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The continued fallout over two health-care workers who contracted Ebola from the first patient to be diagnosed with the virus in the U.S. has sparked action among Canadian officials to better train front-line workers in Canada and avoid the mistakes made in Dallas.
Experts say the protocols established following the SARS outbreak in 2003 will help to prevent Canada from repeating the type of errors made by a Dallas hospital in the initial assessment of Thomas Eric Duncan. He was initially sent home from the hospital emergency room with antibiotics for his high fever, even though he said he'd recently been in Liberia.
"I think because of SARS we have certain protocols in place that would have prevented a lot of the first mistakes that were made in Texas," said Dr. Brett Belchetz, a Toronto emergency room doctor. "The fact that this guy was turned away from the front door, the fact that he was initially allowed to wait in the waiting room with other patients on his visit, that he wasn't put into isolation."
"Given our experiences with SARS, typically all of us have the right protocols in place to identify people and put them straight into isolation," Belchetz said.
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Texas 'has changed everything'
In Dallas, the protocols in place to deal with Ebola-infected patients have come under intense scrutiny, particularly after it was revealed that one of the nurses who had treated Duncan was allowed to board a passenger flight. That nurse, who later tested positive for Ebola, had contacted an official at the Centers for Disease Control, who said she was cleared to fly.
Besides the problem with that clearance, there's the issue that's emerged in Canada about the training of front-line health-care workers who would have contact with Ebola-infected patients. Many Canadian health-care workers and union representatives for nurses have said their members aren't confident they're up to speed on everything they need to know and everything they need to have.
"Where we were going down the road, potentially making the same mistakes [as Texas] is not having the full sets of protective gear and not doing the hands-on drills for our staff on how to use it properly," Belchetz said.
"And I think having seen what happened in Texas, that has changed everything. Hospitals seem to be changing their tune. And they're doing what I called for in the beginning and that's hands-on drills."
In the wake of the two infected Dallas nurses, Health Minister Rona Ambrose said in a statement Wednesday that all public health officers in Canada agreed to look into "further strengthening our protocols" on how to manage Ebola cases. Ambrose also said in a call with her provincial counterparts, she encouraged officials to look into doing test runs to ensure protocols are in place, and proper personal protective gear is available.
In Ontario, Health Minister Eric Hoskins said the province will update its guidelines to help front-line health workers deal with potential Ebola cases.
"I don't want a single health-care worker that feels that they are not adequately protected or secure or don't have the equipment that they require," he said.
Linda Silas, president of the Canadian Federation of Nurses Unions, who has been critical about the lack of Ebola-related preparation and drills given to nurses, said a lot of training has begun this week.
Silas said what happened in Dallas took everyone by surprise and that she will sit down with the head of the Public Health Agency of Canada next week to talk about the revised guidelines and the need to look at how the entire system will manage possible Ebola patients.
Canada also seems to be taking some cues from the Americans in terms of the need for a rapid response to Ebola cases. U.S. President Barack Obama announced on Wednesday he had directed the CDC to establish a rapid response "SWAT team ... to be on the ground as quickly as possible, hopefully within 24 hours, so that they are taking the local hospital step by step through what needs to be done."
Similarly, Transport Canada has been asked to provide planes from its fleet to dispatch rapid-response teams of experts from Ottawa and the Winnipeg microbiology lab in the event of a positive Ebola case in Canada.