There’s a lot of head scratching going on about what the healthcare worker that contracted Ebola from Patient Zero in Dallas did wrong. Did she take off the protective gear improperly? Did the gear touch something? Were the dialysis tubes disposed of improperly?
The fact is, when you have a truly deadly, Biolevel 4 Hazard virus, like Ebola, the only way to safely treat it is in a hospital that is equipped to deal with Biosafety Level 4 microbes.
The microbes in a BSL-4 lab are dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines. Two examples of microbes worked with in a BSL-4 laboratory include Ebola and Marburg viruses.-Centers for Disease Control
“BSL [Biosafety Level] – 4 builds upon the containment requirements of BSL-3 and is the highest level of biological safety. There are a small number of BSL-4 labs in the United States and around the world.
The microbes in a BSL-4 lab are dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines. Two examples of microbes worked with in a BSL-4 laboratory include Ebola and Marburg viruses.
- The laboratory is in a separate building or in an isolated and restricted zone of the building.
- The laboratory has dedicated supply and exhaust air, as well as vacuum lines and decontamination systems.”
US hospitals, doctors and nurses are not prepared to deal with an Ebola outbreak. That was proved when the first case of transmitted Ebola in the US was bungled in Texas.
There are truly only 4 hospitals that can handle Ebola the way it’s supposed to be handled, as a Biosafety Level 4 Microbe. Anything less is just taking chances that a breach will occur, and people will die as a result of that breach. For comparison, the Bubonic Plague is a Biosafety Level 3.
In the US there are 4 Hospitals geared up to handle Ebola:
- The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds.
- Nebraska Medical Center, Omaha, has 10 beds.
- Emory Hospital, Atlanta has 3 beds.
- St Patricks Hospital, Missoula, Montana has 3 beds.
“St. Patrick Hospital administrators have no notice about when or if they will be asked to care for someone stricken with the disease that’s killed more than 3,000 people in Africa in 2014. But the hospital has a special wing of its intensive care unit with three rooms modified to safely handle infectious diseases like Ebola.
“We may never get a patient, but we may someday,” said Carol Bensen, St. Patrick’s senior director for critical care. “We want to help alleviate the rumor mill by making people aware of what we offer. We deal with tuberculosis patients fairly often and nobody expects a press release. We care for lots of different diseases here.”
And any hospital equipped to care for a tuberculosis patient can care for an Ebola patient, according to Dr. George Risi, an infectious disease specialist who recently returned from spending 20 days in a Sierra Leone Ebola ward.
Accompanied by St. Patrick’s intensive care nursing director Kate Hurley, Risi helped local clinic staff care for up to 95 patients at a time. While untreated Ebola kills more than 70 percent of its victims, more than half of those who made it to the clinic recovered.
“It’s a disease to be respected, but not feared,” Risi said. “It’s similar to the HIV-AIDS time, when there was this fatal disease and we didn’t know how it was transmitted and people were afraid to touch a patient. We know how to treat Ebola. And this is a cutting-edge center of excellence for a lot of things – for cancer treatment, for cardiac surgery and for infectious diseases as well.”
The “care and isolation unit” of the hospital occupies one hallway of its intensive care unit. It has a set of hallway doors that can close to keep out other hospital traffic. Each room has an anteroom – a double-doored chamber where medical staff can put on or take off their personal protective gear before tending to the patient. The double doors also preserve negative air pressure inside the patient’s space, so air is always being sucked into the room instead of floating out.
Inside the room, more complicated air circulation and filtration systems blow air from the ceiling across the patient and staff and into filters that remove any infectious organisms before release to the general atmosphere on the hospital roof.
Otherwise, it has the usual equipment needed for critical care: ports for administering breathing oxygen and medicines, draining fluids and related treatments. Outside, a separate nursing station has all the regular ICU medicines, equipment and supplies.
The three rooms are qualified to handle Level 4 safety concerns. Level 1 has protection against things generally not dangerous to healthy people, like brewer’s yeast. Level 2 is the safety margin of the standard hospital microbiology lab, where clinicians test for routine diseases like chicken pox or staph infections.
Level 3 spaces can handle infectious diseases spread by air, like influenza, bubonic plague or yellow fever – that have known cures.
Level 4 units are for exotic agents that may or may not have cures available, or appear in highly concentrated or modified forms from a research institution.
And that’s why St. Patrick has a care and isolation unit. The federal Rocky Mountain Laboratories in Hamilton deals with those kinds of substances on a daily basis, and has done so for years. Some of its researchers are on the forefront of developing a vaccine for Ebola, and have worked with many other unusual disease organisms.”
Q: Can any U.S. hospital safely treat Ebola patients?A: Frieden (Director of CDC) and other health officials say yes, but others say the new case shows the risks.
“We can’t control where the Ebola patient appears,” so every hospital’s emergency room needs to be prepared to isolate and take infection control precautions, Maki said.
That said, “I don’t think we should expect that small hospitals take care of Ebola patients. The challenge is formidable,” and only large hospitals like those affiliated with major universities truly have enough equipment and manpower to do it right, Maki said.
“If we allow it to be taken care of in hospitals that have less than optimal resources, we will promote the spread,” he warned.
Q: Should Ebola patients be transferred to one of the specialized centers that have treated others in the U.S.?
A: Specialized units are the ideal, but there are fewer than half a dozen in the nation and they don’t have unlimited beds. “It is also a high-risk activity to transfer patients,” potentially exposing more people to the virus, Farnon said.
The case heightens concern for health workers’ safety, and nurses at many hospitals “are alarmed at the inadequate preparation they see,” says a statement from Rose Ann DeMoro, executive director of the trade union, National Nurses United.”
In a recent survey by National Nurses United of some 400 nurses in more than 200 hospitals in 25 states found that more than half (60 percent) said their hospital is not prepared to handle patients with Ebola, and more than 80 percent said their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola.
This last case in Dallas is proof that Frieden, Director of the Centers of Disease Control can’t be trusted. He said that all hospitals can treat Ebola, and he says that it is “hard to catch” as it is “not airborne.”
It may not be scientifically defined as “not airborne”, but it can be caught if someone sneezes or coughs, as those particles contain the virus. I find it completely irresponsible and disingenuous for Freiden to not tell the American people that it can be caught in those ways.
Furthermore, he says that any hospital can contain it, yet the Dallas healthworker caught it from Patient Zero while wearing full protective gear. More proof that what Frieden says can’t be trusted.
We must do what we can to protect and educate ourselves, as even the experts – like Frieden at the CDC, have apparently been told what to say, in order to prevent panic.