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Dome - Q&A with Gabor Kelen

Dome November 2014

Q&A with Gabor Kelen

Date: November 6, 2014

Gabor Kelen, Director of the Department of Emergency Medicine and director of the Johns Hopkins Office of Critical Event Preparedness and Response
Gabor Kelen, Director of the Department of Emergency Medicine and director of the Johns Hopkins Office of Critical Event Preparedness and Response

Are we prepared to treat a patient with Ebola virus disease or another emerging infection?

Yes. For a decade, The Johns Hopkins Hospital has been preparing to treat emerging infections, such as smallpox, severe acute respiratory syndrome, swine flu, avian flu and Middle East respiratory syndrome coronavirus. That’s how we’ve built protocol around proper infection control, and we modify based on current reality. Staff members have trained to safely care for an actual patient with Ebola for many weeks. We’ve made sure we have the right personal protective equipment (PPE) and that people are trained properly in its use. 

If the hospital treats a patient with Ebola, is there a risk of infection for patients, visitors and other hospital employees?

If we get a patient with Ebola, only a very few people at the hospital would ever work with this individual. The patient would be isolated to the fullest extent possible. The overwhelming majority of folks won’t be anywhere near a real patient or infected body fluids. Many personnel who usually participate in patient care will not be asked to suit up and go in the room. The same goes for members of environmental services: They’re not going to go into an Ebola patient’s room to clean the way they would with any other patient.

What are the protocols for personal protective equipment?

Simply having the right PPE is not enough; you’ve got to put it on and take it off properly. We use the safety checklist technique and the buddy system. You put the equipment on, and take it off, one item at a time—“Check, check, check…”—while a buddy watches very closely and helps you follow the proper procedures.  A separate observer will also monitor this process. 

How easily is Ebola transmitted?

This is not a disease you get just walking the halls of the hospital or sitting next to someone on a bus. You have to actually come into contact with some type of body fluid. The virus does not go through skin, per se. But if it’s on your skin, you might inadvertently rub infectious material of some kind into mucous membrane, like your eyes or mouth. We assume that Ebola can infect through open wounds, however. But simply being in the presence of an infected patient, since this virus is not airborne, won’t transmit this infection.

What happens to medical waste related to caring for an infected patient?

We have a game plan that includes a certain way to disinfect the waste. Deciding how and where it is ultimately transported also involves [guidelines and standards developed] by the state of Maryland and the Centers for Disease Control and Prevention (CDC).

What about preparedness at the other hospitals in the Johns Hopkins system?

A multi-institutional leadership team confers daily to assure the approach is uniform across the system. At each hospital in our system, we wish to provide a high level of safety for our staff and patients that is in line with CDC recommendations, even when those guidelines change.

—Reported by Patrick Smith