News that a second nurse contracted Ebola after treating a fatally infected man in Dallas has intensified efforts in Louisiana to ensure health care workers can detect the disease and safely treat any patients who have it.
It’s a change in mindset as Ebola moves from a regional problem affecting West Africa to something that could show up in any hospital emergency room in the United States.
“It wasn’t part of our everyday lives. It was a theoretical possibility,” said Dr. Frank Welch, medical director for community preparedness for Louisiana’s Office of Public Health.
The diagnosis of the second health worker prompted an alert for 132 airline passengers on Frontier Airlines flight 1143 from Cleveland to Dallas-Fort Worth on Monday. Although the health care worker wasn’t experiencing symptoms on the flight, which means she likely wasn’t contagious, other passengers are being interviewed to make sure they weren’t infected, the Centers for Disease Control and Prevention reported.
And uncertainty about how long the first Ebola patient in Dallas sat in the waiting room while sick and contagious also has attracted the attention of hospital staff.
“The health care community across the nation and Louisiana is learning from this,” Welch said. “The mindset when a patient walks into the emergency room with a fever for treatment is different than it was a few weeks ago.”
With flu season right around the corner, patients with a fever will be asked two simple questions — whether they’ve traveled in the past three weeks and if they’ve had any contact with anyone with Ebola, Welch said.
“Just those two questions that took eight seconds is really the key,” Welch said.
Those questions are much more likely to be asked now that Ebola is no longer seen as a disease that occurs across an ocean.
There’s “a heightened awareness that this could happen in Louisiana. Right where I am,” Welch said.
Health care workers, who have received information about Ebola for months, are now asking for more than just guidelines. Instead, they want to walk through the procedures, Welch said.
In reality, all hospitals in the state already practice procedures for infectious diseases such as influenza and measles that hospitals and other facilities must deal with, he said. Welch said every hospital in the state is prepared.
“I think Louisiana is much better-prepared than we were two weeks ago, and certainly than two months ago,” he said.
Paul Salles, president and chief executive officer of the Louisiana Hospital Association, said preparedness is taking center stage.
“The broad message is we’re reinforcing and sending out information on CDC guidelines. Some of them are changing as we learn more,” he said.
“This is not brand-new to us this week,” added Allyn Whaley-Martin, project manager for the association’s hospital preparedness program. “I think we’re all aware that the threat exists and we all want to be prepared.”
As part of that preparation, the Governor’s Office of Homeland Security and Emergency Preparedness ran an Ebola exercise Wednesday morning with all state agencies and first responder representatives in attendance to walk through how a patient would be handled.
Patient screening on a 911 call will help alert EMS personnel of a possible Ebola case. The patient can then be taken to the hospital under special precautions. An epidemiologist will meet with the patient to determine if an Ebola test should be done, said Mike Steele, communications director with GOHSEP.
Communication is also important, said John Barry, author of “The Great Influenza: The Story of the Deadliest Pandemic in History.”
“In terms of risk communication, I think the message is pretty simple. You tell the truth, and that includes saying when you’re uncertain,” Barry said.
An obvious example of that, he said, is when President Barack Obama said it was unlikely that Ebola would make it to the United States. Although there are some scientific models that show that the likelihood was very small, it wasn’t impossible, Barry said.
“I think that was a mistake,” he said.
Barry, who also has served on infectious disease advisory boards, said infection control means doing the fundamentals right, and it has to be right every time.
“It’s attention to detail,” he said.
Follow Amy Wold on Twitter, @awold10.