Federal health officials on Monday issued new guidelines to promote head-to-toe protection for health workers treating Ebola patients.
Officials have been scrambling to come up with new advice since two Dallas nurses became infected while caring for the first person diagnosed with the virus in the United States.
The new guidelines from the Centers for Disease Control and Prevention call for full-body garb and hoods that protect worker's necks; setting rigorous rules for removal of equipment and disinfection of hands; and calling for a "site manager" to supervise the putting on and taking off of equipment.
They also call for health workers who may be involved in an Ebola patient's care to repeatedly practice and demonstrate proficiency in donning and doffing gear - before ever being allowed near a patient.
And they ask hospitals to establish designated areas for putting on and taking off equipment, whether it's a room adjacent to an Ebola patient's room or a hallway area cordoned off with a plastic sheet.
Workers at Texas Health Presbyterian Hospital in Dallas were trying to follow earlier CDC guidance. Organizations representing nurses and other health workers have pressed the CDC, saying the old advice was confusing and inadequate, and health workers felt afraid and unprepared.
It's not clear exactly how the two nurses at Texas Health Presbyterian Hospital became infected, but clearly there was some kind of problem, said Dr. Tom Frieden, CDC director.
"The bottom line is the guidelines didn't work for that hospital," Frieden said, in announcing the revised guidelines Monday evening.
4:12 p.m. Texas Health Presbyterian nurses: 'We will reaffirm your trust in us'
Nurses from Texas Health Presbyterian Hospital in Dallas held a press conference earlier this afternoon. There's been concern over how nurses are trained to deal with the Ebola virus after two Texas Health Presbyterian nurses who cared for Thomas Eric Duncan became infected last week.
Cole Edmonson, chief nursing officer with Texas Health Presbyterian, said the hospital will work to reaffirm the community’s trust after the events surrounding Thomas Eric Duncan’s diagnosis and care.
“Texas Health Presbyterian Hospital of Dallas is still a great hospital,” said Edmonson. “We’re asking our community to stand with us today. We will reaffirm your trust in Presbyterian.”
He also added the #PresbyProud hashtag on social media was not started by the hospital’s communication team, but one of the nurses.
Emergency department nurse Julie Boling said that the team did not want to be judged by what happened over the past few weeks.
“This could’ve happened to any hospital, we were just the first in our county that it happened to,” Boling said. “Some things went wrong but we’re proud to say that Presbyterian has owned those things.”
The group did not take questions from the media.
Meanwhile, the hospital has announced its emergency department is coming off diversion for ambulance traffic. The emergency department had remained open for patients not arriving by ambulance.
Update, 1:30 p.m.: Schoolkids who came into contact with Duncan return to school
Four of the five Dallas schoolchildren who were being monitored for Ebola symptoms are back in school. Those children were removed from school after coming into contact with Ebola victim Thomas Eric Duncan.
Dallas school officials had planned for the students to return to school tomorrow, but they came to school today, one day earlier than planned.
“Because they have been cleared by medical authorities and pose no health risk to any students or staff, we have no intent on sending them home. Their interest in getting back into school is encouraging,” Dallas Superintendent Mike Miles said.
School counselors and staff have been warned to watch out for any bullying.
Three students who attended Wallace Elementary in the Richardson school district will now be attending Jill Stone Elementary in Vickery Meadow. Those students also came into contact with Duncan and were being monitored. Tim Clark with Richardson ISD says the students can re-enroll in the school district if their parents wish to.
Richardson released this brief statement:
The three Wallace Elementary students removed from school on October 2 to be monitored for Ebola symptoms were withdrawn from school on October 17. We’re very happy that the students remained healthy and asymptomatic throughout the monitoring period and do not have the Ebola virus.
The reason for the withdrawal was not related to the health of the students and we will respect the family’s privacy regarding additional information.
Richardson ISD and Wallace Elementary wish the students the very best.
