University Hospital in Newark, Robert Wood Johnson University Hospital in New Brunswick and HackensackUMC have been designated to treat potential patients with Ebola under an executive order signed Oct. 22 by New Jersey Gov. Chris Christie.
According to a news release from the governors office, Executive Order 164 creates an Ebola Virus Disease Joint Response team to direct and coordinate on all matters pertaining to New Jerseys public health response. Administration officials, state agencies and departments are to work in a coordinated manner to protect the health and safety of New Jersey residents and to execute decisions in an efficient and effective manner, according to the release. The EVD-JRT also will form an advisory panel of additional administration entities, as well as representatives from the medical community.
Departments included in the multi-agency team are the state departments of health, human services and education, the offices of the attorney general and homeland security and preparedness, and the New Jersey state police. The EVD-JRT also will coordinate with federal and state partners, which include New Jersey Transit and the departments of children and families, environmental protection, transportation and military and veterans affairs.
The three hospitals will be supported by the New Jersey Department of Health and a Centers for Disease Control and Prevention technical assistance teams with onsite visits, training and ongoing technical support.
The health department directed hospital CEOs in New Jersey to conduct drills to test ED processes for promptly identifying and isolating suspected Ebola patients. Drills were completed before Oct. 17.
New Jersey hospital systems have been tested with more than a dozen false alarms in which individuals presented to hospitals with symptoms or travel history. The New Jersey Hospital Association is surveying all hospitals conducting these drills and collecting data that is being shared with the state health department in order to prioritize additional training needs.
The Rutgers University School of Public Health is training key health educators statewide about the prevention of occupational exposure to the Ebola virus. Commissioner Mary ODowd has held briefing calls for 738 hospital officials, county and local health departments and EMS leaders.
The state health department is coordinating with local health departments to assess readiness for management of suspected Ebola cases, including establishing protocols around local isolation and quarantine of individuals as well as the disposal and transportation of regulated medical waste.
The state health department also is working with the CDC to prepare the state lab to test Ebola samples. In preparation, the state police hazardous materials unit has developed protocols with the state for handling and delivery of blood samples. The New Jersey Department of Environmental Protection is working with contractors to establish a removal and disposal protocol for infected debris and waste handling.
On Oct. 16, Newark Liberty International Airport implemented active screening for passengers who had begun their travel in an affected West African country. This screening includes temperature checks, visual inspection for symptoms and history of risk of exposure. Department of Health epidemiologists and physicians are in regular communication with the CDC officials at the airport and responding hospitals to collaborate on management of passenger evaluation and follow-up protocols, including possible quarantine.
If CDC advises the state health department of a traveler who is asymptomatic but has some risk of exposure, the health department will determine whether that traveler will be subject to state quarantine. At that point, the DOH will advise local health officials and state officials will coordinate to meet the traveler, serve the quarantine order and assist.
Symptomatic travelers immediately will be transferred to one of the three designated New Jersey hospitals under escort.
The state Department of Children and Families has prepared guidance for screeners who identify a parent or caregiver exhibiting Ebola symptoms. DCF is identifying resource home caretakers who are willing and able to accommodate children who may require placement in the event a parent or caretaker must be hospitalized or separately quarantined.
Agencies are working to ensure emergency responders, hospital and healthcare workers are appropriately trained and equipped. The health department issued guidance to 911 dispatch centers to ensure individuals who exhibit signs or symptoms of possible Ebola are screened to protect first responders. First responders have received updated guidance and will have access to the Rutgers education sessions for additional opportunities.
The Department of Health also ordered nearly $1 million in personal protective equipment for use by hospitals and healthcare workers.
To protect the health of commuters, New Jersey Transit employees are trained in incident response, management of bloodborne pathogens including Ebola and the management of hazardous materials in compliance with federal and state guidelines. NJ TRANSIT formed an internal task force that includes staff from its medical, office of emergency management, environmental, safety and communications departments, and all of the operating lines.
Schools also are in focus. The Department of Education is hosting a webinar for school nurses reviewing the signs and symptoms of Ebola, management of symptomatic individuals and coordination with local and state officials regarding symptomatic individuals.
The department is including updates on Ebola as part of its weekly broadcasts with all chief school administrators and superintendents. It also is putting in place emergency preparedness guidelines should there be a need to close schools or quarantine groups of students if there are symptomatic individuals.