WHY WAS THE LAST EBOLA PATIENT ALLOWED TO FLY WHOLE BEING MONITORED BY THE CDC

WHY WAS THE LAST EBOLA PATIENT ALLOWED TO FLY WHILE BEING MONITORED BY THE CDC

Amber Vinson, the second nurse to contract Ebola flew across the country from Ohio to Texas, on a commercial jet the day before she was hospitalized with Ebola. Why did this happen?  She was being monitored by the Centers for Disease Control (CDC).  Director of the CDC Dr. Tom Frieden  said she should have never stepped foot on a commercial flight.

Although, before Ms. Vinson flew from Cleveland to Dallas on Monday, she called the CDC (as she was supposed to) and reported an elevated temperature of 99.5 Fahrenheit.  She also informed them that she was planning on getting on a plane, but was never told to not board the airplane.  Interestingly, when she was diagnosed with Ebola on Wednesday, the CDC said guidelines weren’t followed.

Frieden states that "She was being monitored here in Dallas and if she was being monitored correctly, I think she should have never gotten on that flight."

"The CDC guidance in this setting outlines the need for what is called controlled movement. That can include a charter plane, a car, but it does not include public transport," Frieden said. "We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement."

Although the CDC guidelines warn airport screeners that any travelers returning from West Africa with a temperature of 100.4 Fahrenheit or higher may be showing Ebola symptoms.  Vinson’s temperature was almost a degree lower than this, yet was positive for Ebola.

Although the CDC said there is an “extremely low risk” to anyone on that plane, they are asking those passengers to contact them as “extra margins of safety.”

Vinson has been transferred from Dallas to Emory University Hospital in Atlanta.  The first nurse to be infected with the virus, Nina Pham, is in stable condition, in Dallas and there are no plans to transfer her to Emory. Emory has successfully treated two other patients and are currently treating another patient, a male healthcare worker from Sierra Leone.

 

Both of the American nurses had "extensive contact" with Duncan (the first victim of Ebola in the U.S.) when he had "extensive production of body fluids" Frieden said during a conference call.

 

Some nurses at the hospital where the two nurses were infected have complained about the conditions there and have reported to their union that they feel "unsupported, unprepared, lied to and deserted."

"Texas Health Dallas is offering a room to any of our impacted employees who would like to stay here to avoid even the remote possibility of any potential exposure to family, friends and the broader public," the hospital said.

"We are doing this for our employees' peace of mind and comfort. This is not a medical recommendation. We will make available to our employees who treated Mr. Duncan a room in a separate part of the hospital throughout their monitoring period."

Emory University Hospital or Nebraska Medical Center in Omaha would have been better equip to deal with Duncan, as they are among the four hospitals in the U.S. that have biocontainment units and are prepared to treat diseases such as Ebola, which is highly contagious.

 

The first nurse to be infected with Ebola did not break protocol, as was initially stated by Frieden. She wore a gown, gloves, a mask and a face shield while caring for Duncan.  Frieden questioned why this nurse became infected with Ebola if she used proper protocol.   The question of airborne or droplet mutation has been raised. The CDC still maintains the disease is transmitted through direct contact only.

 

There has never been a human virus that has mutated into another form of transmission and it is unlikely that Ebola could become airborne, but it is droplet-borne and it is important that we understand the difference between the two.

There is a misunderstanding between the “medical” definition of airborne and what the general public knows as airborne.  The medical term means that the germs that cause the disease are so small and light weight that they can float around in the air for a long time, which enables them to travel from person to person and be inhaled, for transmission of the virus.

 

Measles, chickenpox, and tuberculosis are examples of airborne diseases. Droplets transmission is caused when a person sneezes, coughs, or vomits, he sprays body fluids into the air in the form of droplets.  Because they are droplets, they weigh more, so gravity brings them to the floor quicker than airborne germs or viruses. It is important to know the medical difference between the two, to understand how some diseases are more transmittable than others. Airborne diseases are more easily contracted than droplet borne diseases.

The CDC sent hazardous workers to Vinson’s residence to decontaminate her belongings.  The workers arrived in hazmat suits, gloves and goggles.  Yet, in many hospitals they are only providing paper gowns, gloves and masks to  nurses who are in direct contact with Ebola patients, not just their belongings.

As nurses, I think it’s important to stand our ground here and insist on proper equipment to care for these patients.  If your hospital does not provide you with ample protection, refuse to care for the patient. It’s not worth risking your own life and the life of your family members.

The CDC seem to be very quick to blame nurses for “breaches in protocol” and state that the second nurse infected should not have flown, when she actually called them before she flew, but was never told not to fly.

As a nurse, what do you think about the CDC stating she should not have been allowed to fly, when they knew she was going to fly but failed to stop her?

 

Why is the CDC recommending screening people who are boarding planes in West Africa and not allowing them to fly if their temperature is 100.4 F or above, when this latest victim’s temperature was 99.5 F and she was positive for Ebola?  Should this be changed?

Should we be allowing people from West Africa to be boarding planes to the U.S. at all?