Failing to follow proper protocol significantly increases the danger as the viral load in a patient’s blood rises—a product of the infection’s later stages. With knowledge of this, Frieden and the CDC is suggesting that care for patients in the late stages of the disease be limited solely to “essential procedures.” Kidney dialysis and respiratory intubation, two procedures performed on Duncan, are procedures unavailable for patients in West Africa that might that pose unanticipated risk to health care workers.
What this means for the hundreds of health care workers in Atlanta, Omaha at the containment Center, and in Dallas is both simple and very complex—caring directly for a patient with late stage Ebola is very dangerous. It also means that workers in the U.S., like those in Spain, may hesitate to work around such patients. Western workers may no longer feel safe volunteering in West Africa. For the U.S. and other nations who have just begun gearing up for a medical intervention there, this is a potentially huge setback.
In the welter of worry though, it is important to consider the experience at the two sites in the US with special training and recent experience treating patients: Emory in Atlanta and the Nebraska Biocontainment center in Omaha. These sites, where healthcare workers go through training and more training, have safely cared for five patients, including the first two, Kent Brantley and Nancy Writebol. For Ebola care, as with all other things, it is likely that practice makes perfect—and that only perfect is good enough.