Emergency officials clad in HAZMAT suits rushed a health care worker with “Ebola-like” symptoms to Bellevue Hospital in New York City, Thursday, the hospital announced.
Bellevue Hospital is one of eight hospitals in New York State that Gov. Andrew Cuomo has designated as “Ebola ready.” The facility will care for confirmed cases from any of the 11 public hospitals in the New York City Health and Hospitals Corporation (HHC) and any suspected cases among patients who fly into John F. Kennedy or LaGuardia airports. The patient, who recently visited one of the West African nations ravaged by the Ebola outbreak, may put the hospital’s new safety protocols to the test. Preliminary results from a medical evaluation will confirm in the next 12 hours whether or not the patient has Ebola, the hospital said. Scientific American asked HHC spokesperson Ian Michaels to explain what it takes to be ready to care for potential Ebola patients.
[An edited transcript of the interview follows.]
What makes Bellevue Hospital “Ebola ready”?
In Bellevue there are four rooms ready to receive potential Ebola patients. These rooms were originally regular isolation rooms but have been fitted to better serve these patients. We can convert additional isolation rooms into Ebola-ready rooms as well if necessary.
In the rooms we’ve added extra electrical capacity in case the patient needs intensive care. Bellevue is also currently building a separate laboratory to handle blood work for patients. Putting blood samples in with regular lab equipment will contaminate the existing laboratory.
The hospital is particularly well suited due to its long history of being on the front lines of epidemics and emerging public health threats. That includes managing an isolation unit for diseases such as tuberculosis for many years with support from and collaboration with the city health department
How are nurses trained to deal with a potential Ebola case?
We have established two levels of Ebola-preparedness training. The first is for all nurses and health care professionals throughout the HHC system. We’ve shown them how to identify and isolate potential Ebola cases that come into their hospitals.
They know that if someone comes in and displays Ebola-type symptoms, the important thing is to get that person’s travel history. From there the nurse would try to determine if that person had contact with an Ebola patient or if they were in one of the countries that had an outbreak in Africa. If the nurse confirms that the patient has been to an Ebola-infected country, then that patient is put into isolation. So far there have been no cases of Ebola in New York City but our hospital has isolated at least 30 people with malaria.
The second level of training comes into play when a patient has tested positive for Ebola. In the HHC system that patient is transferred to Bellevue where we have a team of health professionals especially equipped to treat an active Ebola patient. Our philosophy for treating a confirmed Ebola patient is to have as few people as possible exposed to the patient, and that those people are at the highest level of experience and competency.
How does your hospital screen for potential Ebola cases?
We have screened patients following CDC guidelines to identify risk for Ebola through the presence of symptoms, their recent travel history to Guinea, Liberia and Sierra Leone and/or potential exposure to Ebola. So far we have been able to rule out all potential Ebola patients based on this process. None have required a blood test for Ebola. A decision to test is done in consultation with the New York City Department of Health and Mental Hygiene.
What lessons has your hospital learned from the two cases in Texas Health Presbyterian Hospital in Dallas?
People get hung up on that, but there have been other hospitals in this country that have handled confirmed Ebola cases and sent them home healthy without spreading it to other people. We know that if you follow the CDC guidelines, it is possible to treat patients successfully without putting your staff in harm’s way.