While the Ebola news cycle has slowed down in the United States since its peak in October, the city of Boston has quietly become more prepared to handle a potential case. Though a suspected Ebola patient at Massachusetts General Hospital initially tested negative for the virus, this was not the first, nor, most likely, the last, suspected case the city will see before the Ebola outbreak is over. But health officials say Boston is ready for them.
As the number of cases continues to rise (in its latest estimates, the World Health Organization reports that there have been 15,935 reported cases of Ebola and 5,689 deaths), so does the likelihood that we will see suspected cases in Boston.
“How ‘at risk’ we are for these kinds of importation events—is directly proportional to the number of cases that are actively infective (reported and unreported alike) in West Africa,’’ said Maia Majumder, a researcher in biostatistics and health map modeling Boston Children’s and Harvard Medical School’s HealthMap.
While the cases have climbed, officials say that Boston’s response has become increasingly more effective and efficient. The timing of the most recent Ebola scare could not have solidified that certainty more.
The day before the suspected Ebola case was admitted to MGH, federal officials from the Centers for Disease Control and Prevention were visiting the site to review its Ebola preparedness. The CDC’s Rapid Ebola Preparedness team recentlydesignated 35 hospitals nationwide as “Ebola treatment centers’’ based on their assessment of the hospitals’ capabilities to care for Ebola patients. No Massachusetts hospitals were initially listed, but this may soon change.
According to Dr. Paul Biddinger, the director of emergency preparedness at MGH, CDC officials on Monday’s visit did a full walkthrough of the hospital’s plans and protocols, which have been in development since July. They evaluated it as a part of the overall national network of hospitals that are prepared to identify, diagnose, and treat an Ebola patient. Biddinger said the feedback was positive that day. The very next day, it was put to the test.
The suspected Ebola patient in Massachusetts recently traveled to the United States from a civilian trip to Liberia. Dr. Anita Barry, the director of the infectious disease bureau at the Boston Public Health Commission, outlined the day’s events in an interview with Boston.com on Wednesday. She said a BPHC nurse was conducting twice-daily monitoring of the patient per federal guidelines when the patient complained of symptoms. The nurse immediately notified BPHC and, Barry said, safe transportation to MGH was quickly arranged.
While New York City designated Bellevue Hospital as the center to handle potential cases, Massachusetts has not yet tasked any particular hospital with that responsibility. Instead, the plan is for the Massachusetts Department of Public Health to coordinate patient transfers between hospitals. The six hospitals (Brigham and Women’s Hospital, Baystate Medical Center in Springfield, Tufts Medical Center in Boston, Beth Israel Deaconess Medical Center, Boston Medical Center, and Massachusetts General Hospital) have developed a referral system based on capacities to accept Ebola patient transfers from other hospitals in the state.
Dr. Barry said she thinks this will actually be more effective than New York’s approach, because “it arms everyone with all of the resources’’ rather than focusing everything on one facility.
In light of other suspected cases, including the case in Braintree last October which was also determined to be negative, Barry said the city and state officials have worked hard to develop a healthcare preparedness group that would incorporate officials, facilities, hospitals, and EMS with lessons learned and consistent feedback on preparedness.
“This was an extension of all that work,’’ Barry said. “The time and experience has contributed, but often, it takes developed plans, drills of those plans, and examining what works and what doesn’t work. When we manage an Ebola case much like we handled the Marathon bombing, that system doesn’t happen by accident. That system happens because people have thought out plans.’’
Dr. Biddinger at MGH, who was a key community leader in the hospital’s preparedness and response to the Boston Marathon bombings, agreed with Barry’s assessment of the city’s Ebola response plan. The two have each other’s cell phone numbers and are constantly in communication.
“It was gratifying to see that the plans and the systems that we worked so hard to put in place over the last four months were successful…that there weren’t major surprises,’’ he said. “We’ve built a culture of preparedness in this city.’’