CDC Tightens Ebola Protocol

Two American nurses recently contracted the Ebola virus as a result of being part of the treatment team for Dallas patient Thomas Eric Duncan. The Centers for Disease Control and Prevention (CDC) has now tightened the safety guidelines that pertain to Ebola and how patients with suspicious infections are handled in United States hospitals.

Duncan died earlier this month after having flown from Liberia, a country where the ebola virus is rife, to Dallas, Texas. When he suspected that he was ill, he went to the Texas Health Presbyterian Hospital, where he was evaluated and sent back home. Two days later, Duncan returned to the hospital, clearly displaying symptoms typical of the infectious disease that has already killed almost 5,000 people in West Africa.

The Texas Health Presbyterian Hospital has admitted that mistakes were made. The facility has since altered the protocol for dealing with people who may be infected.

For Nina Pham and Amber Vinson, the two nurses who contracted the Ebola virus while treating Duncan, other than the immediate concern of potential loss of life, there is a financial element to consider. Employers in Texas can legally opt out of the workers compensation system. A spokesperson for the Texas Health Presbyterian Hospital has given assurances that the hospital does not have this scheme in place for workers, and that the cost of treatment for the two nurses is covered.

Workers compensation industry experts say that the Ebola virus, like any other illness occurring as a result of occupational hazard, is compensable. It would have to be proven that the disease was contracted at the workplace. The 21-day incubation period that the virus typically has makes this easier to determine than some other infectious diseases.

Joe Paduda, from Health Strategy Associates, explains that some viruses can be contracted almost anywhere, but the Ebola virus at present is very contained to specific areas. It would be easy for an illness such as influenza to be passed onto a nurse outside of his or her workplace. The Ebola virus is not, however, prevalent enough in the United States for it to be contracted by a nurse outside of the workplace. At this stage, Paduda is confident that no judge would agree that a healthcare worker who had contracted Ebola could have contracted the disease anywhere other than the workplace.

David C. Kurtz, a partner at the employment law firm of Constangy, Brooks & Smith L.L.P., explains that, despite the small number of cases that an employer such as a hospital will have to deal with in terms of workers contracting Ebola on site, each case could represent a huge financial burden. This could lead to an increase in insurance premiums.

The cost of treating Ebola virus patients is high. According to JoAnn Sullivan, senior vice president at Marsh Risk Consulting, isolation treatment room condition maintenance alone can be as much as $1,000 an hour. The high level of attention paid to constant disinfecting and cleaning is also costly, as are the medications. Sullivan also believes that nurses should be given better training on how to treat Ebola, adding another cost to be taken into account. All in all, the burden of providing adequate medical assistance to any person who contracts the disease is high, and hospitals could be hard hit should they run into such incidents.

Dr. Daniel Varga, the senior executive vice president for the parent company of the Texas Health Presbyterian Hospital, Texas Health Resources, has said that the hospital is now taking a more proactive approach to providing hospital staff with the training that they need in order to keep themselves safe. In a press release last week, Varga suggested that the contamination of medical employees resulted from  the hospital’s inability to diagnose the Ebola virus correctly in the first place.

The Ebola virus protocol guidelines from the CDC include the recommendations that no skin be left uncovered when nurses and doctors are treating infected patients and that waterproof boots should be worn to reduce the risk of carrying the infection beyond the isolation ward. The process of putting on and removing protective gear should be strictly monitored by a supervisor at all times, at this part of the process has been identified as a trouble spot.  Adherence to the CDC guidelines is voluntary, and hospitals are not required to follow them by law, but the CDC has issued a stronger advisory suggesting their use in order to reduce the potential for the further spread of the virus.

Pham and Vinson, the nurses who contracted the disease after treating Thomas Eric Duncan, were airlifted to another U.S. based hospital considered better equipped to treat Ebola. Ms. Pham  was declared “cured” two days ago and exchanged hugs with President Barack Obama at the White House before returning to Texas after the news conference. Ms. Vinson has also been declared free of the virus, nine days after her infection was confirmed by blood tests.

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