Keeping disease and people separate isn't easy, even at Ebola treatment centers

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Marco Werman: I’m Marco Werman and you’re tuned to The World. We’ve got basic questions about Ebola coming up. But first, as more healthcare providers are infected with the virus, it’s become painfully clear that the outbreak isn’t just dangerous for patients. You need multiple steps and cross checks to ensure the health of everyone involved. How are treatment centers doing that? Our longtime contributor, physician Sheri Fink, is reporting on the epidemic in Liberia for the New York Times. She gives us a walkthrough of one facility in Monrovia, it’s designed for a one-way flow -- low-risk to high-risk, and then out.


Sheri Fink: So, you start out with the area where the staff do most of their work, where the laundry happens, the pharmacy, where people eat their lunches. So that happens in what’s called a low-risk area, and to enter and exit that, you have to get yourself hosed off; your shoes are hosed off with a chlorine solution, .5%, and you also wash your hands with that. And then we get to the patient areas. So, you “gown up” before you would be in a patient area. This requires multiple layers of the suits that are becoming very well-known now -- the bright yellow suits or the bright white suits, and then there are masks and goggles and multiple layers of gloves, and then the healthcare workers can enter the areas where the patients are. There are two wards: the suspect ward, where people come when they’re suspected of having Ebola and they’re waiting for test results, and then they move in a unidirectional flow into the confirmed ward, should they be confirmed. And then hopefully when a certain percentage of patients do recover, and it’s wonderful to see that, they go through a shower, they have to put all of their personal belongings into a bleach solution, including their cell phones and sim cards, which sometimes make it and sometimes don’t. Then they come out and they’re with us, and then they get to go home.


Werman: The fact that more ETUs, these Ebola Treatment Units, are being built, that must indicate there’s still not enough capacity. So, in each of these places, typically how many people comprises a full unit?


Fink: Well, they’re all built in terms of different sizes. Before this West African outbreak, I think some of the biggest ones could treat maybe a few dozen people -- that was considered really huge. And now we have Doctors Without Borders that has opened, I think, somewhere upwards of 250 beds in their treatment center in Monrovia. But as I understand it, that expansion just occurred and that facility isn’t full. What I think we’re seeing this week, which is kind of interesting, is that some of these centers are not full, and so the question is what could be explaining that? Are there still cases in the community where people just aren’t reporting to the centers? Is there a problem with transportation, contact tracing, active case-finding? All these terms that they use here. But it does seem like now, with more treatment units onboard, that there is more capacity, so there’s an interest in trying to go out and find where the people are who need this help.


Werman: I was curious about that Sheri, because you’re a physician. Do you ever find yourself wanting to, or even doing any medical work while you are reporting?


Fink: Well, I usually keep the lanes really separate and I’ve been focused on journalism for many, many years now, as you know, Marco. So, there are far more qualified people than me who are staffing the Ebola treatment units here, so there’s no need for me to do clinical work. There’s small ways that I can help out, like smiling at a patient or handing a water bottle over, and I think that’s just human and any reporter who’s in a situation like this, in a big emergency, humanity comes first and there are opportunities to cheer people up, to give them a smile, to encourage them. That, I think, is no problem with the dual job description in that case. We’re just human beings. But fortunately, the places where I’ve been have been filled with very qualified health professionals, so I’m not feeling that conflict right now and that’s a good thing.


Werman: Always room for the human connection. Dr. Sheri Fink covering the Ebola outbreak for the New York Times in Monrovia, Liberia. Thank you, as always.


Fink: Thank you.