Ebola screening needs to be done better

The Flathead City-County Health Department recently sent an alert to health care providers and institutions with information about screening and treatment of potential Ebola patients.  

Why is this important? One need only examine the initial contact between the Liberian Ebola patient in Dallas and the failure of the physicians in the emergency room to ask the right questions when the patient first presented to identify the importance of local health departments in the process of protecting the community.  

That patient was seen in the emergency room of an 898-bed hospital which is staffed by emergency room physicians. It was not a failure of the electronic health record or communication between nursing and physicians. Rather, it was a failure of focus of that physician to take an appropriate history that allowed an Ebola patient to circulate in the community for two days before his illness became so severe that he was transported by ambulance back to the same emergency room and was appropriately diagnosed.  

I am not saying that every flu-like syndrome should be quarantined for 21 days and tested for Ebola. But I am saying that even in this day of electronic health records, self-reported patient histories and nursing interviews combined with time-restricted direct physician interaction with patients, the emergency-room physician in Dallas should have taken a travel history from a black man with an accent and flu-like symptoms. (I know the liberals in the audience will call me a profiling racist, but so be it.) William Osler (the great Johns Hopkins physician) is turning over in his grave over this lack of physician-patient interaction.   

One also has to wonder about the response of the local health department in Dallas as well as the Centers For Disease Control, waiting four days to appropriately sanitize the apartment area and move the family to a clean environment. Excuses about permits to move and discard dangerous materials are absurd. This should have been accomplished on day one.  

I think it would be prudent to restrict travelers from West Africa from entering the United States. One reason we are told this is unreasonable is that it would restrict aid workers from going there to help out.

Since even health-care providers who have traveled to West Africa and have reportedly used appropriate protection have become infected, it seems to me that anyone, including health-care providers, who comes from or returns from the infected countries should be quarantined for 21 days.  

Hopefully we in the Flathead and the rest of the country are learning from this first case. Interestingly, the same administration that has been bashing the failures of our health-care system to justify the need for Obamacare now touts that very same system as the best in the world in its ability to deal with this problem.   

Certainly we have the protocols in place to identify contacts and observe for further cases with a single patient. But how well would our system work if there were 8,000 cases (as in Africa) spread across the country? An ER physician not taking a travel history on a black patient with an accent and waiting four days to clean a contaminated environment — so far, I’m not impressed.  

P. David Myerowitz, of Columbia Falls, is a retired physician and member of the Flathead City-County Board of Health. These opinions are his own.