Ebola: Northern Ireland case inevitable says RVH consultant
A consultant in the infectious diseases unit at Belfast's Royal Victoria Hospital has said it is likely Northern Ireland will have to deal with an Ebola case in the next few months.
The doctor advised that the public should not be alarmed as the specialist team has been preparing for such an event for months.
Dr Sara Hedderwick told the BBC that a case in Northern Ireland is inevitable.
She said the risk would continue for at least another 12 months.
"It is reasonably likely that a person with viral haemorrhagic fever (Ebola) comes back to Northern Ireland, but I think we have really good processes in place to prevent the public being worried about it at all," she said.
Following a suspected Ebola case last month, which proved negative, the infectious diseases team at the Royal Victoria Hospital has been put on alert.
According to one of the doctors, who was on call that weekend, the staff who work in the unit went into "autopilot".
Dr Mark McNichol said the team had been preparing for such an incident for months.
"You are thinking of the safety of the patient and, of course, the safety of the staff," he said.
"When the case came to us on the Saturday we immediately activated the contingency plan. The main isolation room is ready and the gear and disposable equipment is sitting ready for us to use."
As well as doctors and a consultant, a team of four nurses was on call to care for the patient.
At the time, the Public Health Agency confirmed that the patient had recently returned from Sierra Leone.
After becoming unwell they had reported symptoms to their GP who then transferred them to the Royal Victoria hospital.
While the case proved negative, according to Dr McNichol it gave the team a dry run.
"You take a bit more time over what you are doing. You are more deliberate when dealing with a real patient, you are making sure you aren't exposed or you aren't putting other people at harm as well," he said.
Trained staff are familiar with the personal protective equipment, that includes two layers of protective clothing, an outer apron, thick boots, two pairs of gloves, a domed helmet, mask and goggles.
The gear, while light to touch, is very hot to wear.
Any member of staff attending the patient must wear the proper attire and dispose of it correctly afterwards.
The clothing is removed in three separate rooms.
It is then triple bagged, disposed of and collected by a special cleaning team who transfer the waste material to Scotland where it is incinerated.
At the final stage of removing the protective equipment the nurse is attended to by a "buddy" who is also wearing protective clothing.
The final room contains a showering area.
As I made my way around the unit I was struck by the dedication of the staff. Despite being in the middle of a potentially deadly virus, these nurses and doctors are dedicated to their patients and their colleagues.
While working in many areas of the hospital is open to infection, the infectious diseases unit is particularly acute.
While the Royal Victoria Hospital has one main isolation unit, there are facilities to isolate up to six patients with Ebola.
However, to cater for such numbers, patients in the infectious disease area would have to be moved elsewhere in the hospital.
In normal circumstances four nurses are required per patient so as to rotate the amount of time they spend on the ward.
Such an event would cause a lot of disruption in the hospital and place staff under enormous pressure.
Dr Hedderwick, who is a consultant in the department said dealing with as many as six at the one time was highly unlikely.
"We do have a contingency plan in place to look after three people in separate rooms. We could look after more for a very short period of time by closing off part of the department," he said.
"But looking after that number would be a huge drain on staff and the hospital. We would have to move patients in infectious diseases to other parts of the hospital."
Dr Hedderwick warned the Christmas holidays would trigger more people travelling to various parts of the world, including west Africa, where Ebola is still lingering. That will increase the risk of people then returning to the UK possibly carrying the deadly virus.
Also, as more volunteers from across the UK arrive in west Africa to combat the deadly virus more will return with symptoms suggesting Ebola.
The Royal Victoria Hospital deals with around 30 cases of malaria per year. That involves the infectious diseases team and the isolation unit.
They were the first batch of NHS volunteers to be deployed by the government after more than 1,000 came forward to offer their services.
Among them are GPs, nurses, psychiatrists and emergency medicine consultants, all of whom will work in treatment centres built by Army engineers and funded by the Department for International Development.
The protective overalls they will wear, made by four British companies, leave no part of their body exposed and will be crucial in keeping them safe - although the risk of infection cannot be ruled out.