A clearly subdued Dallas County Judge (highest ranking county official in the state of Texas) Clay Jenkins, in a press conference this morning at Texas Health Presbyterian Hospital, provided additional details on the first nosocomial transmission of Ebola in the United States.
What we know (some details are being withheld to protect the family, and observe HIPAA regulations), is that a healthcare provider at Texas Presbyterian Hospital – who was involved in Eric Duncan’s care after he was admitted on the 28th - was in isolation last night with a mild fever.
This particular HCW was considered a `low risk’ contact of Mr. Duncan. This patient’s initial tests came back positive around midnight last night.
According to Dr. Varga, head of clinical care at Texas Presbyterian, this HCW was following all CDC recommended infection control procedures (Gloves, gown, facemask & eye shield), but a review is underway to understand what happened.
Here is a statement from Dr. Dan Varga, released at the same time as the press conference was begun:
Statement from Dr. Dan Varga, Chief Clinical Officer, Senior Executive Vice President
Late Saturday, a preliminary blood test on a care-giver at Texas Health Presbyterian Hospital Dallas showed positive for Ebola. The healthcare worker had been under the self-monitoring regimen prescribed by the CDC, based on involvement in caring for patient Thomas Eric Duncan during his inpatient care that started on September 28.
Individuals being monitored are required to take their temperature twice daily. As a result of that procedure, the care-giver notified the hospital of imminent arrival and was immediately admitted to the hospital in isolation. The entire process, from the patient’s self-monitoring to the admission into isolation, took less than 90 minutes. The patient’s condition is stable. A close contact has also been proactively placed in isolation. The care-giver and the family have requested total privacy, so we can’t discuss any further details of the situation.
We have known that further cases of Ebola are a possibility among those who were in contact with Mr. Duncan before he passed away last week. The system of monitoring, quarantine and isolation was established to protect those who cared for Mr. Duncan as well as the community at large by identifying any potential ebola cases as early as possible and getting those individuals into treatment immediately.
Finally, we have put the ED on “diversion” until further notice because of limitations in staffed capacity — meaning ambulances are not currently bringing patients to our emergency department. While we are on diversion we are also using this time to further expand the margin of safety by triple-checking our full compliance with updated CDC guidelines. We are also continuing to monitor all staff who had some relation to Mr. Duncan’s care even if they are not assumed to be at significant risk of infection.
All of these steps are being taken so the public and our own employees can have complete confidence in the safety and integrity of our facilities and the care we provide.
Meanwhile, the city of Dallas has sealed off this new patient’s apartment, decontaminated the common areas in the apartment complex, sealed and decontaminated the patient’s car, and has canvassed the neighborhood – knocking on doors – checking on everyone and providing information to nearby residents.
A close contact of this patient is also in isolation as precaution – but is not currently symptomatic. There is also reportedly a pet in the apartment, and efforts will be made later today to check on, and provide for, this animal.
We will probably be hearing later today from the CDC, the State of Texas, and Dallas County Department of Health.
While obviously a setback, this was not unexpected.
Despite all of the reassurances over the level of precautions being taken, there is no way to reduce the risk of treating an Ebola patient to zero. As Zach Thomas, head of Dallas County Health Department – in a TV interview (WFAA) right after the press conference – warned `Don’t be shocked if we see another case’.