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Ebola fear, monitoring eases for some in Dallas

By R&D Editors | October 20, 2014

 
              Christine Wade, a registered nurse at the University of Texas Medical Branch, greets Carnival Magic passengers disembarking in Galveston, Texas on Sunday, Oct. 19, 2014. Nurses met passengers with Ebola virus fact sheets and to answer any questions.  A Dallas health care worker was in voluntary isolation in her cabin aboard the cruise ship because of her potential contact with the Ebola virus. (AP Photo/The Galveston County Daily News, Jennifer Reynolds)

Ebola fears began to ease for some Monday as a monitoring period passed for those who had close contact with a victim of the disease and after a cruise ship scare ended with the boat returning to port and a laboratory worker on board testing negative for the virus.

Federal officials meanwhile ramped up readiness to deal with future cases. A top government official said revised guidance instructs health workers treating Ebola patients to wear protective gear “with no skin showing.” The Pentagon said it is forming a team to support civilian medical staff in the U.S.

In Dallas, Louise Troh and several friends and family members will finally be free Monday to leave a stranger’s home where they have been confined under armed guard for 21 days—the maximum incubation period for Ebola. They had close contact with Thomas Eric Duncan, a Liberian man who died of the disease at Texas Health Presbyterian Hospital on Oct. 8.

“I want to breathe, I want to really grieve, I want privacy with my family,” Troh told The Associated Press.

The incubation period also has passed for about a dozen health workers who encountered Duncan when he went to the Dallas hospital for the first time, on Sept. 25.

Duncan was sent home but returned by ambulance on Sept. 28 and was admitted. Two nurses who treated him during that second visit—Nina Pham and Amber Vinson—are now hospitalized with Ebola.

Vinson’s family issued a statement Sunday saying they have hired a lawyer and are troubled by comments and media coverage that “mischaracterize” Vinson, who is being treated at Emory Univ. in Atlanta. Vinson “has not and would not knowingly expose herself or anyone else,” the statement says.

Dallas County and federal Centers for Disease Control and Prevention officials cleared her to fly last week to Dallas from Ohio, and “suggestions that she ignored any of the physician and government-provided protocols recommended to her are patently untrue and hurtful,” the family says.

On Sunday, a Carnival Cruise Lines ship returned to Galveston, Texas, from a seven-day trip marred by worries over a health worker on board who was being monitored for Ebola. The laboratory supervisor had handled a specimen from Duncan and isolated herself on the ship as a precaution.

About 4,000 passengers on the cruise had to miss a stop in Cozumel, Mexico, where the boat was not allowed to dock because of the scare. Carnival said it was informed by U.S. health authorities Sunday morning that the worker tested negative for Ebola.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said those caring for Duncan were vulnerable because some of their skin was exposed.

The CDC is working on revisions to safety protocols. Earlier ones, Fauci said, were based on a World Health Organization model for care in remote places, often outdoors, and without intensive training for health workers.

“So there were parts about that protocol that left vulnerability, parts of the skin that were open,” Fauci said.

Health officials had previously allowed hospitals some flexibility to use available covering when dealing with suspected Ebola patients. The new guidelines are expected to set firmer standards: calling for full-body suits and hoods that protect worker’s necks; setting rigorous rules for removal of equipment and disinfection of hands; and requiring a “site manager” to supervise the putting on and taking off of equipment.

The guidelines also are expected to require a “buddy system” in which workers check each other as they come in and go out, according to an official who was familiar with the guidelines but not authorized to discuss them before their release.

Hospital workers also will be expected to exhaustively practice getting in and out of the equipment, the official said.

Nurses have been clamoring for more guidance and better garb, saying they have never cared for Ebola patients before and feel unprepared and underequipped.

“If hospital administrators had to take care of Ebola patients, they would have the gold standard and hazmat suits,” said RoseAnn DeMoro, executive director of National Nurses United, a union with 185,000 members.

In some places where they have the suits, nurses have not practiced taking them on and off.

“The hospital is sending them essentially a link to the CDC website. That’s not preparation. That’s like a do-it-yourself manual,” DeMoro said.

On Sunday the Pentagon announced that Defense Secretary Chuck Hagel had ordered the formation of a 30-person military support team to assist civilian medical professionals in the U.S. to treat Ebola.

The team will be formed by Northern Command’s Commander, Gen. Chuck Jacoby, and will comprise 20 critical care nurses, five doctors trained in infectious disease and five trainers in infectious disease protocols. Once formed, the team will undergo up to a week of specialized training in infection control and personal protective equipment at Fort Sam Houston in San Antonio, Texas, then remain in “prepare to deploy” status for 30 days.

The team won’t be sent overseas, and will “be called upon domestically only if deemed prudent by our public health professionals,” Pentagon press secretary Rear Adm. John Kirby said in a statement.

 

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