In a telebriefing yesterday, Centers for Disease Control and Prevention (CDC) director, Dr. Thomas Frieden announced the new, updated guidelines for the use of Personal Protective Equipment (PPE).

Image/CDC
Image/CDC

“The guidelines we’re releasing today are updated.  They provide an increased margin of safety.  They provide a consensus on better protecting health care workers because even a single health care worker infection is unacceptable. One of the many challenges dealing with Ebola is that there’s never been a case in this country until less than a month ago.  It is truly unprecedented here”, he said

“CDC had guidelines for Ebola and other hemorrhagic fevers which were issued in 2008 and updated in August of this year.  They were developed by experts at CDC with consultation and approval from infectious disease control experts around the U.S.  and consistent with world health organization guidelines and have been used successfully before.  The hospital caring for the first patient, Mr. Duncan, relied on these guidelines.  Two health care workers became infected.  This is unacceptable.  Even a single health care worker infection is one too many.  We may never know exactly how that happened, but the bottom line is that the guidelines didn’t work for that hospital.

“Dallas showed that taking care of Ebola is hard.  The way care is given in this country is riskier than in Africa.  There’s more hands-on nursing care and there are more high-risk procedures such as incubation.  This guidance has been reviewed by people in institutions with lots of experience treating Ebola in the U.S.  in fact, all of the people who have experience treating Ebola in the U.S. as well as doctors without borders, MSF.  That includes input and review by Emory, Nebraska, NIH.  This results in a consensus that allows an increased margin of safety and there are three key points about how to take care of Ebola while minimizing your risk.

“The first is prior to working with Ebola patients, anyone who is going to work with them must be repeatedly trained in and demonstrate competency performing all of the things that they’re going to need to do, specifically putting on and taking off proper personal protective equipment or PPE.

“Second, no skin may be exposed when PPE is worn and third, every step of every time a health care worker puts on and takes off personal protective equipment they must be supervised by a trained observer who documents proper completion of established PPE protocols.

“It’s very important for the media to convey because it’s an important message for health care workers that these are three comprehensive aspects.  The guidelines go through great detail and much more than CDC guidelines generally do in terms of what are the things that need to be done, but while a lot of attention has been paid to the equipment and while that’s critical and important, the greatest risk in Ebola care is in the taking off of whatever equipment health care worker has on whether there’s skin exposed or not.  And one of the critical aspects of these guidelines is a very structured way of doing that step by step which is supervised and in a way, ritualized so that it is done the same way each time with standardized equipment.”

The CDC released the following Fact Sheet yesterday, click HERE