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Canadian nurses: Updated Ebola guidelines don’t protect healthcare staff

WATCH ABOVE: Canadian health officials describe updated Ebola guidelines

TORONTO – Amid concerns raised by the Canadian Federation of Nurses Unions (CFNU) in recent weeks, the Public Health Agency of Canada (PHAC) has been updating its Ebola guidelines should there be a case of the deadly disease in Canada. But CFNU president Linda Silas said Ebola preparedness still isn’t going well on the front lines.

“They’re still living in the dark, and we will not accept it anymore,” said Silas.

“Given the high risk of transmission with Ebola, it is critical that frontline nurses have the protective equipment to stop the infection from spreading. These updated guidelines from PHAC do not meet the standard to protect health care workers.”

Silas said her meetings with Health Canada and PHAC made it clear consistency was needed in Ebola messaging, that she said should start at the federal level.

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“What we’re asking the provinces and territories is to look at the Ontario model and use that as a minimum example.”

READ MORE: ‘We are prepared’ say officials adamant that Ontario hospitals are ready for Ebola

Silas said the biggest debate between her union and federal officials is whether Ebola can be transmitted through the air and if respirators are necessary.

“We cannot predict when a patient is going to vomit…we have to be protected when a patient comes in, when he or she presents initial signs of Ebola,” she said, noting that different categories are being created for healthcare workers in primary care, triage and intensive care.

“And we’re saying no: all healthcare workers, all nurses will be protected as soon as a patient identifies as an Ebola risk.”

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The CFNU is calling for workers to be fully-trained, tested, drilled and monitored in patient assessment and PPE (personal protective equipment) procedures. The statement also called for PPEs to include “at a minimum for low-risk patients an N95, face shield, impermeable gowns, and gloves.”

“For high-risk confirmed cases of Ebola, nurses will be provided with powered air purifying respirators (PAPR), double gloves, leg and feet covers, and biohazard suits that meet a specified standard,” said the statement.

Silas advised nurses to speak with their Occupational Health and Safety Committees or ask managers for the “proper guidelines,” noting a refusal of service is a last resort.

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“Right to refuse is last resort and we will work with managers and ministers of health to make sure we don’t have to take our right to refuse, and we will take care of our patients,” she said. “But that is a right of all workers in this country.”

Concerns voiced last week included a lack of protective suits in certain provinces, potential Ebola patients in common waiting rooms, and ill-fitting gloves and gowns in hospitals across Canada.

READ MORE: Potential Ebola patient ‘horror stories’ in Canada concern nurse union

Canada has enacted Ebola Rapid Response Teams in Winnipeg and Ottawa, that would deploy to the necessary hospital in the event of an Ebola case, PHAC announced Sunday.  The teams are made up of public health experts and epidemiologists; four aircraft have been designated by Transport Canada to move the teams and personal protective equipment anywhere in Canada.

“If at any point Canada was to confirm a first case of Ebola, one of five available teams would be deployed to work with the provincial/territorial and local health authorities to provide surge capacity, additional resources and complementary expertise to prevent any further spread of the disease,” said the PHAC statement.

Ambrose said Sunday’s rapid response team test run—deployed from Ottawa to Halifax—was successful; she feels collaboration between federal and provincial officials is “excellent.” Dr. Taylor added other provinces have since expressed interest in participating in such a test, “so stay tuned, we’ll be doing more,” he said.

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READ MORE: How Canada’s public health system might respond to Ebola

Cruise ship returns to Texas after Ebola scare

Also Sunday, a cruise ship carrying a Dallas healthcare worker who had self-quarantined to monitor for Ebola returned to Texas after a seven-day trip. The lab supervisor had handled a specimen from a Liberian man who died from the disease in Dallas showed no symptoms; Sunday morning she tested negative for Ebola. Carnival Cruise Line staff said she and her husband drove home after the ship arrived in port Sunday.

