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US Health Providers Expand their Ebola Precautions

Associated Press
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Undercover actors and souped-up ambulances among precautions

NEW YORK (AP) — Public hospitals in New York City are concerned enough about Ebola that they’ve secretly been sending actors with mock symptoms into emergency rooms to test how well the triage staffs identify and isolate possible cases.

A small hospital in the Ohio countryside has hung up signs imploring patients to let nurses know immediately if they have traveled recently to West Africa.

And across the U.S., one of the nation’s largest ambulance companies has put together step-by-step instructions on how to wrap the interior of a rig with plastic sheeting while transporting a patient.

There hasn’t been a single confirmed case of someone being infected with Ebola on U.S. soil — the one confirmed case here involves a man who contracted the virus overseas. But health care providers are worried enough that they are taking a wide variety of precautions.

It isn’t yet clear whether those preparations are overkill, or not nearly enough. But medical officials and health experts say that, at the very least, the scare is giving them a chance to reinforce and test infection control procedures.

"The attention has been, in a sad way, very helpful," said Dr. Richard Wenzel, an epidemiologist at Virginia Commonwealth University and a former president of the International Society for Infectious Diseases.

He said even small hospitals far from international travel hubs should be reviewing their protocols and screening questions now, and potentially buying protective equipment such as face masks and protective suits. This will help them avoid repeating the problems that occurred at a hospital in Dallas, where a man with Ebola was sent home only to be readmitted two days later.

"The debacle in Texas should stimulate improved awareness and responses," Wenzel said.

Hospitals around the country are already getting ample opportunities to test their infection control procedures due to a growing number of false alarms.

In New York, 24 patients have been put into isolation over the past eight weeks in city-owned hospitals because of fears that they might have Ebola, according to Dr. Ross Wilson, the chief medical officer at the New York City Health and Hospitals Corporation.

None had the disease (some patients had malaria and one had typhoid), but Wilson said the point has been to isolate possible cases quickly so there is no chance for the virus to spread.

"We’re taking this very seriously," he said.

Some staff has been retrained on how to properly put on and remove protective gear. At the city’s flagship public hospital, Bellevue Hospital Center, technicians are assembling a lab that will exclusively handle Ebola blood tests so that samples won’t contaminate equipment in other parts of the hospital. A small number of beds have been set up in an isolation ward for any confirmed cases. So far, nobody has had to use it.

City 911 operators have been told to ask certain people calling for an ambulance whether they’ve been to West Africa recently.

That question is also becoming the norm at AMR, which operates private ambulances in 40 states. It has told its staff of 19,000 paramedics and EMTs that patients with certain symptoms should be asked about travel to certain parts of Africa. If they answer yes, emergency service workers are supposed to don extra protective gear, including shoe coverings, a mask and goggles, and alert health authorities that the patient might have Ebola.

"We don’t want to respond with a presumption that everyone in the field has Ebola," said Dr. Ed Racht, AMR’s chief medical officer. But he said extra precautions are warranted.

"The idea is, if the travel question is positive with the symptoms, it gives us a yellow flag … It doesn’t mean immediately putting on the space suits."

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