Ebola in the ER: What you should and shouldn’t worry about

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As an ER doctor, right now I’m thinking a lot about Ebola — it’s in the news, in my inbox, and in questions from my patients.  Whether it’s an outbreak, a flu epidemic, or a bombing — we in the ER see them first, and so I’m always thinking about how we’ll be ready.

So, what concerns me, and what doesn’t?

Ebola patients in the ER. As an ER doctor, I’m on the front lines of identifying and rapidly treating Ebola.   At the ER where I work, we question every patient about their travel history. If they’ve been in an African country with Ebola in the past 30 days and have symptoms of Ebola, they’re immediately isolated. The recent infection of a health care worker has shown that there is no room for error, so my patients, coworkers, and family all need me to be concerned, and to act accordingly with caution.

Am I nervous about my first Ebola-suspected patient, which I expect will come over the next few weeks? I know that most  — if not all of them — will likely test negative for Ebola (even if you come back from Africa with a fever, it’s still more likely you have the flu or malaria). I’d be lying if I said no.  I’m worried about Ebola — mainly because it’s a disease that I’ve never treated before.  But as an ER doctor, dealing with dangerous infections isn’t new: tuberculosis, meningitis, the flu — all of these kill more than Ebola.

So, I’ll be supremely careful with every patient in the ER going forward — whether they’re  suspected of Ebola or not.  I’ll also have a much lower threshold to wear protective equipment and enlist the help of specialists with training in this disease.  My patients, my coworkers, and my family all need me to have a healthy dose of concern, and to act with caution to protect and give care.

What really worries me? The upcoming flu season + panic over Ebola = ER crowds. Unfortunately, the early flu can present much like Ebola.   That means that once flu season starts, there will be a flood of people who have the flu, rushing to the ER because they think they have Ebola. What can you do to keep your family safe? Flu shots. Get them. Everyone older than 6 months should get either the flu shot or flu mist (see the CDC site link below to see what type is most appropriate for you).

Wash your hands — for 20 seconds each time. Preventing the flu in the first place will be more crucial than ever. Just as important will be remembering how unlikely Ebola exposure is and not panicking about it.

What else worries me? The growing Ebola epidemic in Africa and the tragedy there. As long as thousands of people are infected in Africa, there will continue to be a tragic loss of lives. There will also probably continue to be people who get through the screening system and arrive in the U.S. infected. They will be a risk to those with whom they live and have close contact. If you live with someone who recently traveled to these areas, then you must be extremely vigilant for any symptoms that they may have. If you don’t, know that the risk to the general public is far smaller.

What doesn’t worry me as much? Being infected with Ebola in the general public. I don’t expect an “Outbreak ” situation over here. I don’t worry about catching it at the grocery store. You may have heard that if someone infected with Ebola sneezes on you, they can infect you and you would have no idea. But guess what, Ebola doesn’t cause people to sneeze or cough. So, at this point, that scenario would be extremely unlikely. Someone would literally have to throw up on you. (I’m sorry for the mental image there, but I really wanted you to understand).

So please, go about your lives. Don’t lose sleep over Ebola right now. If you need to be concerned, I will let you know. Believe me — as a mom myself, I worry about every little thing too. Ebola and its risk to the general U.S. public are just not one of those things right now.

What I want you to do:

  • Get your flu shot (or flu mist, if indicated). Learn about vaccine options.
  • If you are sick, stay home.
  • Wash your hands —  I rely on soap and water as much as I can. If you don’t have access to them, or your hands are not visibly dirty, then you can use an alcohol-based sanitizer with 60 percent alcohol. This is especially important before you eat anything or touch your face.
  • Know the symptoms of Ebola. While the chances are extremely slim, if you come into contact with someone who has traveled to Africa or cared for a patient with Ebola and appears to be ill, call the authorities immediately. 1-800-CDC-INFO is a great start.
  • Clean (or avoid) surfaces touched by many people. Doorknobs, toilet handles, faucets, and buffet serving utensils — all places where germs can reside. As much as I can, I use a paper towel when handling these things (or try pushing the door with my shoulder), or sanitize my hands after touching them. Does it make me look like a germophobe? Probably. Do I really care? Nope.

Darria Long Gillespie is an emergency physician and executive vice president, clinical strategy, Sharecare, and assistant professor, department of emergency medicine, Emory University Hospital, Atlanta, GA.  She blogs at Dr Darria.

Image credit: Shutterstock.com

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