Screening for Ebola? Would the Person with Ebola Please Stand Up?
Appearing in public now after a period of quarantine seems a little strange, some people avoided me, some stood at a distance when greeting me, some approached me tentatively but did not extend their hands and a few did give me heartfelt hugs which I appreciated. I want to convince them that I no longer present a threat to transmit Ebola but the comfort level at which they feel they are not at risk at contracting the infection from a returning volunteer will have to be arrived at by themselves. Full acceptance may come when the Ebola outbreak is over.
My Primary Care Physician knew of my intention to go to Liberia in the fall. The day of my departure for Liberia I was seen at her office urgently because of pain and swelling in my left wrist after hurting it during a hike, this turned out to be a fracture of one of the small bones of my wrist, triquetrum. That afternoon I wore a wrist brace as I hurried to catch my flight. I had a visit with her this week but knowing that I just returned from Liberia she did the right thing by notifying the Infection Control Department. I got a call at home that they had to report to the Department of Public Health that I returned from Liberia but I informed them that I had gone through my 21-day of quarantine with DPH.
The day before my visit to my Primary Care Physician I had an appointment to see a consultant. At the desk I was asked by the receptionist if I had traveled out of the country in the last month to which I replied Yes.
“You might be afraid if I told you where I went. Liberia!”
She looked at me and quickly went to the next room and returned with a piece of paper and saw that Liberia was one of the countries which she should be concerned about. She asked me to fill it out. I stood at the desk and the first question was, have you traveled outside the country in the last month, I checked “YES”. Before I could answer the second question which asked if I had been to Liberia, Sierra Leone, Guinea, she handed me more papers to fill out; papers on demographics, my existing insurance, medications, allergies, etc. and instructed me to fill them out in the waiting room. I wondered to myself whether she had been trained to screen for Ebola.
Even before I could sit down in the waiting room the medical assistant called me in. I indicated to him all the papers I still had to fill out; he assured me that he would help me with them. In the room, the MA was just interested in filling out the paper about my reason for my visit, medications, allergies and ignored the screening form which was sitting right on top of all the pile of papers staring him in the face with the “YES” already checked. After that he asked me to get undressed but when he saw that I was intent on filling out the rest of the papers first, he said the doctor worked fast I should get undressed and the papers could be taken care of later.
Up to this point I still had not be screened. Only the first question on the screening form was checked. Sure enough halfway through undressing there was a knock at the door, the doctor poked her head in and seeing that I was still undressing she said she would be back.
The doctor walked in shortly and came right to the point of my visit. My visit to Liberia was never conveyed to her, neither was the screening completed. The consultation was fast and efficient. I dressed and halfway through there was another knock, the MA peeked in and saw that I was still dressing; he was ready to put another patient in. I went out to the waiting room to fill out the rest of my forms including the screening; the last question asked for the presence of a series of symptoms: fever, headache, abdominal pain, nausea, vomiting, and diarrhea.
When I was done with all my forms, there was a line in front of the receptionist who first greeted me, so I waited. Right across from her were two other receptionists, one of whom said she could help me. She gathered all my forms and I made a move to leave. She said to me that I would need to keep some of the papers in order to see the doctor. Evidently she thought I had not been seen yet.
I left with her staring at all the forms I had filled out. The screening form was placed at the very top.
It was lucky I had already finished my quarantine and I had no symptoms. But even if there is a screening form in place, the process of an actual screening done for someone returning from West Africa as the first line of defense for the detection of possible Ebola at the clinic was non-existent and failed miserably.