In my last blog, I told you I would let you know if you needed to worry about Ebola.
And while I still don’t want you to worry, I want to help you understand the latest news, especially since it probably feels like there’s been some contradictory information floating around. Here are the facts:
Yes, another healthcare worker has gotten sick. That doesn’t mean that Ebola is “easier” to catch than we thought. The details are unknown in each case of infection, but the two nurses were infected while caring for a man at his most contagious when his body was packed with the virus. This is not the case when an infected person is well enough to travel. When this man flew to the US, he had much less virus circulating in his system, which means he was much less infectious. The person, not the virus, becomes more infectious over time as they get sicker.
Additionally, caring for a patient with Ebola is challenging and requires training. The teams that successfully treated patients in Atlanta and Nebraska trained for years to properly prevent disease spread. While it won’t take years to prepare current healthcare workers, extensive education will be crucial to ensure the heroic providers putting their lives on the line are at as little risk as possible.
The CDC has issued new guidelines. Today, the CDC issued new protocols for protecting healthcare workers. Caregivers will be required to wear full coverage (double gloves, hoods and face shields with special masks) so that no skin is exposed. In addition, they’ll be observed by a supervisor while putting on and removing all gear, to further reduce risk of transmission. If you’ve been hearing the term “Doctors Without Borders”, or “Médecins Sans Frontières” (also known as MSF), it’s referring to the national humanitarian aid organization known for treating endemic diseases in developing countries. MSF has been employing this higher standard of protection for the past few months and had low rates of providers being infected. It will be crucial to make sure that all caregivers receive the necessary training, but this is a very important first step and reassuring for caregivers everywhere.
Ebola still requires contact with bodily fluids. The idea of exposed healthcare workers moving through the general public may seem scary, but the likelihood of them infecting the public remains very low. Until an infected person develops symptoms, they are not contagious. As the virus replicates and infects various organs in the body, patients begin to develop symptoms and leak low levels of virus in their secretions. To be infected at this stage, you need direct contact with a lot of body fluid. A sneeze or a brush against someone’s sweaty arm is very unlikely to infect you at the early stages. When significant symptoms develop, like severe vomiting and diarrhea coupled with organ failure, these individuals are shedding huge amounts of virus making all secretions very infectious, but they’re also generally incapacitated and end up in hospital away from the public. Does that mean we shouldn’t treat every Ebola contact with the utmost vigilance? No. What we’ve learned over the past few weeks is that caution is the best way to keep everyone safe.
Thomas Duncan’s family has been released from quarantine. After 21 days without symptoms, Thomas Duncan’s family has been declared “Ebola-free.” This reaffirms that to catch Ebola, you must have direct contact with fluids, and the highest risk is when someone is very ill—not when they’re well enough to be walking around in public. While it’s a good idea for the family to still closely monitor themselves for symptoms for another week as they now go about their lives, it’s very reassuring news.
Nigeria has shown promise in controlling Ebola. By vigorously tracking down every potential contact and repeatedly checking for signs of infection, Nigeria—a country with far less resources than the US—has so far been able to keep the Ebola crisis in check. This serves as an example that what we need is not necessarily high tech—but rather good old fashioned tracking and reporting.
Over the last many weeks, some authorities may have seemed overly reassuring about the Ebola situation in the US, but not in an effort to deceive; rather to prevent excessive – and unnecessary– fear. Frankly, the Ebola issues are more nuanced than whether to be scared or not. Healthcare workers and civilians alike need to use an abundance of caution and must be vigilant—but we should not translate that use of caution into fear. The fact that we must closely monitor every contact doesn’t mean that an outbreak is expected—quite the contrary—it is an intelligent hyper-vigilance on all of our parts that will prevent this grim possibility from becoming a reality.