How NYC Is Protecting Healthcare Workers Treating Ebola

As New York deals with the first Ebola case in the city, the people most at risk are the ones caring for the patient.

The virus's spread cannot be stopped without doctors and nurses, but since they have to deal with infected body fluids when the patient is at his sickest, those healthcare workers are the most at risk. A small slip-up in removing contaminated protective gear, for example, can expose a healthcare worker to the virus.

The discovery that Dr. Craig Spencer, who was treating Ebola victims while working for Doctors Without Borders in Guinea, developed symptoms of the disease while in New York has frightened some in the city.

But New York City should be more prepared to stop Ebola than other places that have dealt with the disease have been.

From the start, the case has been handled according to protocol, despite concerns about what he did before he noticed a fever.

Spencer quarantined himself after realizing he had symptoms, when his fever was still just 100.3. At a press conference yesterday, New York Health Department Commissioner Howard Zucker explained that the emergency medical services personnel that brought Spencer to the hospital were wearing protective gear.

Since health officials have expected that a case could show up in the city for some time now - and they've seen where systems in Madrid and Dallas have fallen short - they've had time to prepare.

Workers in West Africa continue to get infected as they deal with an overwhelming number of sick patients, but a nursing assistant in Spain and two Dallas nurses also contracted the disease while using inadequate protection that they weren't properly trained on how to use.

The virus's spread in West Africa is frequently blamed on its appearance in a place that hadn't seen it before and where people weren't trained and ready to deal with something they'd never seen - something that was also true for the US when the first Ebola case appeared in Dallas. But Guinea, Sierra Leone, and Liberia have fragile, almost nonexistent healthcare infrastructures; New York City has a strong and extensive public health system that has been preparing for this very scenario.

"We are as ready as one could be for this circumstance," said NY Gov. Andrew Cuomo at yesterday's press conference. "What happened in Dallas was the exact opposite."

Why New York Is Different

New York City has been putting plans into place since August to make sure the city is prepared, and has been training people who might have to deal with Ebola cases.

On Oct. 21, more than 5,000 healthcare workers attended a New York City training session in the city on how to deal with Ebola patients. Experts from the Centers for Disease Control and Prevention and city health officials demonstrated, among other things, the proper way to use protective equipment.

That training comes right after updated guidelines from the CDC on how all Ebola cases in the country will be treated. From this point on, the CDC is sending representatives to every hospital that has an Ebola patient. Additionally, a supervisor will watch workers put on and remove protective equipment so that any potential lapse can be spotted and dealt with immediately.

These protocols were not in place when the Dallas nurses got infected while treating Thomas Duncan.

And these aren't the first precautions New York has established for Ebola either.

The city has designated Bellevue as the hospital where Ebola patients will be treated, and special isolation rooms had already been set aside there when Spencer arrived for testing and treatment.

"He's been looked after by experienced healthcare workers who had been preparing and drilling for this for a month," said Mary Bassett, Commissioner of the NYC Department of Health, at Thursday's press conference. Tellingly, no healthcare workers at Bellevue opted out of treating him.

Other hospitals and clinics are being prepared too. The city's Department of Health has sent "patients" pretending to have Ebola symptoms and with a plausible travel history into all 11 city hospitals to evaluate their performance.

Any healthcare workers who see a certain set of symptoms is supposed to immediately call the Department of Health. The city wants to know if a hospital sees anyone who has been to a country experiencing an Ebola outbreak who has a fever over 101.5 degrees F and other symptoms including a severe headache, abdominal pain, bleeding, or diarrhea.

These procedures were communicated to New York City hospitals by the CDC and put into place on Aug. 11.

In Spencer's case, his fiance and two friends he was in close contact with are being quarantined, in case they show symptoms.

While any Ebola case is scary, people who realize they are sick and quickly seek medical treatment are much more likely to survive. Both nurses who were infected in Dallas are now in the clear.