The 4,000-passenger ship was refused clearance to dock in Cozumel, Mexico on Friday, a day after Belize refused to let the passenger leave the vessel. There were no restrictions placed on other passengers aboard the ship, officials said.

120 Americans still monitored for symptoms

Texas health officials said 120 people are still being monitored for possible Ebola infection since they may have come in contact with one of the three people who got the disease in Dallas. Forty-three of 48 people on an original watch list had passed the 21-day incubation period for the viral disease and are now in the clear, but others who cared for the Liberian man who died remain at risk. The wait period will end for all of those being monitored on Nov. 7.

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Watch below: Sense of relief as Ebola quarantine expires for some of those in contact with Texas patient

Spanish nurse appears to be in the clear

Nursing assistant Teresa Romero appears to have beaten Ebola, according to officials in Spain. Romero won’t be officially considered virus-free until a second test on Tuesday. She was among those treating a Spanish missionary who died of Ebola on Sept. 25.

“The first good news is that the evolution of Teresa Romero is positive,” said Spanish Foreign Minister Jose Manuel Garcia-Margallo. “The second is that the 15 others (linked to her) did not present any symptoms.”

Watch below: Spanish nurse beats Ebola, husband urges reform after ‘inefficient handling of Ebola in Spain’

Liberia makes desperate plea for international aid

Liberian President Ellen Johnson Sirleaf said Ebola has killed more than 2,000 people in her country and has brought it to “a standstill.” Sirleaf described the effects of the disease in a “Letter to the World” broadcast Sunday by the BBC.

READ MORE: Liberia’s president appeals for aid, describes devastating effects

The World Health Organization suggests the total death toll has risen to more than 4,500 people from the 9,000 infected. Senegal and Nigeria have been declared free of Ebola, but the outbreak remains out of control in Liberia, Sierra Leone, and Guinea.

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Sirleaf said that the three hard-hit countries were already in bad shape when the first-ever outbreak of Ebola in West Africa began.

“There is no coincidence Ebola has taken hold in three fragile states – Liberia, Sierra Leone and Guinea – all battling to overcome the effects of interconnected wars,” said Sirleaf, adding that Liberia once had 3,000 medical doctors but by the end of its civil war, which ended 11 years ago, the country had just 36.

“This fight requires a commitment from every nation that has the capacity to help, whether that is with emergency funds, medical supplies or clinical expertise … It is the duty of all of us, as global citizens, to send a message that we will not leave millions of West Africans to fend for themselves against an enemy that they do not know, and against whom they have little defence.”

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EU foreign ministers want 1 billion euro fund by Friday

The European Union nations are hoping to reach 1 billion euros ($1.27 billion) in aid by the end of the week to fight the disease in West Africa.

EU foreign ministers began a week of talks Monday so their 28 leaders can agree by Friday on better measures to fight Ebola. Measures would include anything from financial aid to common repatriation procedures, more Ebola treatment facilities and better training for health workers.

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So far, the overall fund total for the EU, including EU national contributions, stands now at nearly 500 million euros ($640 million), with Britain contributing 160 million euros ($204 million) and Germany some 100 million euros ($127 million).

The EU also rejected the idea of stopping direct flights coming from the affected region.

“Instead of going to Brussels or to France, (West African) passengers would go to Dubai or elsewhere and come in from there,” French Foreign Minister Laurent Fabius said. “We would no longer be able to check anything.”

John Kerry calls on Asia

Elsewhere, U.S. Secretary of State John Kerry appealed for Asian nations to step up their efforts to combat the deadly Ebola virus on Monday.

Officials said Kerry is seeking nations to boost contributions to the global effort to stop the spread of Ebola.

Lebanon beefs up border security

Meanwhile, Lebanon is imposing new measures to prevent the Ebola virus from entering its borders, involving the completion of special forms and testing of all passengers should a plane carrying someone with symptoms land at its airport. The country’s health minister said Lebanon is more vulnerable than other Arab countries “because of the large Lebanese community in infected countries.”

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READ MORE: Canada to start shipping experimental Ebola vaccine on Monday