital that would feel ready if an Ebola patient came to our hospital,” said Dr. Bart Rodier, Health Central’s chief quality officer. “We’ve been preparing since August, educating all of our employees on Ebola virus, and we have been assembling the equipment needed to protect our employees, and we have been practicing with the equipment so that we can use it in the proper manner.”
Mike Hassell, safety officer and emergency manager at Health Central, said the staff had worked hard to make the hospital safe with all sorts of emergency plans, this just one among them.
“We’ll make sure the patient is in a safe environment and that the hospital is safe for the rest of our patients and staff,” Hassell said. “We’ve had training videos, training days and classes. I think about 80 system-wide are competent to train these sessions. We want to make sure everyone is comfortable and confident in doing so.”
The first step is identifying potential sufferers of Ebola early, with the disease atop the minds of all employees, Rodier said.
“For example, if a patient calls us, we ask, ‘Have you traveled to West Africa recently or contacted anyone with Ebola recently?’ and Have you a fever and some other signs, such as muscle ache and vomiting?” Rodier said. “If the answers are positive, we tell them to stay there so we can limit exposure and get to them. We have a whole process for immediately isolating them, putting a mask on them, and then activating our whole detailed ebola management plan we have worked with Orlando Health on. We have chosen certain rooms in the hospital that would be used for the patient. We have modeled exactly how we want to keep this patient isolated from everyone.”
Such isolation would involve specially designed negative-pressure rooms equipped similarly to regular hospital rooms, Hassell said. Negative pressure means air only enters the room, never exiting, because of pressure differences between it and the surrounding area. The air is run through a filter and then properly discharged outside the hospital after it has been scrubbed.
This practically eradicates chances of contacting the virus outside that room. As for inside the room, the Centers for Disease Control and Prevention (CDC) have mandated complete coverage from head to toe with zero skin exposure among medical personnel.
“That means a Tivex suit, which is like a coverall that has built-in booties and a hood, coming in different sizes for all workers,” Rodier said. “We wear a special respirator mask to protect us from breathing droplets in. We wear a face shield and tape all of it so there is no exposure to the skin at all. We wear double gloves and double booties. It is important to put on and take off the equipment correctly, so nothing on the outside of the suit gets on your body.”
The gloves are the same type surgeons use in operations, with the second pair a half-size larger than the first, Rodier said. The only way to penetrate both sets of gloves would be to prick oneself hard with a needle, he said.
The disposal process involves several steps, including bleaching of all equipment, linens, and anything else in the room, Hassell said. Those materials are then bagged two or three times, with each bag bleached along the way, he said.
“The whole container goes in a 55-gallon UN-regulated drum that would be shipped out or incinerated on site,” Hassell said. “Everything in the room would also be treated, including a UV light we use to exterminate any possible germ in the room before patients use it again. That’s a regular part of our cleaning protocol.”
Health Central has a licensed carrier to move the drums from the hospital to an incinerator five blocks away, in a process completely regulated by the government, Rodier said.
Rodier has helped lead education on the history of Ebola, as well.
“Ebola virus was discovered in 1976,” he said. “There have been outbreaks in various areas since. It is easy to kill with a leech. It is spread between people by direct contact, such as exposure to a sick person’s sweat, blood or stool. After a person contacts the virus, they develop symptoms between two and 21 days. The person exposed is not contagious until they start having fevers.”
Most U.S. cases of Ebola originated in West Africa, and among those who have had the virus in the U.S., most are out of the hospital and Ebola free, Hassell said.
“The one death we had in the U.S. was from Liberia, coming here with more advanced symptoms,” he said. “It’s the one death we know of ever by Ebola in the U.S. We have the benefit of much more advanced medical practice. We make sure we monitor everyone people with exposure come across.”
For all of the hysteria surrounding Ebola, there are plenty of medical and non-medical epidemics facing the U.S. Hundreds of thousands of Americans die each year from tobacco use, alcohol and drug abuse, medical errors and obesity, the main contributors to well more than half-a-million deaths each from cancer and heart disease every year. Other leading factors include more than 55,000 deaths from pollution, 43,000 from automobile wrecks, around 32,000 from firearms and 20,000 from sexually transmitted infections. All other infectious diseases combine for 75,000 American deaths—just one of them from Ebola.
More than half of these deaths by infectious disease were from the flu last year, with numbers rising across the disease board because citizens are avoiding vaccinations of all sorts.
“The flu kills in the U.S. an average of 30,000 people a year,” Rodier said. “That’s why it’s so important to have the flu vaccine. That is a very real threat, and there are several flu viruses all around us. We’re all at risk for developing the flu every winter.”
With winter approaching, vaccinations have started for this flu season, Rodier said.
“We get people to protect themselves from the winter flu once a year,” he said. “The reason is that there are multiple flu viruses, and every year, the healthcare system determines which are most likely to cause illness and death in the season. They put three or four of the strains in those viruses in the vaccine to protect the most people from the most types of the flu. We’re using this Ebola preparation to make sure everyone realizes that safe practices like hand washing and isolation of patients who have infectious diseases is important for many different diseases, not just Ebola.”
Whether Ebola, the flu or otherwise, the steps to prevent sickness and disease outbreaks are fundamental, Hassell said.
“Get vaccinated, wash hands frequently, and don’t contact sick people,” he said.