A Doctor Shares Lessons Learned From Treating Ebola In America

Originally published on November 2, 2014 6:36 pm
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Transcript

ARUN RATH, HOST:

New York's Bellevue Hospital is reporting this weekend that the Ebola patient in their care, Craig Spencer, has been upgraded to stable condition. And while the virus has been very deadly in West Africa, patients in American hospitals have done much better. So far, U.S. hospitals have treated nine people infected with Ebola, and only one has died.

Dr. Philip Smith runs the bio-containment unit at the Nebraska Medical Center. They've successfully treated two Ebola cases there. Earlier, I asked Dr. Smith what the high survival rate in the U.S. might mean.

PHILIP SMITH: Well, I think the numbers are too small to make any definite conclusions, but it certainly looks like, as we would expect, the mortality rate is lower in the U.S. because of our ability, primarily, to provide better supportive services. So these patients are in an intensive care environment with monitoring of electrolytes and fluids, administration of IV medications and support that would be impossible in any situations in Africa.

RATH: Should the successful treatments here - could that inform the efforts to stop the virus in West Africa?

SMITH: I think it can. One of the things that we have learned here that might be applicable to Africa is the importance of IV fluids. And a great deal of the organ system damage and the mortality probably relates to massive dehydration, which is perhaps exacerbated by the high heat and humidity in Africa. So I think there is planning underway to try to find a method for getting intravenous fluid into patients in Africa that would help jumpstart their recovery and protect some of their vital organs.

RATH: Given what you know about Ebola directly now, what's your opinion about quarantining health workers returning from West Africa the way some states have tried?

SMITH: I think that's a somewhat controversial and complicated area. On one hand, we certainly want to screen people who come to an emergency room or who come back to the United States from a high-risk area or even healthcare workers who have been taking care of Ebola patients. They need to be monitored, and if they get symptoms, they need to be isolated and tested.

However, to arbitrarily quarantine anyone who has returned from a high-risk area - that does not make sense epidemiologically. If they're asymptomatic, they're not going to transmit the infection. I think what it might do is inconvenience and perhaps discourage people from donating their time and taking the risks that they take to provide health care to people with Ebola.

RATH: And as someone who's personally cared for Ebola patient, have you experienced any kind of stigma, any reaction from people because of that?

SMITH: I have experienced a little bit. And I think most of the members of our team have experienced a little bit of stigmatization. We had a nurse, for instance, whose daughter was disinvited from a birthday party when they found out that her mother worked in the bio-containment unit. I've had people that thought they were joking and asked me to leave the table and go sit somewhere else. This is, I would emphasize, a very small minority of people. The vast majority of people will come up to you in the street and say, what you're doing is wonderful work. Keep it up. And they admire that. Their comments are positive.

But I think when someone signs up for duty to take care of a patient in an Ebola unit, then you're not only taking the bit of risk that you take to provide health care, but you're going to be taking a little bit of inconvenience if you're going to be screened and have to follow your temperature for 21 days afterwards. And undoubtedly, there will a certain amount stigmatization or discrimination that you'll encounter.

RATH: That's Dr. Philip Smith. He's the medical director of the bio-containment unit at Nebraska Medical Center in Omaha. Dr. Smith, thanks very much.

SMITH: All right. Thank you. Transcript provided by NPR, Copyright NPR.