Local medical facilities amp up Ebola preparedness training

Palo Alto Medical Foundation increases staff training, upgrades infection-control supplies and equipment

Stanford Medical Center and Palo Alto Medical Foundation are among medical facilities nationwide increasing Ebola preparedness as federal health officials urge the nation's hospitals to "think Ebola."

The amped-up efforts to train health care workers on how to treat patients infected with Ebola comes days after Nina Pham, a 26-year-old nurse at Texas Presbyterian Hospital in Dallas, became the first person to contract the disease in the U.S., according to the Centers for Disease Control and Prevention. Pham provided care for Thomas Eric Duncan, who was the first person to die from Ebola in the nation after traveling to the U.S. from West Africa. A second nurse who treated Duncan has been diagnosed with the deadly disease on Wednesday.

There have been no documented cases of Ebola in Palo Alto or in other U.S. cities outside the Dallas area, according to the CDC.

Stanford Medicine, which includes Stanford Health Care, Lucile Packard Children's Hospital Stanford and Stanford Children's Health, "continually prepares to manage cases of infectious disease, including Ebola Virus Disease," said spokesman James Larkin in an email.

"Stanford Medicine follows protocols established by the Centers for Disease Control and Prevention, and conducts regular training and preparedness drills to assure our readiness to respond," Larkin said.

CDC guidelines for safe and appropriate Ebola screening and patient care include placing an infected patient in a single-patient room with a private bathroom with the door closed; ensuring people who come into contact with the patient wear gloves, fluid resistant or impermeable gowns, goggles and face masks; dedicating medical equipment for patient care; and cleaning and disinfecting non-dedicated, non-disposable equipment used for patient care, according to its website.

Larkin added that the hospital has several isolation rooms designed to contain biohazards like Ebola.

Palo Alto Medical Foundation has increased staff training to identify potential infection cases and teach health care workers how to properly use protective equipment, said Dr. Charles Weiss, head of the infectious diseases committee at PAMF, which has a location in Palo Alto.

Weiss said when a patient comes in seeking treatment for a sudden illness, staff members should ask two "golden questions": "Do you have chills and fever?" and "Have you traveled to West Africa in the past 21 days?"

"Half of the battle is identifying possible cases of Ebola," he said.

PAMF has also started performing drills in which employees pose as patients to test whether the new protocols are effective.

The health care organization has also upgraded infection-control supplies and protective equipment to "reflect the highly infectious nature of the deadly disease," Weiss said.

Weiss emphasized that although Ebola is a serious health concern and people should be vigilant, "it is low risk for the average American."

The California Department of Public Health continues to work with the federal government and medical facilities statewide on staff preparedness and encourages health care workers to follow CDC guidelines on Ebola screening and patient care, said CDPH Director Dr. Ron Chapman during a teleconference with media on the current status of Ebola preparedness in the state.

Chapman added that the Hospital Preparedness Program, a federal program that provides leadership and funding to improve community and hospital preparedness for public health emergencies, has provided funds to the state to prepare local hospitals including providing staff training and Personal Protective Equipment to health care workers who are the most at risk of exposure.

Important components of being prepared are early identification, testing of suspect cases and treating infected patients, said Dr. James Watt, chief of the Division of Communicable Disease Control of the California Department of Public Health.

Symptoms of Ebola

Symptoms may appear anywhere from two to 21 days after exposure to Ebola, but the average is eight to 10 days.

• Fever (greater than 38.6 degrees Celsius or 101.5 degrees Fahrenheit)

• Severe headache

• Muscle pain

• Weakness

• Diarrhea

• Vomiting

• Abdominal (stomach) pain

• Unexplained hemorrhage (bleeding or bruising)

How Ebola is transmitted

Direct contact with bodily fluids or through broken skin or mucous membranes in, for example, the eyes, nose or mouth, or by handling soiled clothing or unsterilized medical equipment, including needles and syringes, used by an infected person. It's not possible to catch it through social contact or by simply being in the same room or space. It is not spread through the air or by water, or in general, by food.

Source: Centers for Disease Control and Prevention website

Related article: Zuckerberg, Chan join fight against Ebola

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8 people like this
Posted by Wondering?
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 1:37 pm

So .. will Stanford be offering to accept Ebola patients from other parts of the US, or even Africa, for treatment here in Palo Alto?

9 people like this
Posted by Local
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 2:01 pm

Well, just to get a sense of local preparedness, I just went to the website of PAMF and the website of Stanford Health. There is nothing on their home page about Ebola and their preparedness for it.

