Urgent-care clinics ill-equipped to treat Ebola

A new concern over the spread of Ebola surfaced recently when a Dallas County sheriff’s deputy who searched the apartment of the first patient to die from the virus in the U.S. started feeling ill and went to an urgent-care clinic.

The rapidly expanding facilities aren’t designed to treat serious illnesses and are ill-equipped to deal with suspected Ebola cases.

Doctors are urging patients to avoid smaller medical centers and head to hospital emergency rooms if they think they’ve been exposed to the virus that has put a focus on weak spots in the U.S. health care system.

The deputy was transferred to a hospital where it was determined this month that he didn’t have the virus, but urgent-care doctors say he should have gone to the ER first.

“Patients have a difficult time deciding where they need to go for care,” said Dr. William Gluckman of the Urgent Care Association of America, which represents more than 2,600 clinics nationwide.

Clinics are rushing to get ready, passing out protective gear and training staff, but they lack essentials, including isolation units, needed to fight Ebola. Given the problems at the Texas hospital where Thomas Eric Duncan died and two nurses were diagnosed with the virus, experts say an Ebola case at a clinic or smaller hospital could have been worse.

“That would be an even less controlled situation,” said Dr. David Weber, a disease specialist with the University of North Carolina. “The likelihood for that is so remote that they may never have thought about that.”

That’s changed recently as the Urgent Care Association of America sent emails to its roughly 6,400 members asking them to send suspected Ebola cases to hospitals for treatment.

If someone has a fever, headache or other flu-like symptoms and has been in an Ebola hot spot, clinics have been told to contain that patient in a single room, call public health officials and contact a hospital for transportation as quickly as possible, per Centers for Disease Control and Prevention guidelines.

The CDC says Ebola isn’t contagious until symptoms appear and isn’t spread through the air; people catch it by direct contact with a sick person’s bodily fluids, such as blood or vomit.

CDC Director Tom Frieden said the agency is bolstering training nationwide on how to respond to an Ebola case.

As U.S. health care has become more complex with retail clinics, urgent-care centers, work-site clinics and even online clinics, it’s also become a challenge to ensure that everyone strictly follows protocol. But that’s not necessarily a bad thing, said Dr. Tom Zweng of Novant Health, an urgent-care system based in North Carolina.

“This is not an exercise in futility,” he said. “This is preparing staff in safe practices. It may be Ebola today, but tomorrow there may be another communicable disease that we don’t even know about. This is about taking health care in this country to the next level.”

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