At first, it appeared a federal official had blamed the worker in the case of a nurse who contracted the deadly Ebola virus in the U.S. But following a public outcry about his initial statement, the head of the CDC now says he didn’t mean to blame the nurse and that his agency has to review its guidance to hospitals on Ebola.
The nurse had helped treat Ebola victim, Thomas Eric Duncan, at Texas Health Presbyterian Hospital in Dallas.
When it was confirmed on Sunday, Oct. 12 that the nurse had indeed contracted Ebola, the head of the U.S. Centers for Disease Control and Prevention, Dr. Thomas Frieden, said a “protocol breach” caused the nurse to be infected.
Officials are now investigating to determine how the nurse, who used protective gear including a gown, mask, gloves and an eye shield, became infected.
Frieden said it’s possible the nurse had breached safety protocol when removing the protective gear.
The head of the CDC’s “breached protocol” statement led to an outcry from some medical circles.
“You don’t scapegoat and blame when you have a disease outbreak,” said Bonnie Castillo, a disaster relief expert with National Nurses United, according to Reuters.
Dr. Gavin Macgregor-Skinner, an expert on public health at Penn State University, said Frieden’s statement put the onus on the nurse. “I think it’s just wrong,” Macgregor-Skinner is quoted by Reuters.
“I suspect no one was watching to make sure the people who were taking care of the patients were taking care of themselves,” said Sean Kaufman, president of Behavioral-Based Improvement Solution. Kaufman helped train healthcare workers in Atlanta where two U.S. aid workers who contracted Ebola in Africa were taken to recover.
As far as watching the caregivers, new information shows that, at the least, the government wasn’t monitoring them. The New York Times reports none of the 48 people in the Dallas area whom officials were initially tracking were healthcare workers who had come in contact with Duncan, with the exception of paramedics who transported him.
Adding the medical team of more than 50 people who treated Duncan now brings the number of those being monitored to more than 100. The Times reports questions are being raised as to why the hospital workers who had been caring for Duncan weren’t monitored. Reports say the healthcare workers were expected to “self monitor” by taking their temperatures twice a day.
Dr. Joseph McCormick, regional dean of the University of Texas School of Public Health in Brownsville, called the lack of healthcare worker monitoring “ludicrous.”
“You certainly can’t assume that because he’s hospitalized and in this unit that everything is fine and everything that goes on will be without any risk,” McCormick said.
What’s more, the chief clinical officer of Texas Health Resources which oversees the hospital where Duncan was treated says the nurse had been following “full CDC precautions.”
A CDC spokesman says the agency is going to step up its education and training efforts for healthcare workers who may come in contact with the Ebola virus. The spokesman said, “Clearly, there is more to do.”
Healthcare workers at the Dallas hospital treating the nurse, 26-year-old Nina Pham, will now be monitored when they put on and take off their protective gear to help prevent exposure to bodily fluids during the process. Ebola is more contagious than hepatitis A, B, C and HIV.
Engineer out hazards
When it comes to eliminating or reducing hazards, there are three options which we’ll list from most to least preferred:
- Engineer out the hazard
- Reduce the risk from the hazard with administrative controls, and last
- Provide employees with protective gear.
What’s being discussed in this case involving the infected nurse has revolved around protective gear – the last line of defense.
OSHA administrator David Michaels recently renewed the agency’s call for more use of engineering solutions rather than relying on protective gear at his speech in September at the National Safety Council’s 2014 Congress.
Are there engineering controls that could be used to protect healthcare workers from Ebola? Good question. Here’s what OSHA’s website says about an employer’s responsibility regarding bloodborne pathogens:
“In order to reduce or eliminate the hazards of occupational exposure to bloodborne pathogens, an employer must implement an exposure control plan for the worksite with details on employee protection measures. The plan must also describe how an employer will use a combination of engineering and work practice controls, ensure the use of personal protective clothing and equipment, provide training, medical surveillance, hepatitis B vaccinations, and signs and labels, among other provisions. Engineering controls are the primary means of eliminating or minimizing employee exposure and include the use of safer medical devices, such as needleless devices, shielded needle devices, and plastic capillary tubes.”
What do you think about the statements by the head of the CDC? Let us know in the comments.