Ebola Information for South Carolina
Nov. 21 Update
While the U.S. remains Ebola-free, the West African nation of Mali now has five confirmed Ebola deaths and should be included as one of the countries that travelers are screened for when asking about their travel histories. That means that health care providers and emergency response workers should also ask if suspected Ebola patients have traveled to or interacted with anyone who has traveled to Mali.
The countries most ravaged by Ebola in West Africa continue to be Guinea, Sierra Leone and Liberia, and the travelers from those countries will continue to be screened at major U.S. airports and monitored for symptoms. With only five deaths and 300 citizens being monitored for the virus, the Mali outbreak is currently being reported as a “limited transmission.” New York’s Bellevue hospital has already treated one individual who recently came to the U.S. from Mali, and that patient was isolated and tested negative for Ebola.
Nov. 5 Update
While we have spent the last several weeks inundated with news stories and rapidly updated guidance related to Ebola preparedness, it’s important that we recognize that through these efforts, hospitals are undoubtedly more prepared than we were before the first U.S. Ebola infection in Dallas.
DHEC, SCHA and other members of the state’s health care and emergency response community have worked together to establish a basic response protocol for Ebola, and will continue to work to fill in the gaps as we get closer to establishing a statewide Ebola response plan. Dr. Steve Berkowitz, a nationally renowned health care consultant, recently shared his sentiments on how hospitals will be safer because of Ebola, and I want to share his message with you and encourage you to share it with your hospital board.
Oct. 29 Update
As hospitals across the nation answer questions from the public and the media about their level of preparedness to deal with a possible Ebola patient, South Carolina hospitals are using various vehicles to answer those questions and calm fears based on lack of information. Some hospitals are holding town meetings with their internal and external audiences. Yesterday, the Greenville Health System held a special news conference to share the system’s plans to help manage Ebola patients both at GHS hospitals and throughout the Upstate as part of a statewide Ebola regional referral system.
For more information, see the Greenville News online coverage, which includes video interviews with nurses and demonstrations of how staff would care for an Ebola patient.
Oct. 27 Update
In a segment on last night’s episode of 60 Minutes, four brave hospital nurses tell their first-hand account of treating America’s first confirmed Ebola patient, Thomas Eric Duncan at Texas Health Presbyterian Hospital in Dallas. While many of the stories about the hospital’s response to the first U.S. Ebola case have been negative, last night’s 60 Minutes segment was a profile in courage that demonstrated the selfless lengths hospital employees will go to protect their communities and colleagues in daunting times.
SC DHEC is hosting several “tabletop” exercises across the state aimed at preparing health care employees for potential Ebola situations and coordinating response efforts. The exercises will include hypothetical scenarios where health care workers are asked to respond to suspected, probable, and confirmed Ebola cases so they can better understand the protocols in place and best practices for treating Ebola patients.
Oct. 24 Update
On Oct. 23, we learned that Craig Spencer, a doctor in New York City who recently returned from treating Ebola patients in Guinea, tested positive for the virus. Spencer was taken to Bellevue Hospital Center where he remains in isolation as investigators work to retrace his steps and determine all of the people and locations he may have come in contact with. While another confirmed U.S. Ebola case heightens concerns surrounding the virus, it is also another opportunity to observe the proper protocol for ensuring a safe and coordinated response.
Similar to the referral system we have set up here in South Carolina with MUSC, Greenville Health System, Palmetto Health, and Spartanburg Regional Healthcare System, Bellevue Hospital Center is one of eight hospitals in New York State that has been designated as “Ebola Ready.” The facility is set up to receive patients from any of the 11 public hospitals in New York City and any suspected patients who fly into one of New York’s major airports. The CDC has already dispatched an Ebola response team to Bellevue where they will confirm the positive test conducted by the city lab and ensure that the facility is doing all it can to isolate and treat Dr. Spencer while also protecting hospital employees. Just like the situation in Dallas, we will use this experience in New York to learn more best practices for responding to infectious diseases like Ebola.
Greenville Health System also corrected false media reports on a suspected Ebola patient. The Greenville Health System does not have a suspected or confirmed Ebola patient at any of its hospitals. Angelo Sinopoli, MD, GHS chief medical officer, and Scott Sasser, MD, chair of GHS’ department of emergency medicine, released a joint statement today correcting false media reports that a patient with Ebola is being treated at Greenville Memorial Hospital. Click here to find out more and to read the statement.
