NY Ebola Response: Polar Opposite of Dallas's

[pnwmom]

Well done, NY.

http://www.nytimes.com/2014/10/26/us/new-york-ebola-response-polar-opposite-of-dallas.html?hp&action=click&pgtype=Homepage&version=LedeSum&module=a-lede-package-region®ion=top-news&WT.nav=top-news

When Craig Spencer, a young doctor just back from treating patients with Ebola in Guinea, fell ill with the virus in New York on Thursday, the paramedics who went to get him were dressed in protective suits. He entered Bellevue Hospital through a rear door, far from the busy emergency room, and was taken to a state-of-the-art isolation ward that was locked and guarded.

The carefully planned response was a world apart from the scene that unfolded in a Dallas hospital last month when a Liberian man, Thomas Eric Duncan, became the first person to test positive for Ebola in the United States.

It was Ebola’s first surprise encounter with a modern medical system, and it was, by all accounts, a bumpy one. Mr. Duncan lay in an emergency department room at Texas Health Presbyterian Hospital for hours, with a fever and frequent diarrhea, while other patients in nearby rooms were treated by the same doctor and nurses, medical workers said. A lab technician had to comb through his inbox to find an email from the government on procedures for Ebola blood samples, only to find that he had handled them improperly, the workers said.

Rules for protective gear seemed to change with the weather, and some of Mr. Duncan’s nurses, unsure of what to wear, resorted to looking for help on the website of the Centers for Disease Control and Prevention, according to a health worker involved in the response.

SNIP

[hedgehog]

1. I love New York, but I think whichever city was first would have been caught

with its pants down around its ankles on this one. Dallas just happened to be the unlucky winner.

[pnwmom]

2. I'm not so sure. I read that Belleview already had regular drills for handling highly contagious

patients, conducted several times a year. So I think they were better prepared.

But I'm glad if everyone has learned from the Dallas experience, from the CDC on down.

[Travis_0004]

7. Bellevue is a level one Trauma center

I would expect them to be better prepared than a level 3 trauma center in Dallas.

They have more than double the beds in New york, probably double the doctors, and a lot more than double the budget, as well as the ability to learn from the mistakes in Dallas.

[etherealtruth]

5. I don't

Large medical centers often prepare for trauma and infectious disease outbreaks. Many (most) have dedicated teams that have specialized training and drills.

No doubt the hospital debacle in Dallas prompted lots of review and probably caused folk to step up the game ... but the total lack of preparation in Dallas (especially as enumerated by the nurses) identified significant weakness in many areas .... complete and total unpreparedness not seen at many major urban medical centers.

[snooper2]

3. don't break that arm NYTimes LOL

[La Lioness Priyanka]

4. when you live in a libertarian wet dream there are consequences

this is one of those consequences.

[kestrel91316]

6. Unfortunately NY now gets a FAIL for joining up with NJ's draconian policy

of imprisoning all medical professionals returning from West Africa in solitary confinement for 3 weeks without due process.

And of course the "Duncans" don't get any such treatment. NY and NJ apparently want to end all medical volunteerism by Americans to fight Ebola.

[uppityperson]

10. Yup, even if they test negative on the test.

[JaneyVee]

8. NY was well prepared before Dallas, before Ebola came to US.

[pnwmom]

9. That's true, at least for this hospital. They were already having drills on handling

illnesses like Ebola several times a year. So they had the system down.

[LisaL]

11. Mr. Spencer told them he worked with Ebola victims. So they knew what to look for.

What do you think would happen if he showed up in the ER with his 100.3 fever (which is below CDC guidelines for Ebola) and GI symptoms, but didn't tell them he worked with Ebola patients?
Probably the same thing that happened with Mr. Duncan.
He would have gotten Tylenol and send home.
Ebola is similar to many other diseases in the beginning.

[pnwmom]

12. I think if he showed up there and told them he'd recently come from Liberia,

they would have been a lot more on the ball than Dallas. OTOH, they did have the benefit of watching Dallas fail.

[Yo_Mama]

13. But they knew it was Ebola upfront, or very probably so. This comparison is apples to oranges.

EMTs are constantly getting people with high fevers and vomiting or diarrhea, and no, they don't automatically come with full Hazmat gear even in NYC.

I'm sorry, but this is kind of a stupid article.

The real comparison will come in when NYC gets its first unexpected case, which the new federal rules for plane travel are supposed to forestall (everyone from outside the country will have the 21 day monitoring, so illnesses will be addressed differently from the first). That's one of the primary reasons for the new federal policy.

Note that if the new federal rules had been in place when Mr. Duncan flew in, the initial health care contact would have been very different. If someone starts to feel ill during the monitoring period, their first contact with the health care system is going to be very carefully controlled and therefore much less risky for everyone.

I hope we never have another Duncan case, although sooner or later it probably will occur. But the new rules for monitoring make that very, very much less likely.