Island hospitals, Northern Ontario, ready to confront threat of Ebola

MANITOULIN—In light of the recent North American cases of Ebola (together with false alarms) affecting those returning from areas of West Africa where the disease is rampant—Ontario has begun its battle against Ebola before it hits with precautions being put into place at the Manitoulin Health Centre, as well as all hospitals across Ontario.

According to the World Health Organization website, “it is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.” Ebola is a strain of hemorrhagic fever that kills upwards of 70 percent of those infected.

“Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids,” the WHO fact sheet continues.

The incubation period (the time interval from infection with the virus to onset of symptoms) is 2 to 21 days, the WHO states. Humans are not infectious until they develop symptoms that include the sudden onset of fever fatigue, muscle pain, headache and sore throat. This is followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (e.g. oozing from the gums, blood in the stools). Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Last week Dr. Eric Hoskins, Ontario Minister of Health and Long-Term Care, and Dr. David Mowat, Interim Chief Medical Officer of Health for Ontario, issued the following statement on Ontario’s preparedness for Ebola virus disease in Ontario:

“We know that Ontarians may have concerns related to the ongoing challenges in West Africa and recent events in the United States regarding the spread of the Ebola virus,” they said in a press release. “Let us assure you that the safety of Ontario’s health care workers, patients and the public are our top priority.”

“We are confident that Ontario is prepared and ready to contain and treat any potential case of Ebola virus in our province—protocols are in place and we’ve seen the system work well in Ontario hospitals,” they continued. “With the experience and lessons learned from the Severe Acute Respiratory Syndrome (SARS) epidemic, our health care facilities now have sophisticated infection control systems and procedures to protect health care providers, patients and all Ontarians. They are fully equipped to deal with any potential cases of Ebola.”

But all health care workers, especially those providing care to patients, must be safe and protected,” they continued. “This is why we are working with health care employers to ensure they are providing appropriate training for their staff on the proper use of personal protective equipment and other occupational health and safety measures. We are also continuing to work with health care workers and employers to further strengthen protective measures and ensure they’re in place at all times. Our health care workers are on the front lines and it is times like these when we are all reminded of how critical their work is in protecting the public. We want them to feel safe. We will be reaching out to our health care partners to ensure they have the maximum protection possible and plan to release revised guidelines by the end of the week.”

The government is indeed working with local hospitals and had sent out directives regarding the Ebola virus by Friday evening for implementation in all Ontario hospitals, explained MHC CEO Derek Graham in an interview with The Expositor.

Leading up to Friday night, the MHC had been in constant contact with the ministry and the Ontario Hospitals Association (OHA) with bulletins about the spread of the disease and any suspected cases in the province.

Locally, the hospital has made sure they are stocked up on protective gear and already have an N95 respirator mask fitting machine which ensures that there is a tight seal between the mask and the wearer’s face. (The N95 mask is the most common of face piece respirators on the market and filters over 95 percent of airborne particles.)

The province also revealed the 10 hospitals province-wide that will be equipped to deal with any Ebola patients, among them Health Sciences North—the only hospital designated as such in Northern Ontario.

“If SARS is any lesson to us, once things start to unfold, the information changes rapidly and we need to take that ever-changing information and implement it,” Mr. Graham said.

The CEO said the hospital has created a readiness team which is meeting regularly to discuss and digest the province’s constant directives.

Those attending the two hospital sites will soon notice signs posted on the entrances asking them to stop and think about questions regarding travel and fever. They may be questioned again at both admitting and the emergency room.

“We’re not at the SARS level yet,” he said, referring to the level of screening that went on at Ontario hospitals during the 2003 crisis.

“This is poised to hit us rapidly,” Mr. Graham said, noting that while the virus has not been deemed an airborne contagion, it is still not certain whether this may in fact be the case.

“If there are any cases with symptoms, we will collect screening samples, get them to a rapid screening lab while isolating that patient and treating their immediate needs, communicating with central sources and transporting them as required,” the CEO explained.

Testing Ebola specimens at Public Health Ontario’s provincial labs began on Monday, October 20.

The province is expected to roll our further instructions regarding rapid transfer protocols for lab testing and transport protocols for patients.

“Because we have such a global society and fairly open borders, these things have the potential to move rapidly—viruses don’t respect our rules and regulations,” Mr. Graham said.