Ebola outbreak: Will Canada avoid the mistakes of Dallas?

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The continued fallout over two health-care workers who contracted Ebola from the first patient to be diagnosed with the virus in the U.S. hassparked action among Canadian officialsto bettertrain front-line workers in Canada and avoid the mistakes made in Dallas.

Experts say the protocols established following the SARS outbreak in 2003 will help to preventCanada from repeating the type of errorsmade by a Dallas hospitalin the initial assessment ofThomas Eric Duncan. Hewas initially sent home from the hospital emergency room with antibiotics for his high fever, even though he said he'd recently been inLiberia.

"I think because of SARS we havecertain protocols in place that would havepreventeda lot of the first mistakesthatwere made in Texas," said Dr.BrettBelchetz, a Toronto emergency room doctor. "The fact that this guy was turned away from the front door, the fact that he was initially allowed to wait in the waiting room withotherpatients on his visit, that hewasn'tput into isolation."

"Given our experiences with SARS,typicallyall of us havethe right protocols in place to identify people and put them straight into isolation,"Belchetzsaid.

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Texas 'has changed everything'

In Dallas, the protocols in place to deal with Ebola-infected patients havecome under intense scrutiny, particularly after it was revealed that one of the nurses who had treatedDuncan was allowed to board a passenger flight. That nurse, who later testedpositivefor Ebola, had contacted an official at theCentersforDisease Control, who said she was cleared to fly.

Besides the problem with that clearance, there's the issue that's emerged in Canada aboutthetrainingoffront-linehealth-care workers who would have contactwithEbola-infected patients. ManyCanadianhealth-careworkers and union representatives for nurses have said their members aren't confident they're uptospeed on everything they need to know and everything they need to have.

"Where we were going down the road, potentially making the same mistakes [as Texas]is not having the full sets of protective gear and not doing the hands-on drills for our staffon how to use it properly," Belchetzsaid.

"And I think having seen what happened in Texas, that has changed everything. Hospitals seem to be changing their tune. And they're doing what I called for in the beginning and that's hands-on drills."

In the wake of the two infected Dallas nurses, Health MinisterRonaAmbrosesaid in a statement Wednesday thatall publichealth officers in Canada agreed to look into "further strengthening our protocols" on how to manage Ebola cases.Ambrose also said in a call with her provincial counterparts, she encouraged officials to look into doing test runsto ensure protocols are in place, and proper personal protective gear is available.

In Ontario,Health Minister Eric Hoskins said the province will update its guidelines to help front-linehealth workers deal withpotential Ebola cases.

"I don't want a single health-care worker that feels that they are not adequately protected or secure or don't have the equipment that they require," he said.

Linda Silas, president of the Canadian Federation of Nurses Unions, who has been critical aboutthe lack of Ebola-related preparation and drills given to nurses, said a lot of training has begun this week.

Silas said what happened in Dallas took everyone by surprise and that shewill sit down with the head of the Public Health Agency of Canada next week to talk about the revised guidelines and the need to look at how the entire system will manage possible Ebola patients.

Canada also seems to be taking some cues from the Americans in terms of the need for a rapidresponse to Ebola cases.U.S. President Barack Obama announced on Wednesday he had directed the CDC toestablisha rapid response "SWAT team ...to be on the ground as quickly as possible, hopefully within 24 hours, so that they are taking the local hospital step by step through what needs to be done."

Similarly, Transport Canada has been asked to provide planes from its fleet to dispatch rapid-response teams of experts from Ottawa and the Winnipeg microbiology labin the event of a positive Ebola case in Canada.