I then did a search of their websites for the term "Ebola". The PAMF website returned absolutely NOTHING for it, even though there is a possibility an infected person could just show up there. As to Stanford, the search yielded a scientific paper, and some older Ebola news dating back to August 2014. That's all.

What is going on here?

2 people like this
Posted by Local
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 2:06 pm

Also, IMO, the last thing that should happen, would be for an infected person to just go to an urgent care or emergency room waiting room, and be in contact with other patients for any length of time.

Teams should be organized to go visit potential Ebola patients where they are at (home for example) and bring them to hospital so that there is no contact whatsoever with other patients. We should not let such patients just show up in ERs!

When is the US going to wake up to how bad this is?

3 people like this
Posted by Nora Charles
a resident of Stanford
on Oct 15, 2014 at 2:34 pm

Nora Charles is a registered user.

It's the travel we should be worried about, and that should be the first step in the fight against Ebola. Will there be screening at SFO or San Jose airports for travelers coming in from areas with the disease? I sure hope so.

3 people like this
Posted by Joe
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 3:38 pm

> Will there be screening at SFO or San Jose airports for travelers
> coming in from areas with the disease?

An interview with a healthcare professional that was web-cast on Yahoo this morning revealed that screening at airports would be unproductive, and a waste of resources for identifying carriers. He was certain that such screening would produce a lot of false positives, and few actual cases of Ebola.

It seems that Ebola has a 21-day incubation period, with the 8th day being when the symptoms show up. If the US were to shut the borders to anyone who has been in West Africa during the past 21 days, then perhaps screening would pay off. But given that there is no way to determine who has come in contact with a traveler from West Africa who is infected, then the screening again becomes problematical.

At the moment, we are going to have to put a lot of trust in the CDC, which has not exactly shown itself to be batting a thousand on this one. Really do have to ask: "Who is Tom Frieden, and is he qualified to hold the health and well being of the US in his hands?"

3 people like this
Posted by Joe
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 4:13 pm

Oh .. just a final point on airport screenings. There are, and will be, rapid Ebola diagnostics that offer screeners a fairly quick way to determine if someone is likely to be Ebola-positive--

Japanese Ebola Diagnostic—30 minutes:
Web Link
Web Link

US Ebola Diagnostic—10 minutes:
Web Link

We haven’t heard anyone in the government actually talking about using this new technology, but someone, somewhere, will.

Like this comment
Posted by Resident
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 5:24 pm

Pleased to hear that local hospitals are gearing up. Hopefully none of this will be needed, but we shall just have to wait and see.

1 person likes this
Posted by Hmmm
a resident of East Palo Alto
on Oct 15, 2014 at 5:46 pm

Local, I think it's clear to medical professionals and officials in our community what the realities are of the Ebola threat. They also balance that knowledge with awareness of other more deadly diseases. What I really hope is that our local medical community doesn't screw up as obviously as the Texas nurses, doctors and officials have. Knowing the realities isn't the same as being prepared with strict protocols that do NOT get violated. Seeing local nurses taking a stand for thorough training hopefully hasn't been a waste of their time.

Why was that second Texas nurse on a flight with a low fever? Why had she felt that it was okay to fly out of town in the first place? I wish these people well, but what the heck are they thinking? The hospital there has screwed up time and again. Letting Campbell leave when he was first ill? Dialysis and intubation for Campbell? First nurse getting sick, most likely due to a protocol breach. Second nurse showing signs, most likely due to a protocol breach, also - and having flown during the Ebola incubation time! Is this a confederacy of dunces running that place and allowing their medical staff to endanger themselves and so many others?

3 people like this
Posted by Joe
a resident of Another Palo Alto neighborhood
on Oct 15, 2014 at 6:08 pm

Why Nurse Vinson was flying is an open question. But she did contact the CDC about her concerns of having a low-grade fever. The CDC gave her permission to fly--

Web Link

CBS News Medical Correspondent Dr. John LaPook reports that Vinson called the CDC several times before boarding the plane concerned about her fever.

“This nurse, Nurse Vinson, did in fact call the CDC several times before taking that flight and said she has a temperature, a fever of 99.5, and the person at the CDC looked at a chart and because her temperature wasn’t 100.4 or higher she didn’t officially fall into the category of high risk.”

1 person likes this
Posted by Bill
a resident of Midtown
on Oct 15, 2014 at 9:01 pm

In addition to asking if someone has been to West Africa, they should also ask if they have been in contact with someone who has been there.

