Issue link: https://www.epageflip.net/i/401392
ByJulieWatson AssociatedPress When a Dallas County sheriff's deputy who had en- tered the apartment of the first patient to die from Eb- ola in the U.S. started feel- ing ill himself, he didn't rush to the nearest hospi- tal. He chose an urgent care clinic. So did a man who re- cently traveled to West Af- rica and was complaining of flu-like symptoms, prompt- ing the suburban Boston ur- gent care practice where he went to briefly shut down last week. The deadly vi- rus' arrival in the U.S. has put the spotlight on weak spots in American hospi- tals, but those facilities are not the only ones who have suddenly found themselves on the front lines against Ebola. Urgent-care clinics for many people have become de-facto emergency rooms. They are not, however, equipped like hospitals to treat serious illnesses, such as Ebola, nor do they have isolation units. Clinics are urging poten- tial patients to get checked for the highly contagious vi- rus at a hospital. Given the problems at the Texas hospital, where Thomas Eric Duncan died and two nurses have been diagnosed with the virus, an Ebola case could have posed even greater prob- lems at a clinic or smaller hospital, experts say. "That would be an even less controlled situation," said Dr. David Weber, an epidemiologist at the Uni- versity of North Carolina's hospital. "The likelihood for that is so remote that they may never have thought about that." Still, clinics are prepar- ing staff in case someone with Ebola does walk in. They are distributing pro- tective gear and quickly try- ing to get up to speed on the best protocols to teach their health providers. Dr. William Gluckman of the Urgent Care Association of America, which repre- sents more than 2,600 clin- ics, said the facilities want anyone who suspects they may have contracted Ebola to go to a hospital emer- gency department. The Urgent Care Associa- tion of America sent emails to its roughly 6,400 mem- bers asking them to spread that message. One of the fastest grow- ing segments of the U.S. health care industry with more than 9,000 clinics, urgent care is designed to treat as many patients as quickly as possible for mi- nor illnesses, like the flu or a sliced finger. But people are increas- ingly using them for any emergency to avoid the costs, long waits and crowds at hospitals. "I think patients have a difficult time deciding where they need to go for care so sometimes we'll see someone come in suffer- ing from an acute heart at- tack or stroke, but urgent care shouldn't be the place to go for that," said Gluck- man, who owns FastER ur- gent care clinic in Morris Plains, New Jersey. MedExpress — which runs 130 clinics in 10 states — said its employees have been told to encourage pa- tients with flu-like symp- toms who have been in West Africa or in contact with someone infected with Eb- ola to go to a hospital. The Centers for Disease Control and Prevention says Ebola isn't contagious until symptoms appear. Ebola isn't spread through the air like the flu; people catch it by direct contact with a sick person's bodily fluids, such as blood or vomit. The urgent care associ- ation recommends front desk staff ask for specifics on symptoms from patients and recent travel history. If that the person has a fever, headache or other flu-like symptoms and has been in an Ebola hot spot, clinics have been told to iso- late them in a single room, Gluckman said. The clinic should call public health of- ficials and contact a hospi- tal to transport them there as quickly as possible, per CDC guidelines. Patients at the urgent care clinic in Frisco, a sub- urb north of Dallas, were held briefly after Dallas County sheriff's deputy Sgt. Michael Monning went there with flu-like symp- toms. Monning had en- tered Duncan's apartment but had no direct contact with him. Monning was trans- ported to a hospital where it was determined that he did not have the virus. Patients at the practice in Braintree, about 12 miles south of Boston, were also held briefly on Oct. 12, while the man was taken to a hos- pital, where it was deter- mined he did not have Eb- ola. The car that he drove to the office in was decontam- inated by crews in hazmat suits. CDC Director Tom Frie- den said the agency is bol- stering training nationwide on how to respond to an Eb- ola case. U.S. health care has be- come more complex with retail clinics, urgent care centers, work-site clinics and even on-line clinics, so ensuring that everyone strictly follows protocol is going to continue to be a challenge. But that's not necessarily a bad thing, said Dr. Tom Zweng of Novant Health, a four-state system based in Winston Salem NC. "This is not an exercise in futility," he said of the mea- sures being taken to protect against Ebola. "This is pre- paring staff in safe prac- tices. It may be Ebola today, but tomorrow there may be another communicable disease that we don't even know about. This is about taking health care in this country to the next level." VIRUS ClinicsrecommendhospitalsforEbolatesting ASSOCIATEDPRESS In this photograph taken Friday, William Gluckman, president of FastER Urgent Care, poses for The Associated Press in his facility in Morris Plains, N.J. By Bashir Adigun Associated Press ABUJA, NIGERIA The World Health Organization de- clared on Monday that Ni- geria is free of Ebola, a rare victory in the months-long battle against the fatal dis- ease. Nigeria's containment of the lethal disease is a "spec- tacular success story," WHO Country Director Rui Gama Vaz told a news conference in Abuja, Nigeria's capital. Nigeria reported 20 cases of Ebola, including eight deaths. One of those who died was an airline passenger who brought Ebola to Ni- geria and died soon after. The WHO announcement came after 42 days passed — twice the disease's max- imum incubation period — since the last case in Nige- ria tested negative. "The outbreak in Nige- ria has been contained," Vaz said. "But we must be clear that we only won a battle. The war will only end when West Africa is also declared free of Ebola." WHO said Nigeria had traced nearly every con- tact of Ebola patients in the country, all of whom were linked to the country's first patient, a Liberian man who arrived with symptoms in Lagos and later died. For an outbreak to be de- clared officially over, WHO convenes a committee on surveillance, epidemiol- ogy and lab testing to de- termine that all conditions have been met. Vaz warned that Nigeria's geographical position and extensive borders makes the country, Africa's most populous, vulnerable to ad- ditional imported cases of Eebola. "Therefore there is need to continue to work to- gether with states to en- sure adequate prepared- ness to rapidly respond, in case of any potential re-im- portation," he said. The disease continues to spread rapidly in Liberia, Sierra Leone and Guinea and has claimed more than 4,500 lives. CONTAINMENT World Health Organization: Nigeria's Ebola outbreak is officially over ASSOCIATED PRESS A health port officials uses a thermometer to screen passengers at the arrival hall of Murtala Mohammed International airport in Lagos, Nigeria, on Monday. "W e m us t b e cl ea r t ha t w e on ly w on a ba tt le . 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