A number of U.S. Ebola milestones were reached this week. Monday at midnight, “Kaci Hickox, the nurse who defied an Ebola quarantine in Maine until a judge sided with her,” arrived at the end of her 21-day period monitoring for symptoms - with no symptoms. Great news for her. And with the release yesterday of once Ebola-infected Dr. Craig Spencer from New York City’s Bellevue Hospital, the U.S. became “Ebola-free for the first time since Sept. 5.” More great news. But if you think that’s the end of the U.S. story, think again.
The New York Times reports today that New York City is running a 24-hour monitoring operation, keeping track of almost 300 people.
Two-thirds of the 289 people being tracked recently came to New York City from Guinea, Sierra Leone and Liberia, the three hardest-hit countries; the rest are workers who have been involved in the care of Dr. Craig Spencer, the city’s first Ebola patient, who was released from Bellevue Hospital Center on Tuesday. The travelers are not under quarantine because they said they did not have contact with Ebola patients.
Those being monitored must take their temperatures twice daily and check in with the health department for 21 days, the maximum known time it can take for symptoms of Ebola to emerge.
They are not always easy to reach. The federal Centers for Disease Control and Prevention gives the city a daily list of travelers from those countries who are destined for New York City. Most come through Kennedy International Airport, but sometimes the information the passengers provide at the airport, such as phone numbers, addresses and name spellings, turns out to be incorrect.
With the help of the health department’s researchers, colorfully known as “disease detectives,” and sometimes aided by the police, almost all are eventually located, health officials said. Since the monitoring began Oct. 24, they said, only four people have not been found.
Just as importantly, today, the National Nurses Union is staging protests around the country and around the world “over what they say is insufficient protection for health workers dealing with patients possibly stricken with the deadly Ebola virus.” They say hospitals “still lack enough hazardous materials suits which leave no skin exposed and sufficient powered air-purifying respirators to properly protect nurses from exposure.”
Recall the nurse who first blew the whistle on Texas Health Presbyterian hospital, where two nurses were infected after treating Thomas Eric Duncan. Mr. Duncan died October 8 after he was mistakenly sent home undiagnosed, only to return extremely sick. And speaking of Mr. Duncan, it was announced today that the hospital agreed to settle with Duncan’s family for an undisclosed sum – money that will go to his parents and four children. A charitable foundation will also be created to “assist efforts to fight Ebola in Africa.”
Good for the hospital for moving quickly on this, especially given that Texas law might have essentially immunize them from suit. But, as ABC notes,
A quick resolution to Duncan's case also benefits parent company Texas Health Resources, which faced weeks of negative publicity over its handling of the case and saw patient visits plummet immediately afterward.
Visits to Presbyterian's emergency room fell more than 50 percent during the first 20 days of October, and the hospital's overall patient census fell 21 percent.
Unfortunately, as we’ve noted, as long as immunity laws stay on the books, the hospital’s incentives for improving patient safety will be lacking.