Sacred Heart prepares for future Ebola cases

Peg Currie was at a Dallas conference last fall when a nurse at Texas Health Presbyterian was diagnosed with Ebola. The nurse had been caring for a Liberian man who died from the disease.

For Currie, Providence Sacred Heart Medical Center’s chief of nursing, the news drove home the critical nature of the task facing her and her colleagues: Prepare Sacred Heart to treat Ebola patients, while keeping the staff safe.

Sacred Heart is one of three hospitals in the state that has volunteered to care for Ebola patients if the need arises. The two others are Harborview Medical Center and Seattle Children’s Hospital.

“We see it as part of our mission to serve the community,” said Currie, adding, “I never dreamed that this is something we’d be dealing with in the U.S.”

The work has included months of planning, staff training and a December visit by the U.S. Centers for Disease Control and Prevention.

Dr. Scott Lindquist, Washington’s epidemiologist for communicable disease, said the chance of the Spokane hospital ever getting an Ebola patient is unlikely but not impossible.

Since September, the state has monitored more than 200 people in Washington who recently traveled from Liberia, Guinea and Sierra Leone, the three West African countries where the most recent Ebola outbreak occurred. The monitoring, which lasts 21 days, has included nine Spokane County residents and one each in Whitman and Stevens counties. Some were military personnel.

No one on the state’s list has been a “high risk traveler,” which would be someone who came into contact with the body fluids of an infected person, Lindquist said. But whether a Washington hospital ever treats an Ebola case or not, he said, the preparedness is invaluable.

“It’s getting us ready for the next one,” Lindquist said. That could be SARS, a deadly influenza or another highly contagious disease.

Sacred Heart is prepared to treat both adults and children, Currie said. The hospital has set up an isolation area, acquired protective clothing and dealt with other logistics, such as tightening security for medical waste disposal. There’s also a protocol for a 21-day monitoring of staff members who have treated Ebola patients.

Sacred Heart based its protocols on work done by Emory University Hospital in Atlanta, which has treated four people infected with the Ebola virus, including one of the two Dallas nurses who got sick while caring for the patient at Texas Health Presbyterian.

“There were a lot of discussions with staff, and conversations with our ethics committee,” said Mary Jo Moore, nurse manager of Sacred Heart’s intensive care unit.

Many on her staff remembered the fear and discrimination HIV-positive people faced in the 1980s. Two dozen volunteered for the specialized training to care for an Ebola patient.

Even in the medical profession, there’s still a lot of confusion about Ebola, Lindquist said. On April 19, he received a call about a West African man who had arrived at Seattle-Tacoma International Airport with abdominal pain. The man’s sister took him to a hospital, where he was diagnosed with kidney disease.

The first hospital sent him to a second hospital for dialysis, but didn’t tell the second hospital that he was being monitored for Ebola symptoms because of his country of origin. When staff at the second hospital learned the man was West African, they were worried about Ebola and were preparing to send him to a third hospital for treatment.

Lindquist confirmed the patient didn’t have the 101.5-degree fever typical of an Ebola infection. The man stayed at the second hospital, where his condition improved with dialysis.

Spokane County had a false alarm last fall when a woman showed up at Sacred Heart’s emergency room with a fever and flulike symptoms and said she thought she had Ebola. She’d been at a conference in Seattle and had lunch with delegates from West Africa.

The emergency room doctor checked with the Spokane Regional Health District, whose epidemiologist deemed it a “no-risk” situation.

The Ebola virus is spread through direct contact with blood or other body fluids of a person who is sick with Ebola, or objects contaminated with body fluids, such as syringes or needles, according to the CDC. The virus is not spread by air, water or, generally, food.

Ebola patients are more contagious at certain times, said Lindquist, noting the girlfriend of the Liberian man who died in Texas had cared for him at home but didn’t get sick.

However, the bodies of people who have died from Ebola are highly infectious. The Spokane Regional Health District talked to local mortuaries to identify which could follow CDC protocols for handling the remains.

Transporting Ebola patients also has emerged as a concern, particularly in rural areas where ambulances are staffed by volunteer EMTs. American Medical Response, the nation’s largest private ambulance service, has stepped up to offer transport. AMR serves Spokane. In addition to staff here, the company could send a specialized team with advance notice, said Dr. Scott Bourn, AMR’s vice president of clinical practices.

The planning happening now could be vital in the future, said Moore, the intensive care nurse manager.

Emory University Hospital developed protocols for caring for Ebola patients 14 years ago, before successfully treating four patients last fall, she said.