When it first became apparent that ebola had arrived in the US I was one of several people who was urging people to listen to and follow the advice of the CDC. Basically we still need to do that to a large extent since they are the point of national coordination in dealing with the potential epidemic and mass panic would create problems just as serious as the virus. However, as information is coming to light about how the CDC has issued inadequate infection control protocols and then tried to place the blame for infections on nurses who did not follow their protocols, I think it is time to regard what comes from the CDC with some skepticism.
Lax U.S. Guidelines on Ebola Led to Poor Hospital Training, Experts Say
Many American hospitals have improperly trained their staffs to deal with Ebola patients because they were following federal guidelines that were too lax, infection control experts said on Wednesday.
Federal health officials effectively acknowledged the problems with their procedures for protecting health care workers by abruptly changing them. At 8 p.m. Tuesday, the Centers for Disease Control and Prevention issued stricter guidelines for American hospitals with Ebola patients.
They are now closer to the procedures of Doctors Without Borders, which has decades of experience in fighting Ebola in Africa. In issuing the new guidelines, the C.D.C. acknowledged that its experts had learned by working alongside that medical charity.
Doctors Without Borders is working in the middle of what can be described as a health care battle zone. Yet, they have managed to treat mass numbers of ebola patients with only
a small number of staff infections and deaths. Only now is the CDC bothering to pay attention to their experience.
They didn't even have to go as far as Africa to get the information.
Sean G. Kaufman, who oversaw infection control at Emory University Hospital while it treated Dr. Kent Brantly and Nancy Writebol, the first two American Ebola patients, called the earlier C.D.C. guidelines “absolutely irresponsible and dead wrong.”
When news that the second Texas nurse to be infected with ebola had flown on a commercial airline, she was being criticized for violating CDC guidelines.
Now it turns out that she contacted the CDC before boarding the plane to inform them that she was feeling ill and had a low grade fever. They gave her clearance to fly. While her temp of 99.5 was below the level that is being used in mass screenings of airline passengers, given her level of exposure to infection, this seems pretty clearly to have been an unsound decision.
The assumption has been that countries with advanced health care systems would be much more capable of containing ebola infections than countries in Africa with inadequate facilities. That should certainly be true and most likely is. However, the failure to learn from the experience of people working in Africa represents a smug level of confidence that isn't warranted.
The CDC is now scrambling to revise its protocols and provide more intensive training. Ebola is exposing some serious flaws in the US health care system. Americans are regularly told that we have the best health care system in the world. What we actually have is the most expensive health care system in the world. Texas Presbyterian which has been the ground zero of medical screw ups is generally regarded as being one of the top hospitals in Texas. That raises some very serious questions.
So far all the available information seems to indicate that ordinary people in Dallas have little reason to worry about ebola. It is health care workers treating ebola patients who face serious risks. I do think that the health care workers deserve to have the rest of us be concerned about their safety.