A man who travels frequently to Liberia caused a stir Sunday afternoon when he arrived at a Braintree clinic with Ebola-like symptoms. But doctors and public health officials say that the man is not considered at high risk for the often deadly virus. His case did, however, give us the first public look at how nurses, EMTs, hospital staff and others have prepared to respond when there is an Ebola alert.
WBUR's Martha Bebinger spoke with WBUR's Bob Oakes on Monday with more on the story.
Bob Oakes: How did this man, who has not been identified, become the focus of police escorts, press conferences and numerous statements on Sunday?
Martha Bebinger: The man called his primary care practice, Harvard Vanguard, in Braintree Sunday morning, complaining of a headache, muscle aches and some other problems. He was given an appointment in the afternoon. The man went to the Harvard Vanguard pharmacy to pick up a prescription for something else, then left.
But after that first call, Harvard Vanguard reviewed his medical record and noticed that the man traveled frequently to Liberia. The office staff then called the patient and "intercepted" him as he was coming in. They asked him to wait in his car while they called for an ambulance. The Harvard Vanguard office was closed for a period of time, while they disinfected surfaces in the pharmacy they believe he touched, and then reopened.
The man waited, cooperatively, we're told, in his car, sort of a self-quarantine, until an ambulance arrived. What kind of precautions were in place there?
Brewster ambulance completed their Ebola response training about a week ago. Brewster's director of training, Jeff Jacobson, says the company was on the scene in 15 minutes with two ambulances, one that had been sealed inside with plastic and three EMTs wearing hazardous materials suits.
"Once the patient is removed from the ambulance and into the hospital, two more folks get into the level B suits and remove all the plastic, put in sealed containers, then the vehicle is disinfected, following the Centers for Disease Control recommendations," Jacobson said.
In all, Jacobson estimates there were 40 responders, including police, firefighters, local public health and Harvard Vanguard personnel.
Forty personnel arrived? And were all of those responders trained in Ebola safety practices?
I heard both yes and no. Only people who may come in contact with the patient or his body fluids need to wear gloves and protective gear. But I also heard there was a call Sunday, after this incident, on which some participants felt the response was too much while others thought that a maximum effort is warranted as responders test and adjust their reaction to Ebola.
The ambulance took the patient to Beth Israel Deaconess Medical Center, where I imagine there were a few nervous staff members. Earlier Sunday, the CDC confirmed that a nurse who treated a man who died from Ebola in Dallas has come down with the virus.
Yes, we did get word of the first case transmitted in the United States on Sunday, but Dr. Kenneth Sands, chief quality officer at Beth Israel Deaconess, said the staff there were ready to deal with Ebola. Sands said the Braintree patient was placed in a special unit with a barrier, a separate ventilation system and safety features for doctors and nurses.
"We felt very good about our plan, despite the results in Dallas, so we are implementing the plan we have had in place for a couple of months and we feel comfortable that it is working in a way that protects our patients and our staff," Sands said.
The man remains in isolation at Beth Israel Deaconess. How have doctors there and public health officials determined that he is not a high risk for Ebola?
Doctors at Beth Israel Deaconess have not explained why they reached that conclusion, but there are clues from Harvard Vanguard, where the man checked in earlier Sunday. While the man had a headache and muscle aches, which could be early signs of Ebola, or many other things, he did not mention a high fever, vomiting or diarrhea, said the chief of infectious disease at Harvard Vanguard, Dr. Ben Kruskal.
"He lacks all of the more typical symptoms. And the time frame from his return from Liberia to now is on the rather long side of the incubation period for Ebola," Kruskal said.
It's been about two weeks since the man returned from Liberia, which is, apparently a little late for the first signs of infection to emerge.
We haven't had any confirmed cases of Ebola in Massachusetts, but if someone does suspect they have the virus, what should they do?
Interesting, the CDC website says "seek medical care immediately," but don't go anyplace besides a health care facility. Now some local doctors are revising that guidance. Kruskal says if you think you may have Ebola, make your first move from home — call your doctor or hospital.
"A lot of people are feeling anxious, and if anybody actually did have Ebola, rushing into the hospital without stopping to figure out the right way to do it would not be a particularly helpful thing. It would probably expose a lot of people needlessly," Kruskal said.
Advice about Ebola will likely be refined as officials review treatment of suspected cases of Ebola. There have been a number of them, this one the most public. So far, none have been confirmed and we'll hope that continues to be the case.
Correction: An earlier version of this post's AP photo caption erroneously reported that Beth Israel was temporarily shut down after a patient was brought in with Ebola-like symptoms. The Braintree clinic was shut down. We regret the error.