The Tribune

EARLIER THIS month, health officials assured the public that protocols were in place to adequately take care of an Ebola-infected patient should one arrive on our doorstep.

Government has since released a complicated 51-page plan outlining the steps to be taken were such a thing to happen. Health Minister Dr Perry Gomez said the plan, which had been worked on for months, was just a part of a national health protocol established by the Ministry of Health and the Department of Public Health, in collaboration with its private and public partners, to deal with such significant public health threats as Ebola.

However, as has been pointed out, a plan is only as good as good as its execution.

So far, Bahamians have seen no execution. Daily they are becoming more concerned because officials have been silent on what the protocols are and how they are to be implemented. They have seen no attempt at the airport to check incoming passengers, while several persons in health care worry about the lack of screening of the hundreds of cruise passengers who arrive weekly at Prince George’s dock.

We agree with Dr Duane Sands, who has dismissed the complicated government document as “too technical and lengthy to be effective”.

Dr Sands said that while the document might be full of interesting information, he did not think it was practical. The average Bahamian cannot read this and understand it, he said, adding that it is “a reasonable start for a national policy, but it is not enough”.

Dr Sands maintains that there is not enough focus on public education, nor is there sufficient detection procedures.

A doctor in the public health care system has agreed that the government’s plan is not sufficient. He said health care professionals needed better training. According to the doctor, while some nurses have undergone training, physicians for the most part have not been briefed.

The United States with all of its fine hospitals, doctors and medical staff seemed to be over confident at Texas Health Presbyterian Hospital in Dallas, where, despite its protocols to protect staff and patients, it bungled the first Ebola case to arrive in the US. Although by the time Thomas Duncan from Ebola-plagued Liberia, went to the Dallas hospital, he was too ill to be saved, two staff members who nursed him are now in isolation fighting for their lives — and all because, despite the protocols, they were not protected from the infection. Officials are still trying to track down other persons who might have been in contact with Duncan before his death.

As Dr Sanjay Gupta observed on CNN this week, as he demonstrated the putting on and taking off of health workers’ safety gowns, Doctors without Borders are the best trained to take care of such cases. He pointed out that these doctors, working in tents in the most primitive conditions in Africa, have treated more than 2,000 Ebola patients, with only two of their staff contracting the virus. On the other hand, in the United States with the best equipment and first world conditions in which to work, its first Ebola patient died while two of the nurses attending him are themselves now fighting for their lives in hospital.

Presbyterian’s nurses have complained that they tended Duncan in flimsy protective gear and that they had had no proper training from hospital administrators in handling such a patient. We hope that the day never comes when this might be the cry of overwhelmed Princess Margaret Hospital staff.

On the other hand, Charles Sealey, CEO of Doctors Hospital, has assured us that not only is Doctors following all of the protocols, but all of its staff have the nonporous gowns, full covering for the head and neck, and the “buddy system” where another staff member helps his colleague take off and discard the safety coverings after caring for a patient. As neurosurgeon Dr Sanjay Gupta demonstrated, it is believed that the two ill nurses who cared for Duncan, got contaminated with his fluids as they attempted to disrobe without assistance.

Doctors also has the recommended Centre for Disease Control (CDC) gloves, which under the protocol are to be sprayed with bleach and washed well after dealing with a patient and before they are taken off.

He said the best decision made by Doctors was five years ago when it became accredited by Joint Commission International (JCI), which works to improve patient and caregivers safety in the international community. It provides education, publications and advisory services. Its services has kept Doctors Hospital on the cutting edge of the most up-to-date methods of handling infectious diseases. As Mr Sealey points out, Ebola’s symptoms are similar to so many other infectious diseases that it can keep a doctor guessing. This is flu season, and the flu is one of Ebola’s symptoms. It can also show symptoms of meningitis, malaria, and the list goes on.

And so when Doctors got the recent call that a Ukrainian seaman from a passing freighter was being dropped off here for urgent medical care, all Doctors staff understood was that the man had a mysterious condition that was probably contagious. And so from its JCI training, Doctors sent out a well prepared ambulance staff to bring in a seriously ill patient. Taking no chances its ambulance staff was fully gowned and gloved.

The patient was rushed back to Doctors and immediately put into isolation. He died shortly afterwards from malaria — not Ebola. However, the rumour around Nassau the following day was that Ebola had arrived.

It is very doubtful, if Princess Margaret would have had all the safety protocols in place to have handled this situation as efficiently.

However, as has been pointed out, Government has to step up its training and put in place the safety protocols to prevent the virus coming to these islands. As a doctor pointed out, if that were to happen, the Bahamas would not have a chance. “We would be overwhelmed.”

We suggest that the government becomes more pro-active, because Bahamians — especially the travelling public — are now starting to panic.