North Carolina is on the forefront of preparation for a potential Ebola crisis as well as helping fight global outbreaks of the dreaded disease, said representatives from the state and national government, the Triangle health care profession, and Triangle private industry at Monday’s Ebola Conference at the North Carolina Biotechnology Center.

Governor Pat McCrory asked that the state be “Over-prepared for potential health care emergencies because he would rather the state be over-prepared and underwhelmed than under-prepared and overwhelmed,” said Aldona Wos, M.D., State Department of Health and Human Services Secretary.

While her department is the lead state agency working on preparations for an potential Ebola outbreaks here, she, like all the speakers at the event, stressed that collaboration and cooperation among numerous stake-holders, from sister agencies to the CDC, state hospitals large and small, and others, has been essential.

Preparations include info site

Preparations include the establishing a web site (http://www.ncdhhs.gov/ebola/), working with federal and local partners to actively monitor travelers from West Africa, and training videos on how to put on and take off spacesuit-like protective clothing (which takes 15 steps to don and 27 steps to remove in the presence of a monitor buddy).

Wos added that “We stress the need for a seamless transition from preparation to a response if Ebola patients turn up in NC.”

The cost handling the single suspected Ebola case that popped up in NC alone points out the need for the funding President Obama has requested to battle the disease at home and abroad. That one “person under investigation” required 1,500 person hours of labor and cost close to $100,000, said Julie Casani, M.D., director of Public Health Preparedness and Response for the NC Division of Public Health.

Also at the conference, several North Carolina companies that are directly involved in the Ebola fight acknowledged facing a variety of complex problems.

Costs are high and funding is needed

Other speakers noted that costs for equipment, salaries, protective clothing, testing, and the person-hours involved in meetings are also high. Caring for a single Ebola patient costs about $30,000 a day, said a UNC doctor.

Congressman David Price of NC’s Fourth District addressed that Congress reconvenes Monday to consider the President’s $6 billion emergency funding request. “It looks like an area where we’ll act in a positive, non-partisan way,” he said. “One thing we shouldn’t do is play this crisis in any way politically,” he said.

A solid note of optimism sounded throughout the event. Current preparations are to some extent based on previous emergency planning for events such as hurricanes and pandemic flu. But the extensive partnerships and collaborations developed among public and private entities, local, state and national agencies, and the state health care systems to prepare for an Ebola outbreak can serve as a model and infrastructure for handling other future emergencies.

Duke/UNC collaborated on preparation efforts

It hasn’t all been easy, said David Weber, M.D., professor of medicine and pediatrics, UNC School of Medicine, said. “It’s like a game of whack a mole, institutionally, you solve one problem and another one pops up.”

Weber outlined the collaborative efforts that Duke and UNC hospital systems have taken to prepare for an Ebola patient.

Weber said a 50-person Ebola care team including doctors, nurses, lab and radiology technicians and respiratory care specialists go through advanced training in a simulation lab using dummies with the training geared to each specialty. Team members retrain on a two week to three month schedule.

They have also worked out transportation mechanisms.

They trained more than 300 people in emergency departments because “You never know when someone might show up” the way one did in Dallas, Texas, where he was not diagnosed.

Flu season will require more “rule outs”

If you’ve been in a Duke or UNC medical facility, you probably already saw all the signs asking if you’ve been out of the country in the last 30 days and personnel ask at least three times if you’ve recently come back from West Africa.

Both Duke and UNC are also working closely with the state’s military installations. Both are also involved in research efforts testing vaccines and treatments in Africa. Weber said the UNC/Duke planning includes protocols even more advanced than those of the CDC.
He did warn that the upcoming flu season, which has already started in NC, is likely to result in people with symptoms similar to Ebola. “We expect a substantial number that have to be ruled out” in coming months.