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Ebola Outbreak: U.S. Health-Care Agencies Need to Review Infectious Control Plans

With the CDC projecting that the spread of Ebola in 2015 will be upward of a million cases in West Africa, now is the time for nations to step up their prevention efforts.

Ebola vaccine
A 39-year-old woman, the first participant enrolled in VRC 207, receives a dose of the investigational NIAID/GSK Ebola vaccine at the NIH Clinical Center in Bethesda, Md., on Sept. 2.
It is clear that the Ebola virus outbreak has devastated Liberia, Guinea and Sierra Leone by killing more than 3,000 people to date of the 7,000 individuals infected. Even more troubling is that the BBC News reported that “five people are infected every hour” and the Centers for Disease Control and Prevention (CDC) stated that “cases in Liberia are currently doubling every 15-20 days, and those in Sierra Leone and Guinea are doubling every 30-40 days.” With the CDC providing confirmation on the first Ebola virus patient in the U.S., as well as projecting that the spread of the Ebola virus in 2015 will be upward of a million cases in West Africa, now is the time for nations to step up their prevention efforts. Because the Ebola virus transmission takes place through the exchange of blood and bodily fluids and is not spread by air or water, health-care personnel and close family caring for the patients are at the greatest risk of getting the virus.

Health-care providers, hospitals, long-term care agencies and primary and specialty care should use this threat to seize the opportunity to refine worker protection and infectious control plans and procedures. With the competing priorities of providing health care, emergency management is shockingly not always on the minds of health-care administration. As many of us know, emergency management planning is often a top priority only when it is desperately needed.

As we experienced during the Severe Acute Respiratory Syndrome outbreak in 2003 and the 2009-2010 H1N1 pandemic, the spread of the viruses hit health-care personnel the hardest due to their close contact with infected patients. From 2002 to 2009, I was in charge of supporting the emergency management planning of more than 800 community clinics in California when I directed the emergency management work for the California Primary Care Association. During the 2009 pandemic — some referred to it as the “plandemic” — one of the biggest issues was the health-care worker personal protective equipment (PPE) recommendations that varied from county to county.

It was confusing for both myself and providers to keep up with the changing recommendations. Some counties used the CDC PPE requirements of N95 masks, gowns and glove; the California Department of Public Health had a different set of recommendations; and some counties came up with their own completely different health-care worker guidelines. As a result, we saw the PPE supply chain slow or dry up as health-care agencies stockpiled supplies. In the end, the CDC estimated that “approximately 60.8 million cases, 274,304 hospitalizations and 12,469 deaths occurred in the United States due to H1N1.” Luckily, H1N1 was significantly slowed by standard infectious control procedures such as the use of personal protection equipment, vaccine distribution and frequent hand washing.

What’s my point for bringing up current and past viruses and what does it mean for emergency managers? From the 1976-1977 season to the 2006-2007 flu season, the CDC estimates that flu- associated deaths ranged from 3,000 to 49,000 annually. If any U.S. jurisdiction had that many deaths and/or injuries from a single event, every available federal, state, local and private-sector resource would be used to combat that disaster. My point is that during virus outbreaks — whether it be the annual flu, Ebola or another viral threat down the road — response is not just the sole responsibility of health departments and health-care providers. FEMA Administrator Craig Fugate’s Whole Community initiative is correct on its in philosophy that everyone needs to come to the table to combat threats and events. Health departments and health-care providers need logistical support from offices of emergency management, public safety agencies and the private sector. Health-care agencies can provide subject-matter experts on virus transmission, vaccines, PPE and personnel to support good outcomes during a health-care crisis.
 

Nora O'Brien is the principal consultant of Connect Consulting Services, a health-care emergency management firm that provides plan development, training and drills, and exercise services to health-care agencies throughout the U.S. She has a master’s degree in Public Affairs, Disaster and Emergency Management and is a Certified Emergency Manager. She can be reached at Nora@ConnectConsultingServices.com or @NoraConnect on Twitter.