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CDC Releasing New Guidelines For Health Workers Treating Ebola


The Centers for Disease Control and Prevention is releasing new guidelines for how hospital workers should protect themselves from Ebola. For example, they prescribe more care in putting on and taking off protective gear. The revised guidelines come after the virus spread from a Liberian traveler to two nurses in Texas. The Dallas Ebola cases put a spotlight on the CDC and how it operates. And it turns out, guidelines are a big part of what it does. NPR's Rob Stein considers how the agency handled the first case of Ebola in the U.S. and how it compares to our expectations.

ROB STEIN, BYLINE: In the movies, when a scary, new virus threatens America, the CDC swoops in and like in the 1995 Hollywood hit, "Outbreak," takes control.


UNIDENTIFIED ACTOR: Your town is being quarantined.

STEIN: But in real life, not so much. Bill Roper ran the CDC in the early 1990s.

BILL ROPER: Principally what CDC does is provide technical assistance and advice to folks on the front line of disease, prevention and control.

STEIN: Like hospitals - state and county health departments and other governments around the world. The CDC does have teams of disease detectives and one of the world's best journal apps but mostly the CDC issues recommendations - rights guidelines.

ROPER: There are practically no examples of CDC's being able to do something unilaterally. It's always in concert with others.

STEIN: And most of the time that works just fine. But sometimes, say when Ebola shows up for the first time, this dynamic can create problems.

LAWRENCE GOSTIN: One problem is, you know, who's in charge problem.

STEIN: Lawrence Gostin is a public health law expert at Georgetown who advises the CDC. Technically, it's the local authorities.

GOSTIN: Some of them are of extremely high quality, and some of the local health department might just have a half-time sheriff who's not even a physician.

STEIN: Still, the CDC is not perilous - far from it. When the director of this federal agency speaks, Roper says people tend to listen.

ROPER: CDC can come in and by force of the presence and expertise in effect lead what happens at the local level.

GOSTIN: It is a very big bully, pull pit.

STEIN: And that's where, it seems, the CDC fell short this time around. The agency did issue lots of guidelines and detailed recommendations for how hospitals should handle any Ebola patients. But the Texas Health Presbyterian Hospital in Dallas initially misdiagnosed Thomas Eric Duncan anyway. And two nurses who eventually cared for him got infected.

JENNIFER NUZZO: There were certainly some mishaps at the beginning.

STEIN: Jennifer Nuzzo at the University of Pittsburgh Center for Health Security.

NUZZO: CDC should have sent a team right away to oversee the medical response - to provide some training to the staff there - in terms of how to take on and off the personal protective equipment.

STEIN: Lawrence Gostin at Georgetown blames the CDC woes on a combination of factors - basic limitations on the agency's powers, a billion dollar budget cut and politics.

GOSTIN: I used to call the CDC this shining star of the federal agency system because they were there in Atlanta. They were politically neutral - immunized if you will from the politics of Washington. And that has changed because the CDC has become very politicized in the last five to ten years. And so I think it's lost a little bit of its luster.

STEIN: He finds all this especially disappointing given the big focus on bioterrorism and biodefense since 9/11.

GOSTIN: We have poured billions of federal dollars into public health preparedness, and here we are with a new disease on our doorstep. And the very, very first case that comes to our soil, two innocent nurses become infected with a potentially lethal disease. It really makes you want to sigh and your jaw drop. What have we learned?

STEIN: But Gostin and others hope hospitals around the country, state and local health departments and the CDC have learned a lot from what happened in Dallas so that things will go better if another Ebola patient shows up in America. Rob Stein, NPR News. Transcript provided by NPR, Copyright NPR.

Rob Stein is a correspondent and senior editor on NPR's science desk.
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