America’s 4 Ebola Hospitals Can Only Hold 9 Patients

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The Nebraska Medical Center in Omaha, one of four specialized biocontainment units in the U.S., held a mock Ebola drill in 2006.The Nebraska Medical Center in Omaha, one of four specialized biocontainment units in the U.S., held a mock Ebola drill in 2006.

Image: Nati Harnik/Associated Press

The two nurses who contracted Ebola in Dallas were transferred this week to two of the four highly specialized hospital centers in the U.S. that are designed to treat the disease, suggesting that health officials may have doubts about the ability of local hospitals to handle such patients.

The problem: These four specially equipped biocontainment facilities — in Nebraska, Montana, Maryland and Georgia — have the combined capacity to treat fewer than a dozen Ebola patients at one time.

The limited number of beds isn’t unusual for hospitals that treat rare diseases, and a widespread Ebola outbreak in America is extremely unlikely. But if the U.S. is forced to handle more than a dozen Ebola cases — either because the disease spreads further within the country, or more Americans become ill abroad and are brought to the U.S. for treatment — the burden will once again fall to the broader, inadequately trained American health system.

The four specialized hospitals have a perfect track record so far this year. None of the Ebola patients in their care have died, and unlike in Dallas, there has been no person-to-person transmission of the virus within the facilities.

They were designed to treat patients with some of the most dangerous pathogens on the planet. These include Ebola virus disease and other viral hemorrhagic fevers, as well as SARS, smallpox, tularemia, plague and multi-drug resistant tuberculosis.

Ebola Map

Image: Mashable

One of the designated hospitals, Nebraska Medical Center in Omaha, is currently treating NBC News cameraman Ashoka Mukpo, who contracted Ebola while filming in Liberia. Taylor Wilson, a spokesman for the hospital, said the biocontainment facility has 10 beds total.

“But it also depends on the disease we are treating. With Ebola, it is pretty labor intensive — a lot of waste is created, a lot of equipment has to be in the patient room, so that number goes down quite a bit. Probably to two or possibly three [beds],” he said.

Emory University Hospital in Atlanta, another specialized center, has two Ebola beds, Wilson said. St. Patrick Hospital in Missoula, Montana, has one or two. Those numbers were confirmed in congressional testimony on Thursday and in an earlier USA Today article.

The fourth facility, at the National Institutes of Health in Bethesda, Maryland, outside Washington, has the capacity to treat two patients in its Special Clinical Studies Unit, according to the National Institute of Allergy and Infectious Diseases at the NIH. Taken together, these estimates mean that the four hospitals could handle a total of nine Ebola patients.

The Bethesda facility on Thursday was scheduled to receive Nina Pham, 26, who was the first nurse to become ill after treating Thomas Eric Duncan, the first Ebola patient to be diagnosed with the disease in the U.S. He died on Oct. 8 at Texas Health Presbyterian Hospital in Dallas, and Pham was diagnosed on Oct. 12.

Pham’s colleague, Amber Vinson, 29, was also diagnosed with Ebola after treating Duncan. She arrived at Emory University Hospital in Atlanta on Wednesday night. That hospital has a biocontainment facility that was developed in conjunction with the Centers for Disease Control and Prevention (CDC). Two Ebola patients have already been successfully treated there, Nancy Writebol and Kent Brantly, both of whom contracted Ebola while working in Africa.

Questions about local preparedness

The transfer of two Ebola patients in two days to these specialized facilities represents something of a retreat from the government’s initial response plan to Ebola cases. Early on, the CDC had maintained that any hospital can diagnose and treat Ebola by isolating infected patients and following CDC protocols for protecting workers. However, with two cases of person-to-person transmission in Dallas, officials are relying more on the specialized centers.

Health officials, including Dr. Thomas Frieden, the director of the CDC and the face of the government’s response effort to date, has acknowledged that the Dallas hospital did not follow the proper protocols to keep its workers safe while they treated Duncan.

At a House Energy and Commerce Committee hearing on Thursday, the Dallas hospital came under fire for its failure, and lawmakers said that health care workers at many other hospitals are worried they lack adequate training and guidelines to protect themselves.

“We need to commit adequate funding to public health infrastructure. Based on what we know, it appears Texas Presbyterian would have not met those standards,” said Rep. Henry Waxman, Democrat of California. “Though in fairness I suspect that many hospitals across the country would not be prepared to respond.”

Ebola Patient Transfer

A person wearing a hazmat suit stepped out of an ambulance as Emory University Hospital prepared to receive an Ebola patient from Dallas on Tuesday.

Image: David Goldman/Associated Press

In stark contrast to the worries expressed by nurses around the country regarding their lack of preparedness to treat Ebola patients, the University of Nebraska facility boasts about its training regimen on the biocontainment unit’s website.

“Our highly trained team is perhaps our greatest defense. They have received many hours of highly specialized training and detailed instruction on how to care for these types of seriously ill patients,” the website states. “They would be using special, personal protective gear to control the spread of disease. We are national leaders in this area of response and care and will ensure every safeguard is in place to protect our staff, our other patients and their families.”

John Campbell, a senior fellow for Africa policy studies at the Council on Foreign Relations in New York, cautioned that the number of biocontainment unit beds is not crucial to America’s ability to prevent a wider outbreak at home.

“I would suggest that figure means absolutely nothing, because in a highly developed country like ours, you could ramp up to 1,700 beds very quickly if you have to,” he said in an interview.

CDC refuses to confirm number of Ebola beds

In a conversation with Mashable, a CDC spokesperson refused to confirm the total number of Ebola treatment beds at the specialized biocontainment units, despite much of this information being found online and from each individual hospital.

“We have not released that information, and we can not confirm or deny that information,” the CDC spokesperson said. “Feel free to call each individual location to get that information, but the CDC has not put out that information and therefore we cannot comment on that information.”

Other reporters have noted what at times has seemed like excessive secrecy about the readiness of the American health system to handle an Ebola outbreak. The CDC and its parent agency, the Department of Health and Human Services, may be motivated by concerns about bioterrorism, despite the determination by FBI Director James Comey that the use of Ebola as a bioweapon is not a threat at this time.

Kari Paul contributed reporting to this article.