What Happens When Ebola Arrives in Virginia?

We all know it’s only a matter of time until Ebola comes to Virginia. According to  Joe Hilbert, Director of Governmental and Regulatory Affairs at the Virginia Department of Health, the state has been planning for such an event for years. [read_more]

There has been ongoing planning and communication around this issue built on years of development of public health and healthcare emergency response capabilities in Virginia. There are well-established systems in place with local, state, and federal partners to address communicable diseases of public health concern, including those associated with international travel. We are responding to questions from health care providers related to Ebola, consulting on whether or not laboratory testing is indicated for an individual patient, and coordinating that testing when needed.

VDH feels confident in its ability and the ability of the entire health care community to respond to this and other public health threats.

Mr. Hilbert issued this summary of the actions the VDH will take when they receive a report of a likely case of Ebola.

Virginia Department of Health (VDH) Actions Upon Receiving a Report of a Probable “High Risk” Case and/or Laboratory Confirmation of a Case of Ebola in Virginia

The following actions would occur concurrently and in coordination with the treating clinician(s) and hospital, the local health district, the Division of Consolidated Laboratory Services (DCLS), and the Centers for Disease Control and Prevention (CDC) in response to a patient who is a probable “high risk” case and/or who has laboratory confirmation of Ebola virus disease (EVD).

Protecting Healthcare Workers

Ensure the medical care facility is aware of the diagnosis and that all healthcare workers are following recommended precautions, including use of personal protective equipment for standard, droplet, and contact precautions.

Recommend, per CDC guidance, that specimen collection be kept to a minimum for the patient a and that laboratory workers and others handling specimens are aware of the potential diagnosis and are following all recommended precautions to prevent work-related exposures to the virus. 

Identifying and Monitoring Personal Contacts of the Ill Individual

Collect as much information about the ill person as possible by asking healthcare workers already in contact with the patient to conduct comprehensive interviews (travel and exposure history, description and history of illness, and dates and types of interactions the person had with anyone since the earlier signs of illness)

Locate and speak with every person who had the type of contact with the ill person that could potentially lead to blood or body fluid exposures since the onset of the earliest symptom, such as when the fever presented. These contacts may include, but are not limited to, household or other close contacts, emergency medical services providers, health care workers providing care to the patient, and laboratorians.

Direct contacts to monitor his/her temperature twice each day and record it in a written log and coordinate daily monitoring of contacts by VDH for out-of-hospital contacts and by hospital for healthcare workplace contacts.

Advise contacts including health care workers, per CDC guidance, that they may perform usual daily activities unless any symptoms of illness develop. An exception is that the contacts will be asked to refrain from taking long trips on public conveyances. (If specific conditions warrant, the Commissioner has the authority to issue an order of quarantine per existing law and regulations.)

If contact develops symptoms, direct person to stay home and away from others to watch to see if symptoms worsen. Person will be evaluated to determine if symptoms are compatible with EVD. If symptoms are such that medical care is required, health care providers would be notified in advance of any care-seeking so that precautions can be put into place to prevent any further exposures.

Communicating

Coordinate information for senior leadership, interagency, and federal and state partners.

Coordinate public messaging with hospital, local health district, DCLS, CDC, and other agencies (e.g., VDEM). If there is laboratory confirmation of EVD, there will be an initial press conference with, at a minimum, State Health Commissioner, local health director and hospital leadership. 

Provide key risk communication messages to the public:

Ebola virus is not communicable to others until a person exhibits signs of illness.

Only persons who have had direct contact with the blood and body fluids of someone ill with EVD are at risk of infection. 

Infection prevention measures used every day in U.S. health care are sufficient to prevent the spread of EVD.

There is a coordinated public health and health care response that will contain the spread of Ebola in Virginia.

Coordinating the Response

Activate incident command if there is laboratory confirmation of EVD. At a minimum, the local health district response would operate under incident command with support of VDH’s Emergency Coordination Center and VDH Central Office resources. 

Does this assurance from Mr. Hilbert make you feel safer? Do you believe our nation and our state are capable of controlling the spread of the Ebola virus? I don’t trust anything the feds tell us, but I am more inclined (perhaps foolishly) to believe the Virginia Department of Health. 

Information on Ebola from the Virginia Department of Health for health care providers is here. 

Ebola information from VDH for the rest of us here. 

More explanation and history of the Ebola virus here and here.