Preliminary testing indicates that the Yale doctoral student admitted to Yale-New Haven Hospital with Ebola-like symptoms does not have the deadly virus, state and hospital officials said.
The student, who had returned Saturday from Liberia, one of three countries most affected by the outbreak, had a fever Wednesday evening and was being monitored in isolation at the hospital. Yale-New Haven’s chief medical officer, Dr. Thomas Balcezak, said the patient was in good condition with a low-grade fever and had improved since being hospitalized.
“Due to an overabundance of caution, before we fully rule it out, we will wait for the CDC official confirmation of the test result,” Balcezak said. “In the meantime, we will continue to monitor the patient using all appropriate protocols and precautions in order to ensure the safety of our staff, patients and community.”
The Connecticut Department of Public Health said confirmation from the CDC could be available Friday, and until then preventive measures would remain in place. The patient and another doctoral student who traveled to Liberia will remain quarantined until 21 days after their return, Yale President Peter Salovey wrote in a message to the university community.
While awaiting the preliminary results Thursday, officials sought to emphasize the efforts to prepare in case someone in Connecticut contracts Ebola virus — while also trying to reassure people that the risk of infection was low.
Yale-New Haven officials said the patient’s admission had gone according to plans established through weeks of work, and state officials said they were strengthening preparedness efforts.
Gov. Dannel P. Malloy said Thursday that he was directing every hospital in the state to conduct a drill to ensure that procedures and emergency medical services were prepared to handle Ebola.
Public Health Commissioner Dr. Jewel Mullen previously asked hospital CEOs to complete checklists on their organizations’ ability to receive a patient with Ebola, and she said Thursday that she had reviewed the responses to determine the extent to which they had taken the necessary steps to prepare.
Malloy also formally established a “unified command team” of state officials to coordinate resources, personnel and communications related to the virus, and to ensure that front-line health care staff and first responders have received necessary training.
“If there’s a reason to take it to the next step, we are absolutely prepared and have the resources necessary to do all of that work,” he said.
Malloy previously declared a state of emergency to give Mullen the authority to quarantine and isolate people she “reasonably believes” have been expose the the virus. Mullen used the authority in the case of the Yale student.
‘Not easy to catch’
As they awaited word on the potential Ebola case in New Haven, Malloy and Mullen attempted to convey both the seriousness of the preparedness effort and the need for people to keep the risk of infection in perspective.
“I just want to remind people that as we continue to take this seriously, as we continue to learn from any new guidance that we get from federal and world experts along the way, Ebola virus is still a disease that is not easy to catch,” Mullen said during a media briefing in the state’s emergency operations center.
“It’s not spread by just simply air or by water,” she added. “It’s not spread by…casual contact.”
The virus spreads through direct contact with blood or body fluids, including urine, saliva, sweat, feces, vomit, breast milk and semen, according to the CDC.
Symptoms include a fever greater than 101.5 degrees, severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained bruising or bleeding.
“We know that people will have symptoms of Ebola, the vast, vast, vast, vast, vast majority not having Ebola, but…a stomach bug, ate the wrong thing, that sort of thing,” Malloy said.
The governor said officials were asking people to “self-triage” in determining whether their symptoms and history could indicate a risk for Ebola.
“Many people today, in the next 24 hours, are going to have a headache. They’re going to have an upset stomach. They’re going to have a case of diarrhea. These things are going to happen,” he said. “The real question to ask yourself is, ‘Hey, have I traveled to West Africa recently? Have I been in contact with anybody who’s traveled? Do I know of any contact I’ve had?’”
If the answer is yes, the person should go to a hospital, Malloy said. If the answer is no, the person probably had a bug or ate the wrong thing or just had a headache.
United Way has made information about the virus available on its website, www.211ct.org. People can also learn more by calling 2-1-1.
Many people have been calling hospitals with questions about whether they’re at risk, said Dr. Rocco Orlando, senior vice president and chief medical officer at Hartford HealthCare, the parent company of Hartford, Windham and Backus hospitals, The Hospital of Central Connecticut and MidState Medical Center.
“The level of anxiety in the community is just phenomenal right now,” Orlando said. “What we’re trying to do, and one of my messages is to really ask people to take a deep breath, stay calm. This is something that the average member of the community is not at risk for. So far, the only way you can get Ebola is by going to West Africa or, if you’re in the United States, being a health care provider who has looked after someone with Ebola. That’s it.”
Hospital preparations
Some hospital officials have wondered whether it would make sense to have specially designated hospitals care for any patients in the state found to have Ebola.
Malloy said that if there is an Ebola case in Connecticut, a team from the CDC would be dispatched to the state to help supervise the care of the patient.
Hartford HealthCare officials have decided that any inpatient care for someone with Ebola in their hospitals would take place at Hartford Hospital, rather than at any of the community hospitals the company runs. Orlando said Hartford Hospital is prepared to establish a “hospital within a hospital” to isolate someone with Ebola.
To address potential staff concerns, Hartford HealthCare has assembled a team of nurses and doctors who volunteered to care for a patient with Ebola. The hospitals are also using the simulation center at Hartford Hospital to train staff on how to put on and remove protective equipment.
Orlando said he wasn’t yet sure whether the number of staff who volunteered would be enough to care for a patient with Ebola. “It’s remarkable. If it won’t totally cover it, it’s going to come pretty close,” he said.
Yale student had been traveling
The patient at Yale is a doctoral student who had been to Liberia as part of a research mission, Salovey, the university president, wrote in a message to people affiliated with Yale.
Salovey wrote that doctoral students who were in Liberia reported that they were not in contact with Ebola patients or caregivers and followed travel and hygiene precautions.
During a press conference Thursday, Yale School of Medicine Dean Dr. Robert Alpern said that the students were in contact with one person who later developed Ebola but was not symptomatic at the time.
The student was being monitored by a community primary care provider, and notified the provider after developing a fever Wednesday. The patient was taken to Yale-New Haven’s emergency department and then admitted to a room with negative air pressure, designed for infection control.
During the press conference, hospital officials said the experience had reinforced their belief that they were prepared to handle a patient with the virus. Hospital President and CEO Richard D’Aquila praised the staff and said the hospital has been preparing for a potential Ebola patient for weeks.
“Everything went just the way we planned last night,” said Dr. Louise Dembry, an infectious disease specialist and hospital epidemiologist at Yale-New Haven.
The hospital was trying to minimize the number of staff caring for the patient, Balcezak said. Two attending physicians with training in critical care and internal medicine will provide care around the clock, he said. The care team will also include two nurses at all times — one to care for the patient, and one to ensure that the other nurse is putting on and removing protective equipment appropriately.
In a statement released earlier Thursday, the hospital said any patient who comes in with Ebola symptoms will be isolated from other patients and cared for in a special isolation room, with staff wearing protective gear, including masks, face shields, gloves and protective gowns or suits. The hospital said it “employs protection measures even greater than those recommended by the CDC.