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CDC To Act Faster When A U.S. Hospital Gets An Ebola Patient


We have some news and an advisory. The news is this, the Texas Department of Health says a second health care worker tested positive for Ebola. The advisory is what we don't know. Dr. Daniel Varga is with Texas Health Presbyterian Hospital.


DANIEL VARGA: A lot is being said about what may or may not have occurred to cause some of our colleagues to contract this disease, but it's clear there was an exposure somewhere, sometime in their treatment of Mr. Duncan.

INSKEEP: Thomas Eric Duncan is the Liberian man who died of Ebola in Dallas. Both health care workers worked with him. At the same time this is happening, the Centers for Disease Control and Prevention is scrambling to improve hospital protocols designed to keep the virus from spreading. NPR's Wade Goodwyn reports.

WADE GOODWYN, BYLINE: When Thomas Eric Duncan was first diagnosed with Ebola at Presbyterian Hospital in Dallas, state and federal health officials, in an effort to reassure the public, presented a face of utmost confidence. Here's Dr. David Lakey, the Texas Health commissioner, in the first press conference in Dallas the day after Duncan was diagnosed.


DAVID LAKEY: This is not West Africa. This is a very sophisticated city, a very sophisticated hospital.

GOODWYN: By a week later, events had wiped out any remaining smug. Presbyterian Hospital misdiagnosed Duncan and sent a seriously contagious Ebola patient back out into the general public. Then for days, the city of Dallas forcibly quarantined Duncan's fiancee and her family in a small apartment packed with Ebola-soiled sheets, towels and mattresses. With the announcement that 26-year-old nurse Nina Pham had caught the virus while treating Duncan, CDC Director Tom Frieden had a decidedly different tone.


TOM FRIEDEN: I think we could - in retrospect, we could have set a more robust hospital infection control team and been more hands-on with the hospital from day one.

GOODWYN: Frieden said candidly he's gotten an earful since the announcement of Pham's illness.


FRIEDEN: I've been hearing, loud and clear, from health care workers from around the country that they're worried, that they don't feel prepared to take care of a patient with Ebola.

GOODWYN: From its experiences in Africa, the CDC has long understood that having a trained expert watch as doctors and nurses put on and take off their protective suits is key to stopping Ebola contamination of medical personnel. The error was to believe that in America, doctors and nurses with little or no experience in treating Ebola patients would nonetheless do it perfectly without the need for an ever-present, third-party expert's set of eyes. At Dallas's Parkland Hospital, with its level one trauma unit that took in President Kennedy after he was shot, Dr. Alex Eastman gives a tour of their isolation unit.

ALEX EASTMAN: What you're standing in now is the dirty room. So obviously as you enter, you enter from clean to dirty. And as you come out, you go from dirty to clean to make sure that you're never having cross-contamination in the facility.

GOODWYN: Eastman says that at Parkland, they've been training to treat Ebola patients since the latest outbreak began in West Africa. But the doctor admits that when Dallas nurse Nina Pham contracted Ebola from Duncan...

EASTMAN: I'll tell you, it was certainly a wake-up call. And what it makes you realize - which is what we, who do this every day, understand - is that it isn't good enough to have a personal protective equipment package. You've got to train in it. You've got to be comfortable in it. You've got to be well-versed in the donning and doffing procedures.

GOODWYN: Eastman says a state-of-the-art facility and up-to-date personal protective equipment constitute only two legs of the Ebola treatment stool. An isolation unit capable of successfully handling a deadly hemorrhagic fever requires staff that are constantly training for contagion.

EASTMAN: To function in this environment involves a set of perishable skills. You've got to rehearse. You've got to train, and when you do that, your comfort level increases and you're able to function if you have to do this for the real-life hazard.

GOODWYN: It raises the question, should the CDC designate a limited number of hospitals across the country which would then receive Ebola patients from other facilities should the outbreak grow? CDC Director Tom Frieden said yesterday they're considering it. Wade Goodwyn, NPR News, Dallas. Transcript provided by NPR, Copyright NPR.

Corrected: October 15, 2014 at 12:00 AM EDT
In the introduction to this story, we misidentify Thomas Eric Duncan as Robert Eric Duncan. We incorrectly say in the story that Thomas Duncan's fiancee and her family were quarantined by the city of Dallas. The quarantine was actually imposed by Dallas County.
Wade Goodwyn
Wade Goodwyn is an NPR National Desk Correspondent covering Texas and the surrounding states.