Preparing for the worst: A conversation with Cedars-Sinai’s director of epidemiology on Ebola

Ebola.

The dreaded word is all over the news and causing a flurry of activity at hospitals across the nation as officials scramble to prepare for the possibility of new cases of the West African disease in the United States. So far, just three cases of Ebola have been diagnosed on U.S. soil, all linked to patient Thomas Eric Duncan, a Liberian who contracted the disease in Africa and died at a Dallas hospital Oct 8. However, with the debacle over two nurses who cared for Duncan contracting Ebola, and the search for possible exposures extending from Texas to Ohio, and to multiple domestic flights and a cruise ship, medical facilities are not taking chances.

To date, Los Angeles County has no suspected or confirmed cases of Ebola, according to the county’s public health department. Nevertheless, government agencies and local hospitals such as Cedars-Sinai are training staff and establishing protocols on how to respond to any new cases of the virus, should they appear.

The Jewish Journal asked Dr. Rekha Murthy, director of the epidemiology department at Cedars-Sinai, to explain how the hospital is taking on the challenge of Ebola preparedness, and whether the public should be overly concerned about the disease.

Jewish Journal: How is Cedars-Sinai preparing for Ebola?

Rekha Murthy: Cedars-Sinai is preparing on multiple fronts. We have taken steps to enhance our early detection system for suspected or confirmed cases of Ebola. For example, we are asking all of our patients if they have traveled to Ebola-affected countries in Africa in the last 21 days or if they have been in close contact with someone who has. In addition, we are training our staff on proper procedures for caring for such patients, including how to put on and take off personal protective equipment. Should we receive a patient with signs or symptoms of Ebola virus disease, we will offer that individual the safe, compassionate care that we offer to all Cedars-Sinai patients and ensure that our patients, visitors and staff are safe.

JJ: What kind of training or guidance has Cedars-Sinai received from the Centers for Disease Control and Prevention (CDC)?

RM: We are developing our protocols while monitoring the guidance of multiple health organizations, including the Centers for Disease Control and Prevention, the World Health Organization, the California Department of Public Health and the Los Angeles County Department of Public Health.

JJ: What kind of space and personnel has Cedars-Sinai committed to dealing with a potential Ebola outbreak?

RM: We have identified an isolation unit where a patient with Ebola would receive care, and we have formed a dedicated Ebola Response Team of physicians, nurses and other health care providers.

JJ: If an Ebola case is detected, how will you ensure medical staff caring for the patient does not contract the disease?

RM: In addition to doing hands-on demonstrations with our nurses, physicians and clinical partners, we have filmed a video demonstration of the best practices for putting on and taking off the personal protective equipment. the training also emphasizes proper disposal methods for contaminated linens and supplies.  We also will follow the CDC’s recommended “buddy system” in which health care workers observe and check each other during the putting on and taking off of personal protective equipment.

JJ: What is the protocol for dealing with family members and other people who have had contact with an Ebola patient?

RM: Should we admit a patient who is suspected of having Ebola or who has been diagnosed with Ebola, we will work with the state and county departments of health as well as the CDC and follow their guidance regarding quarantine procedures.

JJ: How concerned is Cedars-Sinai about Ebola?

RM: Ebola virus is a serious disease that has caused a lot of suffering around the world. However, the influenza virus is much more widespread here in America, especially in the upcoming months of the usual flu season, and is preventable with flu vaccine. So it is much more likely that Angelenos would catch the flu, not Ebola virus. We are encouraging all our patients to protect themselves and get a flu shot this year — especially children, as this year’s flu appears to be targeting children.

JJ: How worried should members of the public be about Ebola?

RM: Ebola virus is a serious disease, so I understand the concern. However, there is virtually no risk of developing Ebola virus unless you have had close contact with sick Ebola patients with symptoms such as fever, vomiting and/or diarrhea. Transmission of this virus occurs only through direct contact with bodily fluids of patients who are ill with Ebola or from objects such as needles or syringes that have been in contact with these fluids. Unless you have been in contact with Ebola patients or have traveled to the affected countries in Africa or had intimate contact with someone who has been in contact with Ebola patients, there is no need to worry.

JJ: Are you seeing an increase in patients coming to the hospital concerned about Ebola?

RM: No. That said, we are aware of the widespread concern in our community and our country. We are dedicated to patient safety, which always has been our highest priority at Cedars-Sinai.  

JJ: What are the symptoms of Ebola that people should be looking out for?

RM: There is virtually no risk of developing Ebola virus unless you have had close contact with sick Ebola patients or have traveled to Africa in the past 21 days. If you have a fever and have traveled to Africa in the past 21 days or have had close contact with sick Ebola patients, seek medical care immediately.

JJ: When should someone seek medical attention if they think they have Ebola?

RM: Immediately. If possible, call your health care provider ahead of time to let them know about your symptoms and that you are seeking care.