I wrote a piece yesterday about "the protocols" used in doffing protective gear after caring for Ebola patients. I said it was more likely that they were not adequate than the nurse had made a mistake in following them.
Today I learned what the protocols actually are. They're here, with full instructions and pictures at the CDC website. The poster made me heave a sigh. I realize that my 15 or so years on the laboratory bench dealing with Hepatitis B and C, HIV and so forth is not worth a single minute actually caring for a patient, but from my position of partially-informed inexperience, I must say you wouldn't catch me trying to work with a living being while wearing only the specified protective gear in that poster. A tray of open viral-positive serum tubes might be slightly scary to the uninitiated but at least they're not going to cough on the back of your neck or projectile vomit on your shoes.
Yesterday I speculated that the nurses weren't being watched as they donned and doffed the gear, and that there might be no showers of bleach in the airlock. Too right. There's no airlock, no observer, no bleach and not even any booties (overshoes) or back of the neck protection. There's only one set of gloves, so removing the gloves first means your bare skin touches your outer protective gear at the back of the neck when you undo the mask. It's like the CDC has never even seen one of those Medecins Sans Frontieres videos...
(Picture from MSF website credited to Sylvain Cherkaoui/Cosmos)
Today, the CDC, according to the New York Times, are changing their "protocols".
And they [the CDC] are now watching hospital personnel as they put on and take off their protective garb, retraining the staff and evaluating the type of protective equipment being used. They were considering using cleaning products that kill the virus to spray down workers who come out of the isolation unit where the nurse is being treated.
“There are a series of things that are already implemented in the past 24 hours,” Dr. Frieden said. “If this one individual was infected, and we don’t know how within the isolation unit, then it is possible that other individuals could have been infected as well.”My very best wishes to the poor nurse, and let's hope that's the last transmission in the US.