New York hospital runs ebola tests on healthcare worker

A New York City hospital is running ebola tests on a healthcare worker who returned to the US from West Africa with a fever and gastrointestinal symptoms, the city’s Health Department said yesterday.

Preliminary test results were expected in the next 12 hours.

The patient being treated at Bellevue Hospital is a healthcare worker who returned to the US within the past 21 days from one of the three African countries facing the ebola outbreak.

The Health Department said it was tracing the patient’s contacts to identify anyone who may be at risk. It also said the patient had been transported by a specially trained unit wearing protective gear.

The news came as the crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.

US hospitals have over the years been criticised for undertaking measures that prolong dying rather than improve patients’ quality of life.

But the care of the first ebola patient diagnosed in the US, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld.

Officials from at least three hospital systems said they were considering whether to withhold individual procedures or leave it up to doctors to determine whether an intervention would be performed.

Ethics experts say they were also fielding more calls from doctors asking what their professional obligations were if health workers could be at risk.

US health officials, meanwhile, are trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of ebola care.

Their concern is that poorly-trained or poorly- equipped hospitals that perform invasive procedures will expose staff to fluids of a patient when they are most infectious.

The possibility of withholding care represents a departure from the “do everything” philosophy in most US hospitals and a return to a view that held sway a century ago, when doctors were at greater risk of becoming infected.