Hospitals have had to improvise in recent months to put together a plan to treat patients with the deadly Ebola virus, and although there is no tried and true model, the Associated Press reveals key principles gleaned from clinics in Africa and the few full biocontainment facilities in the U.S.
At a minimum, treatment units need:
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a hot zone to isolate patients
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a cold zone to keep away anything that might be tainted with the virus
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a warm zone workers can use to remove protective gear
The AP report also examines solutions that hospitals developed in the wake of the Ebola scare:
Mash unit: University Hospital in Newark, New Jersey, set up a medical tent system it used after Hurricane Sandy to create a pop-up isolation unit in a vacant, unfinished floor in the hospital's ambulatory care building. The shelter provided distance from other patients, but also had room to lay out proper hot and warm zones, according to the AP. "It lets us screen and isolate patients and not have an effect on the normal operations of the hospital," Dennis Boos, director of University Hospital's community training center, told the news outlet. "If we had to do this in the emergency room, we would probably lose between three and four beds."
Abandoned intensive care unit (ICU): In addition to the University of Texas Medical Branch in Galveston, Texas, which houses a national biocontainment training center, Texas officials created a unit in a vacant hospital after Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., infected two Dallas nurses who cared for him before his death. The vacant building provided officials with a lab, an ICU free of other patients and living space to keep caregivers in quarantine. The building will remain on standby status to care for future Ebola patients, officials told the AP.
But no one predicted the cost of the prep as well as treatment of patients with the virus. The cost of treating Ebola patients at Nebraska Medical Center's biocontainment unit averaged $30,000 a day, according to Jeffrey Gold, M.D., chancellor of the University of Nebraska Medical Center, who testified Tuesday during a House Energy and Commerce oversight and investigations subcommittee hearing.
In the end, Gold estimated it cost the hospital than $1 million to treat two Ebola patients at the Nebraska Medical Center. Those are the direct costs, the Washington Post reported, and doesn't include the cost of taking 10 beds out of service--a figure he estimates is close to $148,000. The hospital is still waiting for reimbursement but Gold urged Congress to approve funding to cover reimbursement for the cost of care that insurance doesn't provide.
To learn more:
- read the AP report
- here's the Washington Post article