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@@@ 鈥淯nnerving鈥?is how Dr. , chief medical officer of , described the transmission of the disease to the nurse, 鈥渨ho presumably was doing her best to protect herself and yet was still infected.鈥? 鈥淚t tells us this is a fairly contagious virus and really requires every bit of infection control and training that we can muster,鈥?Adler said. The Ebola virus is not transmitted through the air, like the flu, but can be spread by direct exposure to a symptomatic person鈥檚 bodily fluids, such as blood, sweat, vomit, feces, urine or saliva. About half the people who contract the virus die, and there are no approved treatments, although several are being tested. Kaiser training nurses Adler said UCSF plans to strengthen protocols by conducting hands-on training for front-line workers on the use of personal protective equipment, which includes gloves, fluid-resistant gowns, goggles and face masks designed to prevent transmission. 鈥淚t may not be enough to just provide verbal training,鈥?he said. 鈥淲e may have to observe people putting on and taking off protective gear, and ensuring they can do it right every time.鈥? Officials from , one of the state鈥檚 largest health care providers, said they began Monday to train nurses and staff assigned to emergency departments, outpatient medical offices and call centers on the best ways to handle suspected Ebola cases. Dr. , an infectious disease specialist at Kaiser and director of hospital operations for Northern California Kaiser facilities, said in a statement that an instructional video demonstrating the use of personal protective equipment, including how to get it on and off, will be issued Tuesday. Still, some registered nurses say hospitals aren鈥檛 doing enough to protect caregivers. Eighty-five percent of nurses said their hospitals have given them no specific training on dealing with the virus, according to survey results released Monday by National Nurses United of more than 2,100 registered nurses across 46 states and the District of Columbia. 鈥淭hose are alarming statistics about what鈥檚 happening across the country,鈥?said , a registered nurse at Kaiser鈥檚 and board member of the . The nurses say that the standard protection health workers are now getting is inadequate. They want assurances that they will be provided top-grade hazardous material suits, such as those used for dealing with highly contaminated chemicals, and they want hands-on training because verbal or written training will not do. 'Fueling fear鈥? , spokeswoman for the , fired back Monday, accusing the union of 鈥渇ueling fear among the public.鈥?She said hospitals and their staff are prepared to screen and treat patients with Ebola and other infectious diseases. Any changes in protocols that need to be made will come from the , she said. 鈥淲e are looking to the experts at the federal level who have more knowledge than any of us, including the labor unions,鈥?she said. Emerson-Shea also noted that more needs to be known about exactly how the nurse in Dallas, identified Monday as , contracted the disease. CDC Director faced some criticism for blaming the infection on a 鈥減rotocol breach,鈥?in essence blaming the nurse, when it鈥檚 still unclear how she contracted the disease. CDC officials are investigating. The CDC鈥檚 checklist instructing health workers how to put on and take off personal protective gear in infectious disease cases is 29 items long and available on the agency鈥檚 website. Only four U.S. hospitals are designed specifically to deal with highly infectious diseases such as Ebola. They are in Atlanta, the Nebraska Medical Center in Omaha, in Maryland and Rocky Mountain Laboratories in Montana. But most acute-care hospitals in the U.S. have negative-pressure isolation rooms for highly infectious disease cases. But six patients have been treated for Ebola in the U.S., excluding the most recent case. The only one not treated at one of the four specialized units was Liberian patient , the only one to die. 'We have more work to do鈥? UCSF鈥檚 Adler noted that those specialized hospitals have entirely separate isolation units that make it easier to treat infected patients. But Adler said he expects the negative pressure or isolation rooms in most acute-care hospitals to be sufficient. Still, while hospitals may be on the front lines, they鈥檙e not the only way an infected Ebola patient may seek treatment. 鈥淧atients may not necessarily go to the hospital. They may go to doctor offices or a walk-in clinic,鈥?he said. If that happens, no matter how much a hospital is prepared for an Ebola case, it may not matter. 鈥淲e have more work to do to prepare for that,鈥?he said.
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