Although the Massachusetts Department of Public Health (MDPH) has declared that “the risk of Ebola in Massachusetts remains extremely low,” the task of preparing every emergency health care worker and medical facility to handle a suspected or confirmed case is underway throughout the state.
Harvard and the hospitals closest to it are no exception.
In the unlikely event that someone in Harvard is identified as a potential Ebola patient, the town’s EMTs and local hospitals currently have policies and procedures in place to deal with the transport, testing, and treatment of that patient.
Steve Beckman, director of the Harvard Ambulance Service, confirmed that all EMTs who are currently on staff have undergone training to deal with Ebola patients. He also said that the ambulance squad is receiving “near daily” updates on procedures from the MDPH, but “the basic level of coverage is well understood, and there is a high degree of caution with personal protective equipment.” The squad is scheduled for a training session on Nov. 10 to go over “donning and doffing” procedures used to put on and take off protective clothing.
“A 6-foot distance from someone with Ebola virus disease is more than adequate to prevent transmission”
—Dr. Alfred DiMaria Jr.
state epidemiologist
When someone in Harvard calls 911 with a medical emergency, says Beckman, the call goes through Nashoba Valley Regional Dispatch District in Devens, where, if a person is experiencing flu-like symptoms, the dispatcher will ask if the patient or any family member has been out of the country in the region where Ebola has been widespread. If the answer to that question is “Yes,” the dispatcher will notify all responding units that the patient is “a patient with flu-like symptoms with precautions.” At that point, Beckman says, the call would be restricted to adult EMTs, with no Bromfield students participating. Responders have been instructed to keep a 6-foot barrier distance from the patient as they question the individual about symptoms and travel history. According to state epidemiologist Dr. Alfred DiMaria Jr., “A 6-foot distance from someone with Ebola virus disease is more than adequate to prevent transmission.”
If the patient is deemed to be a “ruled-in positive,” meaning that symptoms and travel history indicate the possibility of Ebola, an ambulance specially outfitted for isolation precautions (either MedStar or Worcester EMS) will be dispatched.
“Unless facing an immediate life or limb emergency, Harvard’s ambulance (9A) will not be transporting these patients,” said Beckman. The patient would then be taken to UMass Medical Center in Worcester, which requested that any suspected Ebola cases in Harvard be brought there.
Local hospitals
are prepared
Local hospitals are also prepared to handle screening and isolation of possible Ebola patients. At Nashoba Valley Medical Center (NVMC), all emergency department patients are being screened for recent travel from Guinea, Liberia, or Sierra Leone in the past 30 days, according to Brooke Thurston, VP of media relations for Steward Health Care System, LLC, the company that owns NVMC.
“In order to minimize exposure, any patient with relevant travel history will be put in isolation in our emergency department, assessed for symptoms and, if those symptoms are present, will be cared for by a team that is exclusively dedicated to the patient (with no other patient responsibilities),” said Thurston. “These isolation areas are equipped with all of the necessary protective gear and equipment to care for these patients while keeping our staff and other patients safe. Protective equipment is available at all of our hospitals.” Thurston added that drills and mock simulations are being conducted with the teams that would provide care for Ebola patients.
C. Gregory Martin, MD, senior vice president and chief medical officer of Emerson Hospital had this to say: “We are working closely with the Centers for Disease Control (CDC) and the MDPH to ensure that we are appropriately screening patients with potential Ebola. In addition, we have policies and procedures in place and have the facilities and equipment to properly isolate and treat a patient who is suspected of having Ebola. Extensive training is being given to our emergency department team, nurses, and other appropriate staff at Emerson so they will be fully prepared.”
A statewide collaborative system
On October 31, the MDPH announced in a press release that “six hospitals in Massachusetts have formed a collaborative system and are prepared to treat a limited number of Ebola cases, should the need arise.” The six hospitals are Baystate Medical Center, Beth Israel Deaconess Medical Center, Boston Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, and Tufts Medical Center. These hospitals will accept transfers of patients from other Massachusetts hospitals based on referral relationships and capacity. The MDPH press release went on to say, “Each of the state’s hospitals and their emergency departments are able to screen, identify, and isolate any suspect cases, and will coordinate with MDPH on risk assessment and patient transfers as needed.” Both NVMC and Emerson Hospital confirmed that the determination of which hospital a suspected Ebola patient would be transferred to lies in the hands of the MDPH, which would be immediately contacted if they received such a patient.
Risks of transmission are low
The MDPH emphasizes that “Ebola is not transmitted through air, water, or food. You can only get Ebola from touching the blood or bodily fluids of a person who is sick with or has died from Ebola, touching contaminated objects like needles, or touching infected animals, their blood or bodily fluids, or their meat.”
More information about Ebola is available at www.cdc.gov/vhf/ebola and www.mass.gov/ebola. Additional links to information are available on the Harvard Board of Health website, and these will be updated as new information becomes available.
