The hospital petri dish: It’s never been just about Ebola

Ebola has gripped the headlines and increased Americans’ stress levels to the point where little else is being discussed. To be clear, at least 4,500 people in West Africa have died from the disease. And, the texas presbyterianCenters for Disease Control & Prevention (CDC) is being blamed at virtually every stage of this event by those who claim it should have had procedures in place to prevent spread of infection. Add to this that most healthcare professionals say the chance of Ebola spreading around this country is little to none, and you can understand the public confusion.

On Friday, President Obama appointed Ron Klain as the Ebola Czar, but, as always, there’s a growing number of elected officials in search of whom to blame. In a recent cable news interview, two U.S. House Representatives offered their takes on the governmental response to Ebola:

“Either the CDC directives haven’t been clear enough or the hospital wasn’t interpreting them correctly,” said Rep. Diana DeGette (D-CO). “Ebola is not like flu. But we need to have clearer guidelines for people who have come into close contact with people infected.”

US-CDC-LogoTennessee Republican Representative Marsha Blackburn appeared at odds with her party’s platform, suggesting the government take more control.

“There is great confusion coming from the CDC and lack of coordination in waste disposal,” she said. “The CDC needs to be more aggressive in this regard and tell hospitals what to do.”

But, this looks impossible. A recent TIME article noted the lack of mandate from the CDC in forcing hospitals to adopt procedures. It may take a constitutional amendment. Apparently, the CDC can only take control from local authorities in two circumstances: those authorities extend an invitation or there’s a total breakdown of law and order as outlined under the Insurrection Act.

So, to blame the CDC is perhaps like blaming the toilet when your 4-year old son misses his target. The Ebola situation is less about this disease and more about systemic issues endemic within the hospital network.

During the tragic death of Eric Duncan at the Texas Health Presbyterian Dallas Hospital, CDC officials acknowledged there was little-to-nothing in place to deal with the patient.

“[The administrator] said the hospital originally had no full-body biohazard suits equipped with respirators but now has about a dozen. Protocols evolved at the hospital while Duncan was being treated,” CDC epidemiologist Pierre Rollin told the Washington Post.

Even the nurses who fight the spread of Ebola at their hospital’s ground zero are caught up in this blame game. At one point, the CDC blamed (and has since apologized to) one nurse at Texas Health Presbyterian texas nursesDallas Hospital. The Texas Nurses’ Association fought back, blaming the hospital for not providing adequate protective gear or training.

About 1 in 25 patients get an infection while being treated at a U.S. hospital, amounting to roughly 700,000 hospital-acquired infections annually, according to the CDC. Although most don’t rise to the level of Ebola, that’s a figure that should not only raise eyebrows, but should also be unacceptable.

But American healthcare isn’t without examples for infection disease control protocols. The School of Public Health and Tropical Medicine at Tulane University in New Orleans partnered with the World Health Organization’s Global Outbreak Alert and Response Network (GOARN). So, too, is the North Carolina Hospital Association which is working to distribute additional guidelines to its member hospitals.

Meanwhile, Ebola Czar has his work cut out for him. He has a fine pedigree in management and business organization, but he’s not a physician. He has no training in infectious diseases. His appointment may very well be emblematic of the systemic failures of the U.S. healthcare system – or at least the beginning of another failure.

Ultimately, this situation may not just be about Ebola. Research reveals little, if any, information on standardized protocols for in-hospital protection against infectious diseases. While there are plenty of hospitals that do have system-wide directives, there may be an equal or greater number that don’t.

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