Isle health workers to take part in drills on containing virus

Officials said Wednesday Hawaii health care workers need more training to be sufficiently prepared to handle an Ebola virus outbreak.

"This is a scary disease. We need to prepare," said state epidemiologist Sarah Park at an Ebola briefing at the Capitol. "It cannot be just lip service anymore."

To adequately prepare, the state must first train health workers in how to contain the deadly disease that has killed thousands in West Africa and then move on to other workers who come in contact with the public, such as police, hotel employees and transportation workers.

State Department of Health director Linda Rosen said the training needs to include actual practice drills that will be evaluated by experts in infection control.

"Our usual ways of taking care of patients need to be re-examined," Rosen said. "More intense preparation is needed especially for health care workers. We want to make sure they are ready and they feel confident."

Toby Clairmont, director of emergency services for the Healthcare Association of Hawaii, said the training is crucial because "the highest risk is between the health care worker caring for a badly infected, seriously ill Ebola patient."

Training will touch on everything from the questions a 911 operator should ask in suspected Ebola cases to techniques that ambulance crews should employ while treating a patient.

Park said the training drills will enable officials to "look purposefully for gaps and address them."

She said her team will enforce what already is supposed to be the standard for medical workers when handling infectious disease patients. That includes using a "buddy system" in which a pair of workers would watch each other put on and take off personal protective gear to ensure it is done properly.

The Department of Health and Healthcare Association of Hawaii commissioned a working group Monday that will revamp safety procedures and "infectious control practices" at hospitals statewide within the next two weeks, said Clairmont.

"Our intent is to do face-to-face competency-based training in every facility," Clairmont said. "So if you can get somebody there you can give them the best chance of survival."

Sen. Suzy Chun Oakland, (D, Downtown-Nuuanu-Liliha), questioned health officials about what’s being done to protect other nonmedical workers including hotel employees, park custodians or homeless service providers if they were to come in contact with bodily fluids tainted with the virus.

"They’re not our first priority. There isn’t enough money, time or people to do all this all at the same time," Clairmont said. "Eventually we’ll have to work down to law enforcement, sanitation workers, parks and recreation people. There’s no question we have to do that."

Health officials have identified four Oahu hospitals whose staff will get intensive training in how to handle Ebola.

Lawmakers convened health officials Wednesday to find out how the state is preparing to protect medical workers and residents while reiterating that Hawaii is at low risk for an actual outbreak.

"We’ve had some test runs so to speak," said Senate Health Committee chairman Josh Green (D, Naalehu-Kailua Kona), who called the briefing.

The Queen’s Medical Center treated a patient with possible Ebola several weeks ago, though the Health Department quickly ruled out the virus.

"It’s reasonable for us to be absolutely prepared," Green said. "The committee’s hope is that we cross every ‘t’ and dot every ‘i’ even though we have low suspicion and probability of having a case of Ebola virus."

Health officials wouldn’t disclose which of the main hospitals will be trained as an Ebola-designated facility until agreements are reached with the organizations.

"It’s a risk for (hospitals) to do this. They don’t have to do it. The state can’t make them do it," Clairmont said. "This is all about working together as a partner."

Texas Health Presbyterian Hospital in Dallas, which handled the first Ebola case in the U.S., has seen emergency room visits plummet by more than 50 percent since Oct. 1, after caring for several people who contracted the disease, according to a report by CNBC. That resulted in an $8.1 million, or 25 percent, drop in revenue, the report said.

In the case of a suspected Ebola patient, local hospitals not equipped for high-level intensive care — including all of the rural community facilities on the neighbor islands — must be prepared to isolate and treat a person for at least 24 to 48 hours while testing for the disease is underway, DOH said.

If an Ebola case is confirmed, there is a 20-member specially trained team to transport infectious disease patients, by air if necessary, in a biocontainment unit to one of the four Ebola-designated hospitals.

The initial symptoms of Ebola are nonspecific and sudden. It begins with very subtle symptoms from mild bleeding, headache and fever to vomiting, diarrhea and abdominal pain.

To report a potential case of Ebola, call the state Health Department at 586-4586.

The virus is transmitted through direct contact with bodily fluids and is not contagious if a person doesn’t have symptoms, DOH said.

Treatment, not specific to the disease, includes replacing bodily fluids and blood and using medications for conditions that arise such as high blood pressure. The cornerstone of therapy is to support the body long enough so the immune system can begin to work, DOH said.

There is no cure or vaccine for Ebola and experimental therapies have not been proved. The incubation period for the virus is up to 21 days after exposure.

"Hawaii’s story is not a story of risk, it’s a story of vulnerability," Clairmont said. "Nobody’s going to drive across the border to help us out."