Oct. 23 Update
The Spartanburg Regional Healthcare System has joined the list of level 1 trauma centers in the state prepared to help treat Ebola patients if the need arises. There are no known or suspected cases of Ebola in South Carolina, but all hospitals across the state have been working tirelessly to prepare for the possibility. The Medical University of South Carolina in Charleston, Palmetto Health in Columbia and the Greenville Health System have also agreed to be on call if an Ebola patient is identified and needs treatment. We appreciate the commitment of these hospitals and their employees to help provide the care needed while minimizing the number of persons having contact with patients if they are contagious.
Oct. 22 Update
With no new confirmed Ebola cases in the U.S. and reports that the Dallas nurse who contracted Ebola after treating an infected patient has been upgraded from “fair” to “good” condition, the risk of an Ebola outbreak from the situation in Dallas has declined. The NBC News cameraman who contracted the virus while in Liberia has now been declared Ebola-free, as well as the Spanish nurse who was the first known person to have contracted Ebola outside of Africa. With reports of another potential Ebola carrier from Liberia flying into the U.S., the Department of Homeland Security (DHS) is rerouting travelers from countries affected by Ebola to one of five major U.S. airports and instituting special Ebola screenings at those airports.
While we are encouraged by the positive reports that indicate a lower risk of a widespread Ebola outbreak in America, we must remain vigilant and seize this opportunity to learn everything we can about the best practices for responding to public health emergencies like Ebola. With that in mind, there are a of couple programs I want to make you aware of that focus on Ebola preparedness and how hospitals can demonstrate leadership when there is a major public health concern.
Oct. 21 Update
The Centers for Disease Control and Prevention (CDC) has released updated protocols and guidance for the use of personal protective equipment (PPE) related to Ebola and detailed, step-by-step instructions for how to safely put the equipment on and take it off.
The new guidelines set a firmer standard, calling for full-body garb and hoods that protect worker's necks; setting rigorous rules for removal of equipment and disinfection of hands; and calling for a "site manager" to supervise the putting on and taking off of equipment.
They also recommend hospitals establish designated areas for putting on and taking off equipment, whether it's a room adjacent to the patient's room or a hallway area cordoned off with a plastic sheet. CDC Director Thomas Frieden said it is “critically important every health care worker thinks Ebola,” and that the new guidelines are built on three key principles:
1. Prior to working with an Ebola patient, staff should undergo rigorous training and practice, and demonstrate competence in safely putting on and removing PPE.
2. No skin should be left exposed when PPE is worn.
3. A trained observer should watch every time personnel put on and remove PPE.
With new guidelines issued by the CDC, SCHA will work closely with DHEC to survey all hospitals to determine if they have or can quickly obtain the supplies and equipment needed to meet the new PPE guidelines. Be on the lookout for a questionnaire very soon. Please make sure that the appropriate persons are responding in a coordinated way so we can accurately identify needs, as well as additional resources that may be available to meet a statewide demand.
The CDC will be increasing training opportunities and developing additional materials and videos. A factsheet is available here.
Oct. 20 Update
After 19 confirmed Ebola cases, including seven deaths, Nigeria has been declared Ebola free. The virus is considered contained when a country goes 42 days or two 21-day incubation periods with no new cases.
The Pentagon announced Sunday that it will create a 30-person team of medical experts that could quickly be activated to a region if new Ebola cases emerge in the United States, providing support for civilian doctors who may lack proficiency in fighting the virus.
Ron Klain, the former chief of staff to two vice presidents, has been tapped as the Obama administration's "Ebola czar," and will begin his new duties Wednesday.
Officials from the National Institutes of Health (NIH) announced that any new Ebola patients in Dallas will be transferred to Emory University Hospital in Atlanta, the National Institutes of Health Clinical Center in Bethesda, Maryland, or St. Patrick Hospital in Missoula, Montana for treatment.
EVERY PATIENT COUNTS, EVERY EMPLOYEE COUNTS. We know the safety of health care workers is the top priority for South Carolina hospitals. But others don’t necessarily know how much you’re doing to train and protect your employees, so it’s important to communicate what is being done.
On Thursday, Oct. 23, SCHA will hold a special update at its headquarters for hospital executives, nursing leadership and front line staff, human resource directors, risk managers/compliance staff, communicators, and any other interested persons. The purpose is to discuss the current infrastructure in South Carolina for treating/transferring patients, to share best practices, and to discuss how to keep different groups informed so that they understand the real level of risk and how hospitals are working to protect everyone’s health. Click here for more information and to register.
Questions/Requests from the members
What is the best way to notify DHEC if a hospital receives a patient with a suspected Ebola virus?
DHEC Director Catherine Templeton has asked that hospitals continue to follow the communications protocol that has always been in place for infectious diseases, even when they are faced with a suspected Ebola situation. The initial communication from their organization to DHEC staff is critical and facilities need to centralize that communication to reduce confusion and maximize response.
