The Ebola virus could infect up to 1.4 million people in three countries in West Africa by the end of January and while the threat of an outbreak in Santa Clara County is low, "we absolutely need to be prepared," a top health official told the county's Board of Supervisors Tuesday.
Dr. Sara Cody, the county's health officer, in a visit not on the agenda for Tuesday's Board of Supervisors meeting, said she decided to update the board on the county's response to the potentially deadly Ebola disease that has spread "much more than people could have anticipated."
The U.S. Centers for Disease Control and Prevention, using models of "rough numbers" of cases recorded in Liberia and Sierra Leone, has now estimated that Ebola could infect 550,000 to 1.4 million people by the end of January in those two nations and in Guinea, Cody said.
"What does this mean to us?" Cody asked. "Because there are so many cases there it increases the possibility that someone could leave the areas where Ebola has been transmitted and land somewhere else in the world, including Santa Clara County," Cody said.
"Those sheer numbers change the probability for us," Cody said.
But the risks of contracting Ebola in the county are low because the number of people born in the three countries who live in the county "are relatively small" and "the chances that there is transmission from family visiting family in our county are relatively low."
Still, the county has "an incredibly diverse and active population, we have groups who are providing aid, who are residents of our county and come back, we have businesses with operations in those countries, and so we absolutely need to be prepared," Cody said.
She spoke about the response by the health system in Dallas two weeks ago to a man who contracted Ebola while in Liberia and soon after arriving in the city suffered from its symptoms and could have spread the virus to others from his body fluids.
The hospital the man went to while he had symptoms of the hemorrhagic fever did not recognize he had the disease and sent him home for two days before admitting him.
"There are a number of lessons learned in Dallas that I think are instructive for us," Cody said. "One is the delay in identification of the case, because the right questions either weren't asked or the information wasn't forwarded, (and) is hugely instructive and I think has got everyone talking and thinking."
Also, the holdup in identifying him as an Ebola patient meant delays for public health officials in identifying people Duncan contacted and arranging to safely quarantine them, she said.
"What is absolutely critical is early identification" of an Ebola sufferer, because people are not contagious until they have symptoms of the disease, such as fever and diarrhea, Cody said.
The public health department has distributed guidelines provided by the CDC to the county's hospitals about handling potential Ebola patients, she said.
The staff is focusing on making sure the county's health care delivery system is prepared for Ebola cases and is assessing the levels of preparedness of hospitals "so we have a sense of who's prepared and where the gaps are and what we need to do to help," Cody said.
Supervisor Ken Yeager said, "I think that all of us were just rather stunned at how ill-prepared Dallas was" and asked if the county is better organized about it than Dallas.
Cody said, "We will not have Dallas in Santa Clara County."
But she admitted there are "gaps" so far in the county's plans, including no contract yet with a hazardous materials company to supply protective suits to prevent transmission and no arrangement for the removal of infectious wastes that could affect the spread of the disease.
Supervisor Dave Cortese asked Cody to give the county a written report on its response and plans concerning Ebola.
Supervisor Cindy Chavez expressed concern that the county's public and private health facilities still are not linked together and added that training is vital for health care workers in the networks of clinics and emergency rooms.
People are coming to the county from all over the world each year and Ebola is only one of many public health risks such as the current outbreak of the respiratory illness Enterovirus 68 in the United States, Chavez said.
"The fact that the world is getting smaller, my suspicion is that we are going to be dealing with these kinds of unfortunate situations in the future probably much more than we did in the past," Chavez said.