THE SACRAMENTO BEE

California health officials seek to assure public amid Ebola scare

Cynthia Craft

California’s top health officials tried to assure an increasingly nervous public on Wednesday that they are ramping up readiness to fight the deadly Ebola virus, including seeking screening at all of the state’s international airports.

As Ebola panic took hold nationwide, state Department of Public Health officials said they have launched an unprecedented outreach campaign to ensure hospital systems, clinics, health care workers, nurses’ unions and the federal government have firm protocols in place to contain the virus.

That includes urging hospitals to develop clear preparedness instructions for health care workers and equip them with head-to-toe protective gear before they come into contact with patients who may be Ebola carriers.

“It’s very important that we are able to have systems in place to do early identification of people who are ill,” said Dr. James Watt, chief of the department’s communicable disease control unit. “The reality is that every hospital situation is unique and our strategy is to support hospitals in developing their own plans.”

At present, there are no known or suspected Ebola cases in California, the officials said. Two cases were red-flagged in recent weeks – one in Sacramento and another in Los Angeles – but neither tested positive for the often-fatal disease.

The local case was a patient at Kaiser Permanente South Sacramento, where earlier this week nurses had complained that their training left them feeling inadequately prepared to safely treat an Ebola patient.

Last week, U.S. Rep. Doris Matsui, D-Sacramento, convened a stakeholder meeting with area hospital chiefs to discuss the Sacramento region’s preparedness for battling Ebola, which she said has now escalated into “public crisis of international concern.”

On Wednesday, Matsui sent follow-up letters posing more questions to executives at Dignity Health; Kaiser Permanente South Sacramento; Sutter Medical Center, Sacramento; as well as officials at the Sacramento Public Health office and the Sacramento International Airport.

“I believe it is of utmost importance that we are prepared and communicate that preparedness to our communities. Hospitals are in a unique position to act as leaders on this issue and to help demonstrate readiness,” Matsui wrote.

So far, local hospital systems have been mute on the topic of their levels of preparedness. On Wednesday, UC Davis Health System spokeswoman Karen Finney said the university’s experts on infectious diseases were “way too busy” to communicate their thoughts or strategies to the community. Asked if they were occupied with plans to contain the Ebola virus, Finney said she did not know what they were working on.

In her letter, Matsui made it clear she believes hospitals have a responsibility to residents to be open and transparent about how they will react in case of an Ebola emergency. Among her follow-up queries, the congresswoman underscored her position: “Alleviating concerns of the public is very important to most effectively control and manage this outbreak. The public needs to understand what the risks are. Does your hospital have a plan to articulate infectious disease protocols and procedures to the public?”

In contrast to local hospitals, Centers for Disease Control and Prevention Director Dr. Tom Friedan was upfront in outlining a beefed-up plan to halt the spread of the virus by dispatching a robust, specially trained Ebola response team to hospitals where confirmed cases turn up.

Friedan admitted that the CDC’s initial effort did not go far enough. “I wish we had put a team like this on the ground the day the patient – the first patient – was diagnosed,” he said. “That might have prevented this infection.”

His comments did little to quell the sharp criticism that National Nurses United, a nurses’ union, aimed at health care employers. Following a massive call-in conference that drew participation from 11,000 nurses, including many from California, the labor organization called on President Barack Obama to order all U.S. hospitals to meet the highest standards and protocols to protect workers and the public.

The sinister virus, also called Ebola hemorrhagic fever for the spontaneous bleeding it causes in some victims, rose up in 1995, 2000 and 2003 in African nations. This latest pandemic has killed 4,500 residents in stricken West African countries – and, in the U.S., infected at least two Dallas nurses caring for a patient who later died of Ebola. A total of 76 people, mostly health care workers at Dallas hospital are at risk of taking ill, and another 48 others who’d come into contact with the man outside of the hospital are being monitored for symptoms.

California Nurses Association advocate Charles Idelson said all hospitals should be directed to follow the same, high-standard protocol. But CDC guidelines are just that, not necessarily rules that hospitals must adhere to.

Idelson said he doubted that hospital executives would agree to uniform, high-quality standards because all wrestle with different budgetary challenges. “These days, the hospital is no longer your friend,” Idelson said. “It’s a place you go when you’re sick, and you could very well leave in worse shape than when you entered.”

Meanwhile, state public health officials said it’s crucial that the federal government approve their request to install screening stations at all of California’s international airports, including Sacramento International Airport. So far, the CDC has designated just five U.S. airports – those that receive direct flights from West Africa – for special screening of incoming passengers. Airports fall under the authority of the federal government.

When passing through the screening stations, travelers will be asked where they came from and where they are headed. If passengers say they traveled through one of the African nations crippled by Ebola, Department of Homeland Security investigators will pull them aside to take their temperature. Anyone with a fever would likely be diverted to an isolation room.

Laurie Slothower, spokeswoman for Sacramento International Airport, said the airport receives no non-stop or direct flights from countries in West Africa.

She said the airport is operating according to directives from the Centers for Disease Control and the Sacramento County Public Health Department regarding the handling of any suspected Ebola cases. Sacramento’s airport, however, is not equipped with an isolation room like some of the larger California international airports, such as San Francisco.

If someone at the airport or aboard a plane is reported to be ill, airport rescue and fire personnel respond. If the person’s symptoms and itinerary indicate they may have been exposed to Ebola, rescue and fire personnel would put on the protective clothing and equipment necessary to shield themselves from the virus. Then, they would immediately notify county health officials.

“Airport rescue and fire deal with infectious diseases on a daily basis, so it’s not something new,” Slothhower said.

“The Ebola virus is not particularly hardy,” said Watt, the state’s head of communicable diseases. “It does not live that long on doorknobs, desks, phones. It is not viable for more than a few minutes on dry surfaces. In moist situations – in vomit or blood – the virus would last much longer.” It is through contact with the bodily fluids that people get infected, Watt said.