CDC debuts new safety steps in Ebola training for thousands

Thousands of New York City health care workers — from nurses to janitors — learned how to safely put on and take off a full suit of protective equipment to treat a patient with Ebola at an upbeat Centers for Disease Control and Prevention event in Manhattan on Tuesday.

The CDC debuted its new safety standards for health care workers on Monday — recommending that everyone treating an Ebola patient be fully covered and wear two pairs of gloves and a special mask. The agency has been under fire since two nurses in Dallas fell ill with the disease while treating an Ebola-infected Liberian man, Thomas Eric Duncan, who became the first person to die from the deadly disease in the United States.

“All of us are scared,” Arjun Srinivasan, a CDC official, told the New York health care workers. “It’s OK to be afraid.”

Barbara Smith, a nurse at Mount Sinai hospital, practiced putting on and taking off the new safety equipment as her image was magnified on several large screens. Many of the attendees diligently recorded the presentation on their cell phones, while others took notes.

The new guidelines are informed by the methods used by Emory University Hospital in Atlanta, Nebraska Medical Center and Doctors Without Borders, a group that has been fighting Ebola on the ground in West Africa. The CDC has faced criticism for not basing its safety protocol from the very beginning on what these groups do, drawing on their experience in treating Ebola.

The CDC’s initial guidance for putting on and taking off gear, as well as the amount of gear, was seen by some epidemiologists as inadequate to offer protection from the virus. The agency had stressed that workers needed only an impermeable gown, a single pair of gloves, a facemask and goggles to safely treat patients. Nurses who originally treated Duncan did not have hoods covering their necks or leg coverings because the CDC did not recommend them.

The agency now recommends that health care workers’ entire bodies be covered and that workers wear two pairs of gloves. Health care workers are directed to wash their gloved hands several times as they take off each piece of clothing or equipment so there’s no chance that they will touch their eyes or mouth and infect themselves as they’re taking off the gear.

“The new guidance is designed to increase the margin of safety,” Srinivasan said.

He also acknowledged that, in the future, people with Ebola should be treated at only a handful of hospitals where staff members have been trained in the safety procedures. Every hospital should still be able to diagnose a patient with the disease, but once diagnosed the patient should be transferred, he said. (Two weeks ago, every hospital in New York City was drilled in detecting a patient with Ebola.)

“What we’re learning is, providing the full course of care may be better done at a smaller number of specialty hospitals,” Srinivasan told the health care workers. In New York City, Bellevue Hospital Center will serve as the facility of choice, should the need arise.

Both Dallas nurses who became ill were transferred out of state to hospitals with special biocontainment units where employees were trained in treating Ebola. Before Duncan arrived at Texas Health Presbyterian Hospital, staff there had never even run an Ebola drill.

Gov. Andrew M. Cuomo and New York City Mayor Bill de Blasio both spoke at the event, praising the city’s readiness for the virus.