There will soon be more posts on the current Ebola epidemic than on antimicrobial resistance, a temporary “problem” that I hope will be rectified shortly. Unfortunately, I have also fallen into the “media headlines trap” and am posting more about the 3 US cases and the consequent developments than on the ongoing tragedy unfolding in West Africa. In many ways, however, the US situation is more relevant to how we deal with any imported case of Ebola in Singapore.
But it was surprising to read in the news that Dr Tom Frieden, CDC Director, is under fire for the 3 Ebola cases in Texas and some have publicly called for his resignation. It is probably true that he had said things that he probably regrets saying, including the statement that “essentially any hospital in the country can safely take care of Ebola. You don’t need a special hospital to do it”. I am not sure if he really believed that, or (as is more likely the case) he felt the need to reassure the public and build public faith in US medical institutions. Nonetheless, it is a bit much to have expected him to have sent a full CDC response team to Texas Health Presbyterian Hospital in response to the initial imported patient, whatever he says now – hindsight is usually 20/20. He is changing course fast, and adapting new strategies (that will also be politically acceptable now that there are two healthcare transmissions).
And that should be sufficient at this point. There are few if any that are more experienced in the US, and the same “mistakes” might have been made even if CDC was under different leadership.
It’s important to note the lessons that the US outbreak offers, both in terms of public health response and public messaging. To reiterate a previous point, it is key to have a special healthcare unit that is trained (and undergoes regular training/practices) to deal with such infectious patients – the staff can obviously be functional members of a hospital during non-outbreak periods – and it is vital not to assume that all hospitals in Singapore can cope with the management of patients with conditions such as Ebola, no matter that staff have had training with donning the type of full-body personal protective equipment that is critical for preventing Ebola transmission to healthcare staff.