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Ebola Outbreak in West Africa Deeply Impacts U.S. Health-Care Policy

The Ebola virus has rocked the U.S. public health and health-care community and the public at large.

Ebola protective equipment
Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, is decontaminated by Doctors Without Borders staff after visiting their Ebola treatment unit.
The past few weeks of the Ebola outbreak in Sierra Leone, Guinea and Liberia have gripped the U.S. and the world in bizarre, comical and concerning ways. Every day the news brings stories of sexy hazmat suits that are the most sought out Halloween costumes, it’s fodder for late night talk shows and the Centers for Disease Control and Prevention (CDC) finally released new health-care worker protection guidelines.

The Ebola virus has deeply rocked the U.S. public health and health-care community and the public at large even though we are not likely to see the same Ebola transmission and mortality rates they have in West Africa. There have been only four cases in the U.S. and one death but many of my health-care emergency management colleagues can attest that we are now spending an inordinate amount of time on infection control webinars, donning and doffing training and fit testing, as well as ordering as much personal protective equipment (PPE) they can get their hands on.

It does make sense to cache large amounts of PPE if you are in West Africa but not in west Los Angeles. The PPE grab is a valid preparedness tactic but it begs a larger question: Does it mean we are more prepared for Ebola or any other infectious disease with a high mortality rate just because we have PPE? Maybe. It does mean that if the Ebola outbreak drags on there will be little PPE left for those West African nations that have the greatest need.

We have already seen the cracks in the health-care preparedness system — two nurses who treated U.S. index patient Thomas Eric Duncan in Dallas contracted the virus, and the states of New York and New Jersey are issuing austere but varying isolation and quarantine orders relating to Ebola patient exposure. According to The Sacramento Bee, California’s quarantine order states that “anyone arriving in California from an Ebola-affected country who had contact with an Ebola-infected person will be quarantined for 21 days. This policy, like the ones issued by New York and New Jersey, appears to be stricter than that issued by the CDC on Monday, which only applies to people deemed ‘high risk’ because they were caring for an infected person without proper protective clothing or were exposed to the virus through needle-stick or injury.”

As the Ebola crisis continues, we will see more patchworking of isolation and quarantine guidelines. You can review the current isolation and quarantine statutes in every state by visiting the National Council of State Legislatures.

A public health crisis on the scale of an Ebola outbreak brings many planning challenges to emergency managers. During the co-sponsored International Association of Emergency Managers (IAEM) and National Emergency Management Association (NEMA) conference call today “Ebola Lessons Learned for Emergency Managers,” the Dallas County emergency managers raised a number of planning issues that they encountered such as: where to house the quarantined individuals; how to find properly trained vendors willing to clean the homes of those suspected cases of Ebola; how to properly dispose of the medical waste; and how to coordinate risk communication messaging. These lessons learned can be added to our plans now to strengthen our infectious control procedures. Check the IAEM and NEMA websites for the slides of this great webinar.

I’d love to hear about your Ebola-related stories and planning challenges and your lessons learned from past infectious disease outbreaks. Join the conversation and share your thoughts and experiences below in the comments.

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.