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10192014.5Until now, Ebola has spread with alarming efficiency but far from America’s shores. That distance offered some comfort. The obvious differences in American and African medical care (ie: infrastructure, resources) and daily living conditions offered another layer of comfort. After all, the thinking went, if Ebola happened here, it would be contained easily.

10192014.6Last week a Dallas nurse who cared for African Ebola patient Thomas Eric Duncan were diagnosed with the disease. Nina Pham became the first case of secondary transmission in the United States. Immediately, reports of inadequate training, improper safety equipment, and confused medical protocols emerged and altered Americans perceptions. Perhaps, some worried, an Ebola epidemic could happen here. Then Amber Vinson— another nurse who treated Duncan—traveled from Dallas to Cleveland on a Frontier Airline. She was diagnosed with Ebola when she returned to Dallas. Suddenly it became clear how easily an American Ebola pandemic could begin—with a contagious passenger on an airplane, a bus, a cruise ship.

On Friday, President Obama announced that Ron Klain will serve as the new “Ebola-czar.” Klain’s job is to coordinate communication, and to reassure the American public amid growing safety concerns. “He’ll control the message better than most people would, which is really important from an economic standpoint, from a health standpoint, but it’s also important from a political perspective,” the operative said, speaking on the condition of anonymity. “If anybody can get the way this is being reported and discussed under control in a short period of time, he’s the one,” the operative added.” It is an important task as Americans wonder what is being done to contain the spread of Ebola, and what medical and cleaning protocols will keep us safe? They are crucial questions for a worried public unaccustomed to dealing with Ebola first-hand.

Step One: Contain—

The first step to contain the disease is to identify contagious patients. This sounds like a no-brainer but because the incubation period is 21 days it requires daily monitoring and patience before a person becomes visibly ill. Thomas Eric Duncan is Ebola patient zero in the United States; he was the first patient diagnosed on American soil. Vinson and fellow nurse Nina Pham are secondary infections. The second step is to identify people who had contact with Duncan, Vinson, or Pham while they were contagious and to monitor their health during the 21-day incubation period. ‘Contact tracing’ as it’s called means a team of experts find and monitor people who may be infected.

Once diagnosed with Ebola, patients move to an isolation ward. That also sounds simple—call an ambulance and drive the patient to the hospital. Only, patients as contagious as this cannot ride in an ambulance without preparations.  AMR, American Medical Response, outlines the many procedures for safely admitting an Ebola patient. Four U.S. sites are equipped to treat high-level biohazards such as Ebola. Peek inside the layout of the Emory University facility.

10192014.3Inside the isolation ward, nurses and doctors wear protective gear that looks like something you’d wear during a walk on the moon. This is what stands between them and the Ebola virus. But, wearing adequate protective gear is only part of how caregivers protect themselves. They must also follow strict protocol for how remove the gear. View the levels of protective gear and four short videos that demonstrate how to remove the gloves, gown, shield, and mask.

Step Two: Decontaminate—

What do you do with the protective suit after it’s used? What about the sheets, hospital gown, and mattress? These cannot be reused nor can they be thrown away in the typical garbage. This poses a challenge for hospitals dealing with Ebola waste.

10192014.4The same challenge exists for apartments and houses where Ebola patients lived. Imagine having to remove all soft surfaces and to decontaminate all non-porous surfaces. The Smithsonian.com considers, How do you Clean Up an Ebola Patient’s Home?

10192014.1As Americans strive to protect themselves against Ebola (and Enterovirus-D68), sales of general disinfectants have increased 13% in the past month. Clorox sales have increased 28%. View a list of Clorox and Lysol products that meet the CDC criteria for cleaning Ebola infected areas.

Ebola is not a virus that floats freely in the air. Human to human transmission happens by touching body fluids or inhaling droplets. Among the CDC suggestions for preventing Ebola infection is to avoid direct contact with anyone who might be infected, to wear protective gear, and to wash your hands often. Hand washing is something we all do each day. But, perhaps we don’t do it often enough, or properly. Get the dirt on how to wash your hands. Now go practice singing “Happy Birthday”—twice—while washing your hands.