B.C.'s nurses are "legitimately scared" about Ebola but haven't been adequately trained to safely treat patients and avoid risking themselves or spreading the deadly virus to the broader population, according to their union president.
B.C. Nurses Union president Gayle Duteil detailed her concerns Tuesday in a letter to regional health authorities after three suspected Ebola cases turned up in Lower Mainland hospitals but were ultimately ruled out.
Duteil said Fraser Health and other health regions are "not ready" to respond to the arrival of an Ebola case.
A union survey found nurses in units designated to isolate and treat Ebola patients haven't yet been sufficiently trained in using protective gear to avoid infection.
Duteil is calling for immediate action to plug gaps in Ebola response planning, along with detailed simulations for front line staff.
"This cannot wait until there is another suspected case in an ER within the province," she said. "If the health system wants our members to put themselves at risk of exposure to a deadly disease we expect that every reasonable precaution be put in place on a priority basis."
Provincial Health Officer Dr. Perry Kendall acknowledged more must be done and said he will co-chair a committee to review protocols and coordinate efforts by the health authorities.
"Our first priority will be on establishing the processes to familiarize or refamiliarize health care workers with personal protective equipment so if they have to use it they can use it safely and confidently," Kendall told reporters.
He said health authorities may disagree with the BCNU assessment that they are unprepared.
But Kendall said the handling of each of the three recent suspect cases – two of which were hospitalized in Surrey and Vancouver before being ruled out – turned up some issues in need of improvement. He described those cases as low to medium risk.
North American anxiety about the disease outbreak that has killed thousands in West Africa soared after a patient arrived in Texas with the virus and later died.
A nurse there subsequently tested positive for the virus although it's unclear how she was exposed.
"Given the concern over the breakdown of infection control we heard from Texas It is really appropriate for us to double up on that and make sure people who are going to be on the front lines are confident and competent and comfortable putting the equipment on and particularly in taking it off," Kendall said.
The risk from Ebola to the general public in B.C. is "vanishingly small, if not zero," he added.
Kendall praised the past bravery of health care workers in dealing with outbreaks such as SARS and pointed to HIV as a precedent where fear of exposure at times threatened to hinder treatment.
Unlike airborne viruses, Ebola can only be caught through direct contact with bodily fluids of a patient who has symptoms.
Fraser Health's head of infection control previously predicted the region would successfully isolate and contain any Ebola patient arriving in the region at its designated hospital – Surrey Memorial.
Vancouver Coastal Health Authority hasn't identified a primary hospital to take suspect cases, instead expecting all sites to be ready.
Although suspect patients in B.C. to date have turned out not to have Ebola, public health officials expect health workers here will be confronted with the real thing.
More suspect cases are also likely since about 40 people a month arrive here from West Africa and some are likely to display flu-like symptoms – two factors that trigger isolation pending further assessment.
The BCNU letter warns the union has advised members to only care for suspected Ebola patients if they've been provided proper equipment and training.
It also urges improved procedures on cleaning and handling garbage, protocols on handling the deceased and asks what contingency plans will be in place when ERs are already full.