3 people like this
Posted by Don
a resident of South of Midtown
on Oct 15, 2014 at 9:03 pm

I can't believe that the CDC cleared the second nurse to fly, with ANY fever. Doesn't exactly give me any confidence in them, and they are supposed to tell everyone what to do. Thanks a lot...

Like this comment
Posted by local resident
a resident of Charleston Meadows
on Oct 16, 2014 at 9:57 am

Reading other news online, People are questioning why there is no commercial travel ban of west Africa nations and only allow medical staff, supplies, and necessary personal to in/out. The CDC guy said that commercial travel ban will hurt Africa economy :-( . This is such a stupid answer from CDC to US people. Now, it is going to hurt US economy. CDC is so incompetent and they are responsible for this mess in US.

2 people like this
Posted by Resident
a resident of Another Palo Alto neighborhood
on Oct 16, 2014 at 10:39 am

Unfortunately, there must be a quarantine around the affected areas. Unfortunately it will mess up their economy. Unfortunately, they have to keep this disease contained whatever the cost. Already their economy is affected. Already their is international aid being poured in. I expect many countries will help out financially with whatever burdens these countries experience, as it will be cheaper in the long run than trying to fight it at home.

When will the international community put pressure on these countries to close their borders to non essential medical/relief personnel and equipment to quarantine themselves until such time as cures and vaccines can be found and the situation can be controlled?

2 people like this
Posted by Sea Seelam Reddy
a resident of College Terrace
on Oct 16, 2014 at 11:01 am

Stanford and Palo Alto Medical Foundation

It is the right thing to do.

We need to rise and help on Ebola.

We need to protect humans regardless of where they are from.

We commend you for your courage to start training.


1 person likes this
Posted by Local
a resident of Another Palo Alto neighborhood
on Oct 16, 2014 at 1:13 pm

A travel ban would logically now mean that US citizens should be banned from entering into other countries by those countries since the US itself now is an affected area.

1 person likes this
Posted by Joe
a resident of Another Palo Alto neighborhood
on Oct 16, 2014 at 2:19 pm

> A travel ban would logically now mean that US citizens
> should be banned from entering into other countries by those
> countries since the US itself now is an affected area.

This seems a bit convoluted in its logic.

However, the CDC head has made a claim that a travel ban would keep US medical people from entering those countries where travel is banned. This makes no sense, since obviously the US can construct the ban anyway it wants. Clearly having US medical personnel entering these countries makes sense, as well as quarantining these personnel when they return (or at least monitoring them closely).

How anyone in a position of power, like this Dr. Frieden, can be so inflexible in his thinking makes it difficult to believe much of what he has to say.

BTW—the (AP) is carrying an article just now where several African countries are saying: “closing our borders saved us”--
Web Link

Presumably Dr. Frieden was not consulted about how to constrain this disease in those countries.

10 people like this
Posted by The Last Word
a resident of Stanford
on Oct 16, 2014 at 8:10 pm

[Post removed.]

2 people like this
Posted by A Noun Ea Mus
a resident of Professorville
on Oct 17, 2014 at 8:52 pm

There once was a man from Liberia
Who caused quite a bit of hysteria
What was in his brain
As he got on that plane
And passed the pre flight criteria

He showed up in an ER in Dallas
Got checked from his head to his phallus
Now he might turn us all necrotic
Was told he had a cold
Discharge not put on hold
And sent home with an antibiotic

That first ER nurse was told he was from Liberia
It that down the way from Siberia?
Must be just another slum area
Not like the Hamptons or Bavaria
He came back in his whole body a drainage area

What we really have to worry about is IF we don't stomp on this in West Africa it could spread to Bangladesh, Haiti, etc. Then those foci will mean the disease is really entrenched. If a virus can fester in a debilitated population it can get "it's act" together...ala trenches of WW1 and the Spanish Flu.

But what's happened is that the Tea Party/GOP has wrecked the machinery of government, un-funded organizations, etc., such that this disease got out of control in Africa. Now it's another political godsend as they can make hay over it and make absurd and buffoonish calls to close air-traffic, etc. Either way they gain, using fear again. Gee maybe an ISIS fighter will infect himself with Ebola, pretend to be a Mexican and cross our border, then jump into a wood chipper amidst Times Square when it's crowded? Ohhhhhh just in time for Halloween.

Actually a huge massive REAL pandemic would force society to get it's act together as regards healthcare.

Our big problems (climate change and this international disease) can not be fixed in the capitalist structure we know have. It will take socialistic solutions and mindsets. It will be fascinating to see how it all plays out.

Sorry, but further commenting on this topic has been closed.

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