Update, 11:19 a.m.: Emory launches 'Ebola Prep' website for healthcare providers
Emory University Hospital in Atlanta has launched a website for full of best practices and protocols for treating patients with the Ebola virus.
The website provides guidance for health care providers on proper screening for patients and the appropriate use of personal protective equipment.
“Health care providers throughout the United States are very concerned about the potential spread of Ebola virus and the possible arrival of patients with Ebola virus disease at their emergency departments, hospitals and clinics,” John Fox, President and CEO of Emory Healthcare, said.
“We fully acknowledge the risk factors that make this area of health care very challenging for any organization. However, we firmly believe that all of American health care needs some level of preparedness for Ebola and other types of communicable diseases that can always impact us at any point. Emory Healthcare is committed to sharing our processes and experience on how to provide safe, effective care for patients with Ebola virus disease."
Here's a tour of one of Emory's isolation units:
Emory University Hospital is one of four hospitals fully-equipped with ‘patient biocontainment units’ to care for Ebola patients. Amber Vinson, the second Dallas nurse infected with the virus, is currently being treated there. The hospital has successfully treated past Ebola patients such as Dr. Kent Brantly and Nancy Writebol.
Update, 7:44 a.m.: 43 out of 48 people are cleared from the 21-day watch period
The 21-day monitoring period expired at midnight for the first group of people who were in contact with Thomas Eric Duncan, the man who died in Dallas after contracting Ebola in Liberia.
The Texas Department of State Health Services said in a press release at 7 a.m. Monday: "A group of 43 people in Texas who had contact with the state's first Ebola patient have been cleared from twice-daily monitoring after reaching the 21-day mark, the longest incubation period for the disease."
They have no Ebola symptoms and are not at risk of developing Ebola, the health department says.
"They are able to continue normal daily activities without being monitored for symptoms," the statement says. "The group is a mix of health care workers, household contacts and community members whose last possible contact with the state's first patent was Sept. 28."
Officials said Monday that 43 of 48 people on an original watch list had passed the 21-day incubation period.
Texas health officials say 120 people are still being monitored for possible infection with Ebola because they may have had contact with one of the three people who got the disease in Dallas.
But others who cared for Thomas Eric Duncan, who died Oct. 8 at Texas Health Presbyterian Hospital, remain at risk, along with two nurses he infected there. Nov. 7 is when the wait period will end for all of those being monitored.
Dallas County Judge Clay Jenkins addressed the media at a 7:30 a.m. press conference.
6:48 a.m. Monday: Amber Vinson wouldn't knowingly expose herself or anyone else to Ebola, family says
The family of a Dallas nurse who tested positive for Ebola after flying to Ohio and returning home says suggestions she ignored medical protocols are false.
It says in a statement issued Sunday through a spokesman that nurse Amber Vinson wouldn't knowingly expose herself or anyone else. It says she reported her body temperature three times before boarding her Oct. 13 flight home.
The U.S. Centers for Disease Control and Prevention has acknowledged Vinson checked in repeatedly and was cleared for travel.
Three people have been quarantined in northeast Ohio following Vinson's visit to Cleveland to prepare for her wedding. None has exhibited Ebola-like symptoms.
Vinson cared for Thomas Eric Duncan, who died from Ebola in Dallas.
Ebola is spread through bodily fluids. Someone who's infected doesn't become contagious until she shows symptoms.
Original post, Sunday evening: 21-day monitoring period coming to an end for Duncan's family, friends
The 21-day monitoring period expires at midnight Sunday for the first group of people who were in contact with Thomas Eric Duncan, the man who died in Dallas after contracting Ebola in Liberia.
The 48 people, which includes friends and family, came into contact with Duncan through Sept. 28, when he was admitted to Texas Health Presbyterian Hospital. He died Oct. 8.
None of the 48 people are showing Ebola symptoms.
The end of the monitoring period “will be a good thing for those families,” Dallas County Judge Clay Jenkins said Sunday morning on ABC’s “This Week.” “At the same time, we’re extremely concerned about these health care workers. We continue to make contingency in the event there are more cases.”
