Ground Zero: Ebola Hits Home in Dallas
September/October 2014 Far, far away…. September 2014 In the U.S., Americans are touched – yet untouched – by news coverage on the Ebola virus overseas. Medical personnel are fighMng an epidemic with no cure in several African countries. An ocean and a conMnent shields the U.S. from harm. The Clock Starts Ticking September 20 •  Thomas Eric Duncan leaves Monrovia, Liberia, and lands at DFW Airport. •  Dallas is unaware and unprepared to become Ground Zero for Ebola. •  Mr. Duncan has been exposed to the virus but has no symptoms; he is not contagious yet. Symptoms, Sickness and a Misstep September 24 • Mr. Duncan’s family first notes he is ill. • Emerging symptoms indicate he is contagious. • Mr. Duncan is living with family members and his fiancée in a Dallas apartment. First Hospital Visit September 26 •  Mr. Duncan makes his first visit to Texas Health Presbyterian Hospital, only a few miles from the apartment he shares with his family. •  He is sent home with anJbioJcs. •  Debate later follows why his country of origin was not noted and considered in his diagnosis. Back to the Hospital September 28 •  EMTs are called to transport Mr. Duncan to the hospital; he is taken to Texas Health Presbyterian. •  Family members suggest to EMTs that he may have a contagious illness. •  He is criJcally ill and placed in intensive care. IsolaCon September 30 •  The Centers for Disease Control (CDC) confirms that Mr. Duncan is ill with Ebola. •  He is the first paJent to be diagnosed with the disease in the United States. •  Mr. Duncan is placed in isolaJon at Texas Health Presbyterian Hospital. DCCCD: First Involvement September 30 •  Call from UT Southwestern Medical Center about student involved with potenJal health care issue signals first involvement for the district. •  Return call the next day links student to EMT team who transported Mr. Duncan to the hospital. •  District and college begin to collect informaJon on the student; preparaJon for inquiries begins. The Ripples Begin October 1 • Mr. Duncan’s condiJon improves. • Other individuals who have come in contact with the paJent – including paramedics and children – are under observaJon for symptoms. • Officials later determine that the highest risk for exposure occurred September 28-­‐30, 2014. Ripples Spread October 2-­‐5 • Mr. Duncan’s condiJon worsens, and he is placed on the criJcal list. • The family is quaranJned by court order and then moved to an undisclosed locaJon. • Treatment with an experimental drug is unsuccessful. DCCCD: CommunicaCons Plan Formulated October 6 •  Previous H1N1 documents from risk management office serve as guideline for Q&A/scenarios to share with employees. •  First Ebola fact sheet is wri`en, using informaJon from the CDC and Dallas County HHS. •  Other CDC materials are idenJfied for use to inform students and employees about the Ebola virus. DCCCD: IniCal InformaCon to District Is Sent October 7 •  Districtwide email to employees and students is sent to allay fears and provide facts about Ebola. •  Q&As, Ebola fact sheet and flyer are a`ached for reference. •  Web pages are set up to share informaJon and documents about Ebola and procedures for handling potenJal issues. Tragedy Strikes October 8 • Thomas Duncan dies from the Ebola virus. • Sgt. Michael Monnig, who was inside Mr. Duncan’s apartment several days prior, is transported from a Frisco medical clinic to Texas Health Presbyterian. • Sgt. Monnig had been told to bag Mr. Duncan’s clothing and boots on the day of his visit -­‐-­‐ DMN. Concern Spreads October 9 • School children exposed to Mr. Duncan’s family are sent home for monitoring; four school districts eventually become involved. • The general public learns about contact tracking. • Sgt. Monnig’s Ebola test is negaJve. • DCCCD sends first student eNews noJce about Ebola. The Ripples ConCnue October 10 • Nurse Nina Pham, who cared for Mr. Duncan, has a temperature and goes to the hospital. • Debate begins about the care of Nurse Pham’s dog, Bentley (driven by reacJon to incident in Spain). Another “First” October 12 • Nurse Nina Pham is diagnosed as the first person to contract Ebola in the United States. • She is placed in isolaJon and treated in Dallas at Texas Health Presbyterian Hospital. • All non-­‐essenJal hospital personnel are told not to return to work; all student clinicals are canceled. DCCCD: Changing Circumstances October 12 •  All clinicals for students in nursing and allied health care canceled for El Centro and Brookhaven Colleges. •  Dracs for next eNews le`ers for students and employees are wri`en based on evolving situaJon. •  CommunicaJons staff members