FYI.

This story is over 5 years old.

Tech

How New York City Is Fighting Ebola Before It Even Arrives

At hospitals around the country, doctors are scrambling to prepare for Ebola, but nurses say they are still unprepared.
Colorized scanning electron micrograph of filamentous Ebola virus particles (blue) budding from a chronically infected VERO E6 cell (yellow-green). Image: NIAID

Update October 23, 4 p.m. EST: An NYC health care worker is being tested for Ebola. 

Update October 8, 9 p.m. ESTThomas Duncan, the only known Ebola patient in the U.S., has died.

As health officials in Dallas examine as many as 100 people who may have been in contact with an Ebola patient, doctors in America's biggest city aren't waiting. They're already ready, they say.

"Would we get one or two cases? It's absolutely possible. But on a mass scale? That's not going to happen in New York," Dr. Jay Varma, Deputy Commissioner for Disease Control at New York City's Health Department,  told the Daily News.

Advertisement

"We have been working for a long period of time to ensure that what happened in Texas would not happen here," he said.

On Saturday morning, a father and daughter who had landed at Newark Airport were quarantined after the father began vomiting on-board. They were found later to be free of the disease.

In Texas, the failures have been myriad, starting with the simple fact that when America's patient zero, Thomas Duncan, arrived at Texas Health Presbyterian Hospital on Sept. 25, his doctor didn't know he had just come from Liberia, the epicenter of the outbreak.

First, hospital officials blamed a flawed medical records system, in which, they said, information gathered by nurses sits in a separate bucket from information gathered by doctors. It's a system of multiple layers and firewalls that is endemic in healthcare computing. Later, they revised that claim, saying the computer system was not flawed.

Either way, tiny errors in cases like this often don't rest just with computers but with the humans who rely on them. (See, for instance,  the lessons of the Challenger disaster.) Anyone working in the hospital should have known that the information gathered by nurses doing triage is not automatically relayed to doctors. But more fundamentally, it was a failure to think. Put simply, doctors should know that Ebola is a problem, and they should know the warning signs.

Ashish Jah, a professor at Harvard's School of Public Health, told the New York Times there were "literally multiple failures" that led to the situation in Dallas, and chastised the Texan health officials. Instead of "helping every other hospital in the country understand where their system failed and learn from it, they have thrown out a whole lot of distractions."

Advertisement

According to internal communications gathered by Motherboard, doctors in New York are resting on their experience from past outbreaks of smallpox, anthrax, SARS, bird flu, and MERS (Middle East respiratory syndrome) to prepare for Ebola. "There is no reason whatsoever any New Yorker should have any concern, beyond a general concern," Gov. Andrew Cuomo said on the  Capitol Pressroom radio program on Thursday.

Monitoring travel: If a patient at a city hospital has a fever after a visit to West Africa—particularly in the last 21 days, Ebola's incubation period—they would be isolated immediately. Even the city's 911 operators have been instructed to ask about travel history if someone calls in to report Ebola-like symptoms. Emergency responders would wear Tyvek suits and goggles that leave no part of their bodies exposed.

Hospital vigilance. In the city's 11 public hospitals, an aggressive campaign to watch out for Ebola patients has included sending in undercover workers masquerading as potential victims to assess ER staff preparedness, reports the Daily News. At Mount Sinai Hospital, hospital staff have run repeated drills to find security holes. One lesson: the hospital shouldn't use glass tubes to draw blood because they can break and cause injuries. It now uses plastic tubes.

How to suit up for treating Ebola. Video: WSJ

The right gear: Emergency departments at New York Presbyterian, for instance, are equipped with Ebola Emergency Response Supply Barrels, which contain personal protective equipment, disposable supplies like blood pressure cuffs, stethoscopes, and thermometers, and a leak-proof container for waste. Bellevue Hospital Center, where patients arriving at JFK Airport would be observed, boasts isolation rooms, as do a number of other public and private hospitals.

Advertisement

Airport security: US Customs officials and the CDC have teamed up to improve screening of travelers arriving from West Africa to JFK and Newark Airports. Update: beginning Saturday, travelers from Guinea, Liberia, and Sierra Leone will be subject to [added screening at these and three other U.S. airports](: www.whitehouse.gov/blog/2014/10/08/five-us-airports-are-enacting-new-screening-measures-protect-against-ebola).

An animated GIF map showing the spread of Ebola over the summer in West Africa. Image: CDC

It's at airports that the chance for contamination with the virus is highest. But it can only be contracted through direct contact with a sick person's bodily fluids: saliva, feces, urine, blood, vomit, or semen. It isn't transmitted through the air, so you are more likely to catch a cold on a flight or in an airport than Ebola.

Anyone exhibiting signs of illness is not being allowed to board commercial flights, the CDC has mandated. "At this point, there is zero risk of transmission on the flight," CDC Director Tom Frieden said on Tuesday about the Dallas victim. "The illness of Ebola would not have gone on for 10 days before diagnosis. He was checked for fever before getting on the flight, and there's no reason to think that anyone on the flight that he was on would be at risk."

The virus has already killed more than 3,300 people in Liberia, Sierra Leone, Senegal, Guinea, and Nigeria—the worst Ebola outbreak in history. In addition to patients under scrutiny in Dallas and D.C., an American journalist, Ashoka Mukpo, will be flown back to the U.S. on Sunday for treatment, after being diagnosed with Ebola. He had recently worked with VICE News producers, but they have shown no symptoms.

Advertisement

After the Dallas debacle, the CDC acknowledged this week that U.S. hospitals could be better prepared. "We let our guard down a little bit," Abbigail Tumpey, a CDC spokeswoman, told theWashington Post on Friday. "We as a health-care system have to make sure not to let our guard down and be vigilant that patients with Ebola could show up at any U.S. health-care facility. . . . Now that we've seen this happen, we know now that we need to do more to make people feel prepared."

Meanwhile, a survey of 700 nurses by National Nurses United, the largest nurses union in the U.S., found that 80 percent of respondents said their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola. Nearly 40 percent said their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use.

"We knew it was only a matter of time before we would see this occurring in the US, this is international,"  Liz Jacobs, a spokesperson for the group, told VICE News, adding that, when it comes to developing plans and training, hospitals need to "involve the people on the frontlines putting their lives at risk and that's the nurses."

Meanwhile, doctors in New York and around the country are monitoring the spread of another disease,  enterovirus 68. The respiratory disease is suspected of sickening children in at least 43 states, according to the CDC.

The virus often starts out much like a common cold, with patients usually complaining of coughing or a runny nose. In rare cases the respiratory problems can become severe, particularly for asthmatic patients. At least four other patients who tested positive for the enterovirus 68 have died, and on Friday officials said that a four-year-old in New Jersey had died as a result of the disease.

Watch Part 1 of VICE News' report from the center of the outbreak, the Liberian capital of Monrovia.