Winnipeg's city and health officials moved quickly on Tuesday to pour water on allegations from the firefighters' union that the city is not ready for a case of the Ebola virus.
At a late afternoon news conference, city officials said they have four special ambulances that would be sent out to any calls that may involve or be suspected of involving, a case of Ebola.
Each ambulance will be equipped with protective gear and staffed by two paramedics and one medical supervisor with proper training and the support of a doctor, said Dr. Robert Grierson, medical director of the Winnipeg Fire Paramedic Service.
"The medical supervisor, as a supervisor, [is] watching the donning and doffing of the personal protective equipment that is all designed to minimize the exposure to the personnel," Grierson told reporters.
"Once the paramedics are on scene and have evaluated the patient, if the patient is stable, they will be able to contact a physician from that residence and have the physician assist in the questioning of the patient," he added.
If a patient is deemed to be not in a stable condition, they would be transported directly to hospital.
Officials emphasized that no firefighters would be sent to the call.
The city said if a paramedic is possibly exposed to the virus, the city would follow instructions from the Winnipeg Regional Health Authority and provincial health officials as to how to proceed.
“I would like to reassure the public that the [Winnipeg Fire Paramedic Service] has been working closely with the Winnipeg Regional Health Authority in the proactive development of processes for identifying potential cases of Ebola and the required safety equipment needed to safely transport suspected cases to health-care facility,” said WFPS acting assistant chief Tom Wallace in a news release.
Wallace said Winnipeg was also one of the first Canadian cities to begin planning for potential Ebola cases, and the development of emergency medical processes began at end of August.
"As early as the second week of September, we had a specialty crew equipped and trained to respond to a potential EVD case in Winnipeg," he told reporters.
Firefighters' union sounded alarm over new procedures
Alex Forrest of the United Fire Fighters of Winnipeg said earlier Tuesday that Winnipeg wasn't ready to handle potential cases of Ebola.
He released an internal memo the city sent to the WFPS on Oct. 9, describing preparations the city is taking to work with the Winnipeg Regional Health Authority and the Province of Manitoba to prepare for the possibility of an Ebola case and ensure a co-ordinated response.
It also instructs employees to check internal city websites and videos for information on how to use protective gear.
Forrest contended that first responders weren't ready, saying it was only last week that paramedics started to receive training on how to use protective equipment provided by the WRHA.
He said first responders were worried they didn't have the tools in place to respond safely.
And Forrest said there's a sense of urgency: given Winnipeg's diversity of immigrant communities, it's only a matter of time before an Ebola case surfaces here, he said.
"If you look at Canada, we have a large ethnic population from identified countries," he said. "So Winnipeg, out of all the cities in Canada such as Toronto, Vancouver, Calgary, Edmonton, these are the areas where it's going to show up first."
In fact, a patient showed up at St. Boniface Hospital's emergency room last week with flu-like symptoms and "combined with a positive travel history, the infectious disease specialist was called, additional travel questions were asked and the individual was cleared of any concern for Ebola," according to an e-mail from Hélène Vrignon, senior corporate affairs and communications officer.
The patient's symptoms were treated and that person was released from hospital.
911 operators screening calls
The city also said on Tuesday that 911 operators have been screening calls for Ebola-like symptoms, asking people calling 911 whether they have been to any of the areas affected by the Ebola outbreak.
The internal memo said if a patient has recently travelled from an area where Ebola is present and exhibits the symptoms of the virus including a high fever, the incident will be "flagged" and first responders wearing the same personal protective equipment as hospital staff will transport the patient to a predetermined WRHA site, most likely the Health Sciences Centre, as the WHRA has indicated earlier this week.
Winnipeg is already at the forefront of the fight against the deadly virus, given the location of the National Microbiology Laboratory in the city.
Samples from patients suspected of having Ebola are sent to lab in Winnipeg for testing.
Forrest said the Ebola crisis has paramedics and firefighters on high alert.
"We have two suspected cases in Ontario," he said. "We have to be prepared. Our brothers and sisters in the United States are already dealing with this."
Forrest said the WRHA's new policy left first responders with more questions than answers.
"This is not SARS. This is not avian flu. The mortality is such and chance of spreading is so great, what we're doing is we have to be more aggressive in our quarantine process," he said.
Paramedics not worried
But the union representing Winnipeg's paramedics downplayed firefighters' concerns.
Union president Chris Broughton said paramedics have dealt with SARS and the H1N1 strain of flu, so they are prepared and know what's at stake.
"This isn't a new issue for health-care providers and paramedics in general. We face infectious diseases all the time," he said.
"There's reasons why we have isolation units in hospitals, because we face these kinds of outbreaks from time to time."
Broughton said while paramedics haven't done any special exercises to get ready in the event someone infected with Ebola shows up in Winnipeg, every day is an exercise.
In response to Forrest's remarks, Broughton said authorities are trying to reduce the number of personnel involved in these types of situations.
"If you have less people involved to someone potentially infectious, then you have a less likely occurance of that virus being transmitted to a group of people," he said.
"It's been determined in a lot of cases that the fire isn't essential to providing care and that they would be kept out of the care process when one of these situations would present, so there might be some concern because they haven't been involved as heavily in training as much as our advanced care paramedics have been."
Broughton said he believes the risk of Ebola showing up in Winnipeg is low, and more people would likely die of the flu every year.
WRHA says procedures in place
The Winnipeg Regional Health Authority also held a hastily called news conference Tuesday afternoon.
Spokesperson Helen Clark said the WRHA has a plan with the Winnipeg Fire Parademic Service in the case of a potential case of Ebola.
She said staff have been trained and they are ready.
"They have the personal protective equipment. They have a screening system in the 911 communication centre. So they are ready to go," she said.
Clark said not all staff have been trained yet but there is a core of people available on each shift who can deal with a suspected case.
She said if a first responder encountered a situation in which a person had Ebola-like symptoms yet the first responder didn't have the necessary protective gear or weren't familiar with how to use it, a protocol is in place.
"What we recommend in that scenario is a no-touch approach, maintain a distance of two metres between yourself and the person, and then isolate them as soon as possible by directing them to a space where they can be separated from you and then start asking the questions about travel history."