“Keep Calm and Carry On” the poster says.
And as true Brits, we’re doing exactly that. Ebola looms large in most people’s minds, but we’re ready and not panicking.
Ready, yes. Prepared, yes. But seriously under-resourced.
The thin white line
Whitehall’s medical brass might reckon our health services are robust enough, there’s still only a thin line of white coats between us and staying on top of it.
Four hospitals across the country are on first-level alert for handling Ebola: the Royal Free Hospital in London – which rescued British nurse William Pooley from the disease – the Royal Hallamshire in Sheffield, the Royal Victoria Infirmary in Newcastle and Royal Liverpool University Hospital.
Currently, the Royal Free is the only specialised High Level Isolation Unit in the country. It has just two fully equipped containment beds.
A question of backup
But it’s not the number of beds. It’s the one-on-one backup to keep them going. And the backup for the backup – the hospital-wide services to ensure hygiene levels are maintained and all personnel are safe.
At the Ebola front-line, containment protocols are meticulous. Senior nurses scrutinise medicos prepping, watchful for any errors in scrub-ups or donning protective clothing. But such staff will only go on duty for an hour.
The one-hour rule
Sir Leonard Fenwick, chief executive of Newcastle Hospitals NHS Foundation Trust spells out why. “On the hour, the one-to-one staff ratio must change to ensure procedure protocol is strictly adhered to without exception. Together with constant vigilance and support, this is the overriding requirement.”
Hands-on carers routinely go through UV radiation to ensure they are free from any infection. The ultra violet kills all germs and bacteria by destroying their cell DNA. Outside their bodies, these staff are completely sterilised.
It’s not the same in other parts of these hospitals, where hygiene levels are maintained by traditional methods. Rub and scrub, mop and bucket – doing it the hard way.
Thin on technology
Only in a very few places is there technology to help – either UVGI units or hydrogen peroxide auto-sterilisers. Or as at Plymouth’s Derriford Hospital, a second level designated Ebola facility, which has a negative pressure room – no air can escape, isolating any contagion.
Such machines would be invaluable and are easy to operate – 100 of the hydrogen peroxide type were recently sent to Nigeria, the one African country to have brought the present Ebola outbreak under control.
At the touch of a button, hygiene levels move up to a very much higher level. Rooms are completely sterilised in around twenty minutes, freeing up valuable hygiene maintenance resources to be deployed elsewhere.
Fortunately at the moment, UK has no Ebola-positive patients. Some cases are inevitable. A large number of Britons – especially the armed forces – are involved with humanitarian aid in Sierra Leone, many in direct contact of Ebola victims.
The hard way
But when cases start arriving, it’s not the Ebola facilities that will be under pressure. It’s other departments feeling the knock-on effect – fewer staff, longer hours, yet more over-stretched resources.
Yes, we’re ready – but it’s going to be hard.
“Keep Calm and Carry On.”
Nobody said it was easy.