DEVELOPMENTS
• President Barack Obama urged his top national security and public health officials on Monday to incorporate lessons from the most recent Texas Ebola infection into the U.S.’s response plans to the deadly virus. He also called on the international community to deliver assistance more quickly to the countries of West Africa that are struggling against the disease, spending most of his day on the outbreak.
• The federal response to Ebola became a full-blown political issue Monday the Democratic Congressional Campaign Committee sought to link Republican fiscal policies to the Ebola outbreak. It contended that congressional Republicans’ budget-cutting zeal crippled the response of federal health institutions to the crisis. Several Republicans, including House Speaker John Boehner of Ohio, have criticized Obama’s response to the crisis as being too slow and limited, with Sen. Ted Cruz, R-Texas, calling for blocking travel from the West African countries at the epicenter of the outbreak.
• A state judge signed an order Monday temporarily blocking ash from the incineration of Ebola victim Thomas Eric Dunan’s belongings from being disposed of at a southwest Louisiana site. Attorney General Buddy Caldwell had sought the order to stop the soot from linen, bedding and carpet taken from the Dallas apartment where Duncan stayed from being brought to a Calcasieu Parish facility run by Chemical Waste Management Inc. of Lake Charles.
• Officials on Monday said they were trying to find a place to monitor and care for a dog belonging to Nina Pham, the Dallas nurse who contracted Ebola while caring for Duncan. They do not believe the pet has any signs of Ebola. A dog belonging to an infected Spanish nurse was euthanized, drawing thousands of complaints.
— From news services
Nurse Nina Pham and other health care workers wore protective gear, including gowns, gloves, masks and face shields — and sometimes full-body suits — when caring for Thomas Eric Duncan. Despite the precautions, the 26-year-old Pham became the first person to contract the disease within the United States.
Federal health officials on Monday urged the nation’s hospitals to “think Ebola” and launched a review of procedures for treating infected patients, while the World Health Organization called the outbreak “the most severe, acute health emergency seen in modern times.”
Pham’s family told WFAA-TV in Dallas on Monday that she was the health care worker with Ebola. A rector at her family’s church, Hung Le, said Pham’s mother told him her daughter has the virus.
The Texas Christian University nursing school graduate was monitoring her temperature and went to the hospital Friday night as soon as she discovered she was running a low fever. She is in isolation and in stable condition, health officials said.
Public-health authorities have intensified their monitoring of other Dallas hospital workers who cared for Duncan.
Centers for Disease Control and Prevention Director Tom Frieden said he would not be surprised if another hospital worker who cared for Duncan became ill because Ebola patients grow more contagious as the disease progresses. Pham’s name appears frequently in Duncan’s medical records, provided by his family. They show she was in his room Oct. 13, the day before he died.
Progress reports note he had loose, watery stool and nurses had difficulty inserting a needle at one point. Pham’s notes also describe nurses going in and out of Duncan’s room wearing protective gear to treat him and to mop the floor with bleach.
Frieden has said a breach of protocol led to the nurse’s infection, but officials are not sure what went wrong. Pham has not been able to point to any specific breach.
The CDC now is monitoring all hospital workers who treated Duncan and planned to “double down” on training and outreach on how to safely treat Ebola patients, Frieden said.
When asked how many health care workers are being checked, Frieden said officials “don’t have a number.”
Health officials have relied on a “self-monitoring” system when it comes to U.S. health care workers who care for isolated Ebola patients and wear recommended protective equipment. They expect workers to report any potential exposures to the virus and watch themselves for symptoms.
Besides the workers, health officials continue to track 48 people who were in contact before Duncan was admitted to the hospital and placed in isolation. They are monitoring one person the nurse was in contact with while she was in an infectious state.
None has exhibited symptoms, Frieden said.
The case involving Pham raised questions about assurances by American health officials that the disease will be contained and that any U.S. hospital should be able to treat it.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases was asked on ABC’s “Good Morning America” if federal health authorities should consider requiring that Ebola patients be sent only to highly specialized “containment” hospitals.
“That is something that should be seriously considered,” Fauci said.
Among the things the CDC will investigate is how the workers took off protective gear, because removing it incorrectly can lead to contamination. Investigators will also look at dialysis and intubation — the insertion of a breathing tube in a patient’s airway. Both procedures, performed on Duncan, have the potential to spread the virus.
Fauci suggested that in cases where the patient has deteriorated to the point where he or she cannot be saved, such high-risk procedures should not be performed.
Every emergency room needs to be prepared to take action because no one can control where an Ebola patient might show up, said Dr. Dennis Maki, University of Wisconsin-Madison infectious disease specialist and former head of hospital infection control.
However, only large hospitals such as those affiliated with major universities truly have the equipment and manpower to deal with Ebola correctly, Maki said.
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