Existing protocols under scrutiny
Current safety procedures may not be enough
DALLAS — As Thomas Eric Duncan’s health deteriorated, nurses Amber Joy Vinson and Nina Pham were at the Ebola patient’s side.
They wore protective gear, including face shields, hazardous materials suits and protective footwear, as they inserted catheters, drew blood and dealt with his body fluids.
Still, the two somehow contracted Ebola from the dying man.
As health officials try to figure out how that happened, the nurses’ cases have brought new scrutiny to national Ebola protocols that had never before been put to the test at a general hospital. Authorities are examining whether those guidelines need to be rewritten.
A nurse at Texas Health Presbyterian Hospital, Briana Aguirre, said on NBC’s Today show that nurses and other employees were asking their supervisors what they should be doing.
“Our infectious disease department was contacted to ask, ‘What is the protocol?’ ” Aguirre said. “And their answer was, ‘We don’t know. We’re going to have to call you back.’ ”
Aguirre, who did not deal directly with Duncan but helped take care of Pham, said the protective gear they were provided left the neck exposed.
Texas Health Presbyterian had no immediate response to Aguirre’s comments. It had said earlier Thursday it followed federal guidelines in treating Duncan and “sought additional guidance and clarity.”
The U.S. Centers for Disease Control and Prevention protocols for Ebola recommend nurses use personal protective equipment such as gloves, goggles, face shields and fluid-resistant gowns — as Vinson and Pham did.
They also recommend diligent cleaning and disinfection of any items containing contaminated materials.
More than 75 people have been identified as being involved in Duncan’s care, including the now-sick nurses.
CDC director Dr. Tom Frieden told a congressional hearing on Thursday that while the CDC is “absolutely looking for other mutations” in the Ebola virus, it hasn’t found any.
“We don’t think it is transmitting in a different way” other than through body fluids, he said. He added that the investigators have “identified some possible causes.”
Discovering the cause of the exposure is vital in assessing whether the CDC protocols themselves failed and should be changed.
Lawmakers expressed amazement that the nurses were not wearing full-body gear from the moment Duncan arrived.
The World Health Organization and Doctors Without Borders have developed relatively safe ways to care for people during many large and deadly outbreaks in Africa over the past four decades.
But Ebola is a new phenomenon in the U.S., providing an opportunity for health officials to revise protocols.
The current outbreak is blamed not on protocol violations but on a lack of care. The virus has killed almost 4,500 people, most of them in West Africa.