Dr. Daniel Varga is chief clinical officer for Texas Health Resources, a network of 25 hospitals that includes Presbyterian in Dallas, which treated the first person diagnosed with Ebola in the United States.
I spoke with Varga today about the lessons the hospital learned in its battle with Ebola. Here are a few highlights:
-- When index patient Thomas Eric Duncan first entered the hospital on Sept. 28, he informed a nurse of his travels from Africa, and that information was entered into Presbyterian's electronic records system. When he was seen by a physician, the doctor asked his own question about where Duncan lived, and Duncan gave his local address.
Varga says Duncan is not to be blamed.
"This isn't the patient's fault," he said. "... People who are sick and are asked the same question by a couple of different people, a couple of different ways, not infrequently give an answer that isn't identical."
-- The doctor assumed Duncan was part of Dallas' nearby African immigrant community, which uses the hospital regularly. As a result a contagious Duncan was released back into the general public. By the time he came back to Presbyterian two days later, he was critically ill with Ebola.
-- Duncan's symptoms were extremely virulent — projectile vomiting and diarrhea that would not stop. The Presbyterian staff treated him for two days with protection equipment that included caps, goggles, paper masks and plastic face plates. But Duncan was a hot mess of billions of Ebola virus on and around his body. It was only after the CDC confirmed Duncan had Ebola, 36 hours later, that the staffers went to using fully hooded hazmat suits while treating their patient.
Varga says the painful lesson learned is this: "What you do if you have a high suspicion of Ebola on first contact in the ER is immediately move to full hazmat personal protective equipment.
"There is no substitute for combat."
-- Varga says hospital staff can train and train, but until they see and learn from their mistakes, there's no way to truly prepare for something as rare as Ebola.
Unlike health care workers in West Africa who work with Ebola all day, Varga said, the staff workers at Presbyterian didn't have the hemorrhagic fever at the front of their minds. But they sure do now. Varga says after all the hospital has been through and learned, he believes it's the best place in the country to get diagnosed for Ebola.
-- After two of its nurses caught Ebola while caring for Duncan, Varga says the entire hospital carries the weight of those mistakes and is passionately rooting for Nina Pham and Amber Vinson to get well.