WASHINGTON – The director of the Centers for Disease Control and Prevention cautioned against proposals to ban flights from West African countries affected by the Ebola epidemic during a hearing held by the House Energy & Commerce Committee’s Subcommittee on Oversight and Investigations Oct. 16.
At the hearing, subcommittee chairman Tim Murphy (R-Penn.) proposed an immediate ban on commercial, non-essential travel from three West African nations to the United States. Additionally, he called for a mandatory quarantine for any American who treats an Ebola patient in those countries.
Dr. Tom Frieden told the subcommittee that a flight ban might drive people to come into the country by other means, which could lead to potentially more infections because those people would not be efficiently tracked. He added that the CDC continues to be “confident that Ebola is not a significant public health threat to the United States.”
Starting today, passengers from Sierra Leone, Guinea, and Liberia are screened upon exiting those countries, he said. They are having their temperatures taken and are being subjected to additional screening upon entering the United States at five major airports: Atlanta’s Hartsfield; Dulles, near Washington, D.C.; New York’s J.F.K.; Newark, N.J.; and Chicago’s O’Hare.
“Your protocol depends on everyone being honest,” Rep Murphy countered. It depends on thermometers being accurate, and it still does not catch people who are asymptomatic but carrying the virus.
House subcommittee members also wanted to know whether officials at the CDC and Texas Health Presbyterian Hospital had determined how two nurses involved in the care of an Ebola patient became infected, despite theoretically following CDC protocols. Nancy Pham and Amber Vinson provided care for Thomas Eric Duncan, who developed the infection after flying from Liberia to Dallas, where he died on Oct. 8.
“We’ve learned frontline hospital workers were not fully trained in those procedures, do not have proper equipment, do not know how to properly put on and remove safety gear,” said subcommittee chairman Tim Murphy (R-Penn.). “Educating, training and assisting our public health workforce on the frontlines across the country must be a priority.” Dr. Daniel Varga, chief clinical officer and senior vice president for Texas Health Resources, the parent company of Texas Health Presbyterian Hospital, said the investigation continues. Both nurses were “using full protective measures under the CDC protocols,” and officials still don’t know how or when the nurses were infected.
Dr. Frieden said that “more than 20 of the world’s top disease detectives” are at the Dallas hospital trying to determine what went wrong and that they are also conducting extensive contact tracing.
Dr. Varga acknowledged that there had been no actual training rehearsal of the hospital’s emergency room workers in handling a potential Ebola patient before Mr. Duncan arrived at the facility in late September.
“Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes,” said Dr. Varga.
Rep. Murphy called for immediate and thorough training of U.S. hospital personnel in the proper use of personal protective equipment. Specialized medical centers should be identified for treatment of Ebola patients, and those centers need to be expanded, he said.
Currently, there are four specialized centers and they have a limited bed capacity. They are located at the National Institutes of Health in Bethesda, Md. (2 beds), at Emory University (2 beds), the Nebraska Medical Center (10 beds), and St. Patrick Hospital in Missoula, Mont. (3 beds).
The CDC is continuing to field calls from health care providers, and to offer training and education, Dr. Frieden said.
Hospitals and clinicians should keep Ebola in mind when treating any patient who presents with a fever or flu-like symptoms, and ask whether the patient has traveled to West Africa within the last 21 days.
Meanwhile, 45% of Americans say they are worried about contracting Ebola, according to a poll released on Oct. 16 by the Kaiser Family Foundation. A similar number thought, mistakenly, that they could get the virus by shaking hands with someone who is asymptomatic. A majority said they had confidence in the CDC, their local hospital, and state health officials to contain the virus.
The Oversight and Investigations Subcommittee plans to hold another hearing on Ebola preparedness in November, said Rep. Murphy.
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