A second Dallas nurse undergoing treatment for Ebola was released today from Emory University Hospital after doctors said she had been cured from the deadly virus. Nurse Amber Vinson, 29, was discharged after spending the last the last two weeks in Atlanta undergoing treatment in its biocontainment unit..
The following items were found on a continuing medical site oriented to US physicians, from an Emory Hospital spokesman, 2 weeks ago:
American healthcare workers can safely treat patients with Ebola. That's one of the lessons learned from the care of patients treated at Atlanta's Emory University Hospital, according to Bruce Ribner, MD, ... medical director of the hospital's serious communicable diseases unit.
..."This is a virus which is well controlled with standard infection control measures that every hospital in the U.S. is capable of providing," he said.
However: A patient (not Dr. Brantley nor Nancy Writebol) was airlifted to the U.S. and admitted to Emory in early September, but Ribner said patient confidentiality rules forbid him from revealing any details of the case, or even confirming whether treatment is continuing.
Does this mean there may be US Ebola patients currently being treated, but unknown to the general public and political leadership? Back in the days when quarantines were public information, patient confidentiality was minimal.
However: Dr. Ribner cautioned that until that epidemic is brought under control, more people with Ebola will appear in the developed world, including the U.S., he said, and there is "no way" a small number of select institutions, such as Emory, will be able to handle them.
I remain unconvinced that, beyond a small number of select institutions, many US hospitals can duplicate the level of care delivered at Emory, should it become necessary.
However, Dr. Ribner disclosed some unexpected obstacles encountered by Emory up until 2 weeks ago.
- While CDC recommendations suggest that lab tests for Ebola patients can be carried out safely using standard precautions, the reality was that a spill would mean having to shut down the main lab for decontamination. There was also a concern that few lab techs would be willing to work on such samples.
Instead of using Emory's main lab, Ribner said, the unit set up a satellite within the biocontainment unit and staffed it with volunteers from the main lab.
What other hospitals are capable of this? - Outside the hospital, he said, they ran into difficulty shipping samples across town to the CDC. Such samples would be classed as Category A -- labelled as Ebola and packaged inside a rigid box with two watertight containers inside -- but even shippers certified to handle Category A specimens refused.
How Emory got around this problem, was not discussed in the article. - while the CDC says wastes can be put in leak-proof containers and discarded as regulated medical waste, Emory's contractors refused to take it unless it was certified free of Ebola.
As a result, Ribner said, the hospital had to autoclave some 350 bags of medical waste, which then filled 218 boxes, before it could be taken away.
Again, how many US hospitals have this capability? - The CDC also says sanitary sewers can be used for safe disposal of fluids from patients, but the local watershed authority threatened to cut the hospital's service if that method was used. Instead the hospital disinfected patients' liquid wastes with bleach or quaternary disinfecting detergents for at least 5 minutes before flushing.