Those 75 health care workers have received documents from the Texas health department asking them to stay away from public places.
“These are hometown healthcare heroes; these are people who have put their lives on the line to take care of Eric Duncan," Jenkins said on ABC. "They want to do what they’re asked to do. They just needed the protocols to be put in place for them and those protocols were lacking for them when they traveled.”
Jenkins said if any other health workers test positive for Ebola, a plan is in place that includes:
- all intake will be done at Texas Health Presbyterian Hospital.
- ambulances have been instructed to bring anyone with a history of West Africa travel and a fever to that hospital.
- those found to be infected will be transferred by air ambulance to one of three national health centers set up to handle very risky germs, or by ground ambulance to the University of Texas Medical Branch at Galveston, which has the capability of disposing of the "copious waste" that Ebola cases generate.
- If a large number of cases surface, a triage unit at another, undisclosed location will be set up in the next 24 hours, with isolation units. The location was to be announced later Sunday.
Duncan's fiancee releases statement
The 48 contacts who are nearing the end of their 21-day monitoring period include Duncan's fiancee, Louise Troh. On Sunday afternoon, she sent out this statement:
Tomorrow, my family and I will complete the 21-day quarantine period we were required to undergo because of the Ebola virus in Dallas. We are so happy this is coming to an end, and we are so grateful that none of us has shown any sign of illness.
Our happiness is mixed with sadness at the same time. My beloved fiancée, Thomas Eric Duncan, who was also the father of my son, Karsiah Eric Duncan, did not survive with us. We continue to mourn his loss and grieve the circumstances that led to his death, just at the time we thought we were facing a happy future together. Our hearts also go out to the two brave women who have been infected by this terrible disease as they were trying to help him. We are also aware of how much this has affected many other people of my city, Dallas, and my country, the United States of America, even as it has in the country of my birth, Liberia. We also know that many people who work in Presbyterian Hospital are hurting because of this tragedy. We pray that God will bring healing to all in our community soon.
We thank all people of kindness who have prayed for us during this time, and we join your prayers now for others who are suffering too. We have lost so much, but we have our lives and we have our faith in God, which always gives us hope.
Even though the quarantine is over, our time of mourning is not over. Because of that, we ask to be given privacy as we seek to rebuild our home, our family and our daily living. We will not give any interviews at this time. I do have a story to tell, and I look forward to telling it in my own way at the right time.
At this time, I would like to give my thanks to Mayor Mike Rawlings and Dallas County Judge Clay Jenkins for all the help and kindness they have shown me in the last three weeks. These two men have cared about me as a person. The many people who work with and for them, and also the state health workers who have cared for us, have been angels from God who have kept our spirits up through all of this. And of course I want to thank all my family, the Liberian community, and my friends at Wilshire Baptist Church. I look forward to seeing you all soon.
All glory be to God.
Watch the ABC "This Week" interview
Update on Bentley, the dog of Ebola patient Nina Pham
While the monitoring period comes to an end for those 48 people, monitoring is under way for one four-legged individual: Bentley, the one-year-old dog of Ebola patient Nina Pham.
Dallas Animal Services will begin monitoring Bentley, the dog of Ebola patient Nina Pham, for any signs of Ebola. Bentley was moved from Pham's apartment on Oct. 11 and placed in a temporary home. DAS will be keeping Bentley in quarantine for 21 days.
For the monitoring process, Bentley will be placed in a special kennel sometime this week so workers can collect his feces and urine for testing. He'll be returned to his normal kennel and routine after the collection is complete.
Not much is known about how the Ebola virus affects dogs. There have been limited evidence that the Ebola virus can live in dogs, but not much is known on how long the virus lives in its droppings, or if dogs can become contagious.
“We are hopeful that Bentley’s journey will contribute to what we know about Ebola and dogs, since they play such an important role in so many peoples lives," Dr. Cate McManus, operations manager with Dallas Animal Services, said.
The Associated Press contributed to this report.