Ebola fears in Alcorcón: ‘how does this happen?
It’s really scary’
At hospital where nurse tested
positive, some patients have dared to show up but many wonder how worried they
should be
As she waited for her bus next to
an advert urging people to donate money for the fight against Ebola overseas,
Elena Felican could only shake her head at how close the threat posed by the
virus now felt to her in Spain.
“My sister called me first thing
this morning, telling me not to go to near the hospital,” said the catering
worker. “She told me the patient lived in Alcorcón. How does this happen? It’s
really scary.”
Few details have emerged about
the first person known to have contracted the Ebola virus outside west Africa.
The Spanish nurse, who tested positive on Monday, was part of a team that cared
for two elderly Spanish missionaries who both died after being evacuated to
Madrid for treatment.
On Tuesday night her husband said
she had followed all the regulations. “She did all that they told her to. At no
moment was she worried about being infected,” he told El Mundo. The pair had
intended to go on holiday, but changed their plans after he injured his leg, he
told the newspaper in a phone interview from the room where he has been
isolated.
He complained that health
authorities had told him his dog would have to be put down because it had been
in contact with his wife. “They told me that if I didn’t give them my
authorisation, they would get a court order and enter the house by force to
kill the dog. Then what will they do next? Sacrifice me too?”
In Alcorcón, a city of 170,000
people on the outskirts of Madrid, many wondered just how worried they should
be.
“She might have been living in
this neighbourhood for days with Ebola,” said Felican. “Did she go to the
supermarket? The gym? We don’t know anything.” Three primary schools ringed the
hospital where the nurse had tested positive, she pointed out, and all of them
were open on Tuesday.
Her concerns were echoed inside
the imposing hospital. Juan Pulido, who sat casually flipping through a
newspaper while he waited for his wife to finish her appointment, said his
family had urged him not to go. “Every day I sit here, waiting for my wife. I
decided today would be no exception,” said the retiree, brushing off their
worries. “But it seems like nobody else dared to come – it’s empty today.”
The infected nurse was
transported to Madrid’s Carlos III hospital late on Monday. She was placed in
isolation, as was her husband, who has shown no signs of the virus. Health
officials said on Tuesday they were monitoring 50 more people who may have come
into contact with the nurse.
Authorities placed a second nurse
from the same team in isolation after she complained of diarrhoea. Noting that
she did not have a fever, the most common initial symptom for Ebola, doctors
said her initial test results were negative.
A man who had recently travelled
from Nigeria to Spain was also in quarantine at the same hospital but tested
negative for Ebola in his first test.
Health authorities said they had
two priorities: compiling a list of all the potential contacts that the woman
had before being hospitalised, and determining exactly how she had been
infected.
The nurse had helped care for
Miguel Pajares, 75, who was the first person to be repatriated
to European soil for treatment in August, but she is thought to have
become infected while looking after Manuel García Viejo, 69, who died in Madrid
after being evacuated from Sierra Leone two weeks ago.
The nurseShe would have entered
García Viejo’s room twice, said Antonio Alemany, from the regional government
of Madrid. The first time to was to change a nappy and the second time was to
collect material from his room after he died.
After complaining of a fever on
30 September, the nurse was told to check herself into hospital if her temperature
exceeded 38.6C. Fernando Simón, of Spain’s health ministry, acknowledged on
Tuesday that it might have been better to have admitted her to hospital right
away despite her not showing serious symptoms.
When she was admitted on Monday,
the nurse remained in a bed in the emergency room, separated from other
patients only by curtains, while waiting for her test results to come back,
hospital staff said.
Several associations representing
health professionals in Spain painted a picture of a healthcare system reeling from cutbacks,
drastically underfunded to tackle the challenge of Ebola, and led by a health
ministry creating policy on the fly.
Elena Moral, of the CSI-F, a
union that represents healthcare professionals, said the delay in admitting the
nurse to hospital hinted at deep flaws in the protocol. “A patient suspected of
having Ebola and a history of working with Ebola patients should have been put
in the first ambulance they could find.”
She dismissed any suggestion of
human error, pointing to a lack of training, infrastructure and safety
measures. In some cases, training for health professionals dealing with Ebola
was limited to a 15- or 20-minute talk, she said.
In July a group of nurses in
Madrid brought a complaint before a judge in Madrid over the “lack of training
and knowledge regarding protocols” when it came to treating potential Ebola
cases.
Moral also laid blame on the
impact of austerity measures on the Spanish healthcare system. “We’ve been
protesting for a long time that the dismantling of the Carlos III hospital
could provoke extreme situations like this one.”
In recent years, she said, the
Carlos III hospital was closed, gutted of its emergency rooms and then turned
into a hospital specialising in tropical diseases.
“The repatriation of the two
missionaries turned the hospital into something just short of a field hospital.
Authorities activated the protocols without keeping in mind the actual state of
the hospital.”
Opposition politicians called on
the health minister, Ana Mato, to explain the safety lapses, while around 200
health professionals gathered outside a hospital in Madrid calling for her
resignation.
The European commission said it
had written to Mato “to obtain some clarification” as to how the nurse had
become infected. “There is obviously a problem somewhere,” said the commission
spokesman, Frédéric Vincent.
Spanish health authorities said
medics treating Ebola patients in Spain followed the protocols laid out by the
World Health Organisation, but their claims were widely disputed. While level 4
protective equipment is required to attend to Ebola patients, healthcare
workers in Spain who treated the missionaries had only level 2 equipment, said
Juan Carlos Mejias, of Satse, a union that represents nurses. “Level 4 is
what’s being used in other European countries.”
In August, when Satse learned of
plans to repatriate a patient with Ebola to Spain for treatment, it asked the
health ministry for a written description of the protocols that would be used.
“How many nurses would be involved? How would the nurses be monitored
afterwards?” said Mejias. He said the union received no response, suggesting
“there was a serious improvisation in how the situation was handled”.
Inside Alcorcón hospital, two
women working at the hospital gift shop said they knew only what had been
reported in the media. “Our co-worker left after her shift last night wondering
why there were journalists outside the hospital. Nobody told us anything or
warned us that we should be careful,” said one. “At least they could have given
us hand sanitiser.”