Maimonides Doctors Weigh in on Ebola

By Monica Friess

Though the likelihood of contracting Ebola in the Lehigh Valley is quite low, the disease, nevertheless, is the subject in the forefront of many people’s minds. In the U.S., one man has died of the illness he contracted in Liberia, and two healthcare workers involved in his care have tested positive.

Information and guidelines from the CDC seem to change daily, and the general public is frightened.

Two Lehigh Valley residents who are directly involved in local emergency preparedness have provided needed insight into this emerging crisis.

Dr. Alex Rosenau currently serves as president of the American College of Emergency Physicians (ACEP), a professional advocacy society comprised of 33,000 members. He is also senior vice chair of emergency medicine at Lehigh Valley Health Network (LVHN). Rosenau said he feels assured about the area’s healthcare system and the level of training being given to providers in the event of a local occurrence. 

“Our EMS systems, hospitals and professional societies are keeping current with the guidelines, practicing disaster drills and sharing expertise with colleagues in the region,” Roseneau said. “LVHN has a strong disaster management team and a strong infectious disease department, and they are taking appropriate steps to prepare for the rare but real possibility of a patient with Ebola showing up in the emergency department (ED).” 
Dr. Jeffrey Jahre is the senior vice president 

of medical and academic affairs at St. Luke’s University Hospital and is an infectious disease specialist. In a recent briefing for the staff at St. Luke’s regarding the hospital’s readiness, he expressed frustration about the frequent changes in CDC recommendations but said, “Despite the CDC’s uncertainty, St. Luke’s is actively planning for all situations.” He is confident in the hospital’s ability to be proactive and also stated that the hospital will deliberately exceed the CDC standards for safety in its selection of personal protective equipment.

Because there is no proven treatment for Ebola – only experimental ones – Jahre said hospitals must focus on three areas: A patient must be kept isolated until he or she can be transferred. Jahre said there are only four hospitals in the country with separate biocontainment units and adequate personnel to care for these patients. He is confident that hospitals in the Lehigh Valley can control the situation and prepare a safe transfer. An Ebola patient can lose up to 10 liters of body fluid per day and, therefore, must be kept fully supported with fluid replacement therapy in order to prevent organ failure.

Healthcare workers must continually receive updated training and information. Rosenau and Jahre said simulation drills have been instituted in the area’s hospitals and that personnel will be prepared in the event Ebola presents in the ED. 

As president of ACEP, Rosenau provides invaluable insight into the state of the country’s EDs. A recent report card issued by ACEP stated that there is a low surge capacity – this is a measurable representation of ability to manage a sudden influx of patients – in the nation’s hospitals. 

“At the last government sequester, disaster funding was cut by 50 percent,” Rosenau said. “Adequate support and resources must be committed on a national basis to ensure challenges will be met.” He also stressed that a way to cut down on visits to the ED is to get a flu shot. 

“Ebola is scary but unlikely,” Rosenau said, “and the flu is a reality that killed over 25,000 people in the U.S. last year.” The differences in viral illnesses are difficult to discern in early stages. Both Ebola and influenza will begin with similar flu-like symptoms; EDs are already dealing with cases of the flu, and ED visits will only increase as fear of contracting Ebola increases.

Jahre cited the need for increased funding to prevent the spread of Ebola and stressed the need to get to the source in West Africa to learn how to stop its spread. 

“We live in a global village,” he said, where an infected person is just a plane ride away. “As Jews, we are taught not to stand idly by the blood of our brethren. We are our brothers’ keeper.” 

Rosenau echoed this sentiment. “We’re all related and are in this together. Getting this right is in the true spirit of tikkun olam.”

For more information and the latest guidelines on Ebola, go to CDC.gov

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