Has Ebola caused a revolution in health care?

Three human figures in full-body protective suits, one of them stepping from the open back door of an ambulance
When medical missionary Dr. Kent Brantly emerged from the back of a Grady ambulance on Saturday afternoon, August 2, 2014, clad in a full-body protective suit and holding onto his EMS escort for support, he became the first Ebola patient to set foot on American soil.

In August 2014, the first of what would come to be four patients infected with the Ebola virus came through the doors of Emory University Hospital’s Serious Communicable Diseases Unit. The unit, staffed in partnership with the Centers for Disease Control and Prevention, was one of only four units in the United States equipped to treat serious infectious diseases like Ebola. Colleen Kraft, Associate Professor of Infectious Diseases at Emory’s School of Medicine who currently leads research in the SCDU, was working in the unit first-hand with the patients.

Those patients included Kent Brantly, a doctor from the United States infected with the Zaire strain of the virus, the deadliest strain of Ebola, while working in Liberia. Two days later, Nancy Writebol, a missionary worker who had contracted the virus in Liberia, was flown to Emory. On September 9, Ian Crozier, a doctor who volunteered at an Ebola Treatment Unit in Kenema, Sierra Leone, and was the most critically ill of Emory’s Ebola patients, was flown in. Lastly, Amber Vinson, a nurse infected while caring for a patient with Ebola at Texas Health Presbyterian Hospital in Dallas, was transferred to Emory on October 15.

Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
AMR is an increasingly serious threat to global public health that requires action across all government sectors and society.
Without effective antibiotics, the success of major surgery and cancer chemotherapy would be compromised.

Kraft, along with lead SCDU nurse Sharon Vanairsdale, were painstakingly rehearsing the protocols for donning and doffing personal protective equipment and cleaning the unit on a near continuous loop.

“At the time, while we were in the throes of taking care of patients with Ebola, we didn’t think a lot about how much the experience would ultimately change our perspective on health care,” says Kraft. “We were literally just trying to keep ourselves safe all the time.”

The cost of health care for patients with resistant infections is higher than care for patients with non-resistant infections due to longer duration of illness, additional tests and use of more expensive drugs.
In 2016, 490,000 people developed multi-drug resistant TB globally, and drug resistance is starting to complicate the fight against HIV and malaria, as well.

By the time the last patient was discharged with a clean bill of health on October 28, 2014, both Kraft and Vanairsdale were already beginning to have crucial conversations about the rigorous protocols they had used and wondering what would happen if they were to translate those practices to everyday use.

“We just started thinking: how many hospital-acquired infections could we prevent if we were to just take these learnings and apply these to every day patient care?” says Vanairsdale.

Hospital-acquired infections (HAIs) are the most common complication in hospitalized patients, with an estimated incidence of 4.5 HAIs per 100 hospital admissions and an annual cost between $35 billion and $45 billion.
Hospital-acquired infections (HAIs) result in more than 90,000 deaths each year, ranking death due to HAIs among the top 5 leading causes of death in the United States.

Together they’ve established new, innovative training that involves virtual reality and augmented reality. Vanairsdale has partnered with the HHS, Nebraska Medicine, and NYC Health + Hospitals to educate more than 10,000 health care workers on caring for patients with infectious diseases. Kraft is a part of The National Ebola Training and Education Center (NETEC), an organization committed to increasing the capability of public health care systems in the United States to handle Ebola and other special pathogen incidents.

With infectious disease rates on the rise and growing concerns over antibiotic resistance, Kraft and Vanairsdale know the next pandemic is closer than we think.