Ebola and Infectious Disease: How We Prepare

Covenant HealthCare has always taken a proactive approach to preparing for emergency situations and infectious diseases.

Due to the high sensitivity to the cases of Ebola now reported in the United States, and our continuing responsibility to providing extraordinary care to the health and well-being of our patients and staff, Covenant infectious disease and emergency medical teams began preparing as early as August for any potential local outbreak of the Ebola virus.

“Just as we operated during the SARS event, it was a collaborative effort to immediately enact preventative protocols,” said BJ Helton, Patient Safety and Quality manager. “Covenant is prepared. We are as safe as any hospital can be. However, we want to make sure our entire organization is well aware and educated.”

Initial action steps concentrated on the Emergency Care Center (ECC). A station located at the ECC entrance directs patients who have travelled out of the United States within the last 30 days to put on a protective mask before entering the building and to report directly to the triage nurse in the triage area. MedExpress locations and physician offices now display similar signs. More recent activity has focused on the organization as a whole.

General preparedness measures that have been completed, in development and are ongoing at Covenant HealthCare include:

  • Developing and reinforcing patient screening and triage questions and guidelines based on Centers for Disease Control (CDC) and prevention recommendations for emergency departments, ambulatory care (outpatient), and inpatient settings.
  • Ensuring a process is in place to allow safe and effective testing
  • Following CDC guidelines for handling tested specimens
  • Outlining/mapping triage questions, isolation procedures and isolation areas
  • Patient screening should now be taking place on all clinical floors
  • Initial supplies of personal protective equipment (PPE) have been secured
  • Displaying signs at main campus and off campus entry points that encourage patients to report to clinic staff if they have symptoms and travel history in any areas considered high risk areas by the CDC
  • Sharing information on Ebola patient management with Emergency Department staff.
  • Equipping clinical areas with protective clothing and protective equipment to be used in the event of a suspected Ebola case
  • Providing extra training for staff on proper use of personal protective equipment and other components of safe management of potential patients.
  • Adding screening questions to the EMR Assessment tools
  • Following comprehensive procedures for disinfecting patient rooms and removing/disposing of linens and cubicle curtains
  • Preparing to safely disinfect and destroy necessary supplies used to treat patients
  • Standardizing the triage process and documentation with representation from all care settings including inpatient, Surgery, Radiology, Emergency Services, Ambulatory Care, Procedure areas and Labor and Delivery
  • Preparing to communicate with state departments, employees and media in case of highly-suspected or confirmed case of Ebola
  • Providing via the Covenant HealthCare website, Frequently Asked Questions and CDC flyers to patients and visitors who have concerns about Ebola.
  • Collaborating with national, state and local agencies such as the Saginaw County Health Department, Region 3 and Waste Management, as well as reviewing and reinforcing processes for identifying and caring for patients with Ebola infection in the event that it is required.

Ebola: Frequently Asked Questions

What is Ebola?

Ebola is a rare and deadly disease. According to the CDC, the 2014 Ebola outbreak in West Africa is the largest in history and the first Ebola epidemic the world has ever known. Being prepared, following sound clinical protocols and working together is the key for Covenant to meet this challenge should we be called upon to do so

Where are cases of Ebola found?

The outbreak — the first Ebola Virus Disease (EVD) epidemic in history — is affecting people in Guinea, Liberia, Nigeria, and Sierra Leone in Africa. The Centers for Disease Control & Prevention recently confirmed the first case of EVD in the U.S. in an individual who traveled to Dallas, Texas, from West Africa. 

What are the signs and symptoms of Ebola?

 •Fever

 •Severe headache

 •Muscle pain

 •Weakness

 •Diarrhea

 •Vomiting

 •Abdominal (stomach) pain

 •Unexplained hemorrhage (bleeding or bruising)

Symptoms may appear anywhere from two to 21 days after exposure to Ebola, but eight to 10 days is average. Recovery depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

How does someone get Ebola?

When an infection occurs in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with:

 •blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk and semen) of a person who is sick with Ebola

 •objects (like needles and syringes) that have been contaminated with the virus

 •infected animals

 •Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitoes or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus. Individuals who are not symptomatic are not contagious.

Who is at risk?

Persons who have recently traveled to West African countries of Guinea, Liberia and Sierra Leone within three weeks and are experiencing fever and any above symptoms should go to the Emergency Department immediately to be assessed.

What is the possibility of contracting Ebola?

The risk of catching EVD is extremely low and Ebola poses no significant risk in the U.S. However, health care providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with the blood or body fluids of sick patients. People also can become sick with Ebola after coming in contact with infected wildlife. The virus also can be spread through contact with objects (like clothes, bedding, needles, syringes/sharps or medical equipment) that have been contaminated with the virus or with infected animals.

How can I protect myself from Ebola?

Protect yourself from Ebola by avoiding non-essential travel to areas affected by the Ebola outbreak. If you must travel to an affected area, avoid contact with blood and body fluids of those infected and any items that have come in contact with an infected person.

What is the treatment for Ebola?

Early diagnosis and timely treatment of Ebola is very important for good outcomes. Standard treatment of patients infected with Ebola virus is limited to supportive therapy, such as providing IV fluids, balancing electrolytes, maintaining oxygen and blood pressure, and treating other infections if they occur. Experimental vaccines and treatments for Ebola are under development.

What are the prevention measures for Ebola? 

Currently there is no FDA approved vaccine for Ebola virus. Following CDC guidance, Covenant HealthCare is working to keep our patients safe through preparedness and the prompt identification of suspect patients.

Resources

Michigan Ebola website http://www.michigan.gov/ebola

The CDC Ebola website http://www.cdc.gov/vhf/ebola/index.html