“ ‘Ebola’ isn't coming to Emory. It's an Ebola *patient*, a human being.” Reading this FB status Friday evening made me feel grateful that at least one other person online was thinking more about the patients affected by the epidemic than the virus itself. Over the past week, I’ve become increasingly frustrated with the lack of empathy for the Liberians, Guineans, Sierra Leoneans and the two Americans who contracted Ebola virus and more so, with the lack of knowledge surrounding its mode of transmission. West Africa is roughly 4,644 miles away from New York so I wondered what all the fuss was about.
Rather than wrote this post on the FAQs of Ebola (Gawker does a way better job), I thought I’d focus on the FAQ of my FB minifeed:
“How likely am I, a NYC resident who spends roughly 1-2 hours a day on the MTA in close contact with people who may or may not practice hand hygiene and shower regularly, likely to get Ebola?” With anxiety rising after a male patient was admitted to Mt. Sinai yesterday morning with Ebola-like symptoms, let’s take a look at some facts.
According to my global health guru, the WHO, Ebola is spread through “direct physical contact with body fluids like blood, saliva, stool, urine, sweat, etc. of an infected person and soiled linen used by a patient.” Ebola is not airborne; it is a communicable disease whose mode of transmission is compared to HIV/AIDS. So, unless any of us have direct physical contact with an infected person, the chances of us getting Ebola are slim to none. While I find New Yorkers to be very helpful, concerned citizens, I’d venture to say that (aside from healthcare workers) most people take a step back when someone is bleeding out, urinating, defecating or profusely sweating. And that is probably for the best.
But let’s tie this back into nursing. How can we protect ourselves from a patient who is exhibiting classic symptoms of Ebola like fever, vomiting and lack of appetite? According to the CDC, my infectious disease go-to, all healthcare workers coming into contact with Ebola affected patients should at minimum, don gloves, gown, eye protection and facemask. Basic contact precautions can protect us from this very virulent virus.
I’m sure you’re wondering if contact precautions are all it takes to prevent the transmission of Ebola, how is it that 887 people have died from it and 1,603 have been infected to date? Without delving into a discussion on health-disparities in third world countries, suffice it to say that working and medical conditions in Liberia, Guinea and Sierra Leone are less than ideal. In countries where the population lives at 76%, 76.8% and 52.9% below the poverty line, respectively, healthcare workers need to do outreach work to persuade people to come to clinics and most of the time, masks or protective clothing is foregone. Mistakes are made and precautions aren’t always adhered to which, as we are seeing can prove fatal.
In hospitals like Mt. Sinai, NYU Langone Medical Center and NY Presbyterian, where not complying to strict hand-washing can lead to thousands of dollars of fines by JCO, it is safe to assume that there is almost no risk of an Ebola outbreak and if there was, it would be contained immediately. Although I find myself huffing at how frequently I have to Purell, this epidemic has made me appreciate how strict infection control is. It protects us as much as it does our patients.
It’s sad but certainly not surprising that a contagious disease has resurged in third-world countries where sanitation and hygiene practices are inconsistent and limited by other factors. While I am not concerned about an Ebola outbreak in my own city, I am concerned that communicable diseases are a chronic problem in countries struggling to piece together so much, let alone healthcare. For New Yorkers, an ocean away from the epicenter of the outbreak, to panic about contracting a disease transmitted by physical contact, dare I say suggests narcissism and a disregard for facts and information about the disease. I hope that the global health community continues to keep this in mind as this epidemic persists and others arise.
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