Ebola has now killed more than 4,500 people this year with the majority of deaths in Liberia, Sierra Leone and Guinea. There has been some good news – Nigeria, which had 20 known cases, was recently declared free of Ebola, a result largely attributed to the quick isolation action of the nurse who treated the first case but who then contracted and died of the disease herself.
Indeed, all the nurses and careworkers have been at great risk of contracting Ebola. According to figures from the Office for the Coordination of Humanitarian Affairs (OCHA), 1 in 50 Liberian health workers have been infected with Ebola.
In the West, despite having some of the best equipped hospitals in the world, two nurses treating Thomas Eric Duncan, the first patient found in the US with the disease, were also infected. Accusations followed of the nurses not having adhered to the correct gowning protocol during treatment, which included dialysis and intubation. These have since been countered by the nation’s largest nurses’ union, the National Nurses United, alleging that hospitals were not providing healthcare workers with adequate protective gear.
Unthinkable as it may be, especially in such a litigious country, some in the healthcare system are having to weigh up the risks of carrying out medical interventions, such as dialysis for patients with Ebola, because of the risks to healthcare workers.
Meanwhile, the US Centers for Disease Control and Prevention has updated guidance on what PPE is required and how it should be used. The guidance reflects lessons learned from the recent experiences and emphasises the importance of training, practice, competence, and observation of healthcare workers in correct donning and doffing of PPE selected by the facility – something cleanroom operators will be familiar with.
The cost of a full protective suit, according to OCHA, is US$61.48; the cost of proper training and observation by gowning experts would add more. Add to that practice runs and Contamination Event Recovery Plans (CERPs) and the expenses mount.
But all these costs are likely to be dwarfed by the cost of any prospective lawsuits.