Is the U.S. Prepared to Handle Ebola?

Source: National Nurses United 

The passing of Eric Duncan, the first patient diagnosed with Ebola in the U.S., 10 days after being admitted to Texas Health Presbyterian Hospital, is a stark reminder of Ebola's insidious nature. It's a tough to treat disease, without an FDA-approved treatment, and just 50% of patients diagnosed survive it.

Duncan's death -- and the possible misdiagnosis that preceded his eventual admission -- should serve as a catalyst for preparedness, but that raises a question: Just how ready for Ebola are we?

Closing gaps
According to a survey of nurses this week by National Nurses United, a nurses union with 185,000 members, there's a lot of work to be done in getting healthcare workers up to speed on the disease.

The union surveyed 1,700 registered nurses at over 250 hospitals in 35 states and discovered that the vast majority -- some 85% -- report their hospital has yet to offer them thorough Ebola education.

That prompted Bonnie Castillo, director of the union's registered nurse response network, to say, "Handing out a piece of paper with a link to the Centers for Disease Control, or telling nurses just to look at the CDC website -- as we have heard some hospitals are doing -- is not preparedness. Hospitals can and must do better, and we should have uniform national standards and readiness." 

Clearly more needs to be done to make sure that every hospital and urgent-care facility in the United States has the knowledge necessary to properly diagnose patients, but these facilities may also be caught flat footed in other ways, too.

According to the survey, roughly 40% of nurses said that their hospital doesn't have a plan to equip the isolation rooms with the items, such as plastic-covered mattresses, necessary to help contain the potential spread of the disease by an infected patient. Hospitals also seem to be coming up short on personal protective equipment like eye goggles, despite those items being readily available for purchase through distributors like Owens & Minor and Cardinal Health . And fluid resistant, or impermeable, medical gowns like those made by Kimberly-Clark's soon-to-IPO Halyard Health may be in tight supply, too.

If those shortfalls weren't enough, plans also appear lacking for disposing of infected items used by patients and healthcare workers in these settings. If necessary, those services will likely be handled by Stericycle , a leading medical waste handler that was picked to dispose of the infected items at the Dallas hospital where Duncan was treated.

Source: Community Health Systems

Beyond treatment
The ability to contain a virus like Ebola will rely far more on preparedness than on treatment.

Despite the emergency use of non-FDA approved Ebola vaccines from manufacturers including GlaxoSmithKline , Tekmira , and Mapp Biotherapeutics, it's not proven that any of these medicines will work in large populations. Far more studying needs to be done before the Centers for Disease Control can claim that it has found a cure that works in everyone.

The fact that we don't know a great deal about the efficacy of these drugs, however, isn't (perhaps) as relevant as the shortage of their stockpiles. Since these promising medicines were mostly preclinical, investments had yet to have been made in the production necessary to produce millions of doses.

Until doctors can determine which drug, or drug combination, is most effective, and manufacturers can create these drugs in large enough numbers to treat many, rather than a few, the battle against Ebola will rely most on preparedness.

Turning on a dime
Make no mistake, the resources available to our healthcare system to ramp up Ebola readiness exist.

The CDC is front and center in education and lessons learned in Africa are shortening the learning curve here in America. That suggests that hospitals will be laser-focused in the coming days on ensuring that their workers are educated on identifying potential Ebola patients and the protocols necessary for isolating them. It also means that healthcare providers will likely be creating purchase orders at medical distributors to bulk up their inventory of protection and infection apparel. If so, the next survey by the nurses union should be far more encouraging.