Transcript: Ebola Effects | Feb 08, 2016

Steve sits in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a gray suit, white shirt, and dark blue tie.

A caption on screen reads "Ebola effects."

Steve says MORE THAN 11,000
PEOPLE DIED IN THE 2014 OUTBREAK
OF EBOLA IN WEST AFRICA, AND
MANY OF THEM WERE HEALTHCARE
WORKERS.
SINCE THEN, A NEW STUDY SUGGESTS
HEALTHCARE WORKERS IN THE FUTURE
MAY NOT BE AS WILLING TO TAKE
SUCH RISKS.
JOINING US NOW FOR WHAT THAT
COULD MEAN FOR THE NEXT OUTBREAK
OF A CONTAGIOUS DISEASE:
IN ATLANTA, GEORGIA:
DR. KEREN LANDMAN, INFECTIOUS
DISEASE AND PUBLIC HEALTH
SPECIALIST AND A GLOBAL
JOURNALISM FELLOW AT THE
UNIVERSITY OF TORONTO'S MUNK
SCHOOL OF GLOBAL AFFAIRS;

Keren is in her late thirties, with short curly chestnut hair. She's wearing a black blouse and a white choker necklace.

Steve continues AND HERE IN STUDIO:
DR. SUSY HOTA, INFECTIOUS
DISEASE SPECIALIST WITH THE
UNIVERSITY HEALTH NETWORK.

Susy is in her thirties, with shoulder-length wavy brown hair. She's wearing a purple blazer over a white shirt, and a beaded necklace.

Steve continues I THANK BOTH OF YOU FOR COMING
IN TONIGHT FOR THIS DISCUSSION.
I WANT TO START BY JUST PUTTING
OUT ONE KEY FACT FROM THE OPEN
FORUM INFECTIOUS DISEASES STUDY
THAT WAS JUST PUBLISHED

A slate appears on screen showing a picture of a man wearing personal protective equipment.

Steve continues AND IT SAID THAT OF 514 HEALTH CARE
WORKERS SURVEYED, 25 percent SAID IT
WAS ETHICAL TO REFUSE TO PROVIDE
CARE FOR EBOLA PATIENTS, 25 percent.
DR. KEREN LANDMAN, TO YOU FIRST.
WHAT DO YOU MAKE OF THAT NUMBER?

The caption changes to "Keren Landman. Infectious disease specialist."

Keren says IN SOME
WAYS IT'S SURPRISING, STEVE.
IN SOME WAYS IT'S NOT.
THE HIPPOCRATIC OATH IS ONE
THAT DOCTORS TAKE AND MANY
HEALTH CARE PROVIDERS HAVE THE
SAME SORT COMMITMENT TO CARING
FOR THEIR PATIENTS, BUT WHEN
SOMETHING SCARY LIKE THIS
THREATENS PEOPLE AND THEIR
FAMILIES. PEOPLE'S COMMITMENT
TENDS TO GO INWARD INTO
NUMBER ONE AND TO THE PEOPLE
AROUND THEM, SO WE SAW SOME
TRENDS LIKE THIS
DURING THE H.I.V.
EPIDEMIC WITH PEOPLE REFUSING TO
CARE FOR PEOPLE IN HOSPITALS OR
HEALTH CARE FACILITIES.
IN THAT SENSE IT'S NOT SO MUCH A
SURPRISE.
BUT THE NUMBER OF PEOPLE, BEING
A QUARTER OF PEOPLE BEING
SIMILAR TO THE NUMBER WHO WOULD
HAVE REFUSED DURING THE H.I.V.
EPIDEMIC, I WOULD HAVE THOUGHT
THAT WOULD BE LOWER NOW WITH OUR
ABILITY TO PROTECT OUR SELF FROM
THE SPREAD OF DISEASE.

Steve says DR. SUSY HOTA, WERE
YOU SURPRISED BY THAT NUMBER?

The caption changes to "Susy Hota. Infectious Disease Specialist."

