When the first Ebola patient was brought back to the US, I took a lot of flack from some folks on LinkedIn when I questioned whether EMS and Emergency Departments in the US would get exposed to this threat long before they realized it and opined that emergency providers would be at the front line of risk.
For risk managers, there is no satisfaction in being proven right. The horse is now out of the barn in Dallas, and there is concern about possible spread because the ED missed the indicators. Now the ED personnel and members of the public have the potential for contamination. The typical Ebola patient in Africa transmits to 2 up to 21 other people, according to news reports, but there is no experience to provide reliable indicators on potential spread in a first world urban setting — same, less, or more.
In a gratifying display of lack of foresight, the CDC has now issued an advisory to EMS and ED providers with information that should have been a priority dispatch when the first Ebola patient was brought back to the US:
In light of the recent domestic case of confirmed Ebola, the U.S. Department of Health and Human Services (DHHS)’ Office of the Assistant Secretary for Preparedness and Response (ASPR) and Centers for Disease Control and Prevention (CDC), encourage the entire emergency care community to take steps to ensure that they are able to protect, detect, and respond. Specifically, we are requesting your assistance to ensure that screening criteria is placed in all emergency departments, ambulances, and other “first contact” locations.
Every healthcare organization should ensure it can detect a patient with Ebola, protect healthcare workers so they can safely care for the patient, and respond in a coordinated fashion. In order to assist with screening and detection of persons with the signs, symptoms, and travel history consistent with exposure to Ebola, we have developed Ebola Virus Disease screening criteria.
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At this point, it appears that the CDC does not wish to cause “panic” by getting serious about preparation instructions — albeit, one would think that general bio-hazard preparations would have been in place since the anthrax scare 13 years ago. So, it falls upon the local emergency planners and risk managers to refresh their troops on field response, field containment, transport, isolation, and decontamination protocols because it is no longer “if” or even “when” Ebola (or other bio-threats) will get into the wild in the US.
And folks, “it won’t happen here” is not a strategy or a plan.