Monday, Oct. 20, 2014

Ebola Update

Task Forces Forming

BC gov't looks to reassure public

Released by the BC Gov't/Website photo Health Minister Terry Lake


ealth Minister Terry Lake issued the following update on the health-care system’s preparation for the low likelihood of a case of Ebola in B.C.:


“On Oct. 16, 2014, senior staff and I met with the CEOs of B.C.’s health authorities to discuss British Columbia’s Ebola preparedness. I also met with Gayle Duteil, president of the BCNU, who raised concerns about the state of our readiness.


“We want to reassure British Columbians that health authorities have response plans in place if a suspected Ebola case does present, and that those plans are being refined and updated based on the latest information and reviews from Europe and the United States.


“The Ministry of Health has set up an Ebola preparedness task force, co-chaired by provincial health officer Dr. Perry Kendall and associate deputy minister Lynn Stevenson, which will co-ordinate information and best practices across the regional health authorities. The task force is meeting regularly and will address, as a priority, equipment needs, training needs and preparedness, as well as update clinical information on how best to provide treatment and follow up in the unlikely event that a person is diagnosed with Ebola.


“The task force is reviewing the training in the health authorities to ensure it is being applied consistently across the province and based on the current national guidelines. As well, the task force is asking health authorities to prioritize training for health-care workers who would be engaged with a patient.


“We are continuing to talk with the Public Health Agency of Canada (PHAC) on their protocols and the most effective measures to protect health-care workers and the public. Over the weekend PHAC is reviewing equipment standards and will be making recommendations early next week. Once they make their recommendations, B.C. will review and update our protocols as needed. Health authorities have been reviewing and updating their inventory and availability of personal protective equipment, including the availability of N95 protective respirators for cases that may require them.


“In addition, the task force is looking at designating a single referral hospital to treat possible cases of Ebola in the Lower Mainland as well as the other referral hospitals in the regional health authorities that have not already designated a site. We will provide an update early next week.


“We also welcome the assistance offered by the federal government and the support it would provide in a B.C.-led response to an unlikely occurrence of a case of Ebola in B.C.


“Our experiences with the SARS outbreak in 2003 and H1N1 in 2009 have shown that British Columbians can be confident of our preparedness and a vigilant response in the low likelihood that a case of Ebola materializes in B.C. Again, I want to thank all the front line health-care workers that are continuing their hard work to protect the public from the spread of all infectious diseases.


“It is worth reiterating that while the cases of transmission to health-care workers in Dallas are concerning to us, we can learn from those experiences and we will follow the findings from that investigation to help inform any updates to our plan.


“The risk remains very low. But British Columbians can be assured that hospitals, health authorities and the Ministry of Health are doing everything possible to be prepared to respond to a case of Ebola in B.C.”



Monday, Oct. 20, 2014

Ebola Update

Rapid Response Team Practices Deploying on Simulated Ebola Case

Public Health Agency looks for rapid response

Public Health Agency of Canada

OTTAWA, Oct. 19, 2014 — The Honourable Rona Ambrose, Minister of Health, today announced that the Government of Canada has begun to exercise its Ebola Rapid Response Teams to ensure Canada is ready to respond in the event of a first case of Ebola in Canada.

Today the Public Health Agency of Canada and Nova Scotia's Department of Health and Wellness are conducting a joint exercise. For this drill, one of the Ebola Rapid Response Teams from Ottawa deployed to Halifax, Nova Scotia. The team will engage with provincial and local public health officials – who are the lead on any response - to practice supporting them in the event of a case of Ebola.

"Drills, dry runs, and practicing are important to ensuring that our teams are able to respond without hesitation in the event of a case of Ebola. It is imperative that our frontline healthcare workers have the guidance and information they need to deal with Ebola. The purpose of the Ebola Rapid Response Team is to assist those healthcare workers with containing the spread of the virus by providing expert public health guidance and support.  We will continue to work with the Provinces and Territories to protect Canadians and ensure we are prepared,"  said Honourable Rona Ambrose, Minister of Health in a release on Sunday.

Transport Canada has designated four aircraft, two planes centrally located in Winnipeg and two in Ottawa, with the capability of quickly moving the rapid response teams and personal protective equipment anywhere in Canada.  These planes are loaded with key equipment and ready to take off at a moment's notice.

Today's exercise follows a smaller one on Friday, October 17th in Ottawa, which tested the teams' ability to quickly assemble with the proper gear and equip one of the dedicated aircraft.

