Snohomish County Ebola plan in the works, just in case

EVERETT — On the rare chance that someone with Ebola shows up in Snohomish County, paramedics, hospitals, clinics and public health experts would be faced with a contagious, dangerous disease unlike anything they’ve ever seen.

That’s why they’ve been quietly working together for weeks on a comprehensive plan involving all the health care providers in the county. Resources are in place, and those partnerships have come from coordinating on previous events, such as the H1N1 pandemic in 2009 — known informally as swine flu — and the more recent Oso mudslide, said Shaughn Maxwell, a captain with Snohomish County Fire District 1.

That work involves simulations and drills for paramedics, hospitals and clinics. The practice runs have found the gaps.

In addition, two fire rigs in the county have been outfitted to safely transport an Ebola patient, and emergency responders throughout the county have received additional training on preventing the spread of disease, Maxwell said.

The importance of running simulations is not just about the technical skills and the science, but also about accounting for human behavior, including fear — among patients and medical providers, said Dr. Kent Hu, medical director for quality and patient safety at The Everett Clinic.

The Ebola virus has been known for decades, and scientists have a good understanding of how it works, Hu said.

At the clinic level, the focus is on basic infection control and prevention, and a “tremendous amount of training” to care for patients and also keep staff safe, he said.

Patients visiting for other reasons are asking questions about Ebola, and the clinic encourages that, Hu said. Part of the clinic’s role is to “help everybody by promoting education and understanding the science and helping them put that into perspective,” he said.

Meanwhile, Providence Regional Medical Center Everett is the designated hospital if a suspected Ebola case is reported in the county, said Dr. Joanne Roberts, the chief medical officer. She talks daily to the county’s health officer, Dr. Gary Goldbaum, and others about the topic.

If an Ebola case is confirmed, a critical care area, using isolation measures, would be set up at Providence, Roberts said. A multi-room isolation area is one of the features of the new tower at the Colby campus. The Centers for Disease Control and Prevention also would fly in a team of experts.

Hospital staff have mapped out separate areas for donning and removing protective equipment. They’ve done drills using paint to represent contagions, allowing them to hone skills in not spreading infectious materials. They also use a three-person buddy system to monitor patient care and staff safety.

“We know how the disease progresses,” Roberts said. “We’ve been practicing putting on the equipment and taking off the equipment. We’ve really been accelerating that training.”

They’ve already learned from recent drills what is working and what needs more attention, Roberts said. For some people, talking about Ebola might summon emotions similar to those seen during the early years of the AIDS epidemic.

“We had to really find out quickly where our strengths and our weaknesses were,” she said. “There was some nervousness, and it was mostly around people who just didn’t understand the virus and the contagion and how it’s transmitted. We did have folks in the background, we had chaplains, because we knew our staff would need support.”

At Fire District 1, the interior of a reserve ambulance has been shrouded in heavy-duty plastic and duct tape, Maxwell said. All porous materials have been removed, and the stretcher is sealed in plastic with plastic seatbelts. Similar modifications were made to Everett’s designated rig, Fire Marshal Rick Robinson said.

The idea is to make the rigs safer for operators and less-hospitable to any viruses that might be brought aboard by patients.

The District 1 crews got a chance to test their rig sooner than expected. On Oct. 19, they were summoned for what proved to be a false alarm regarding someone with potential symptoms of Ebola. There was no Ebola, but the crews were able to test their readiness, Maxwell said.

“We have one chance to get it right,” he said. “That’s why we’re working so hard behind the scenes.”

Rikki King: 425-339-3449; rking@heraldnet.com.

About ebola

Ebola is one of the diseases known as viral hemorrhagic fevers. These diseases are caused by viruses that lead to high fevers and, in some cases, severe bleeding. The disease caused by the Ebola virus is particularly dangerous, with a death rate of up to 90 percent. Symptoms include fever, headache, body aches, diarrhea, vomiting, stomach pain and abnormal bleeding.

The Ebola virus is not easily spread. People must come into direct skin contact with an infected person’s blood, vomit or other bodily fluid. Ebola cannot be spread through coughs or sneezes or through food or water. In fact, it is less contagious than mumps or measles.

There have been no suspected or confirmed cases of Ebola in Washington state. There have been cases of Ebola in other states, but there is no widespread outbreak of the disease in the U.S.

Harborview Medical Center in Seattle is one of a handful of U.S. hospitals designated to treat Americans sickened with Ebola, including those who might need to be flown here from West Africa, where the virus was discovered.

Sources: Snohomish Health District, state health department and Harborview Medical Center.

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