We are told by Tom Frieden / CDC that it was a “protocol breach” when a nurse in Texas taking care of US Ebola patient no. 1 got infected? At the same news conference, he tells us he doesn’t know what kind of breach actually occurred. So what is he talking about? 
I am dumbfounded: Next time a tire blows on a truck driving down the highway, should we assume the driver did not follow protocol? Because our US tires don’t blow up – ever!
What if our CDC-promulgated Ebola protection measures turn out later to be totally inadequate?
When nurses and doctors take care of patients with infectious diseases, don’t they all take a ‘risk’ of getting infected? Does it always amount to a ‘breach in protocol’, or is it always considered to be a lack of care givers following precautions?
From the safe distance of an office at CDC or NIH, it is easy to talk about isolation measures in absolute terms. The real world is different: How many surgeons got infected with HIV when they had a torn glove during an operation? They were double-gloving and wearing face masks but the nature of the intervention brought them into intimate contact with highly infective body fluids. How many physicians in training in the early 80ies became infected with HBV because they were drawing blood on patients they didn’t even know were infectious? They all followed protocols that existed which we now know were at times woefully inadequate.
Ebola is a foe we have little to no experience with. The African nations, much maligned in recent weeks for their ‘inadequate medical systems’ were able to handle several outbreaks in past decades. The claim that US hospitals are well equipped to deal with this scourge is based on – nothing. There is no track record, quite the contrary.
If anything, the uncontrolled CRE outbreak at the NIH hospital in recent years should have taught our top ID representatives at NIH and CDC some lessons in humility. By Tom Frieden’s standards, protocols were breached there, constantly, by the best trained teams, over many months. If NIH cannot do a better job, why this air of confidence, actually arrogance, that “we in the US” can control Ebola, a much more dangerous foe, by following a protocol?
And, one claim recently in the press that we needn’t worry because “we are not West Africa” – does the Ebola virus really care whether here or there?
Hats off to the nurses that expose themselves to one of the most dangerous viruses we ever had to deal with. They are doing a job in a setting of inadequate training, emerging standards of care and precautions, inadequate knowledge about the disease and the way it is spread. They are at the frontlines in this battle to contain Ebola, they have all my sympathies and respect.
