The First Ebola Patient in the US

Many of you have been wondering just how much we are in danger of Ebola outbreak and just exactly how did we do in handling the first case in the United States. I was very disappointed and alarmed to see Texas Health Presbyterian Hospital, an affluent and well-funded Hospital in Dallas, send the first Ebola patient home with free antibiotics diagnosed with a sinus infection, even though they knew that the patient had come from Liberia. The danger, of course, was that he would infect numerous individuals over the few days he was home rather than hospitalized. For example, Dallas was scrambling to find the homeless man that rode in the ambulance to the hospital with Mr. Duncan upon his return. They found him and he is disease free but there could have been a different outcome. It will be up to the lawyers and perhaps a jury to determine if the delay in diagnosis and treatment resulted in Mr. Duncan's death. Fortunately, we know now that his family was not infected. This is common treatment of uninsured individuals in the United States. The Dallas hospital has received much poor publicity and has had to temporarily close their Emergency Room, which is now reopened but unpopular. Many potential patients are refusing to go their which has resulted in a loss of revenue. If you had a choice, would you go to a hospital that has allowed their staff to become infected with Ebola when you could to somewhere else? The economic loss to the hospital and its parent company, Texas Health, is a good thing for the rest of us, because this will motivate administrators of hospitals all over the country to be certain they are prepared for an Ebola patient walking in their door. The Affordable Care Act fines hospitals that have readmissions due to misdiagnosis or lack of follow-up, and this hospital had been fined in the past. The amount of the fine, evidently, did not act as a deterrent for this hospital. Hopefully, the economic fallout for a misdiagnosis or a transmission to staff will provide the motivation. If not for the failure of the hospital to protect its staff, we would be Ebola free in the US right now. Under CDC guidelines in place at the time of his admission, the department of health would have been notified. Under Dallas County regulations in effect at the time, Mr. Duncan would have been sent home due to the misdiagnosis of a sinus infection and the lack of awareness that the pregnant woman that he assisted in Liberia had Ebola. The CDC is tightening its guidelines and I hope the County of Dallas will do the same.