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Are Ebola screening measures ineffective? – Part 2

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  • HARI SREENIVASAN:

     This was a day when even one of the government’s top health officials said there were things that didn’t go the way they should have. We look at those concerns and other moves by the government with Stephen Morrison, the director of the Global Health Policy Center at the Center for Strategic and International Studies.

    So, Mr. Morrison, let’s talk a little bit about those lessons learned that Anthony Fauci was talking about. We don’t know everything yet about what’s happened in Dallas, but what can we take away from the way that the hospital and the region and the local authorities handled this?

  • STEPHEN MORRISON, Center for Strategic and International Studies:

    Well, we know from what you have just reported that there were mishaps in the systems at various points, and there’s a need for a much higher vigilance and training and awareness.

    And it — I don’t think, in retrospect, that this is all that surprising that you have a sudden introduction of something as lethal and dangerous as this into an unexpected environment, and then that you have mishaps that happen along the reporting at the desk when he first reports to the Presbyterian hospital, that there’s mishandling of the waste material later when he shows up, that there’s clumsiness in the way the family is — that had been exposed is handled.

    I think these are serious lessons, and the systems will have to improve as we get additional cases, which are quite probable.

  • HARI SREENIVASAN:

    The government says that they have been trying to prepare people for months, but what does this say about the state of hospital readiness around the United States, sort of until we had this situation happening in Dallas, and now we’re hearing about not quite confirmed cases in other cities?

  • STEPHEN MORRISON:

    I wouldn’t draw the conclusion that Presbyterian wasn’t well prepared. They had, themselves, just a week ago gone through an extensive internal training.

    They had created an isolation unit within their ICU. They had the systems in place. I don’t think this was a catastrophic failure. I think there were some mishaps along the way, and anxieties at the public level were so high because of the lethality of this and because it was such an alien and frightening event, that — that these mishaps became quite magnified.

    And they will have to be handled differently and better into the future.

  • HARI SREENIVASAN:

    Partly because of that fear that you’re referencing and the concern that people in the region or in the area have, is containment or isolation even possible?

    Because one can understand the families’ concerns, saying, you’re quarantining me inside an apartment that apparently has a deadly virus the whole world is concerned about, and nobody’s even come and changed the sheets yet.

  • STEPHEN MORRISON:

    Well, they have moved — they have relocated the family members who were exposed and who were quarantined.

    And the county judge, Mr. Jenkins, apologized for the way that was handled. And as we get into cases where there has been an importation of someone contagious with Ebola who exposes others, I would expect you’re going to see much more rapid and humane procedures in place. This was a moment of pretty intensive learning this week.

  • HARI SREENIVASAN:

    And one of the things that people are also talking about is trying to contain it at the source.

  • STEPHEN MORRISON:

    Right.

  • HARI SREENIVASAN:

    The Pentagon is going to increase the number of troops that — going there, but, of course, we have politicians and others that were saying, let’s figure out how to change that policy on creating some sort of a flight ban.

    Is that — is this a policy that should be looked at again?

  • STEPHEN MORRISON:

    This is a very difficult issue.

    What we saw with Duncan coming here was that the screening procedures are not all that effective if you were unsymptomatic and you don’t personally and voluntarily disclose.

    So what do you do under those instances? You cannot insist upon prior vaccination, because there is no vaccine. There is no rapid test. The only thing that you can begin to consider is a 21-day quarantine period for people coming out of the worst affected areas, and how you would implement that has yet to be really considered.

    But that really, I think, is the only option at this moment that could be considered. And I want to add here, the humanitarian workers who are coming in, both those that are nationals and getting trained up and providing care and treatment in exile, the external expatriate folks, when they are removed because of exposure, they go through a 21-day quarantine period coming out of the region. There’s already practices in place around that.

  • HARI SREENIVASAN:

    All right, Stephen Morrison, thanks so much for your time.

  • STEPHEN MORRISON:

    Thank you.

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