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Go inside a U.S. hospital preparing for more Ebola cases

In a special ward of Mount Sinai in Manhattan, doctors, nurses and security are prepping at top speed for a dreaded scenario: someone with Ebola walking through their doors. The NewsHour’s Megan Thompson reports from one of eight hospitals in the state of New York designated to respond to the disease.

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  • JUDY WOODRUFF:

    Now: how hospitals are preparing for possible Ebola cases in this country.

    A judge in Maine ruled today against state officials who sought to quarantine nurse Kaci Hickox, who returned from West Africa after working with Ebola patients. Hickox has no symptoms and has refused to observe a voluntary quarantine. But the judge did say she must continue to be monitored for symptoms and must coordinate any travel with state officials.

    The debate over that case comes as hospitals are scrambling to prepare for any future Ebola patients.

    In New York state, Governor Andrew Cuomo designated eight hospitals that need to be ready.

    The “NewsHour”‘s Megan Thompson visited one of those hospitals in Manhattan.

  • MEGAN THOMPSON:

    On Wednesday afternoon, staff was buzzing at the Mount Sinai Hospital on Manhattan’s Upper East Side. In a special ward, doctors, nurses and security were prepping at top speed for a dreaded scenario: someone with Ebola walking through their doors.

    Dr. David Reich is the hospital’s president.

    So, you have been at this hospital for 30 years. Have you seen anything like this before?

  • DR. DAVID REICH, President, Mount Sinai Hospital:

    There’s really nothing like this that’s ever been dealt with at this hospital before. And, in fact, I would say that, of all the hospitals in New York City, there really is nothing — there has really never been anything quite like this.

  • MEGAN THOMPSON:

    New York’s first case of Ebola last week, at nearby Bellevue Hospital, only added to the pressure. Mount Sinai is a top-notch hospital, but Ebola represents a whole new challenge.

    The first thing that greets you when you walk in the door, big new signs in 13 languages. They say, “If you have symptoms and have traveled, tell us immediately.”

  • MAN:

    So, this is an isolation room in part of the emergency department.

  • MEGAN THOMPSON:

    Possible Ebola cases can be isolated here. Luckily, the only patient today is a mannequin used for training. So far, there have only been a handful of false alarms in the entire Mount Sinai system. But, until now, this hospital didn’t really have another place outside of the E.R. to provide long-term care for an Ebola patient.

    Last week, this section of the hospital was part of the cardiac critical care unit. But, in just a matter of days, Mount Sinai has transformed it into a brand-new unit to care for possible Ebola patients. They’re still finishing it up, but they say that if somebody walks into the hospital today who might have Ebola, they’re ready for them.

  • DR. DAVID REICH:

    And we have completely walled it off.

  • MEGAN THOMPSON:

    The new unit is sealed off. And while Ebola is not an airborne disease, a negative pressure system and heavy-duty air filters are in place as extreme precautions.

    Special protocols are followed to get rid of all waste. And this new communications system will allow staff to monitor and talk to patients without having to get close.

  • DR. DAVID REICH:

    The facility is in some ways only the smallest part of this. Creating a team that is competent and confident in their skills to care for a patient with this deadly disease that provides extreme risk to health care workers, that is the real challenge for us.

  • MEGAN THOMPSON:

    So, Mount Sinai conducts training regularly to make sure the staff is prepared. An expert from the CDC is here to consult. One of the most important and new procedures to learn is how to put on the protective personal equipment.

  • WOMAN:

    I’m going to read out the safe work practices.

  • MEGAN THOMPSON:

    Nurses train with a coach and a checklist. There are special coveralls and thigh-high plastic booties, a respirator, hoods, goggles, a second gown, two sets of rubber gloves, and a face shield. Every detail is rehearsed, down to the type of knot securing the smock.

  • WOMAN:

    We have to make sure we’re hydrated before we suit up, if you need to use the bathroom, because it’s going to take time for us to do that again.

  • MEGAN THOMPSON:

    Plus, it’s just hard to work draped in all that plastic and rubber.

  • DR. DAVID REICH:

    We did a simulation last Thursday with the CDC watching us. After about 45 minutes, they were exhausted, they were soaked in sweat. It’s very clear that anything that we take for granted in terms of normal functions in an intensive care setting is so much more difficult.

  • MEGAN THOMPSON:

    So staff practice maneuvering around in all the gear.

  • MAN:

    Spray everything with bleach.

  • MAN:

    Keep everything nice and calm and stable.

  • MEGAN THOMPSON:

    And during simulations, they troubleshoot to find holes in their systems. Here, a doctor pretends to be an Ebola patient who accidentally tore off the nurse’s gown.

  • MAN:

    She comes out on her own.

  • MEGAN THOMPSON:

    The team must figure out how to react.

  • MAN:

    The patient needs to understand that they cannot pull on you.

  • MEGAN THOMPSON:

    And then there’s taking off the protective gear. What might seem like a simple act could actually be the most dangerous, because this is when exhausted nurses and doctors could accidentally contaminate themselves.

    The hospital is constructing another isolation unit outside that will eventually be the primary Ebola care center. But all in, the new units will only be able to handle about three patients at a time. And that could pose a problem if the outbreak grows dramatically worse.

    Hospital officials wouldn’t provide specific numbers, but it’s clear the costs for all this will be considerable.

    Dr. Kenneth Davis heads the entire Mount Sinai system.

  • DR. KENNETH L. DAVIS, CEO and President, Mount Sinai Health System:

    This is expensive. The drill — the drilling, the equipment, the construction, it’s all not been budgeted. And in hospitals like ours, which have a very large percentage of patients who are largely Medicare or Medicaid, the margins are very narrow. So, we’re ultimately going to be looking for federal, state, local help.

  • MEGAN THOMPSON:

    While all of this might look like something out of a sci-fi movie, Dr. Davis says, everyone needs to remember to stay calm.

  • DR. KENNETH L. DAVIS:

    What separates this from anything else we have ever seen is the degree of anxiety, almost hysteria, that’s in the population about this. Let’s remember, there is one case in New York. There are less than a handful of cases in the United States. And the cases are, by and large, health care workers.

  • MEGAN THOMPSON:

    For weeks to come, Mount Sinai’s health care workers will continue to practice the new procedures, procedures they hope they will never have to use.

    For the “NewsHour,” this is Megan Thompson reporting from New York.

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