Minnesota updates Ebola hospital planning

Minnesota is restructuring its Ebola response plan so that all hospitals can identify and isolate patients suspected of infection, but then transfer them to as-yet-unidentified "centers of excellence" that would provide long-term care against the deadly virus.

Learning from Texas, where two nurses caught Ebola after treating the first U.S.-diagnosed case of the virus, Minnesota leaders have decided patients should wind up at hospitals with the best know-how and safety precautions, said Dr. Ed Ehlinger, state health commissioner.

"We want all hospitals and clinics to be able to use standard precautions to identify patients, to assess them, to stabilize them, to isolate them," he said, "until they can transfer them to a facility with more expanded capabilities."

Ehlinger's remarks came at a briefing with Gov. Mark Dayton, U.S. Sens. Al Franken and Amy Klobuchar, and Rep. Keith Ellison as state leaders met to review Ebola precautions after a week of rapid and startling developments in Texas and other parts of the country.

They also reflected a week in which Minnesota's existing response plan was tested by travelers returning to the state with suspect symptoms. A traveler from Ghana was tested for Ebola at a hospital Thursday because of symptoms matching those that first emerge with the infection. The test was negative. Ghana isn't one of the West Africa countries where the current Ebola outbreak is concentrated, but state health officials decided to go beyond federal testing recommendations in the patient's case.

"Until the crisis in Africa is resolved," Ehlinger said, "this is going to be a concern for us in Minnesota." He did not identify the hospital.

More far-fetched was the scenario in Rochester on Thursday, when the fire department dispatched an emergency response team after a resident dialed 911 to say she had returned from Texas and wasn't feeling well. They determined it was a false alarm, in part because she had been in Texas before the first Ebola case occurred there. But Kris Ehresmann, director of infection control for the state Health Department, said federal rules call for a basic and consistent level of response to any such threat.

At the same time, state leaders said they understand the public's anxiety and said they wanted to urge calm considering the relatively low risk of an Ebola case emerging in the state. "We can't be overly cautious," Franken said. "At the same time, it's important that we not panic people."

Ellison expressed concern that the estimated 30,000 Liberians living in the Twin Cities — the largest concentration of people from that country in the United States — not be stigmatized or feared. The largest human Ebola outbreak in recorded history has caused more than 9,200 infections and 4,500 deaths in West Africa, and Ellison noted that many Twin Cities residents have lost loved ones to the virus.

"So we need compassion," said Ellison, who will be meeting in Brooklyn Park with members of the local Liberian community and others.

Changes in Minnesota's hospital planning have been fueled by the infections suffered by two nurses at Texas Presbyterian Hospital who treated the first U.S. Ebola patient until he died earlier this month. Beyond a new hospital triage system, Dayton said he would meet this weekend with doctors, nurses, paramedics and others to make sure their safety concerns are addressed.

While Ebola isn't an airborne virus, it does spread through contact with such infected bodily fluids as blood, saliva, feces, vomit and urine. Federal guidelines recommend that health care workers treating Ebola patients wear impervious gloves and gowns, along with masks and either goggles or face shields to cover their eyes. However, the Minnesota Nurses Association took a stand earlier this week calling for hospitals to provide caregivers with full protective bodysuits and respirators to further reduce the risk of contamination.

"They want to be safe," she said. "They want to do the right thing, and they want to be ready."