Federal health officials are tightening the rules for Ebola care after facing a storm of criticism over the way patients were handled at a hospital in Dallas.
Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), said Monday that anyone who treats Ebola should wear protective gear that does not expose any parts of the skin.
The preparedness of U.S. healthcare workers is under scrutiny, after two Dallas nurses became infected while treating an Ebola patient, Thomas Eric Duncan. A federal investigation into the two cases is ongoing.
“We may never know exactly how that happened,” Frieden said, adding that U.S. health officials decided to raise its standards “given what we’ve seen here” in Dallas.
He said the skin exposure during Ebola treatment, such as wrists or parts of the neck, “made people nervous.”
“It’s certainly sensible to say that’s not something that should happened because of the chance that someone could unconsciously touch their face, and that could result in contamination,” Frieden said of the protective equipment.
He added that other hospitals have prevented Ebola using those procedures, but the CDC wanted to add another for "increased margin of safety."
International health organizations have blasted the U.S. standards for Ebola care. American health workers were previously told it was acceptable to wear gloves that exposed their wrists and parts of their necks. Most health workers in West Africa are told to wear full headgear as well as two pairs of gloves.
Frieden said that he was not aware of major differences between the new U.S. standards and those of West Africa, though he said “there are some things that are hard to translate from African context in tent hospital to hospital in the U.S.”
He added that Ebola care in the U.S. is riskier than West Africa because of more invasive procedures, such as intubation.
The infected Dallas nurses who cared for Duncan did not wear special protective gear for several days because he had not been diagnosed with Ebola.
Texas Health Presbyterian Hospital, which cared for Duncan, has sought to blame the CDC for the spread of the disease. The hospital argued that all workers followed federal guidelines while treating patients, suggesting that the guidelines themselves were insufficient.
The hospital said some nurses “raised questions and concerns about the fact that the skin on their neck was exposed.”
The two cases, which marked the first time that Ebola has spread in the U.S., has raised concerns that hospitals nationwide are unprepared for the disease.
The loudest voice in the fight is the country’s top nursing union, National Nurses United, which has claimed that hospitals have failed to equip their staff for Ebola. The union launched a national campaign on Monday to demand tougher mandatory Ebola protocols at hospitals around the country.
Frieden also said Monday that people infected with Ebola are likely better off at specialized centers. The comments mark a shift from his previous stance, when he said any hospital with an intensive care unit could safely treat the disease.
“There is a need for specialized center when there is a patient with a confirmed Ebola case,” he said.
About 400 potential cases of Ebola have been flagged across the country, though just 10 percent of those people were tested for the virus. Only one test, that of Duncan, has been positive.