Should Boston Worry About Ebola? An MGH Doctor Explains the Risk

“Masks are not going to accomplish anything for members of the public,’’ said Ednan Bajwa, ICU Director at Massachusetts General Hospital.
“Masks are not going to accomplish anything for members of the public,’’ said Ednan Bajwa, ICU Director at Massachusetts General Hospital.

On October 13 and October 17, Boston.com spoke with Dr. Ednan Bajwa, Massachusetts General Hospital’s intensive care unit director, about what Bostonions should be concerned about when it comes to Ebola. Given Tuesday evening’s news of a suspected case of Ebola at MGH, we reprinted excerpts from those conversations below.

Q: I know Ebola is not airborne now, but could it mutate and become more communicable? Is it worth buying those little masks that people wore during the SARS epidemic?

“It’s extremely unlikely. No virus has ever been known to mutate sufficiently to make the jump from non-airborne to airborne. In order to become airborne, a virus has to undergo major changes that would change other characteristics of the virus as well. For example, even when scientists have actually tried to manipulate viruses in the lab to increase their aerosol potential, usually it changes the virus enough that it becomes less dangerous. Masks are not going to accomplish anything for members of the public. They are only helpful to healthcare workers taking care of sick patients because they can protect the face from splashes of body fluids. That situation is not going to apply to anyone who’s not working around sick patients.’’

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Q: Is there anything I should do when in close quarters with people, like on the MBTA or in an elevator? Should I not touch railings or door handles in public?

“Even if there were cases reported in the Boston area, people are most infectious when they’re very sick and producing body fluids. People who are that sick are typically not well enough to be out and about.’’

Q: Ebola is passed through “close contact,’’ but what exactly does that mean? If an Ebola patient touches a light switch and I touch it right after, can bodily fluids transfer that way?

“Keep in mind that the Dallas patient who died of EVD was severely ill at home with his family for a few days and yet, over two weeks later, none of his family members have become infected. It’s just not that easy to transmit unless you’re in direct contact with infected body fluids. In the light switch scenario they would have to directly contaminate the switch and you’d have to touch it within a few hours and then put your hands in your mouth or eyes, or have an open cut on your hand. It’s possible but extremely unlikely.’’

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Q: Are there people who are more at risk? Hospital workers? Ambulance drivers? Elderly? Infants? People whose immune systems are compromised?

“Members of the general public don’t need to worry right now even if they’re elderly, young, or immunocompromised. Healthcare workers and first responders are at risk of exposure, yes. There has been extensive training underway for people in these professions for a while now.’’

Q: What if I’m a patient in a hospital that’s holding an Ebola patient? What are you doing to keep me safe? What if I’m giving birth at a hospital where an Ebola patient is being treated? Should I be worried?

“A patient in the same hospital as an EVD patient is extremely safe. Hospital plans involve putting EVD patients into isolation rooms. Dedicated teams of doctors, nurses, and other staff would be taking care of those patients and would not be involved in the care of other patients. Any waste or equipment from that room would be specially handled. There’s virtually no chance of it spreading from patient to patient in a hospital.’’

Q: Is this still something people should worry about, or is it something that’s super unlikely but should be monitored by the general public?

“I think there has to be a clear distinction made between spread in the hospital setting, and possible spread among the public. As we know from the way the virus works and the experience with the first patient in Dallas, no one in the public was infected despite several days of exposures, and even in the hospital, the health care workers infected were those who had a very high degree of exposure to infected bodily fluids. People should look at that information and be reassured that there’s nothing mysterious going on. The virus works the way that we know it works, and it’s hard for it to spread in public.’’

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