conJnue to monitor student and employee comments and conversaJons to track concerns. A Dubious “Second” October 13 • Nurse Amber Vinson, who also treated Mr. Duncan, travels by plane from Cleveland, Ohio, to Dallas. • She has a low-­‐grade fever but received prior approval to travel. • Nurse Pham’s dog, Bentley, is moved to an undisclosed locaJon and will be monitored for 21 days. DCCCD: The Student Shuffle October 13 •  El Centro College noJfies DCCCD system office that all clinicals are canceled. •  All nursing/allied health students noJfied that clinicals at Texas Health Presbyterian are canceled. •  Both El Centro and Brookhaven colleges begin transferring students to alternate assignments. •  Brookhaven College cancels ALL clinicals for three days and mandates PPP retraining. Dealing with Disease October 14 • NaJonal Nurses United alleges terrible condiJons for nurses at THP – no proper protecJve gear or protocols. • Brookhaven College spends three days retraining all nursing and allied health students on personal protecJve procedures. • Training at Brookhaven covered by the news media. • Special thermometers ordered for all DCCCD colleges as medical equipment shortage looms. Confirmed October 15 • Nurse Vinson is diagnosed with Ebola – the second confirmed case to be contracted on U.S. soil. • Hazmat teams clean her apartment. • Texas Health Presbyterian announces she will be transferred to Emory Healthcare in Atlanta for care. • Concern grows in Cleveland and among passengers on FronJer Airlines about exposure to Nurse Vinson. DCCCD: Area Partners October 15 • Invited to city-­‐wide meeJng with officials from Dallas, Dallas County, police and fire, sanitaJon, Dallas County Medical AssociaJon. • Discussion focuses on community reacJons, ciJzen quesJons and mistrust of informaJon from CDC that begins to change almost daily. • Partners agree to use informaJon issued by DCMA instead of CDC – credibility issue. DCCCD changing flyers
DCCCD: More CommunicaCons October 16 •  Brookhaven College PPP training coverage by news media goes naJonal. •  Dracs for next student and employee eNews updates are started; official documents on procedures, quesJons and facts are updated. •  Navarro College announces it will no longer accept students from Ebola-­‐affected countries (later retracted). Catching Up October 17 •  Texas Health Department issues guidelines for EMS personnel and hospital procedures. •  DCCCD finalizes, sends new eNews updates. •  DCCCD develops more scenarios, with responses, for potenJal Ebola-­‐related situaJons at work and in the classroom. •  Chancellor proposes video Q&A for students, employees. DCCCD: Final Phase October 18-­‐20 •  DCCCD asks Dr. John Carlo, Dallas physician/infecJous diseases expert, to assist with Ebola Q&A video. •  Interview scheduled for Monday, October 20. •  District responds to employee and student concerns by asking them to send quesJons by email for interview. •  Email account set up for student, employee quesJons; text for email opportunity is draced. DCCCD: Answering QuesCons October 20 • Email sent district-­‐wide to solicit Ebola-­‐based quesJons with a 3 p.m. deadline that day. • Media relaJons staff receives, sorts and compiles quesJons, creaJng a list for the interview. • Script is wri`en for chancellor’s intro and closing. • Interview is taped at the end of the day with Dr. Carlo; video is edited down to 30 minutes and posted two days later. Take-­‐Aways •  Importance of Jmely external communicaJons. •  AnJcipaJng requested informaJon and conducJng research in advance. •  Understanding fear and rumors that circulate in such a tense situaJon and responding to them quickly. •  Listening, sharing, talking, planning, responding with Jmely, accurate informaJon. More Take-­‐Aways • Importance of communicaJng facts and providing regular updates to internal audiences. • CriJcal need to communicate with other enJJes involved in the crisis. • Effects of facing a crisis for 21 days, 24/7 on everyone. • Involve everyone: chancellor’s office, colleges, administrators, risk management, legal, media relaJons, web staff, markeJng, IT, college police, health centers, nurses, other key players. Lessons Learned •  Importance of trust. •  Importance of accuracy. •  Importance of Jmeliness. •  Importance of listening. •  Importance of acknowledging human nature and anJcipaJng how it affects communicaJons in a crisis. Documents Used •  Fact sheet(s). •  Q&A/procedures (parJcularly for employees). •  Email. •  eNews updates. •  Fact sheets •  Note: Accuracy, Jmeliness, frequency are key Thank You! Ann Hatch District Director, Media RelaCons DCCCD [email protected] 214-­‐378-­‐1819