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CDC tightens health care workers' equipment guidelines on Ebola

The Centers for Disease Control and Prevention Monday night officially tightened health care worker guidelines on "donning and doffing" personal protective gear while treating patients with Ebola.

"We're increasing the margin of safety with three consensus guidelines," said Dr. Thomas Frieden, director of the CDC, who emphasized that he wants the new methods to become a ritual for health care workers.

The new measures stress that health care workers must undergo rigorous and repeated training on how to put on and take off equipment; that they have no skin exposure while equipment is worn; and that the process be done in the presence of a trained supervisor.

The agency is also recommending that hospitals designate "clean" areas for putting on gear and "dirty" areas for its removal.

A change in the agency's guidance came after more than a week of speculation following major lapses in previous federal guidelines at Texas Health Presbyterian Hospital in Dallas, where two nurses became infected while treating Thomas Eric Duncan. The Liberian national was the first patient to be treated for Ebola in a U.S. hospital. He died two weeks ago.

Frieden said the agency is not recommending specific types of gear or brands. But the new guidelines do call for double gloving, waterproof boot covers and respirators.

"The University of Nebraska and Emory University used different approaches," Frieden said of the two institutions that successfully cared for Americans who contracted Ebola in Africa.

One used the N95 respirator, a particulate-filtering device that covers the nose and mouth. The other used a PAPR respirator, which is a full head-and-shoulder shield with air supply.

Hospitals across Long Island have been conducting training sessions for weeks as the epidemic in West Africa has continued to grow exponentially.

More than 4,000 people, mostly in three hard-hit countries, have died from Ebola.

Last week during a news conference at Nassau University Medical Center in East Meadow, chief executive Dr. Victor Politi noted that removing the equipment poses the greatest risk of infection.

Frieden said the tightened measures do not carry the weight of law because the CDC is not a regulatory agency. He said OSHA -- the Occupational Safety and Health Administration -- and state health departments are responsible for regulations.

He said the new measures are a consensus agreement and reflect many of the guidelines put in place by Doctors Without Borders in Africa. That volunteer organization has borne much of the weight of patient care in the stricken nations.


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