Health & Fitness

Dallas nurse with Ebola sent to special unit in Maryland

Nina Pham, the young nurse who is battling Ebola and grew up in Fort Worth, was transferred late Thursday night to a special biocontainment unit in Maryland — one of four in the nation — for treatment, officials said.

And amid a cascade of other developments at the federal and local levels, Dallas County’s top public health epidemiologist confirmed Thursday evening that she spent time at Ebola patient Thomas Eric Duncan’s bedside and that she is among those potentially exposed to the virus.

Duncan died Oct. 8.

Pham, 26, released a statement Thursday through Texas Health Presbyterian Hospital Dallas: “I’m so thankful for the outpouring of love and support from friends and family, my coworkers and complete strangers,” she said. “I feel very blessed, and have gained strength from their support. I appreciate everything that my coworkers have done to care for me at Texas Health Presbyterian Hospital Dallas. I’m doing really well thanks to this team, which is the best in the world. I believe in my talented coworkers. I am #presbyproud!”

Also late Thursday, the facility released a video of Pham speaking with a doctor and other medical staff in her hospital room. She invited her colleagues to Maryland and said, “I love you guys.”

The community at the Fort Worth church where Pham and her family worship supported the move.

“We all feel it’s in the best interest of not only the family but for everyone involved,” said Hung Le, president and counselor at Our Lady of Fatima Catholic Church. “We think it was done to make sure that everyone working with her was well-trained. … We think it was a good move for everyone and as far as the CDC is concerned. That way we don’t spread it.”

The Dallas hospital, which has been publicly criticized by nurses, federal agencies and Congress for its procedures with Duncan, said part of the reason for moving Pham is that 75 of its workers are sidelined for Ebola monitoring after contact with Duncan.

Some are being furloughed, but others have continued to work, depending on the level of exposure. The hospital has offered free rooms to patients who want them. None are allowed to use public transit.

Presbyterian decided the transfer was “in the best interest of the hospital employees, nurses, physicians and the community to give the hospital an opportunity to prepare for whatever comes next,” a statement says.

Pham remains in good condition. Another nurse who cared for Duncan, Amber Joy Vinson, 29, of Dallas, is being treated at Emory University Hospital in Atlanta, another biocontainment unit.

School disruptions

Vinson’s illness has triggered a series of school warnings in Tarrant County and school closings in Belton because she flew on a Frontier Airlines flight to Cleveland and back while she had a slight fever.

At least two school districts in Texas closed some facilities after learning that students or parents flew on one of the same flights as Vinson, or both. The Belton school district in Central Texas closed three schools Thursday and Friday, and the Royse City school district in eastern Rockwall County canceled school Friday for cleaning.

Both districts disinfected all their buses Thursday.

Some schools in northeast Ohio also were closed Thursday, and seven people were voluntarily quarantined after having contact with Vinson during her trip, The New York Times reported.

Thursday night, the CDC expanded is search for passengers who may have had contact with Vinson, announcing it is now asking anyone who was on that flight to contact the agency.

The Dallas County epidemiologist, Dr. Wendy Chung, was also with Duncan and is being monitored, she said Thursday. Until now, public statements have indicated that the only people potentially exposed were Presbyterian hospital workers, nurses and doctors — not public health officials.

“Yes, I have been alongside other physicians and nurses in addressing this patient,” she said in an email. “I am under the same monitoring protocols which are currently recommended for my clinical colleagues who are in the same exposure category as mine.”

Duncan’s hospital chart shows she was with the victim at least once.

Dr. Barry Rosenthal, chairman of emergency medicine at Winthrop-University Hospital in Mineola, N.Y., said that while he cannot speak to the situation in Dallas, it’s not typical for an epidemiologist to enter an isolation room and interview a contagious patient.

Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, has said that too many health workers had contact with Duncan, and he announced steps this week to minimize the number of people in the room with Ebola patients.

Chung was not available for further comment.

Dallas County Judge Clay Jenkins, who is responsible for the county’s disaster and emergency preparedness, said he and Chung have been working side by side throughout the outbreak. Jenkins said their pace has been so intense at a hospital command center that they’ve set up a room with cots where Chung and others can rest.

He said he has not heard she was being monitored in any way, “and it would be surprising if I wouldn’t know that.”

Hospital challenges nurses’ claims

Duncan visited the emergency room 13 days before his death. He was sent home, misdiagnosed with a sinus infection. He returned in an ambulance two days later. Presbyterian has given different reasons why he was turned away the first time.

The hospital first said that he didn’t have Ebola symptoms, then that the computer system didn’t notify physicians of his travel history. The last statement about that visit said the computer system functioned correctly. That series of statements set off criticism from sources that most recently included Congress and another nurse employed there who was on NBC’s Today show Thursday.

The nurse, Briana Aguirre, said supervisors didn’t know what to do as far as protection around Duncan. Her comments, which echoed those released in a teleconference by the National Nurses United union, were rebutted point by point in two hospital statements released Thursday.

Aguirre said on Today: “Our infectious-disease department was contacted to ask, ‘What is the protocol?’ And their answer was, ‘We don’t know. We’re going to have to call you back.’ ”

Aguirre, who did not deal directly with Duncan but helped take care of Pham, said the protective gear they were provided left the neck exposed.

“In the second week of an Ebola crisis at my hospital, the only gear they were offering us at that time, and up until that time, is gear that is allowing our necks to be uncovered,” Aguirre said. “I just flat-out asked several infectious-disease nurses, I asked the CDC, ‘Why? Why would I be wearing three pairs of gloves, three pairs of booties, a plastic suit covering my entire body and then leave my neck hanging out this much so that something can potentially go close to my mouth or nose?’ ”

The hospital’s rebuttal says: “When the CDC recommended that nurses wear isolation suits, the nurses raised questions and concerns about the fact that the skin on their neck was exposed. The CDC recommended that they pinch and tape the necks of the gown. Because our nurses continued to be concerned, particularly about removing the tape, we ordered hoods.”

The rebuttal notes that the equipment was what the CDC recommended at the time. The CDC, which has also been criticized for the events that left Pham and Vinson sick and many others exposed, has stiffened its protocols since Duncan’s death.

The hospital also denied other accusations made during the National Nurses United phone conference with reporters. No union represents nurses at Texas Health Presbyterian, but the NNU said it was passing along information provided by them.

Among the points in the hospital’s rebuttal:

In the second statement released Thursday night, hospital officials blasted “out-of-context and sensationalized” media coverage.

Staff writers Monica S. Nagy and John Gravois contributed to this report, which also includes material from The Associated Press.

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This story was originally published October 16, 2014 2:56 PM.

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