Two Americans infected with Ebola were treated at the Emory Hospital, Atlanta, Georgia. Dr Kent Brantly and Nancy Writebol arrived in an air ambulance from Liberia where they served as health care workers. Dr Kent arrived on August 2 and Nancy was admitted on August 5.
While this was happening, I was at the adjacent Emory University’s School of Public Health on a fellowship on Leadership in Public Health supported by the NIH and the Public Health Foundation of India. I was fortunate to witness the sheer professionalism and preparedness of the hospital staff in dealing with the patient infected with the virus.
Right from the start, the hospital was prepared to deal with this emergency. The isolation unit has unique equipment and infrastructure that provides high level of isolation. The unit is situated separate from the regular ICU and is regularly inspected by the Center for Disease Control, which is situated in the adjacent building and the World Health Organization. It is the one of only four such units in the United States.
The specialized team of doctors and nurses at the Emory Hospital are specially trained in infection control and they follow strict protocols. Strict confidentiality was maintained with regards to the patient and the public fears were addressed on a regular basis to quell all speculations of a major outbreak that was reported in the press.
The isolation room is a negative pressure unit, which means that air in this unit goes from the hallway, to the preparation room and to the patient room. The air is then HEPA filtered. According to the hospital officials, the air filtration in this case was above and beyond what we need to care for patients with Ebola.
The unit is designed as an intensive care unit, so the patient would never have to be moved to another part of the hospital if a higher level of care is needed. It is also designed so all necessary lab testing can be done within the unit. All materials coming out of the unit was autoclaved to kill all infectious viruses and then sent for incineration. The Emory hospital had prior information that they will be receiving the patient which gave them time to prepare for the event.
The frequent pictures of medical workers dressed like astronauts dealing with patients did create panic among residents and hospital staff. The personnel were using the powered air purifying respirators (PAPs) because they were dealing with the patient for 3-4 hours at a stretch and these respirators would only make them more comfortable. Good facemasks and goggles would suffice as Ebola is not air borne, but they were only doing it for their comfort.
I was also fortunate to have been involved in the team dealing with the first SARS case reported in India in 2003, which incidentally happened at the Goa Medical College. We do have a long way to go to meet the same standards of emergency preparedness in our country, but it is never to late to make a start.
The hospital rejoiced when Dr Brantly recovered from Ebola virus infection and could return to his family and to his community without public health concerns, thanks to the USA’s preparedness that made the difference.
