It works just fine sending people by medivac or ambulance (depending on what is needed) to those hospitals that are prepared to serve patients with special needs. It's the only thing that makes practical sense. And it's worked for ages. Not every hospital has or needs a special burn unit, trauma center, children's hospital, etc. since the area they cover does not provide enough patients needing that special care to warrant it. The costs of every hospital having all these specialized units with the staff trained and experienced to deal with such patients would be astronomical, and those units would be largely empty most of the time with the staff twiddling their thumbs while not gaining more experience.
To insist that every hospital have the infrastructure, equipment, trained and experienced staff, etc. to handle a BSL-4 infected patient is ludicrous. This country doesn't GET loads of patients infected with such viruses needing that level of care. This is the first time we've even HAD Ebola in this country, and so far only a handful of infected. Why on earth SHOULD every hospital in the country be outfitted with the infrastructure, specialized staff, equipment, etc. to handle something here that basically doesn't happen?
The US does have four excellent hospitals that are capable and do handle BSL-4 infected patients with a total of 19 beds between them, and it has so far been MORE than enough. The purpose of these specialized hospitals is to care for any BSL-4 infected patient in an environment designed to not only care for them but to STOP THE SPREAD of the infection. Had Mr. Duncan been sent to one of these hospitals as every one of the infected Americans were he would not have infected any health workers just as none of the health workers that cared for all the other Ebola infected patients became infected.
However, the US has to have a practical PLAN in place to deal with some unknown horrible virus that may some day cause a horrific outbreak that kills loads of people. Even NOW, we don't have any huge emergency for all hospitals because of Ebola. Our plan in place that until Mr. Duncan worked just fine was to send any BSL-4 infected patient to one of the 4 hospitals in the country for care AND because of their infrastructure, equipment, experienced and trained staff stops the infection spread THERE. That's what they're for. Had the CDC followed that plan which was working just fine for the infected Americans in Mr. Duncan's case there wouldn't be two and possibly more infected Ebola patients save for the possibility of those people who came into contact with Mr. Duncan before he was hospitalized, and it looks like none of those people will become infected as they're close to being through with the quarantine time with none of them having shown symptoms.
Since we knew of the Ebola outbreak running rampant in West Africa for months, the CDC SHOULD have realized that some infected persons may arrive here just as he did while they were infected but not symptomatic. They should have had a plan not just in place but followed up at all hospitals as to what ER's should need to look for and what certain information meant. They dropped the ball on that because most hospitals DON'T have that information being filtered down to the workers that encounter such people. The Dallas hospital dropped the ball in suspecting that Mr. Duncan had Ebola when he first presented and told them he was from Liberia/West Africa. That obviously didn't ring any bells for the workers because the hospital did not communicate to the staff what having recently been in Liberia/West Africa MEANT and how such a case should be handled. BUT, the CDC did not communicate to the hospital what information and correct action should be.
It's the CDC's job to not only provide a CORRECT plan to all hospitals concerning Ebola but to make sure that every hospital is communicating the plan to their staff at all levels and providing whatever PPE, disinfection, isolation of the patient, etc. is required. The CDC did NOT provide any hospital with the CORRECT PPE or disinfection protocol for a BSL-4 infected patient or suspected patient. Instead, all these months the CDC was saying that Ebola wasn't going to happen here... until it did.
Yes, the Dallas hospital woefully dropped the ball in the assessment of Mr. Duncan and should have suspected that he might have Ebola. But the hospital was not given correct instruction about that from the CDC who had been claiming it wasn't going to happen here and thus did not communicate anything to the staff about what to do in case of the possibility. This is why hospitals from the top down are now in an uproar. They have NOT gotten a correct plan from the CDC. The CDC putting information on their website or providing a call-in phone number isn't nearly good enough.
Hospitals needed to GET that information, and the CORRECT information, from the CDC, and the CDC needed to FOLLOW UP that every hospital puts in place the information, equipment, training, etc. to the staff on what to do in the event that someone comes into the hospital with suspected Ebola. And the FIRST thing that hospitals and their staff need to know is what the travel history of a patient MEANS and the correct communication of that information to everyone that needs to know and thus can equip themselves appropriately and isolate the patient.
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