The cleaning staff at Carlos III Hospital in Madrid say they were not scared about contracting Ebola until Teresa Romero, the nursing assistant who they would see on a daily basis, caught the virus. The same goes for the nurses in the center, who took care of the two Spanish missionaries with Ebola who were brought back from West Africa for treatment at Carlos III, but died soon after.
The staff explain that the “respect” they had for the virus has turned to “fear.” And that fear has spread further than the hospital, which is Spain’s “Ground Zero” for Ebola – it is also to be found in Alcorcón Hospital, where cleaning staff refused to clean up the area in the emergency room where the nursing assistant, Teresa Romero, was treated for nearly the whole of Monday, before she was diagnosed with Ebola and transferred to Carlos III.
There is fear on the streets of Alcorcón too, where some residents are wearing facemasks to protect themselves from the risk of infection, as well as in healthcare centers throughout the region, which have been sent protective suits for staff. These suits, however, are the same ones used during the 2009 swine flu pandemic, and only two units have been sent to each center, where as many as 60 people can work.
The panic has also invaded the personal lives of medical staff. “Their children are not being invited to birthday parties and their friends are canceling their joint vacation plans,” explains Juan José Cano, from the Satse nursing union at Carlos III. “They have become ‘the Ebola nurses,’” he says. “It’s very, very unfair.”
Thirty doctors from La Paz – Carlos III’s sister hospital – have demanded to be given written instructions as to who must go to Carlos III, and who is ordering them to do so. They denounce the fact that they are being forced to treat Ebola patients and suspected cases “without the adequate training,” and that the facilities are “clearly deficient.”
The medical authorities have also not escaped the climate of chaos, and are taking decisions that have a whiff of improvisation about them. In the case of Miguel Pajares, the first Spaniard to be repatriated from West Africa with Ebola, the authorities decided to empty out the hospital and transfer all the patients. In the case of Manuel García Viejo, the second missionary to be brought back to Spain, they kept the patients in their rooms and continued consultations and surgeries as planned.
Staff explain that the “respect” they had for the virus has turned to “fear”
Now, in just 24 hours, the regional health department has ordered two of the hospital’s floors to be emptied: first the fifth floor, and then the fourth, from which 18 patients were either discharged or transferred.
The decision is undoubtedly linked to the fear of the medical professionals: as the hours go by, more and more staff members who examined the nursing assistant in the days prior to her diagnosis, when she was already presenting symptoms and therefore able to transmit the virus, are opting to be admitted voluntarily to hospital for monitoring in isolation. The official advice was for them to stay at home and check their temperature twice a day, but given the result that had for the nursing assistant, they have opted to go to Carlos III.
The emergency room doctor from Alcorcón Hospital who treated Teresa Romero on Monday, Juan Manuel Parra, has taken this step, as has the nursing assistant’s family doctor, an ambulance crew member who came into contact with her, and another doctor from the ER at Alcorcón. Staff at that hospital – where Parra was forced to treat Romero with an ill-fitting suit that didn’t cover his wrists – have decided to take matters into their own hands and will be buying dozens of protective suits themselves.
There is fear in Alcorcón, where residents are wearing facemasks to protect themselves from infection
“We are trained in isolation procedures,” explains a nurse from Carlos III, which until a few months ago was a leading center for infectious diseases: the Madrid regional government has decided to dismantle it in order to turn it into an ordinary hospital as part of cost-cutting measures. “We live with tuberculosis, HIV, tropical diseases, hepatitis … But professionalism alone does not protect you. We don’t know what could have gone wrong.”
Nerves are also frayed among cleaning staff at Carlos III, who are employed through construction giant Ferrovial. On Thursday UGT labor union members held a meeting to express their fears and demand that the protocols in place to protect them be improved. “I might not get infected, but my colleague could and then she could pass it on to me,” one of them complained. Seven or eight cleaners take turns to decontaminate the room and the “airlock” where the medical staff put on their protective suits. Two more workers are charged with transporting the waste to a second company that takes it to be incinerated.
Carlos III Hospital has been forced to hire extra personnel to deal with any suspected cases that arrive. In some cases they are replacing nursing professionals who are refusing to work with Ebola patients on the basis that they do not think the safety measures in place are adequate. “There are staff members who are handing in their notice so that they don’t have to enter,” explains Elvira González, the provincial vice-secretary of the SAE nursing assistants’ union.
The medical authorities have not escaped the climate of chaos, and are taking decisions that seem improvised
She explains that there are nurses and nursing assistants who have formally presented their resignations, as well as others who have refused to treat Ebola patients under current conditions. The health service will not release information about how many people have done this nor if measures have been taken against them. “Right now, when the question is being asked as to whether the protective suit is adequate, whether the protocol is correct, a health professional could accuse the administration of a public health offense if they are forced to work in conditions that are not adequate,” González explains.
Unemployed health workers are being given opportunities under the current circumstances. L. S., who is 25 and recently graduated with a nursing qualification, left a résumé at La Paz on Wednesday morning. He received a phone call that same afternoon. “Do you want to work? You can start tomorrow on the fifth floor of Carlos III,” he was told. Not a single mention of Ebola was made. During a second call, he was advised that he would be working with Ebola isolation patients. “I told them that I didn’t have training and they replied that we are nurses and that we have the obligation to treat patients.” After thinking it over with his family, he gave his reply: “I’m not interested.” “It’s incredible to hear that they are calling people up who have only just finished their degrees,” he told EL PAÍS on Thursday. He has told his colleagues not to pick up the phone if they call from Carlos III to avoid reprisals. He believes that he will never hear from them ever again after turning them down.
Additional reporting by Elisa Silió, José Marcos and Elsa G. de Blas.