Bellevue
'Isolation Unit' By Patricia Doyle
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| Hello Jeff - According to this article, and I suppose after
the doctor's obvious "man about town" escapades after his return from treating
Ebola patients, and our, as well as other media discussions of his lack
of quarantine skills, now we hear that the reason Dr Spencer called MSF
is because a call to them if fever develops is the MSF protocol. The article
also states that Dr Spencer followed quarantine protocol. If that
is MSF protocol then MSF is lacking in knowledge of true Ebola quarantine. HCWs who work for MSF are also told to stay within 4 hours of a designated hospital that is set up as Ebola isolation units. If I were Dr Spencer I would have gone to Atlanta and camped out at Emory. I also read that NY and NJ governors now state that people who were in contact with anyone with Ebola 21 day quarantine will be mandated. How will contact with an Ebola patient be ascertained? It should take into fact those who are returning health care workers but how do we determine the average W African coming to the US. A questionnaire? We know that Mr. Duncan had contact with an Ebola patient but lied on the questionnaire. Also anyone who is monitoring their own temperatures can also lie about a fever, especially in the early stages when a fever is low grade, say 100.1. We also know that 15% of all Ebola cases show no fevers. The only way to really ensure the US stay relatively Ebola free is the require 21 day quarantines, with "no man or woman about town escapades," for returning HCW's and military. As for any further travel from W Africa, a ban should go into effect for a 3 month period or sooner if the outbreak gets contained. The 3 month ban should be flexible according to how the outbreak is responding in W Africa. As for the article below, I do not believe for one minute that Dr. Spencer acted responsibly. ...and if MSF protocol condones Dr. Spencer going jogging and bowling and taking subways and cabs, then MSF needs to rethink "quarantine." My opinion of the following article is that it is 'DAMAGE CONTROL.' Patty NYC Doctor Craig Spencer Followed Proper Protocol After Returning From Ebola-Stricken West Africa Médecins Sans Frontières announced this evening that the New York City doctor diagnosed with Ebola on Thursday followed all protocols that the aid group recommends for any staff returning from Ebola-affected countries. Craig A. Spencer, MD, MPH, is an assistant professor of medicine at Columbia University and fellow in international emergency medicine at New York-Presbyterian Hospital. Dr. Spencer recently returned to the U.S. after volunteering with MSF to care for Ebola-stricken patients in the West African country of Guinea. He has not worked at the hospital since returning on October 17. After developing a fever Thursday morning, Spencer stayed in his apartment until paramedics transported him to Bellevue Hospital Center, one of eight hospitals in New York State that were declared “Ebola-ready” by Governor Cuomo’s office. Dr. Spencer tested positive for Ebola virus within hours of his admission to Bellevue’s isolation unit, constructed in the 1990s for HIV/AIDS patients. The current West African outbreak began in the Guinean village of Guéckédou with the December 6, 2013 death of a two-year-old boy. The disease then killed the boy’s mother, three-year-old sister, and grandmother before being transmitted to a health care worker in Guéckédou. In addition to Dr. Spencer’s medical training, he is fully proficient in French, the national language of Guinea. One might predict that his ability to speak the language assisted in his ability to care for the scared, mortally-ill Ebola virus victims. One of the first responses of the daily outrage factory that is Twitter was why Dr. Spencer ventured from his apartment at all anytime in his first 21 days back in the U.S. (the incubation time for the virus). Officials at Bellevue Hospital said tonight that Dr. Spencer had gone for a three-mile jog yesterday, taken the A, L, and 1 trains in New York City, and used an Uber driver to return home from bowling with friends at The Gutter, a beloved, old-timey bowling alley in Williamsburg. MSF stressed in a statement tonight that Dr. Spencer followed their explicit protocols for any staff returning from tours of duty in Ebola-stricken countries. Dr. Spencer is the first of over 700 expatriate West Africa volunteers who developed Ebola virus disease upon return to their home country. The medical aid organization says that all volunteers are debriefed before returning home and, with the CDC’s assistance, told which hospital to contact in the event they develop symptoms during their first 21 days back. Neither MSF or federal, state, or city public health officials require that medical professionals caring for Ebola-infected patients completely isolate themselves upon returning home. Instead, they require the following: 1. Check temperature two times per day 2. Finish regular course of malaria prophylaxis (malaria symptoms can mimic Ebola symptoms) 3. Be aware of relevant symptoms, such as fever 4. Stay within four hours of a hospital with isolation facilities 5. Immediately contact the MSF-USA office if any relevant symptoms develop These guidelines are the same as those used by the CDC for anyone returning from Ebola-affected countries in West Africa. The moment that Dr. Spencer detected that he had a fever on Thursday morning, he contacted MSF offices in New York and the predetermined plan to transport him to Bellevue went into motion. Dr. Spencer has had close contacts with only three or four other people, including his fiancée, who is also under quarantine at Bellevue. His other friends have been notified but it’s not yet clear if they will be isolated in their residences or at a health care facility. Dr. Spencer completed his work in Guinea on October 12 and left for the U.S via Europe on October 14. He arrived back in New York on October 17. The question that will obviously be discussed in coming days is whether returning healthcare workers from West Africa should be subjected to a mandatory 21-day quarantine, at least at their home. Officials reiterated that Spencer was not infectious when he socialized on Wednesday evening. http://www.forbes.com/sites/davidkroll/2014/10/24/ny-doctor-craig-spencer-followed-msf-protocols-for-staff-returning-from-ebola-stricken-west-africa/ |
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