Hospitals, first responders practice Ebola scenarios


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By ED RUNYAN and WILLIAM K. ALCORN

news@vindy.com

YOUNGSTOWN

Ebola Preparedness

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Awareness: Ebola Preparedness for First Responders

St. Elizabeth Health Center is the hospital in the multi-state Mercy Health system that will handle any Ebola patients who require treatment at one of its facilities.

Donald Koenig, executive vice president and chief operating officer of Humility of Mary Health Partners, said St. Elizabeth was chosen from among the five “highest complexity hospitals” in the Mercy Health system. The others are in Toledo, Lima, Cincinnati and Paducah, Ky. In all, Mercy Health has 23 hospitals.

None of the hospitals in the Mercy Health system has had an Ebola case, but St. Elizabeth and its other Mahoning Valley hospitals and emergency rooms are continuing their preparations in case they do get one.

For example, HMHP is providing staff with screening protocols to be used to determine whether a patient has Ebola. It starts with a determination of whether the patient has a temperature and then questions about whether the patient has traveled to any of the places where the disease has been found, or whether they were on the flight from Cleveland to Dallas last Monday on which Dallas health care worker Amber Vinson flew before being diagnosed with Ebola.

People who indicate having traveled to such places and have a fever will be tested, but no local hospitals are able to do the test. Several specific locations in Ohio are able to do the test, Koenig said.

If the hospital sees someone who was on the Cleveland to Dallas flight but does not have a fever, that person’s information will be forwarded to the Ohio Department of Health, which will advise the patient what steps to take.

Other protocols deal with personal protection for HMHP staff and plans for the type of room in which the patient will be placed.

Each HMHP hospital has isolation rooms where patients typically are kept if they have an infectious disease such as flu, chicken pox or measles.

With Ebola, a patient would be kept in a negative pressure room, in which the air from the room stays in that room and is filtered. Each HMHP hospital has a negative-pressure room, Koenig said.

For an Ebola patient, staff would use “droplet protection,” meaning goggles and face shields, along with impermeable gowns.

Practice

The hospital had a “tabletop exercise” Friday with the Mahoning County Board of Health and Mahoning County HazMat to practice all procedures that would be followed. “We’re rehearsing our drills,” Koenig said.

In light of the infection of two health care workers who treated an Ebola patient in Dallas, Koenig said HMHP is focused on following “very specific protocols” to avoid a similar situation here.

He noted that two Ebola patients were treated at the Nebraska Medical Center and several others at Emory University in Atlanta without healthcare workers becoming infected.

“We need to learn from them,” he said of the facilities that succeeded at keeping their workers safe and the one that wasn’t.

“Our most important message is that there is no reason to panic,” Koenig said. “Health care professionals are used to handling infectious diseases, like the flu. We follow the evidence-based protocols to keep our patients and our staff safe. We’re learning every day.”

Sandy Swann, director of nursing for the Trumbull County Board of Health, said her agency has been receiving health alerts on Ebola from the U.S. Centers for Disease Control and Prevention since late July and forwarding them by email or fax to physicians and hospitals, “and we will continue to do that.”

The health department also has participated in conference calls with the Ohio Department of Health and CDC. Checklists for things to watch for with Ebola have been circulated. They can be helpful in sorting out whether a patient has Ebola or the flu, as symptoms are similar.

Dr. James Enyeart, Trumbull County health commissioner, said he hopes if there is an Ebola case in the county, people involved will reach out to the CDC, and the CDC will send a “go team” here to assist with the case.

Isolation

It will be important to identify an

Ebola patient and isolate them as quickly as possible, he said. As for the hospitals, they “have assured me they are all up to speed, drilling and educating,” Dr. Enyeart said.

Based on the travel that the Texas health care worker did to Ohio and to her family’s home in Tallmadge, Dr. Enyeart said he hopes for a greater focus on limiting people’s travel plans if there is a chance they have Ebola.

Bob Pinti, deputy Warren health commissioner, said his agency will work closely with the two hospitals in Warren. The health department is responsible for declaring quarantines if necessary for certain buildings or certain populations of people that might have been exposed to the virus.

“We just hope and pray that it doesn’t come this way,” Pinti said.

Complicating the situation is the beginning of flu season because flu symptoms, such as elevated temperatures, are the same as for Ebola.

“If anyone has flu-like symptoms and think they could have been exposed to the Ebola virus, there are procedures in place to isolate those individuals until they are tested,” said Dr. David M. Davis, Youngstown Health Department medical director.

If they are brought to a hospital, they would be isolated there, and the CDC called to test for Ebola, Dr. Davis said.

“CDC is prepared to respond within one or two hours,” he said.

Response

First responders, such as fire and police and ambulance services, would initiate their protocol for any type of virus that is spread through bodily fluid, notify the hospital they are coming, and then the hospital would notify CDC, Dr. Davis said.

“We have to be very cautious in dealing with Ebola and take every precaution to protect health care personnel and others,” he said. “I think we have to be able to trust our health care providers and CDC to identify possible infections. The threat is there, but everything humanly possible will be done to fight the threat.”

Air Force personnel, including those from the 910th Airlift Wing at Youngstown Air Reserve Base in Vienna, will avoid nonessential travel to the countries of Liberia, Guinea and Sierra Leone, said Brent J. Davis, chief of public affairs.

Unit commanders will ensure airmen considering travel to these areas are adequately informed of risks and requirements. At this time, the 910th is not deploying any aircraft or personnel to West Africa, Davis said.