Research Suggests Healthcare Workers Could Balk At Treating Ebola Patients

Given the current and developing situation in Dallas, where two health workers have become infected with Ebola while caring for a patient, it is reasonable to ask if health workers might decide to call in sick for a few months until this whole highly infectious often fatal disease thing blows over. Daniel Barnett, of the Department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health, has looked into health workers’ unwillingness to report to work when there is a potential for infectious-disease transmission to themselves and their family members.

The health workers I know tend to run into burning buildings or jump into frozen lakes and such to rescue people, so I can’t see that happening. Apparently it has been an issue in Spain and in West Africa. I can’t explain Spain, but things are so dismal in West Africa that it is not at all unexpected. But what about in the US?

So far there doesn’t seem to be an issue according to Barnett’s research, but he cautions that continued willingness to work with Ebola patients here is not assured. In an earlier study, Barnett and colleagues found that one-third of workers at a large U.S. urban medical center would be unwilling to respond to a severe infectious disease outbreak.

“An individual’s personal perception of the importance of his or her work during the response phase and his or her sense of confidence in performing this role effectively, are among the most powerful determinants of willingness to respond,” notes Dr. Barnett. “Our research also suggests that familiarizing health responders with laws and policies designed to protect their wellbeing in an emergent infectious disease event is important for bolstering response willingness,” Barnett adds.

Barnet notes that for training to be effective it must provide clear guidance on infection control protocols and instill a clear understanding of outbreak response duties. I asked him about the domestic side of this, about training of health workers regarding in relation to thier behavior or decision making when they are off duty. This seems to have arisen as an issue with the second Ebola-infected worker in Dallas, who took an air flight after starting a fever (if reports are accurate) and before diagnosis as having the disease.

“Preparedness and response trainings on emergent infectious diseases need to cover not only work-related protocols,” he told me, “but also address behavioral elements outside of the healthcare setting in the interest of public health. To date, there's essentially been no research or 'environmental scan' on the extent to which such trainings actually encompass behaviors and practices outside of the health care workplace. However, this type of training on precautionary measures outside the workplace is essential. It needs to be imbedded into trainings and harmonized across healthcare institutions to ensure consistency.”

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If you don't get paid sick leave, if you don't have employer paid health insurance (and life insurance), if you don't get a living wage, if you don't have disability insurance that will cover you and your family if you become incapacitated, it would be unreasonable to expect people to work under such conditions.

Throw in the fuster-cluck of mismanagement by people who do have all those things, and balking for better conditions makes perfect sense.

The health care system that provides all of these things to all health care workers as a matter of course, buys a great deal of good-will when things become dicey, because people are confident they won't be flushed down the toilet to increase profits for those at the top.

When flushing those at the bottom down the toilet to increase profits is SOP, then it is not unexpected that such disposable workers would balk,

By daedalus2u (not verified) on 16 Oct 2014 #permalink

Beraing your comments in mind it would be reasonable to assume that this has been thought out at highest level. If there is an ill designed handling and management plan, if the correct equipment in sufficient quantities is not in place, if there is no global waste containment and disposal plan, if there is no facility for rest and recovery for these workers and if the workers continue to be blamed - who will be left who will be prepared to put their lives in unnecessary danger?In all Nations, all must get fingers out, including admin staff, management staff and all the talkers who will have to be putting in the positive preventative measures.

By Elsdon Ward (not verified) on 16 Oct 2014 #permalink

The nurses and doctors who volunteer and risk their lives to help ebola patients are true heroes. Major, *major* respect -and best wishes and hopes for them.

By Astrostevo (not verified) on 17 Oct 2014 #permalink

If there is a problem, they can ask for volunteers, give them a little more status and pay and there will be plenty of takers. Anyone dealing with highly infectious people and having to wear those suits should have special training and extra benefits anyway.

The belief was that an Ebola case could be safely treated by a typical general hospital in such an advanced country like the U.S. (or Spain). That belief is pretty much exploded now, and I was glad to see the patients transferred to specialized facilities. There is not much room at these facilities though, so I expect much stricter quarantines in the future. Here in Dallas, the government is finally waking up and starting to put these kinds of things in place. Officially, it is "voluntary" quarantine, but I expect that is mostly to keep other people calm.

I think the health workers who treat ebola patients are very brave because everybody is scared of this disease since it is very contagious and harmful.


By Shobede Q.K (not verified) on 15 Apr 2015 #permalink