Susy says AGAIN NOT
ENTIRELY SURPRISED, YOU KNOW AT
A TIME OF CRISIS WHEN SOMETHING
BECOMES A REALITY, IT'S LIKE OUR
PRIMITIVE BRAINS TAKE OVER AND
SUDDENLY THE THOUGHT OFPOTENTIALLY
INFECTING PEOPLE
YOU LOVE AND CARE FOR REALLY
TAKES OVER.
I HAVE TO SAY I'M NOT THAT
SURPRISED BY THE NUMBER.

The caption changes to "Denying care."

Steve says KEREN, WHAT MIGHT
HEALTH CARE WORKERS BELIEVE IS
THE ETHICAL REASON THEY DON'T
HAVE TO DO THEIR JOBS?

Keren says IN THIS
STUDY, THE LEAD AUTHOR AND HER
COLLEAGUES FOUND THAT 90 percent OF THE
FOLKS WHO FELT IT WAS ETHICAL TO
REFUSE CARE WERE MOST CONCERNED
ABOUT THEIR FAMILIES'
WELL-BEING.
IT'S KIND OF A SURPRISE BECAUSE
WE KNOW THAT EBOLA ISN'T
TRANSMISSIBLE IF PEOPLE DON'T
HAVE SYMPTOMS, BUT THAT I THINK
DROVE AM PEOPLE'S REFUSAL
THINKING IT WAS ETHICAL TO
REFUSE.
I THINK A LOT OF THEM FELT THEY
WOULD NOT HAVE ACCESS TO
DISABILITY INSURANCE OR
SHORT-TERM LIFE INSURANCE AND
THAT THEIR HEALTH CARE WOULDN'T
BE COVERED IN THE CASE THAT THEY
WERE INFECTED, AND I THINK THE
AUTHORS FELT THAT THAT MIGHT
HAVE BEEN A MOTIVATOR TOWARD
THAT REFUSAL.

Steve says SUSY, ARE THOSE
REASONABLE CONCERNS IN YOUR VIEW?

Susy says I THINK THEY ARE.
YOU KNOW, I REALLY THINK THE
THOUGHT OF POTENTIALLY SPREADING
THINGS TO OTHERS WHEN THERE IS
AN ELEMENT OF UNKNOWN, AND I
THINK IT'S THE UNFAMILIARITY OF
THIS DISEASE IN OUR POPULATION
THAT REALLY KIND OF GUIDES THAT.
YOU MAY HEAR HOW IT'S
TRANSMITTED BUT WHEN YOU'VE NOT
DEALT WITH IT BEFORE, I THINK
THAT REALLY DRIVES PEOPLE'S
REACTIONS.

Steve says KEREN, DO YOU THINK
IT'S INDICATIVE OF A LARGER PROBLEM?

Keren says YEAH, I
THINK PEOPLE'S TRAINING AND
EDUCATION IS UNIVERSAL CAUTIOUS.
THERE ARE WAYS WE KNOW WE SHOULD
PROTECT OURSELVES FROM PATIENTS
IF WE SUSPECT THEY ARE INFECTED
OR NOT.
IT SEEMS TO BE OVERCOME BY FEAR
DURING EPIDEMIC PERIODS AND I
THINK THAT INDICATES THAT OUR
TRAINING IS NOT SO MUCH IN DOING
WHAT'S RIGHT DURING EMERGENCIES
BUT DOING WHAT'S RIGHT WHEN
THINGS ARE FINE.
SO I THINK WE CAN DO BETTER IN
EDUCATING AND TRAINING HEALTH
CARE WORKERS TO RESPOND IN A
CONSISTENT WAY TO PEOPLE WHO
NEED OUR CARE DURING EMERGENCY
SITUATIONS.

Steve says SUSY, LET ME PICK
YOUR BRAINS FOR A SECOND ON WHAT
YOU DID WHEN YOU WERE I PRESUME
PART OF THE PREPARATIONS HERE IN
THE PROVINCE OF ONTARIO WHEN THE
EBOLA THING HAPPENED IN WEST
AFRICA AND YOU HAD TO KIND OF
PREPARE, RIGHT?
YOU HAD TO PREPARE ONTARIO FOR
WHAT-IF.
DID YOU TAKE FEARS SUCH AS THOSE
WE'RE TALKING ABOUT INTO ACCOUNT
WHEN YOU DID YOUR PREPARATIONS?

