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Texas lawmakers confront Ebola missteps in Dallas


A Texas Senate committee quizzed experts Tuesday on missteps that occurred in Dallas with the nation’s first diagnosed Ebola case and repeatedly asked: What can lawmakers do to better protect Texans from serious contagious diseases?

Members of the Senate Committee on Health and Human Services did not hear ideas for specific laws but got clues, mainly from a newly created gubernatorial task force that will issue its first recommendations Dec. 1, ahead of the January legislative session.

“There have been a lot of successes in handling” the Ebola patient and tracing his contacts, said Chairman Charles Schwertner, a Georgetown physician. He noted that the disease has not spread to others, although the state is monitoring 48 contacts, including 10 deemed to be at high risk.

At the same time, Schwertner said, the committee testimony made it clear there were problems with communication, coordination and chain of command after Thomas Eric Duncan went to Texas Health Presbyterian Hospital Dallas on Sept. 25 and initially was sent home. After Duncan’s condition worsened, he returned to the hospital three days later and was admitted — seriously ill with Ebola.

Hospital officials have said that a failure to fully communicate that Duncan had come to Texas from Liberia, a country where the disease is raging, was a key problem. Although the hospital had prepared to deal with an Ebola case, “communication continues to be a problem” with so many people involved in the patient’s care, Dr. Gary Weinstein, chief of critical care medicine at the hospital, told the committee. “There will be lots of lessons learned.”

The hospital is doing a thorough review of what occurred before it admitted Duncan, who has been in critical condition since Saturday, Weinstein said.

Dr. Kyle Janek, chief of the state’s Health and Human Services Commission and a task force member, said he could not promise there will never be a misstep, especially when dealing with the country’s first case of a disease. “Not a single hospital in the United States wanted to have that first case,” he said.

One thing that can be improved is more careful questioning of patients in the emergency room, especially about their travel, he said, stressing that the Ebola virus can only be spread by direct contact with the patient’s blood or bodily fluids. “We’re going to learn a whole lot more with this task force,” he said.

The 17-member Texas Task Force on Infectious Disease Preparedness and Response, named Monday by Gov. Rick Perry, will develop a comprehensive plan designed to ensure that Texas is ready for an infectious disease outbreak. It also will make recommendations and inform the public. It is focusing on six key issues, said its leader, Dr. Brett Giroir, CEO of the Texas A&M Health Science Center:

• The ability of hospitals to quickly identify patients posing public health threats through screening and testing so those patients can be isolated. Weinstein said his hospital followed protocols it had in place to treat Duncan after he was admitted and could handle a maximum of three Ebola cases at once.

• Identifying lines of authority in health emergencies and outlining ways that local, state and federal assets collaborate with shared data and communications. For example, members of the committee said they want to know when the state can step in and order a quarantine.

• Ensuring resources are on hand to monitor patients, collect data and track contacts.

• Methods for decontaminating areas and waste disposal that comply with laws and protect others from disease.

• Educating health care providers on proven treatment options and experimental therapies when treating patients with unusual or rare diseases.

• Making sure that contacts being monitored have food, clothing, shelter and other services, including counseling.

“Preparedness requires clear, decisive and prospective management aimed at rapid response, and also long-term solutions,” Giroir said.


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