If it turns out that foreign country is in West Africa, you’ll get a mask, your own waiting area and a nurse in protective gear.
If you traveled to West Africa and have a fever, headache, stomach pains or other concerning symptoms, you’ll get all of the above — plus a blood test that’s rushed to Boston and an isolation room in the hospital. Your ER doctor will also call the Maine Center for Disease Control & Prevention.
“We have to be ready for whoever walks through the door,” said Pete Tilney, director of Central Maine Medical Center’s emergency department.
CMMC and St. Mary’s Regional Medical Center say they are.
The hospitals showcased their Ebola preparations for media Friday, highlighting each progressively cautious step, starting from the moment a patient walks through the door to an ER doctor’s decision to call the state CDC.
But within the demo was a public service announcement: Flu is more prevalent than Ebola and kills far more people in the United States.
“We’re working and planning for this, but the biggest threat which walks through our doors … is influenza,” said Kevin Oliveira, director of emergency services at St. Mary’s Regional Medical Center.
Lewiston’s two hospitals began prepping for Ebola about three weeks ago, when a Texas nurse was diagnosed with the disease after treating a patient with Ebola in her hospital. Since then, CMMC, St. Mary’s and area first responders have collaborated to train workers and make sure their policies and procedures meet CDC guidelines.
“Obviously there’s some gaps that you have to adjust your plans for, for whatever the emergency is,” Oliveira said. “That’s what we’re doing. That’s what this collaboration is all about. It’s about treating the community and keeping the community safe.”
The hospitals already had emergency room isolation areas and procedures for patients who show up with an infectious disease. Ebola protocols have added new layers of precautions. Check-in staff are required to ask about patients’ travel history and sometimes don masks. Nurses and other staff members must train to get in and out of protective gear. Doctors must determine when to call in state medical officials.
The city’s two hospitals follow the Ebola guidelines laid out by the federal and state CDCs, making their protocols virtually identical to each other. But their responses differ in some ways.
To separate patients in the waiting area, CMMC offers a screened-off sitting area, while St. Mary’s set aside a pair of open seats in front of reception, beside the emergency department doors.
St. Mary’s doctors and nurses can see isolated emergency patients through a glass wall and connect with them over an internal phone line to limit contact, while CMMC sends in a pair of nurses in protective gear.
Two CMMC nurses don their protective gear in a hallway outside the emergency isolation room while a third person talks them through the procedure. At St. Mary’s, one nurse, with the help of a buddy, puts on protective gear in a special anteroom connected to the emergency isolation room.
Both hospitals say the protocols continue to evolve.
“Every day it evolves,” Tilney said. “This kind of clothing and protective equipment recommendation has been changed by the federal CDC and the state CDC. And, you know, we expect it to change tomorrow. That’s how fast this is evolving.”
St. Mary’s has not yet had to use its emergency isolation room for someone suspected of having Ebola. Although a handful of patients have come in after traveling to a foreign country, they either weren’t in West Africa or weren’t in contact with anyone who was sick.
CMMC on Thursday briefly isolated a patient who had been to Africa. The person did not speak English and could not answer questions about which country he’d been to or what his symptoms were. CMMC connected over Skype with a translator who was able to talk with the patient.
“Within minutes we were able to take off the gowns and everything and say, ‘Sorry.’ And he was very nice,” Tilney said. “But we took the most conservative route. Expect the worst, hope for the best.”
The two hospitals and other community health organizations will host a public forum on Ebola at 6 p.m. Wednesday, Nov. 12, at the Franco-American Heritage Center in Lewiston. Medical workers will be available to answer questions about the disease and how they are prepared to respond to it.
Before and after the forum, the hospitals will offer flu shots. Health professionals say the flu, which kills tens of thousand of people in the U.S. every year, is the bigger threat to the community.
While people are thinking about Ebola, medical officials want them to think about another, more common virus.
“Our concern for our community is flu,” St. Mary’s spokeswoman Jennifer Radel said. “We’re really using this as an opportunity to get the word out: ‘Get your vaccination, get your flu shot.'”