Thursday’s Ebola scare — which -instantly triggered statewide concern about the spread of the disease — has brought Yale-New Haven Hospital, the University, the city and their plans to prevent the proliferation of the virus under scrutiny.
In particular, Thursday’s uncertainty has raised questions about University officials’ determination that two graduate students returning from Liberia did not need to isolate themselves for 21 days, the incubation period for Ebola. Late Thursday afternoon, University President Peter Salovey announced in a University-wide email that the students would in fact be sequestered for 21 days, as required by the state of Connecticut.
Shae Selix SPH ’15 said the negative result of the test did not completely excuse the original decision to cancel sequestration.
“The fact that he didn’t get Ebola probably shows that the initial judgment not to quarantine him was correct, but that seems to go against precautionary principle and would have initiated some kind of panic,” he said.
Selix added that students at the public health school displayed greater caution Thursday, with some students skipping classes to avoid entering a building where infected students had potentially been.
Others scrutinized the complex duty of public health researchers to the populations they study and live in.
“We do try and send people into these epidemic situations if we think they can help,” said Michael Bracken, professor of epidemiology at the public health school. “But it’s also important to remember these people come back to Yale and the New Haven wider community, and there’s also an obligation to protect [Yale and New Haven] as well.”
But other students said they were not overly concerned about the risk of the disease on campus. Sarah Ali SPH ’15 said she had not heard of anyone that was too concerned, but that she would continue to monitor the situation. Many undergraduates also said they trusted that YNHH could handle the case.
According to a Monday email sent by the public health school Dean Paul Cleary, a University-wide team of physicians, epidemiologists and administrators deemed the sequestration — which the researchers had volunteered for — unnecessary. Cleary also noted that CDC officials approved the plan for the students to self-monitor their health rather than isolate themselves.
“It sounds like they consulted the head of the School of Public Health and the CDC,” said Yale Global Health Fellow Teresa Logue ’15. “Other public health students are pretty confident in the ability of Yale and the Yale-New Haven Hospital authorities.”
The students traveled to Liberia on Sept. 16. Before leaving the United States, they informed the military and the Centers for Disease Control and Prevention, said Cleary in an email to public health school affiliates on Oct. 2.
Efforts to prevent the spread of Ebola to the Elm City, though, have extended well beyond the School of Public Health.
Discussions about the city’s response to Ebola cases have been ongoing since as early as February, said State Public Health Commissioner Jewel Mullen ’77 GRD ’96. The Connecticut Department of Public Health has engaged in outreach to local healthcare providers.
The Department of Public Health has sent letters to hospitals, health centers, schools and EMS providers to encourage “situational awareness” and strengthen the state’s public health infrastructure, Mullen said at an Oct. 9 meeting with state legislators and public health officials.
Another component of the state’s outreach has involved implementing a CDC-issued checklist for hospitals to review their Ebola response protocol. The checklist includes measures such as checking symptoms, running tests, maintaining stock of appropriate personal protective equipment and training personnel.
All 29 acute-care hospitals in Connecticut have completed this checklist.
Edward Badamo, operations manager of American Medical Response, the privately contracted first responder responsible for transporting the patient to YNHH, said he was not aware of receiving explicit protocols from the state. However, he said that the national guidelines that his company follows are at least as stringent as Connecticut’s procedures.
On Wednesday night, American Medical Response was made aware of a potential Ebola patient to be transported by Yale Health. The warning allowed the first responders to arrive prepared to carry out the appropriate isolation procedures, Badamo said.
“The [case] last night was able to be planned for,” Badamo said. “We didn’t walk in and discover that they had traveled to Western Africa. There’s a difference between that versus walking into the unknown.”
Badamo said this is the first suspected case of Ebola that the New Haven AMR has had to respond to, and it was the first actual application of their Ebola response protocol.
But the preliminary test results do not signal an end to emergency preparations for the city, said Rick Fontana, deputy director of emergency management for the city. He said that the Emergency Management team will review the city’s response to Thursday’s threat to make improvements for future responses.
The review, said city hall spokesperson Laurence Grotheer, will also include the University and YNHH.
“It was a drill for us, to make us better in our next response,” Fontana said. “We’re going to criticize our response to make the next ones better.”
Fontana added that although the patient in New Haven tested negative for Ebola, there are still cases of the virus in the United States, so the city needs to remain prepared. The city currently keeps track of who in the Elm City travels to New Guinea, Liberia and Sierra Leone — the three countries identified by the CDC as high-risk areas for the virus.
Senator Richard Blumenthal LAW ’73 said that the threat of Ebola reminds officials about the importance of preemptive measures in containing the virus.
“The protocols followed by Yale-New Haven seem to have been very thorough and robust,” Blumenthal said. “But other hospitals around Connecticut might not be as effective.”
Blumenthal added that the threat of the virus indicates a need for screenings at local seaports and airports, in addition to immediately isolating people who exhibit symptoms.
Elsewhere in the country, fears of Ebola have prompted the closing of schools, where diseases can quickly spread. On Thursday, officials in Texas and Ohio closed a limited number of schools after it was revealed some students may have been exposed to a nurse infected with Ebola in Dallas, Texas who had also travelled to Ohio.
Upon receiving news of the Ebola threat, leaders at New Haven Public Schools responded by sending information home to parents, said NHPS Director of Communications Abbe Smith. Smith said that the schools have also begun a registration process for families who have lived in or travelled to West Africa.
According to Smith, when new students register for school at NHPS, the families are asked if they have been in West Africa in the past 21 days. If the family answers yes, then the school contacts the Department of Health, which then review health information with the family.
Weeks before the graduate student was admitted into the hospital, the Yale-New Haven Hospital held a conference on emergency response to a patient with Ebola, Vender said. “We were hoping that our preparations would be unnecessary, but we recognize that we may not be immune to the problem.”
YNHH is the primary teaching hospital for students at the Yale School of Medicine.