A survey of nurses in the US reveals a stunning lack of preparedness in our hospitals to handle a major infectious disease outbreak. The survey conducted by National Nurses United (NNU) indicates our front-line health care safety net is not ready. As reported in Infection Control Today, 85% of RN respondents stated that they had been given no information on Ebola by their hospitals. Could this have been the communication breakdown in Dallas that sent an infectious Ebola patient back into the public? They also report a lack of the basic personal protective gear required to handle Ebola patients.
The recommendations by NNU make sense. Treat this as an emergency. Communicate and train. Distribute supplies to those who need them.
One of the concerns in an outbreak like this is who will report for duty. As has happened in other natural disasters and disease outbreaks, some health care workers choose self preservation over doing their noble work. Despite protective gear and other precautions, fear of something that cannot be seen like Ebola becomes overwhelming. Descriptions of the disease such as “a fire straight from the pit of Hell” do little to reassure. Health care workers fail to report for work and walk away. That leaves a reduced number of true heroes to provide care for patients. The situation turns ugly.
But the impact of an outbreak such as Ebola reaches out in ever expanding circles. Everyone involved in patient contact must be trained and provided protective gear. That would include people who do housekeeping in the hospital. They may be asked to do clean up in the Emergency Room. Normal universal precautions for blood borne illnesses don’t seem adequate in the face of Ebola.
The City of Houston Emergency Medical Service has eghty-eight patient care vehicles. Less than half of those are staffed and equipped to provide Advanced Life Support (ALS). As seen in Dallas, an ambulance unit transporting an Ebola patient was taken out of service for extensive decontamination. It would not take many Ebola infected patients to remove a high percentage of Houston EMS vehicles from service for an indefinite period of time. Those Paramedics and EMT’s who staff those units might also be removed from the streets for monitoring. All of the expected fires, car wrecks and health emergencies will still happen. Will there be enough services available to respond?
Our health care system could be quickly overrun despite our advanced infectious disease control procedures. This version of Ebola moves fast. Can those in charge of our health care systems move faster?