U.S. Hospitals Can't Handle Many Ebola Cases

If researchers at Northeastern University are correct in estimating that there may be 25 Ebola cases in the United States by the end of November, we might be in trouble. According to Mashable and ABC News, of the four American hospitals with Ebola units, less than a dozen total slots are available. Moreover, given that four people are already being treated in these facilities, the most conservative estimates suggest that there are only five more slots available, while the most generous puts the number of open beds at nine. Either way, it's a lot less than 25, and that may present a considerable problem if virus continues to spread.

The four hospitals that are considered most prepared to handle Ebola cases are located in Nebraska, Georgia, Maryland and Montana. Of these four facilities, the Montana clinic is the only one that has yet to receive a case.

Emory University Hospital — 2 beds

The hospital at Emory University in Atlanta, Georgia, previously treated Dr. Kent Brantly and Nancy Writebol, the first two Americans infected with the disease, as well as a rarely mentioned third patient who has never been publicly identified. That patient told the Washington Post on Wednesday that he or she will be "discharged very soon, free from the Ebola virus and able to return safely to my family and to my community." On Wednesday, the facility received Amber Vinson, one of the nurses infected while caring for deceased Ebola patient Thomas Eric Duncan. In total, Emory University Hospital has only two beds, both of which are now occupied, which explains why fellow Dallas nurse is being taken to Maryland rather than Georgia.

Maryland NIH — 2 beds

The National Institutes of Health hospital in Maryland is soon to receive Dallas nurse Nina Pham, who also contracted the disease from Duncan. Pham's flight departed just after 7 p.m. on Thursday night, and she is expected to arrive in Maryland later in the evening. The Maryland facility, can house another two patients in its Special Clinical Studies Unit, according to the National Institute of Allergy and Infectious Diseases at the NIH.

Nebraska Medical Center — 3 beds

The Omaha facility cared for Dr. Rick Sacra, who made a complete recovery in late September, and is currently treating NBC camerman Ashoka Mukpo, who recently received a transfusion of Dr. Kent Brantly's blood. Mukpo also appears to be on the road to recovery, and took to Twitter to share his good spirits and improving health. While Nebraska Medical Center has always been known as the largest of these biohazard facilities, with 10 beds total, Taylor Wilson, the hospital's spokesman, told Mashable that the number of beds does not directly correspond to the number of patients the clinic can hold:

...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].

St. Patrick Hospital, Montana — 2 beds

Finally, Phil Smith, medical director of the biocontainment unit at Nebraska Medical Center in Omaha, told USA Today that St. Patrick Hospital in Montana has one, or at most two beds, available for Ebola patients. This means that in total, there are around nine total spots available for Ebola patients.

Level 4 Biohazard containment units

What makes these four hospitals so special? Their differentiating factor lies in their Level 4 Biohazard containment units, and if there's any good news in this whole scenario, it's that thus far, all of the patients treated at any of these facilities have made full recoveries. Nebraska's biocontainment unit has a "special air-handling system to ensure that microoganisms don’t spread," a "dunk tank for lab specimens," and a "pass-through autoclave [which] assures that hazardous materials are decontaminated before leaving the unit."

Emory University's facilities house a unit that is "physically separate from other patient areas and has unique equipment and infrastructure that provide an extraordinarily high level of clinical isolation." As for Maryland, the NIH released a statement on Thursday assuring the public that Nurse Pham would be treated in a Special Clinical Studies Unit "specifically designed to provide high-level isolation capabilities and is staffed by infectious diseases and critical care specialists."

And Montana has a specific department dedicated to viruses like Ebola, complete with "maximum-containment laboratories [that] allows scientists to use advanced technology in their quest to protect people from the emerging infectious diseases."

State of the art infection control

At the very least, the patients who have been lucky enough to receive treatment at these hospitals are getting the absolute best of care, and no person-to-person transmission has yet occurred. But even so, if the number of Ebola cases continue to rise, these four clinics simply won't have the real estate to handle a growing number of patients. Even the most generous estimates from Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, place the maximum number of simultaneous cases in these four hospitals to be 13. But even if there's space for these patients, Phil Smith told USA Today that he wasn't sure "if they (NIH) have the staffing" to care for them.

William Jarvis, the Center for Disease Control's former chief of infection control practices, told USA Today that it was unrealistic to assume that most American hospitals, which he notes " don't have the best infection control programs on earth," (emphasis mine) would be able to responsibly care for patients with Ebola, which would require the best infection control programs. Instead, Jarvis says, "The care of these patients should be at…specialized regional centers."

But if cases increase at the rates that scientists expect them to, this simply may not be a viable option. And if there are only a dozen beds available for up to 25 patients, just how well can the United States contain Ebola?

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