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"We will likely continue to get occasional patients in the U.S. who may have brought the disease with them, but aggressive intervention and contact tracing won't allow it to spread the way it has in those pockets in West Africa," he said.
Ironically, the U.S.'s aggressive contact tracing, which involves backtracking on a patient's activities and notification of those even considered low risk and possible self-isolation of those considered to be higher risk, may have inadvertently raised the fear level on the recent Ebola cases — when, in fact, it helped keep the nation safe.
"Surveys show that people continue to think they can get Ebola from casual contact or that they think their chances of contracting Ebola are high," said Shirley. "We could save thousands of lives in the U.S. if people were as worried about the flu as they are about Ebola." Half of Americans are still failing to get vaccinated against influenza, even though it kills thousands every year. Flu kills an average of 23,000 people in the U.S. annually across all demographics, including otherwise healthy children and even young adults.
Said Shirley, "Even with the concern about Ebola, the best health advice I can give anyone — especially this year — is to get a flu vaccine early."
Safely transporting and treating patients
At GHS, potential Ebola patients would be evaluated at the hospital where they sought initial treatment but then would have appropriate PPE placed on them and be transported immediately by a dedicated specially-outfitted Mobile Care ambulance and crew to Greenville Memorial Hospital. The vehicle, which has been "wrapped" with plastic completely on the inside, segregated from the ambulance cab and equipped with special supplies, would be sanitized following CDC protocols after each use. As an academic, referral and Level I trauma center, GHS has established relationships and a strong history of collaboration with the Emergency Medical Services community in Greenville County, said Sasser.
"This has enabled work closely with EMS on Ebola planning to ensure our plans mesh well and to provide the best care for our patients — both in the hospital and before they arrive," he said.
GHS protocols are exceptionally detailed and move the suspected patient quickly but securely to either a special holding room in the emergency department or immediately up to an isolation ward by trained protected staff. All plans feature specific direction regarding routes of transportation and movement of masked or specially-enclosed patients. An isolation unit at Greenville Memorial Hospital has the capacity to house up to three patients. The completely walled-off unit features negative-pressure capabilities, HEPA filters on the air supply and an on-site point-of-care lab that will help speed lab results and safely process any patient samples away from other samples. As an additional precaution, the unit will be controlled access and feature 24-7 security.
GHS continues to work with state officials and local hospitals to ensure appropriate safe patient care through the statewide referral system. GHS will also work with any physician office — regardless of affiliation with GHS — to help work with staff and provide guidance about guidelines.
Extraordinary response by volunteer clinical staff
To help minimize the number of caregivers involved, specially trained volunteer nursing, physician and respiratory staff will care for patients in the isolation unit.
Unit volunteers will not care for any other patients, and, as an added precaution, will be monitored and self-isolate themselves during that time. They will remain quarantined until 21 days after their last encounter with an Ebola patient.
The majority of day-to-day care will come from nursing staff. Nurses will not only provide clinical care but provide meals to the patients and ensure that any waste material is safely contained.
"I couldn't be more proud of our nursing staff," said Michelle Taylor-Smith, GHS' chief nursing officer and vice president of patient services. "Many have stepped forward without hesitation to do whatever is needed to provide care in the event they’re needed.
"Compassionate care is the core of nursing practice — and not just in potential emergency situations but in every-day care. It’s what we do."
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