Ebola: The lessons learned in Dallas
The Lessons of Ebola
Dr. Jay Varkey, who treated the first Ebola patient to arrive in this country, says we're not yet ready to handle a major epidemic.
By Dr. Sanjay Gupta
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Ebola was a practice run. We may see more cases in this country, but we know now that our public health system can contain it. SARS was also a practice run. So was bird flu. None turned into the pandemic we feared. But health experts agree that one day we will be confronted with a dangerous infectious disease that we cannot contain. Are we ready for it?
Jay Varkey, MD, is a specialist in infectious diseases at Emory University Hospital, one of just four hospitals in the country with a specialized bio-containment unit. Dr. Varkey and his team had just 72 hours notice before they received the first Ebola patients in the United States.
In our interview we discuss the lessons learned in handling this highly dangerous disease, and whether we’re ready for the infectious disease that goes global, whatever that turns out to be. His answer: We’re not ready now, but the lesson of Ebola is that we need to get ready.
Sanjay Gupta, MD, Everyday Health:Did you ever imagine when you were a medical student or in your training that you would take care of a patient with Ebola?
Jay Varkey, MD, Emory University Hospital:No.
Dr. Gupta:What was it like when you got the call saying that you’re going to do just that?
Dr. Varkey:To be totally candid with you, there was certainly a feeling of thrill.
Dr. Gupta:Ebola had never been in the United States. There was no treatment for it and no cure.
Dr. Varkey:As you know, hospitals get asked to transfer sick patients all the time, but the stakes here clearly were much higher.
RELATED: 10 Essential Facts About Ebola
2 Patients = 3,000 Pounds of Medical Waste
Dr. Gupta:Were there surprises?
Dr. Varkey:One of the things that we learned quickly when dealing with caring for patients with Ebola virus disease is that you generate a lot of waste, medical waste. To get specific: two patients, 33 days in the hospital, we generated over 3,000 pounds of regulated medical waste.
Dr. Gupta:There were a couple of examples of things that may have been unexpected reactions from the community: pizza people refusing to deliver pizza anywhere in the hospital, a blood transport company refusing to pick up samples to just take them down the road to the CDC, people concerned about the sewer pipes from the hospital with potentially contaminated waste.
Dr. Varkey:Each one of those things did happen, but you know, we had contingency plans for it. I think it’s important to recognize that anytime somebody is dealing with a possibility of an infection that’s new to them, or any kind of threat that seems new, to be fearful. But I think the Atlanta community has been terrific in terms of coming around to this idea that this is the right thing to do, and that when the opportunity comes up to care for somebody who is sick, it’s a choice that you say yes to.
Dr. Gupta:For the most part when I am operating and taking care of patients, I’m not risking my own life to do so, but it’s a little bit of a different equation here. Was it all voluntary, in terms of the staff that took care of these patients?
Dr. Varkey:It’s a great question, and this is something that I feel very strongly about. So, every single member that was involved in our Communicable Disease Unit and had any role in dealing with our patients with Ebola was completely voluntary.
Dr. Gupta:It is very easy in a hypothetical situation to say I’m on board, I’m on the team, but when it becomes reality, things change a little bit. You think about your own family, your own health, things like that. Did anybody who was supposed to be on the team basically say, "I’ll sit this one out"?
Dr. Varkey:Not everyone that was a candidate to be on the team had to be involved up front. So the short answer to your question is yes, there were those that for personal reasons, for work reasons, couldn’t be involved.
Doctors “Pick up a Mop”
Dr. Gupta:Those are the healthcare providers. What about the other people, people who were delivering the food, cleaning the sheets, as you and I know, making a hospital work and run? What was their obligation?
Dr. Varkey:This is I think a real key point. There was a small group of providers, mostly nurses, a core group of physicians, that were dealing with the patient. Those that would deal with bed pans or cleaning the room, that was all done by the nurses and physicians in that room. It’s a good example and another place where you probably have to ignore the initials after your nametag and if you have a spill, if you have an area of the room that needs to be cleaned, you don’t worry about that. You pick up a mop.
The Big Outbreak
Dr. Gupta:Ebola is going to be contained. This isn’t going to be a big outbreak, as scary as it may seem. But there will be a big outbreak of something at some point. What would you predict? What’s it going to look like? What would it feel like?
Dr. Varkey:I think we’ll know when we see it, but the short answer is that I think we need to be ready. So whether that be a particularly severe flu season, whether that’s spread of a disease caused by an animal, whether it’s spread of a disease that’s being propagated by changes in climate — recognizing those public health threats and being ready for it I think is a key lesson that we need to be ready when Ebola is contained.
Dr. Gupta:Are we ready for it right now?
Dr. Varkey:Just doing the math, I think it’s clear that four bio-containment units is not enough. But I think we have an opportunity, and actually one of the key lessons of dealing with Ebola is to actually be ready for the next emerging disease whenever that might occur.
Video: Global Health – The Lessons of Ebola | USMx on edX | Course About Video
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