"Our experience in dealing with public health issues, including SARS, H1N1 and H5N1, has strengthened Canada's preparedness for public health risks or outbreaks. Nevertheless, we are and will continue to actively pursue all options to enhance domestic readiness and leave us on the best possible footing in the unlikely event of a first case of Ebola in Canada," said Dr. Gregory Taylor, Chief Public Health Officer of Canada.

If at any point Canada was to confirm a first case of Ebola, one of five available teams would be deployed to work with the provincial/territorial and local health authorities to provide surge capacity, additional resources and complementary expertise to prevent any further spread of the disease.

Containing the spread of an infectious disease like Ebola requires collaboration across all levels of government and the health sector. These exercises are designed to ensure that the teams are able to respond rapidly and collaborate effectively with provincial, territorial and local health authorities.

The Public Health Agency of Canada continues to advise that the risk to Canadians remains low.

Quick Facts

Video footage from the October 17th drill

• There are five rapid response teams, each consisting of seven subject matter experts.

• The teams are comprised of a team lead, a field epidemiologist, an infection control expert, a biosafety expert, a laboratory expert, a communications expert, and a logistics expert.  

• The teams will work with local health officials to assist in containing the spread of the disease including ensuring that all the necessary containment protocols are followed, contact tracing, laboratory expertise, proper use and removal of personal protective equipment,  and providing any supplies from the National Emergency Strategic Stockpile that are required, such as masks, gloves and face shields.

• Vials of Canada's experimental Ebola vaccine would be sent independently to the affected hospital as an added precaution.

• To date, Canada has committed $65 million in support of humanitarian and security interventions to address the spread of the Ebola virus in the West Africa region.

• There are no direct flights from the affected countries to Canada.  Anyone travelling to Canada who has visited the affected countries is required to have a mandatory health assessment conducted by a Public Health Agency of Canada Quarantine Officer.

"While the risk of an Ebola case in Nova Scotia remains low, we have been working with partners across our health system and across the country to ensure we are prepared for this or any other infectious disease. We are pleased to help the Public Health Agency of Canada with this test of their rapid response team as part of our ongoing collaborative preparedness efforts, and we're also continuing to practice and refine our own provincial plans," said Dr. Rob Strang, Nova Scotia Chief Medical Officer of Health.


Monday, Oct. 20, 2014

Ebola Update

Establishing a National Standard

NNU say US system 'fragmented'

National Nurses United (US)


OAKLAND, Calif., Oct. 15, 2014 — With concern escalating across the U.S. about the threat of a wider Ebola outbreak, National Nurses United today called on President Barack Obama to "invoke his executive authority" to order all U.S. hospitals to meet the highest "uniform, national standards and protocols" in order to "safely protect patients, all healthcare workers and the public."


The request, send in a letter to the President, came on a day in which NNU, the largest U.S. organization of nurses, hosted a national call-in conference in which 11,500 RNs from across the U.S. joined to discuss what steps should be taken to confront a virulent disease that the World Health Organization has termed the most significant health crisis in modern history.


On the call, RNs from California, the District of Columbia, Florida, Massachusetts, Michigan, New York, Oregon, and Texas described widespread concerns in their hospitals about inadequate preparedness at a time at least two nurses have been tested positive for the Ebola virus in a hospital where one patient infected by the disease has died.


The call came just hours after NNU released a statement by RNs who work at Texas Health Presbyterian Hospital in Dallas voicing frustration and concern over what they viewed as a lack of preparation and training at their hospital, the first in the U.S. to see, first a patient with Ebola who subsequently died, and now an RN who has been infected with the virus.


In the statement, the Texas RNs described confusion in the hospital over policies in responding to patients with Ebola, inadequate advance training and availability of proper personal protective equipment, and changing guidelines. In the end, the nurses, said they felt "unsupported, unprepared and deserted to handle the situation on their own."


"Sadly, the problems expressed by the heroic Texas Health Presbyterian RNs was predictable in our fragmented, uncoordinated private healthcare system, and it mirrors concerns we've heard from nurses across the U.S.," said NNU Executive Director RoseAnn DeMoro.


It is the circumstances in Dallas, which have mirrored the concerns nurses across the U.S. have been expressing, both on the call and via an online NNU survey filled out by more than 2,500 nurses that have prompted NNU to call on President Obama to mandate improved safety standards in U.S. health facilities.


