By Brenda Goodman, MAWebMD Health News

Reviewed by Arefa Cassoobhoy, MD, MPH

Sept. 15, 2014 — The CDC is looking for a few good nurses and doctors — but especially nurses — to help fight the Ebola epidemic.

In response to the critical needs for more health care workers in West Africa, the agency plans to launch a 3-day training course to teach qualified professionals to safely treat people with Ebola. It will be held at the FEMA-run Center for Domestic Preparedness in Anniston, AL. Classes will begin Oct. 6.

The training is expected to be an important part of President Barack Obama’s plan to step up the U.S. response to the crisis in West Africa. Obama is due to announce more details of the plan from the CDC’s Atlanta campus on Tuesday, according to the White House.

On Friday, Margaret Chan, MD, director-general of the World Health Organization, said the Ebola-affected countries are running short on almost everything.

“But the thing we need most of all is people, health care workers,” Chan said. “The right people. The right specialists. And specialists who are appropriately trained, and know how to keep themselves safe.”

Cuba — a country famed for its medical training programs — offered 165 doctors, nurses, and infection control specialists who will travel to Sierra Leone, a country that lost a fourth doctor to the deadly virus over the weekend.The Ebola outbreak has taken a heavy toll on health care workers in countries where health care had already been gutted by years of poverty and civil war. More than 300 health workers have become infected and nearly half have died, according to the WHO.

Training Course Details

The course offered by the CDC is modeled on the training provided by Medecins Sans Frontieres (MSF), or Doctors Without Borders. Among other things, instructors will teach participants to safely put on and take off the full-body personal protective equipment that doctors must wear around highly infectious patients. It will also teach the buddy system that MSF uses to help keep its doctors safe. Partners are taught to watch each other as they don the gear to make sure no steps are missed.

“This is an unprecedented event that’s occurring,” says John Brooks, MD. He’s an infectious disease specialist with the CDC who is in charge of the program. “The call for people who can provide medical care to the hundreds of patients who have Ebola virus disease, it’s a big call. The first step in getting people to go care for these people is to provide them with the proper training to make sure they themselves don’t get infected and can provide that care safely.”

Brooks says the greatest need is for mid-level care providers like nurses and physician assistants.

“There may be a misperception that the kind of care that people need for Ebola virus disease is intensive-level ICU care. That’s the ideal,” Brooks says. “But that’s simply not available in these countries.”

He says the main care provided to people with Ebola is giving them medications by mouth like acetaminophen (Tylenol) to bring down a fever, giving injections, and starting IV lines.

People who have those skills also need to have an invitation from a volunteer organization to work in the affected countries before they can take the course. They should also have some experience working in resource-poor settings, and will have to pay their way to and from the training center.

Hurdles in the Way

It’s not clear whether the program will have many takers.

When the course was first advertised on ProMED-mail, a listserv for infectious disease experts, the response was polite, but tepid, says Larry Madoff, MD. He’s the editor of the forum, which is affiliated with the International Society for Infectious Disease.

“Most of us just can’t go,” Madoff says. “Many of us feel it would be great to be available to help. We do it in ways that we can.”

But he says many doctors feel that leaving for weeks or months would mean abandoning their own patients here at home. Others are in contractual agreements with hospitals that don’t allow for time off.

“Most people have home and family and job responsibilities that prevent them from just picking up and moving to West Africa. Even if you didn’t add the element of danger and difficulty, it’s very hard for people to leave on short notice and do something like this. I’m not surprised that a lot of people can’t do it,” he says.

Something else that’s likely to stop people is the expense, says Dan Lucey, MD. He’s an infectious disease specialist at Georgetown University in Washington, D.C., who has recently treated people with Ebola in West Africa.

“In my view, one thing that could readily be removed as an obstacle altogether is paying your own way. Really, why would volunteers who are going to go and put their lives in harm’s way to help with the Ebola effort, why should they have to pay their own plane fare?”

Even with some hurdles to overcome, Brooks is hopeful that people will be interested in volunteering. He says getting more boots on the ground is critical to stopping the outbreak.

“This effort of training people and generally raising the level of infection control and awareness within this region is a first step in restoring trust in the health care system,” he says. “Scared people who are fearful that health care centers are where you get Ebola are not going in for care. We need to restore that trust.”

SOURCES: John Brooks, MD, leader, HIV epidemiology research team, the Centers for Disease Control and Prevention, Atlanta. Larry Madoff, MD, editor, ProMED-Mail. Dan Lucey, MD, infectious disease specialist; adjunct professor, Georgetown University, Washington D.C. Press Briefing, World Health Organization.

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