Tags: ebola | case | dallas | duncan | botched | handling | risk

Top Doctor: Bungled Ebola Case Shows US Hospitals Unprepared

By    |   Thursday, 02 October 2014 01:47 PM

The Dallas hospital that handled the first patient diagnosed with Ebola in the U.S. “totally dropped the ball” and bungled the case, a top doctor tells Newsmax TV. The case spotlights enormous gaps in the nation’s public health safety net and ability to manage the deadly virus and keeping it from spreading here, he adds.

Sanjay Jain, M.D., a board-certified physician and author of “Optimal Living 360,” says the Dallas case raises troubling questions about U.S. health officials consistent claims that the country's healthcare system is well prepared to contain any spread of Ebola through careful tracking of people who may have traveled to the West Africa outbreak zone and had contact with infected individuals.
“Here we have people singing the praises of the United States healthcare and [with] the very first diagnosis we completely drop the ball,” says Dr. Jain, in an interview on Newsmax TV’s America’s Forum. “So it's very frustrating. I'm actually myself personally upset that this happened. And I'm just like everybody else, how did this happen?”
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The patient, identified as Thomas Eric Duncan of Liberia, first visited Texas Health Presbyterian Hospital in Dallas last Friday, with a fever and other symptoms consistent with Ebola infection. But hospital workers sent him home with a prescription for antibiotics, even though he informed them he had recently traveled to West Africa, health officials said.
Dr. Edward Goodman, an infectious disease specialist at the hospital, told a news conference on that Duncan returned two days later with more serious symptoms, arriving by ambulance — potentially putting at risk the emergency responders who transported the patient that Sunday and others over the weekend.
The hospital’s decision to initially turn him away was a critical missed opportunity that likely resulted in other people being exposed to the deadly virus, according to infectious disease experts and the Centers for Disease Control and Prevention.
As many as 100 people were in contact with Duncan at some point and are being tracked for the condition, which kills 50-60 percent of the people who contract it through exposure to bodily fluids. Four members of Duncan’s family have been ordered to stay home as a precaution even though they are not showing symptoms, the Texas Department of State Health Services said in a statement.
His case has sparked concern over the potential spread of the deadly virus from West Africa, where at least 3,338 people have died in the worst outbreak on record.
For months, the CDC has been warning American hospitals to be on alert for the virus, but argued the U.S. healthcare system is prepared to handle and contain any Ebola risk. The CDC has urged hospital emergency department staff to ask patients whether they have recently traveled to Liberia, Sierra Leone or Guinea, the three countries hardest hit by the outbreak.
But Dr. Jain notes the Dallas hospital workers apparently did not follow the protocol.
“The patient went the hospital ER the first time and was sent home, [and staff] totally missed the fact that he went to Africa,” Dr. Jain says. “Then he comes back even sicker and who knows what happened in between?”

David L Vastola, M.D., an internist and gastroenterologist from Palm Beach, Fla., agrees.

"The hospital botched it with overlooking his symptoms and a history of traveling from Liberia," he says. "Also, if they thought he had a virus, they gave him an antibiotic, which will not work against viruses."
But it’s not just hospital standards that were breached, Dr. Jain notes. News reports say Duncan traveled from Liberia to Brussels, then to Washington, D.C., before boarding a plane to Dallas. He believes the case provides a strong argument for restricting travel between the U.S. and West Africa until the outbreak is contained to avoid similar cases.
“There's a lot of question marks,” he says. “First of all, he was knowingly exposed to Ebola. The story that's out there is that he actually carried a pregnant woman who had Ebola and took her to a clinic ... So he knew he was exposed. So here he is getting on a plane, knowing that he was exposed, going to Brussels, then to Washington, D.C., transferring a flight to Dallas …Why are we creating a thread from one side of the ocean to another? If we can keep it on that side of the ocean, let's do that.”
Because Ebola symptoms — headache, fever, fatigue, muscle pain, and sore throat — can take up to 21 days to develop after a person is exposed to the virus, Duncan apparently did not appear sick while flying between West Africa and Dallas. Health officials say other passengers on those flights are not likely at risk because the disease can only be transmitted when infected individuals are symptomatic.
“There should have been airport measures at the Liberia airport, but unfortunately he didn't have any fever,” Dr. Jain notes. “So how effective are the airport measures to stop [infected] people who don’t have the early signs of Ebola to fly? So there's a lot of frustrations here. First of all the airport security, then you’ve got the issue of the ER missing the diagnosis the first time. So there's a lot of issues, a lot of questions are being raised.”
Dr. Vastola also says he is concerned that federal health officials' response to Ebola may feed what he believes is a growing distrust of government among many Americans.

"There is a serious problem with a lack of public trust for anything that is government related," he says. "Scandals over and over again with lying to cover ups like the recent IRS and Secret Service news, and many more are the reason why. I saw the interview with the head of the CDC, and he seemed disingenuous to say the least, and I'm a health professional."

Dr. Vastola adds that while he believes most hospitals will be able to handle isolated cases, the nation is not prepared to handle a large number of infections.

"Local hospitals, in my opinion, can take care of the problem currently but if a pandemic occurs, the national answer is no. We don't have the capacity to isolate and treat hundreds of patients along with the sterilization procedure too," he says. "It's a matter of numbers."

He also worries about the prospects of Ebola mutating and becoming more easily transmissible through the air, the way cold and flu viruses can spread.

"Viruses mutate and change very frequently depending on many factors, including their environment and changing it from Africa to the USA may change its characteristics like the method of spread," he notes.

"If you look at all the [CDC] press releases they say, 'not reported yet,' which leaves that first time not reported yet. Not that it will never happen."

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Dallas hospital workers’ botched handling of the first U.S. Ebola case spotlights enormous gaps in the nation’s ability to manage the deadly virus and keeping it from spreading here, a top doctor says.
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Thursday, 02 October 2014 01:47 PM
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