Dinner conversation topics in my home can vary from the serious to the mundane. My kids (all pre-teens and teenagers) still communicate with me in more than a series of grunts. They acknowledge each other’s existence. It’s fantastic. Imagine my chagrin when we spent a whole meal discussing their fears for my well-being. My kids are pretty aware of the world around them. They listen to and read the news. They also have a clear understanding of what I do every day. So, when they hear about health care workers who have contracted Ebola in Texas, it is no giant leap for them to worry about and for me. As a hospital-based health care worker in a city rich with citizens who hail from hundreds of countries, it is likely that there will be many Ebola scares close to home in the near future. I practice in a hospital that was at the epicenter of the SARS outbreak in Toronto in 2003. While my children were too young at the time to remember it, they have heard about it and have even seen the movies-of-the-week that were based on it.
I remember the first child who had contracted SARS from family members who had already succumbed to the disease. When that child was admitted to hospital, my colleagues and I (all young professionals with young children, except for one single guy) looked at one another and tried to decide who would don the N-95 mask, gown, face-shield and gloves and care for the patient. Those early days in the outbreak were filled with many questions but few answers. We were faced every day with new instructions and new rules about how we were supposed to be screened, to protect ourselves and to care for our patients. One of my colleagues, the unmarried physician in our group, selflessly volunteered to expose himself to that first patient so that the rest of us could minimize our risk to ourselves and to our young families. We all remained healthy throughout the SARS outbreak, which lasted for several months but the memories of working in those conditions are still quite vivid.
Now, my children are old enough to understand what might happen with Ebola. They are concerned for me, and for the fallibility of PPE (personal protective equipment). They ask me about resource allocation, too. What will happen if there are not enough ventilators or ICU beds for all the sick patients? Who will decide who receives intensive care and how will those decisions be made? Are all states and provinces approaching preparedness in a consistent fashion?
These are all excellent questions. Unfortunately, no one yet has those answers. The real risk of an Ebola outbreak in North America is low. However, past experience suggests that we will have to be prepared so that if there is an outbreak, we will have the answers to my kids’ questions before we need them.