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Thursday, October 16, 2014

Paging Dr. Obama

Paging Dr. Obama

EDITORIALS
JACQUELYN MARTIN/AP
All hands on deck.

The American health-care system’s failure to prepare for Ebola became even more terrifyingly evident with the revelation that a Dallas nurse traveled by air after treating a patient who ultimately died from the virus.

Amber Joy Vinson began running a fever the day after her flight, putting her on the edge of communicability when she crowded among fellow passengers. Tests later confirmed that she carried the lethal microbe.

Still struggling to get command of the country’s response to Ebola more than six months after the current outbreak started in West Africa, Centers for Disease Control Director Thomas Frieden was left to spell out a principle that should have been set weeks or months ago — and backed up with stringent enforcement.

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“She should not have traveled, should not have been allowed to travel by virtue she was in an exposed group,” he said obviously.

Later on Wednesday, after cancelling a congressional campaign trip to Connecticut, President Obama said that the U.S. would become more aggressive in coordinating the national response to Ebola, including sending a CDC team to any hospital with a confirmed Ebola case.

But, by stopping short of issuing mandatory protocols, the President again fell back on the catch-as-catch-can system that produced such disastrous results in Dallas. He did so at the peril of health-care providers and the public — because trust that individual hospitals here, there and everywhere would perform superbly is decidedly misplaced.

Frieden acknowledged that he erred badly in assuming that virtually any hospital could stop the spread of Ebola by following proper protocols. Cluelessness about those protocols appears to remain widespread.

Neither Obama nor Frieden had the sense to issue directives with the firm, clear quality of standards sought by National Nurses United, representing thousands of nurses across the country.

The group called on Obama to order hospitals to follow procedures used at the University of Nebraska Medical Center, a leading infectious disease facility, as well as to set requirements for protective equipment, staffing levels and training.

Vinson was the second nurse to contract Ebola at Texas Health Presbyterian Hospital, an institution afflicted with incompetence of such criminal magnitude that a manslaughter charge might be warranted should a nurse die.

The outrages there were so extreme — having nurses protect their necks with tape, failing to isolate an Ebola patient, sending crucial medical tests through routine delivery systems — that it would be easy to see the hospital’s failings as atypical.

But no such conclusion is warranted at this time.

A webinar offered to health-care professionals by experts at Nebraska and Emory Healthcare, another center of excellence, documented the huge complexities of confronting Ebola.

Every hospital department, from the emergency room to anesthesiology to environmental management, must be trained. Lab tests must be conducted with sophisticated protective equipment and should be done in a special location, because a spill would require closing a hospital’s entire lab for decontamination.

As for protective garb, it’s best used by "dedicated staff with years of training."

In interviews Wednesday, city Health Commissioner Dr. Mary Bassett, Health and Hospitals Corp. President Dr. Ramanathan Raju and Office of Emergency Management Commissioner Joe Esposito all said they believe city hospitals are properly geared up.

Lisa Baum, occupational health and safety representative of the New York State Nurses Association, agreed in regard to Bellevue Hospital, designated as HHC’s Ebola response institution. After meeting with Bellevue officials, Baum said the hospital had taken aggressive steps, including consulting with national experts, providing greater protective gear than required and conducting extensive training.

Pray that Baum is right, because Obama and Frieden have left New York and the rest of the country far too much on their own.


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