An American doctor spent time in a small isolation room in Prague
- Jul 24
- 6 min read
Updated: Aug 9
Hisanori Murasawa,
5th-year Student, General Medicine,
First Faculty of Medicine, Charles University
On May 21, I was going daily between the university's affiliated hospital for surgical rotations. After lectures and practical exercises held during the day, I had studied with classmates to prepare for the last final exam of the year. Amidst all this, there was a moment when everyone's hands paused. This is because news broke that an American doctor suspected of being infected with Ebola virus would arrive in the Czech Republic tonight.
At that moment, I was surprised and recalled the Brovka Hospital (Fakultní nemocnice Bulovka) located in Prague. I think it's a hospital that readers may not be familiar with, but to me, it's a very familiar hospital. This is because the hospital is affiliated with the First Faculty of Medicine, Charles University, where I belong, and is the country's leading hospital, with internationally recognized facilities for infectious diseases. And it was precisely there that I participated in the infectious disease rotation this January and successfully passed the exam.
Because of this, I became curious about where he had been taken and continued my investigation, and as expected, it was Brovka Hospital.
He received news of an outbreak of Ebola disease the Republic of Congo just 20 minutes before boarding the flight back to the U.S. on May 15 to see his wife and children. It was discovered that he was possibly infected with Ebola virus and had contact with several patients who later died, prompting the U.S. Embassy in Prague to contact Czech authorities. The authorities immediately agreed to accept him at the hospital.
Then, on the night of May 21, the special plane carrying him landed at Václav Havel Airport Prague, the largest airport in the Czech Republic. At that time, he was asymptomatic and was transported to the hospital under strict security in an ambulance escorted by police.
During the rotation, I was able to see firsthand the rooms used for patients suspected of having been infected with highly fatal infections like Ebola virus. These were compartments isolated from other infectious disease patients, and each room used a biobox. A biobox is a highly airtight, tent-like structure that is a box-shaped negative pressure chamber. On the bedside, there are armholes designed for medical staff to perform treatment without directly touching the patient.
According to the infectious disease specialist who was in charge of my training, medical professionals can only enter each room using a dedicated IC card and must wear special suits. This special measure also applies to all waste generated inside the biobox (including biological waste). "The waste passes through the decontamination room in protective packaging, and then is professionally processed by the designated department of the hospital's integrated rescue system," he explained.
Since the incubation period for Ebola virus is up to 21 days from the last contact with an infected person, he was immediately transferred to a Baiobox upon arrival and stayed there for about three weeks until discharge.
In the confined environment of the isolation room, how did healthcare professionals respond?
I will explain step by step.
First, the management system is stricter than for other patients. Remote surveillance cameras are installed in his room, and it is mandatory for two doctors and nurses to observe him 24 hours a day.
Also, the frequency of rounds differs from usual.
Once a day, the attending doctor and nurse enter the isolation room to visit the bedside and perform necessary medical procedures through the armholes. As mentioned earlier, he had no symptoms at the time of admission, so the frequency is lower compared to other patients.
One of the most complicated procedures is the method of entering and exiting the hospital room. MUDr. Hana Roháčová, Ph.D., head doctor of the hospital's infectious disease department provides a detailed account of the situation at the time. "Entering an isolation room is complicated and takes at least 20 minutes. To avoid direct contact with him who may be infected, it must be conducted with utmost care. Even the slightest mistake is unacceptable." she stated. When doctors or nurses leave the isolation room after medical procedures, they first enter the adjacent decontamination room, wear protective clothing, and are exposed to a special disinfectant for 10 minutes to remove any potentially life-threatening contaminants. Then, wait another 10 minutes until the disinfectant starts to work. Only then can the protective suit be removed, and the removed suit is immediately incinerated. Additionally, all biological waste generated during medical procedures and other waste were treated using the methods mentioned above.
That's not all. They also needed to be creative in how they serve meals.
When I saw it during my internship, meals for all patients on the same floor were loaded onto one large cart, and each room was visited at a set time. However, in the case of him, to minimize the risk of virus leakage, the food was prepared individually and slipped into the biobox through a chamber maintained under negative pressure.
Despite the need for such unusually complex procedures, the hospital was able to discharge him perfectly without making even a minor mistake, because the hospital had long been training and mindful of team-based medical care, accommodating highly fatal infectious diseases like Ebola disease. I deeply respect not only him who had to spend three weeks hospitalization in such a confined space, but also the dedicated doctors and nurses who engaged in medical procedures while caring for other patients.
Then, about three weeks later, on June 10, the hospital determined that since his test results were not positive, there was no need to take additional measures and discharged him. He did not develop Ebola disease during his hospitalization. However, hospital officials stated that they will continue to respond to similar situations going forward.
In fact, this is not the first time he has been informed of possible contact with Ebola patients. In 2018, it was transferred to a specialized facility in Nebraska, USA.
He told Czech media that his first impression upon learning of the Ebola disease outbreak was the possibility of being placed under quarantine for the second time. He also pointed out that a major difference this time was that stricter measures were implemented. In both cases, although he was asymptomatic, when being isolated to Nebraska in 2018, he was treated as uninfected, but this time he was treated as a patient with a possible infection, and the measures were stricter. He cited that each country has varying tolerance for risk, and that the COVID-19 pandemic has changed people's views on similar situations.
Additionally, Adam Vojtěch, the Czech Republic's Minister of Health, has commented on the circumstances leading up to the discharge of this American doctor. On social media, he stated, "It is extremely important for us that the Czech healthcare system has once again demonstrated expertise, professionalism, and the ability to respond quickly and effectively to emergencies," adding that the issue has attracted international media attention.
Unfortunately, the spread of Ebola virus disease remains a serious situation.
The World Health Organization (WHO) has warned that the number of people suspected of having Ebola disease in the Republic of Congo continues to surge, and the situation remains extremely serious. As of writing, there are 1,500 suspected deaths from Ebola disease, of which 493 have died. The spread of infection is concentrated in Ituri Province in the northeast of the country, where over 90% of cases have occurred. Since the outbreak was declared several weeks late, the actual number of cases is believed to be even higher.
At first, I viewed the Ebola disease outbreak as something happening in a distant country.
However, this case, where a patient was actually transported to the hospital where I was training and safely returned home, became a valuable experience that overturned my preconceptions. He also reaffirmed the importance of constantly asking ourselves what we can do in today's ever-changing society. Going forward, I will continue to investigate the detailed situation on site and pray that the days when people can live with peace of mind will come as soon as possible.
What is Ebola disease?
Ebola disease is a viral disease that spreads through contact with infected individuals or contaminants. Early symptoms include fever, vomiting, diarrhea, and muscle pain, and as it progresses, it can lead to bleeding tendencies, severe symptoms like impaired consciousness, and may even be fatal. There are treatments and vaccines available for some variants of the Ebola virus. However, there is no vaccine-effective treatment for the variants currently circulating the Republic of Congo and Uganda.
Reference:
《Author Biography》
Hisanori Murasawa
After graduating from the Institute for Language and Preparatory Studies at Charles University, I proceeded to the First Faculty of Medicine, General Medicine, at the same institution, where I am currently a fifth-year student.
Comments