Start with a $100,000 order for more personal protective equipment than usual and the price quickly mounted when the University of Kansas Hospital last week cared for a possible Ebola patient.
Add about $8,000 to $10,000 worth of heavy plastic sheeting and materials used to seal off the isolation area from the rest of the hospital.
Count in nursing overtime. Tally extra costs for hazardous waste removal. Figure in communication costs to handle the media. And note that an entire seven-bed intensive care unit — which usually would have been filled with other patients — was devoted to the care of just one person.
“There were major categories of costs and expenses above and beyond what we’d necessarily have for any other patient,” said Chris Ruder, vice president of patient care services at the hospital.
The Kansas City, Kan., Ebola scare, which turned out to be more of an infectious disease practice event, gave the hospital a clear window into the cost of best-practice care for the infectious and often fatal disease. By using equipment and procedures that the Centers for Disease Control and Prevention has since said are the right things to do, KU Hospital had an expensive 48-hour experience.
The full bill isn’t known, but a recap of those stressful days hints at what any medical center might face if a possible Ebola sufferer comes to its doors.
“For example, everything the physicians and nurses wore when they went into the patient’s room was completely disposable,” Ruder said. “And we had six nurses at any one time taking care of that one patient — a twelvefold increase in nursing care instead of the usual one nurse taking care of two patients in the ICU — plus physicians and a dedicated infectious disease team. The ratio of human resource to one patient was exorbitantly higher.”
The expensive, airtight protective suits, hoods, gloves and respirators could only be worn for two to four hours at a stretch before the workers became drenched in sweat. The hospital even bought underwear, socks and booties in all sizes for the workers to wear because they also had to be disposed of after each two- to four-hour service time.
Separately, the International Association of Fire Fighters calculated an average cost of $382.31 for one set of personal protective equipment that would be considered adequate for a first responder to handle a possible Ebola victim.
The association points out that the protective suit’s cost doesn’t begin to consider extra costs for throwing away a gurney mattress, blankets or anything else that may carry the virus after a sufferer is transported in an ambulance. Nor does it figure the expense of disinfecting care providers, equipment or vehicles.
Ruder noted that major hospitals, already prepared to handle infectious disease, have many materials and facilities, such as negative-airflow rooms, already on hand. But the emergency construction of separate caregiving zones outside the patient’s isolation room required a temporary sealed tunnel of plastic sheeting and creation of anterooms for workers to put on and take off protective gear and move to the shower.
“We’ve even replaced the ceiling tiles in our negative-airflow rooms with nonporous tiles,” Ruder said.