What responsibility do hospitals have for gathering and sharing health care workers’ email addresses in accordance with the public order that DHEC issued last week?
Hospitals are asked to notify licensed health care workers that DHEC is calling for their email addresses so they can communicate directly with them. However, it is not the hospitals’ responsibility to collect and share that information. It is the responsibility of the licensed professional. DHEC is also working with the licensing boards and mailing letters directly to health care professionals for who addresses are available. Information is available and you can register for updates directly from DHEC.
Oct. 17 Update
Three South Carolina medical centers have volunteered to serve as regional referral centers for patients diagnosed with Ebola. Those include Palmetto Health, Greenville Hospital System, and MUSC. SCHA is currently working with DHEC and our hospitals to establish procedures for this referral system to ensure we minimize exposure to the virus and reduce risk for hospital employees.
One of South Carolina hospitals' top priorities is to ensure that health care workers are safe and prepared to treat Ebola patients. Hospitals are doing everything they can to train and prepare anyone who may come in contact with an Ebola patient.
For updated information on the status of Ebola preparedness in South Carolina, please monitor SC DHEC's website.
Oct. 16 Update
Three hospitals in South Carolina have been identified to be a part of a regional referral system for confirmed cases of Ebola - Greenville Memorial Medical Campus, Palmetto Health Richland and the Medical University of South Carolina. Check back for more information.
Last night, SCHA President Thornton Kirby appeared on WIS-TV at 11pm to answer questions on Ebola. Kirby stressed that South Carolina hospitals are prepared, because "this is what we do." But, he pointed out, that preparedness is a moving target. Each day brings new guidance from the CDC, so each day our hospitals much adjust their plans and protocols to remain prepared.
Please continue to monitor the CDC web site for information on sides and symptoms, prevention, transmission and more.
Oct. 14 Update
With the first Ebola death occuring in the U.S. at Texas Health Presbyterian Hospital of Dallas (read more in Oct. 7 Update), South Carolina health experts testified on South Carolina’s preparedness for dealing with the deadly virus on Thursday, Oct. 9.
SC Department of Health and Environmental Control (SC DHEC) Director Catherine Templeton opened the testimony by assuring senators that there was little risk of widespread infection in South Carolina. She reported that SC DHEC had been coordinating with the Centers for Disease Control and Prevention (CDC) throughout the summer as news of the Ebola outbreak in West Africa continued to dominate headlines. Templeton reinforced the three crucial steps that should be followed to increase the chances of containing Ebola: identify, isolate and communicate.
South Carolina Hospital Association (SCHA) President Thornton Kirby reported on SC hospitals’ readiness to treat and respond to Ebola. He reported that while there were no known or suspected cases of the virus in any SC hospital, SCHA had been coordinating information with every acute care hospital in the state, and they are prepared to respond. Kirby explained that the SCHA and DHEC were communicating daily on the issue, and that steps had been taken to ensure that all hospitals knew of their responsibilities to educate frontline workers on the tools to identify and manage Ebola patients, including asking patients about their travel histories. He reported that hospitals were holding drills to gauge the hospitals’ ability to identify, isolate, and communicate potential Ebola cases to DHEC and the CDC.
State epidemiologist Dr. Linda Bell provided an overview of the basic history and facts about Ebola. She stated that the virus is not an airborne disease that could be transmitted through casual contact and can only be transmitted by direct contact with bodily fluids of the infected. Dr. Bell informed the committee that Ebola has a 50 percent mortality rate and that the nation’s five major airports were instituting new Ebola screening procedures for passengers arriving from Ebola-affected countries in West Africa. “Surveillance remains critical to ensure containment,” said Dr. Bell.
The first case of the Ebola Virus Disease diagnosed in the United States was reported to the Center for Disease Control by Dallas County Health and Human Services on September 28. The patient had traveled without symptoms from Liberia a week earlier. When he became ill, he sought medical care at Texas Health Presbyterian Hospital of Dallas, where he was treated and released. Two days later, he returned to the hospital and was admitted. The diagnosis was Ebola. The hospital has come under great criticism for failing to identify the possibility of Ebola during the patient’s first encounter in the emergency department. That oversight resulted in additional persons being exposed to the virus over the two-day period.
While hospitals across the country, including South Carolina, prepare for the possibility of an Ebola case, it is critical that all front-line hospital employees be vigilant and prepared to respond appropriately, should that occur.
At this time, there are no reported or suspected cases in South Carolina, and national public health experts remain confident that the necessary procedures and protocols for identifying and containing the infectious disease are in place.
It is imperative that hospital workers are making sure the proper procedure is followed for every patient. This is not a new role. Caregivers deal with infectious diseases every day. For more information on Ebola, refer to the CDC web site.