"Not one more patient, nurse, or healthcare worker should be put at risk due to a lack of health care facility preparedness," DeMoro said in the letter to President Obama.  "The United States should be setting the example on how to contain and eradicate the Ebola virus."


The letter also states:


"Every healthcare employer must be directed to follow the Precautionary Principle and institute the following:

 • Optimal personal protective equipment for Ebola that meets the highest standards used by the University of Nebraska Medical Center

 • Full-body hazmat suits that meet the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration, the ASTM F1671 standard for viral penetration, and that leave no skin exposed or unprotected and National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50 – or a higher standard as appropriate.

• There shall be at least two direct care registered nurses caring for each Ebola patient with additional RNs assigned as needed based on the direct care RN's professional judgment with no additional patient care assignments.

• There will be continuous interactive training with the RNs who are exposed to patients. There will also be continuous updated training and education for all RNs that is responsive to the changing nature of disease.  This would entail continuous interactive training and expertise from facilities where state of the art disease containment is occurring.

• If the Employer has a program with standards that exceed those used by the University of Nebraska Medical Center, the higher standard shall be used.

The Ebola pandemic and the exposure of health care workers to the virus represent a clear and present danger to public health.


We know that without these mandates to health care facilities we are putting registered nurses, physicians and other healthcare workers at extreme risk.  They are our first line of defense.  We would not send soldiers to the battlefield without armor and weapons.


In conclusion, not one more patient, nurse, or healthcare worker should be put at risk due to a lack of health care facility preparedness.  The United States should be setting the example on how to contain and eradicate the Ebola virus.


"Nothing short of your mandate that optimal standards apply is acceptable to the nurses of this nation," the letter from DeMoro to the President concludes.



Monday, Oct. 20, 2014

Ebola Update

Canadian Nurses Concerned About Ebola Plan

Plan does not go far enough says union

National Nurses United (US)


OTTAWA, Oct. 20, 2014 - After a meeting with the Public Health Agency of Canada (PHAC) on Ebola preparedness, the Canadian Federation of Nurses Unions is concerned that PHAC continues to question the scientific evidence instead of protecting health care workers and the public. Since the insufficient Interim Guidance on Ebola was produced over one month ago, nurses have been raising the alarm on Canada's Ebola preparedness. Their call for stricter guidelines has not been heeded. The CFNU is troubled that PHAC is disregarding the evidence of the potential for aerosol transmission, and failing to protect nurses and mandate proper nurse staffing.


The Canadian Federation of Nurses Unions President, Linda Silas, said: "All prevention preparedness has to begin with the precautionary principle and a commitment to safety first. Given the high risk of transmission with Ebola, it is critical that frontline nurses have the protective equipment to stop the infection from spreading. These updated guidelines from PHAC do not meet the standard to protect health care workers."


"We will continue to press the federal government for the needed changes and improved guidelines, but our attention will also be on provincial and territorial governments to at least match the recently released Ontario guidelines," said Silas. "Nurses will not allow the safety of frontline workers and the public to be compromised again."

The key points of the CFNU directive are (full document available at

• Safety is not negotiable when dealing with infection control.

• Workplace Occupational Health and Safety Committees must be involved to ensure the guideline implementation.

• No nurse or health care worker will be in contact with a potential Ebola patient without the proper training and PPEs (personal protective equipment).

• Workers will be fully-trained, tested, drilled and monitored in both patient assessment and PPE procedures.

• Policy directives will be established for how to advise patients on where to go for assessment; how to equip separate rooms for triage and separate isolation rooms when needed.

• PPEs will include at a minimum for low-risk patients an N95, face shield, impermeable gowns, and gloves.

• For high-risk confirmed cases of Ebola, nurses will be provided with powered air purifying respirators (PAPR), double gloves, leg and feet covers, and biohazard suits that meet a specified standard.

• Staffing will be at a minimum two RNs per patient, due to the acuity and complexities of caring for Ebola patients.

• All health care facilities will implement a communications plan that will provide consistency around national standards and an information number to call.

• PHAC will deploy a rapid response team to each case of Ebola diagnose.

• Monitoring and emotional support will be provided to all health care workers in care for Ebola patients, regardless if in direct care or in quarantine as established by PHAC.

The Canadian Federation of Nurses Unions represents almost 200,000 frontline nurses, continues to be committed to working with public health agencies across Canada and with employers, to ensure health care workers and the public are protected, and that knowledge and understanding of the spread of disease are raised.



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