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Doc: Info systems may have helped slow Ebola outbreak


By Gintautas Dumcius


STATE HOUSE — Health information technology would have helped stem the Ebola outbreak in a place like Guinea, one of the African nations hit with the deadly disease, according to a top Massachusetts health official.

Michael Wong, a member of the state’s Public Health Council and a physician at Beth Israel Deaconess Medical Center’s infectious diseases division, said this week that the international response to the outbreak was initially slow, with a “strong” response finally coming only in July.

“I think if there was much more attention to the actual epidemic on the ground and sharing of information across borders . . . that probably would have helped the World Health Organization and other organizations like the CDC to respond in a way that would be much more timely,” Wong said Tuesday after speaking to attendees of a international conference on health information technology that drew biotechnology experts and entrepreneurs to the Great Hall. “Because remember the first numbers didn’t look all that bad. It was only after they went back and reanalyzed everything where we really started saying, ‘No we’re not getting under control, the numbers are actually really going up.”

Wong said one health organization in West Africa still had doctors using paper charts, and the few medical professionals available were not writing down enough information as they dealt with patients.

Wong has been participating in the World Health Organization’s Ebola task force since early August.

The U.S. Department of Homeland Security announced on Tuesday that starting on Wednesday, travelers from Guinea, Sierra Leone and Liberia will be restricted to to New York’s JFK, Newark, Dulles, Atlanta and Chicago airports, which have special screening protocols in place.

Also on Tuesday, National Nurses United applauded the call in the latest guidelines from the Centers for Disease Control and Prevention for “rigorous and repeated training” for nurses and other health workers responding to the Ebola virus.

“It is clear from the abrupt change in position of the CDC in some areas that the registered nurses have moved the country and the CDC as the nurses champion protection for their patients and articulate the vulnerabilities for themselves. Nevertheless, the optimal standards should be in place tomorrow and, regrettably, they will not be,” NNU Executive Director RoseAnn DeMoro said in a statement.

Wong said he was optimistic about world efforts to slow the spread of the disease. “But I do think this is one of those lessons where after-action reports need to be done and where it’s really transparent,” so they can prepare for the next outbreak, he told the conference’s attendees.

“Mother Nature is just going to keep throwing these things at us,” he said.

Wong pointed to two hospitals, one in Atlanta and another in Nebraska, treating patients with Ebola. “What was learned in both Emory and Nebraska was using a full body suit than just a standard gown, that really does seem to make a difference,” he said.

The head of UMass Memorial Medical Center, speaking to a legislative panel last week, raised concerns that hospital staffers don’t have enough training on Ebola, while the chief nursing officer at East Boston Neighborhood Health Center stated she would welcome government efforts to supply small medical centers with protective gear.

State officials have repeatedly stressed that an Ebola outbreak in Massachusetts is unlikely.

Wong said in West Africa, there is a lack of understanding within local communities and little familiarity with the virus.

The area also has overall health infrastructure issues, he said, citing statistics that say Guinea has one doctor for every 100,000 people, compared to the U.S. having 2.4 physicians for every 1,000 people.

Wong said there are currently at least 12 different “vaccine candidates” for Ebola. There are also a number of therapeutics, with five in the most advanced phase of development, having been recognized by the Centers for Disease Control (CDC) and the Food and Drug Administration (FDA), he added.

Wong, who is also a senior medical director of infectious disease at Sarepta Therapeutics in Cambridge, said the company is working on an anti-virus agent that could help combat Ebola.

Ebola was first identified in 1976, and there had been 23 outbreaks through December 2013.

Asked if there has been a public overreaction to the disease, Wong said, “As my own personal belief, I think there is a bit of an overreaction that’s happening.”

Wong stressed that no subsequent infections in the U.S. have occurred beyond two Dallas nurses who dealt with an Ebola patient who eventually died from the disease.

“There’s been a lot of information, misinformation and lies across the internet,” he told the crowd, noting that Ebola is not an airborne virus.

He pointed to a recent cholera outbreak in Haiti and an outbreak ten years ago of Severe Acute Respiratory Syndrome (SARS), which was “far more infectious at the time.”

The Legislature’s Joint Committee on Public Health on Thursday afternoon resumed an oversight hearing on Ebola response and preparedness, with health care providers, first responders and clinicians expected to testify.

Prior to Thursday’s hearing, Massachusetts health care providers and hospitals said they were working collaboratively to address concerns over the virus.

“We have a common goal in this effort – to strive for the highest level of preparedness and ensure that all hospital, health centers and clinical staff are able to safely provide high quality, appropriate, patient care,” they said in a joint statement. “We are committed to ensuring nurses, physicians, and all appropriate frontline healthcare providers have the proper training, equipment and protocols to remain safe and provide the highest quality of care for our patients.”

The organizations that issued the statement were Massachusetts Hospital Association, the Massachusetts Medical Society, the Organization of Nurse Leaders of MA-RI, the American Nurses Association Massachusetts, and the Massachusetts League of Community Health Centers.

They said they are working “closely” with officials from the state Department of Public Health, the federal government and local groups. “Preparation is an ongoing process that demands continued perseverance and improvement,” the health care groups wrote. “Every day clinical leaders across the state are focused on ensuring that proper protocols are in place and followed, and that appropriate training and education is provided.”