It was disheartening to learn that a second Dallas heath care worker has been diagnosed with Ebola. The infections have raised questions about our understanding of Ebola and our confidence in the ability of the US healthcare system to respond to Ebola cases. However, we need to keep our perspective and not give in to our fears.
Ebola is a scary disease. Yesterday, the World Health Organization indicated that the mortality rate for the epidemic in West Africa is close to 70 percent and that the rate of new infections could increase to 10,000 per week over the next six weeks (http://www.nytimes.com/2014/10/15/world/africa/ebola-epidemic-who-west-africa.html?hp&action=click&pgtype=Homepage&version=HpSum&module=first-column-region®ion=top-news&WT.nav=top-news). However, Ebola is not easily spread. As the CDC and other health officials keep reminding us, people must come in contact with a person’s bodily fluids – like blood, stool, and vomit – to be at risk of infection (http://www.cdc.gov/vhf/ebola/transmission/index.html). That explains why those who care for Ebola patients – all of them from doctors and nurses to the people who clean the rooms – are at risk of infection.
Although Ebola is scary, proper infection controls can prevent transmission. So what went wrong in Dallas? Right now, we don’t know. Although CDC has provided information about infection control in the context of Ebola, a New York Times piece suggests that this is both complicated and cumbersome (http://www.nytimes.com/interactive/2014/10/12/us/how-hospital-workers-are-supposed-to-treat-ebola-safely.html). Nurses, who have more close contact with patients than many health care workers, have complained that they have not received proper training (http://www.npr.org/blogs/health/2014/10/14/356130469/nurses-want-to-know-how-safe-is-safe-enough-with-ebola). The first US Ebola patients who were repatriated after contracting Ebola in Africa, were treated in hospitals with specialized isolation wards developed to handle rare and serious infectious disease. CDC now recognizes that community hospitals that do not have such specialized equipment and training need additional help. CDC Director, Thomas Frieden, has both acknowledged that CDC should have responded more quickly to the case in Dallas (http://www.nytimes.com/2014/10/15/us/cdc-says-it-should-have-responded-more-quickly-to-dallas-ebola-case.html?hp&action=click&pgtype=Homepage&version=HpHeadline&module=span-ab-lede-package-region®ion=top-news&WT.nav=top-news) and has promised to send CDC experts to any hospital in the United States with a confirmed Ebola case (http://www.mcclatchydc.com/2014/10/14/243392/cdc-will-send-ebola-response-team.html).
The US has the resources to deploy the CDC’s expertise to respond to any additional Ebola cases. It also has the resources and infrastructure to monitor contacts and to respond quickly to identified cases. Thus, we can be hopeful that, with appropriate supportive care, the two healthcare workers in Dallas will recover, as have other US patients and that there will be few other cases resulting from patient care.
We are in the midst of a global public health emergency, and we have limited experience with Ebola on our shores. While our response has not been perfect, our public health officials have been responsive to changing information and stakeholder concerns, and willing to admit mistakes publicly and change policy. We should not let ourselves be distracted by our own fears, but rather keep our focus where it belongs – on West Africa where the epidemic rages on and where our help is desperately needed.