The mayor of Braintree -- the city that recently weathered an Ebola scare -- said protocols and communication can and should improve between local and state authorities when responding to such incidents.
Mayor Joseph Sullivan, speaking before the legislature's Joint Committee on Public Health this morning at the State House, said communication between incident command staff "needs attention," called for clearer Ebola testing criteria and better guidance on decontamination.
"This is an issue that is beyond any city or town to deal with in an individual manner," said Sullivan.
Last Sunday, a patient who had flu-like symptoms and had recently travelled to Liberia admitted himself to a Braintree clinic. He was isolated, then transferred to Beth Israel Deaconess Medical Center, where tests showed he did not have the disease.
Today, before the State House hearing, the Massachusetts Nurses Association reiterated past concerns about the lack of Ebola preparedness amongst hospitals in the state. Before the meeting, nurses lamented a lack of training, protocol regarding bodily waste disposal, isolation rooms and equipment.
"We have protocol for one Ebola patient," said Meredith Scannell, an emergency room nurse at Brigham and Women's Hospital. "So if there's more than one, there's no plan. There's no plan."
Patricia Powers, another nurse at Brigham, said the state is "absolutely not" prepared for an outbreak of Ebola.
"If it was me, I'd want to go to Emory (in Atlanta), I'd want to go to Nebraska, where they can handle these cases," she said. "It's disappointing."
State officials, including Gov. Deval Patrick have maintained the state is well prepared, while stressing there have been no confirmed cases of the disease in the commonwealth.
Dr. Michael VanRooyen, who works in Brigham's department of emergency medicine, told the committee hard travel bans for people coming from west Africa, where Ebola has killed more than 4,000 in recent months, would be an ineffectual way to address the spread of the disease. He said people would find aways around the ban and it could make it more difficult to track potentially problematic travel history for an individual. He advocated travel screening instead.
"This threat will never stop unless we stop it at its roots -- in west Africa," he said.
VanRooyen told the lawmakers the disease could only be spread from one person to another if the person with Ebola was symptomatic. In other words, if a person had Ebola but had not become sick, that individual could not spread the disease to another.
The main difference between Ebola and the common flu, he said, was the former could not be spread through respiratory droplets. Community awareness of the realities of the disease -- what the symptoms are and how it is spread -- will be key in dealing with any outbreak in the U.S., he said.
"The war on Ebola will not be won in hospitals," he said. "It's a classic public health threat."
Dr Paul Biddinger, Massachusetts General Hospital's medical director for emergency department operations, acknowledged at the hearing that the risks of not being able to care for an Ebola patient "are very real."
Hospitals need isolation areas and staff that are fully trained with proper protective equipment.
With flu season around the corner, a patient's travel history will be very important in determining who should be screened for Ebola, said Dr Biddinger.