How Your Hospital Can Prepare for the Ebola Virus Disease
A person who had...
The Centers for Disease Control and Prevention has confirmed the first domestic case of the deadly Ebola virus in the United States.
A person who had traveled to Dallas, Texas, from Liberia developed symptoms four days after arriving in the US and sought medical care at Texas Health Presbyterian Hospital of Dallas on Sept. 26. Following isolation and sending specimens to the CDC and a Texas laboratory for testing, a CDC team was dispatched to the hospital on Sept. 30 following positive results.
While the incident remains isolated, CDC officials say the virus incubated in the United States for at least a number of days and others may have been exposed.
“Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director, Dr. Tom Frieden, M.D., M.P.H. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”
The recent Ebola outbreak is the largest in history and the first Ebola epidemic the world has ever known, according to the CDC, affecting multiple countries in West Africa and now the United States. Hospitals and health care professionals operating in the United States need to be aware of how to detect a patient with Ebola and respond in an efficient and coordinated manner.
Prepare to Detect Ebola-Infected Patients
Early recognition is critical for infection control. Health care providers should be alert for and evaluate any patients suspected of having Ebola.
Hospitals should review infection control policies and procedures and incorporate plans for administrative, environmental, and communication measures, the CDC advises, as well as personal protective equipment (PPE) and training and education.
Hospitals should also define the individual work practices that will be required to detect the introduction of a patient with Ebola or other emerging infectious diseases, prevent spread, and manage the impact on patients, the hospital and staff.
A person who has consistent symptoms of a fever greater than 101.5 degrees Fahrenheit and severe headache, muscle pain, vomiting, diarrhea, or abdominal pain while also exhibiting risk factors within the past 21 days before the onset of symptoms (such as contact with blood or other bodily fluids of a patient known to have or suspected to have Ebola, residence in or travel to an area where Ebola is active, or direct handling of bats or non-human primates from disease-endemic areas) should be considered a person under investigation.
Upon detection, hospitals should ensure that all triage staff, nursing leadership and clinical leaders are familiar with the protocols and procedures for notifying the designated points of contact to inform.
Designating points of contact within your hospital for communicating with state and local public health officials will allow for a smooth and efficient method of operation.
Communicate with state and/or local health departments on procedures for notification and consultation for Ebola testing requests.
Prepare to Protect Your Hospital from Further Infections
Your hospital should conduct a detailed inventory of all available supply of PPE suitable for standard, contact and droplet precautions, according to the CDC. Ensure an adequate supply for all health care personnel of impermeable gowns, gloves, shoe covers, face masks, and other infection control supplies.
Verify that all your health care personnel meet all the training requirements in PPE and infection control and are able to use PPE correctly. Encourage health care personnel to use a “buddy system” when caring for patients and when putting on and removing PPE.
Review your hospital’s infection control procedures to ensure adequate implementation for preventing the spread of Ebola and post appropriate signage alerting health care personnel to isolation status, PPE required, proper hygiene and handling/management of infected patients and contaminated supplies.
Prepare to Respond After a Confirmed Ebola Case
Hospitals should plan for regular situational briefs for decision-makers, including suspected and confirmed Ebola-infected patients; isolation, quarantine and exposure reports; supplies and logistical challenges and policy decisions on contingency plans and staffing.
Maintain a situational awareness of reported Ebola case locations, travel restrictions and public health advisories and update triage guidelines accordingly.
Most importantly, stay informed. As of Sept. 29, the CDC has reported 6,574 cases and a total of 3,091 deaths and that number shows no signs of stopping. The Centers for Disease Control has produced several resources and references to aid health care workers in preparing for and caring those with Ebola virus. To learn more, visit CDC.gov.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.