The sign taped to the glass as you enter the Massachusetts General Hospital emergency room poses a question that lately has taken on new urgency: “Have you traveled outside the United States in the past three weeks? Please tell the nurse.”
The nurse will ask you that question, too, before she asks your name or birthdate.
But the sign has been there for years, starting long before the Ebola epidemic in West Africa aroused fears of the disease coming here, said Dr. Paul D. Biddinger, the hospital’s chief of emergency preparedness. Other infectious diseases, such as pandemic flu and Middle Eastern respiratory syndrome, have long been a concern in a world where a plane ride can turn a local epidemic into a global threat.
Now, however, Mass. General is taking preparedness to a new level after several Ebola cases arrived in the United States. The hospital, Biddinger said, has invested roughly $1 million in equipment, renovations, and staff training to prepare for an Ebola case — considered unlikely but possible.
On Friday, Cheryl Bartlett, the Massachusetts public health commissioner, visited the hospital to see the Ebola preparations firsthand. Mass. General is one of seven hospitals that have agreed to treat Ebola patients and the first of several Bartlett intends to visit.
Biddinger took her on a tour of the emergency department, walking her through the steps a patient with possible Ebola would take. He later repeated the tour for reporters.
If someone has visited one of the three countries stricken by the Ebola epidemic, and also has symptoms that could be Ebola, he or she is escorted through the ambulance garage into a room normally used to decontaminate people exposed to chemicals.
The patient waits there while staff don protective equipment in a cordoned-off section of the emergency department. Then the patient is taken into an isolation room in the emergency department for further evaluation.
The hospital has installed two doorways turning a hallway into a separate “doffing room” for medical workers to remove protective equipment after caring for the patient. The patient stays in isolation until Ebola is ruled out.
So far, Mass. General has not had any suspected Ebola cases that needed to be taken to this room, Biddinger said. But he said the hospital is ready for the next level: a confirmed Ebola case, which would be transferred to an isolation room in the medical intensive care unit. Mass. General can handle one adult and one child with Ebola.
“We know for sure,” Biddinger said, “it is safe for us to take care of an Ebola patient and not put anyone at risk.”
Bartlett also observed a training session in donning and removing personal protective equipment. The hospital is training 350 employees — doctors, nurses, respiratory therapists, and the people who clean up — in the slow and exacting process of safely getting in and out of moon suits.
The commissioner said she was impressed with what she saw. “I’ll be able to sleep better tonight,” Bartlett said.