Susy says ABSOLUTELY.
IT WAS ONE OF THE PREMISES OF
OUR WHOLE PLAN WAS INVOLVING THE
HEALTH CARE WORKERS WHO WOULD BE
SEEING THESE PATIENTS AND
DIRECTLY INTERACTING WITH THE
PEOPLE IN THE SYSTEM IN THAT
PREPARATION.
SO WE ACTUALLY TRIED TO REACT TO
THIS QUITE QUICKLY AND I THINK
THIS GAVE US A BIT OF AN
ADVANTAGE AT OUR HOSPITAL AND WE
DID BECOME THE DESIGNATED SITE
FOR REPATRIATION OF CANADIAN AID
WORKERS FROM WEST AFRICA DURING
THE EPIDEMIC WITH EBOLA.
WE HAD THE TIME TO REALLY SORT
OF THINK THAT THROUGH AND
RECOGNIZE THAT MAKING SURE
PEOPLE FELT SAFE WAS REALLY THE
CRUX OF IT ALL AND WE INVOLVED
OUR FRONT LINE HEALTH CARE
WORKERS IN A LOT OF THE
PREPARATIONS, RIGHT DOWN TO THE
NITTY GRITTY OF HOW YOU WOULD
DRAW BLOOD FROM A SUSPECTED CASE
OF EBOLA TO WHAT KIND OF
CONSIDERATIONS WOULD YOU HAVE TO
TAKE INTO PLAY IF A PATIENT
BECAME AGITATED IF IT WAS
SOMEBODY BEING INVESTIGATED FOR
EBOLA AND MOCK EXERCISES TO
INVOLVE PEOPLE IN HANDS-ON
TRAINING.
I COULDN'T AGREE MORE THAN WHAT
KEREN SAID ABOUT INVOLVING
PEOPLE AND MAKE SURE YOU DO THIS
BETWEEN EPIDEMIC PERIODS WHEN
THERE'S CALM BECAUSE YOU HAVE TO
HAVE THEM COMFORTABLE WITH THE
APPROACH.

Steve says YOU SAY IN BETWEEN
EPIDEMIC PERIODS.
THIS IS NOT AN EPIDEMIC EXERCISE
FOR SOME PEOPLE WHO HAVE BEEN IN
HEALTH CARE FOR MORE THAN A
DECADE.
WE REMEMBER 13 YEARS AGO, 44
PEOPLE DIED FROM S.A.R.S.

Susy says YES.

Steve says PRESUMABLY THAT
INFORMED YOUR THINKING ON THIS
AS WELL?

The caption changes to "Impact of SARS."

Susy says ABSOLUTELY.
THAT WAS QUITE CRITICAL IN OUR
EARLY DISCUSSIONS WITH OUR STAFF
IS COMPARING AND CONTRASTING
WHAT HAPPENED WITH S.A.R.S. AND
EBOLA.
THERE IS A LOT OF I'D SAY ALMOST
POST TRAUMATIC STRESS THAT'S
STILL IN HEALTH CARE WORKERS,
ESPECIALLY THOSE WHO WERE
INVOLVED DIRECTLY WITH THE
PATIENTS DURING S.A.R.S. AND SAW
SOME OF THEIR COLLEAGUES FALL
ILL, AND IT WAS A DISEASE THAT
DISPROPORTIONATELY AFFECTED
HEALTH CARE WORKERS.
WE HAD TO REALLY DO A LOT OF
MYTH BUSTING RIGHT UP FRONT TO
THE POINT WE WERE CIRCULATING
COMPARING AND CONTRASTING EBOLA
AND S.A.R.S. AS DOCUMENTS TO
FRONT LINE HEALTH CARE WORKERS
ADDRESSING THEIR CONCERNS RIGHT
OFF THE BAT AND ALSO ENSURING
THAT AS PART OF OUR CARE MODEL
WE HAD PSYCHO-SOCIAL SUPPORTS
AVAILABLE TO THE HEALTH CARE
WORKERS DEALING WITH PATIENTS.

Steve says KEREN, IT'S A HARD
QUESTION TO ASK BUT LET'S DO
THIS ANYWAY.
WE REALLY CAN'T EXPECT HEALTH
CARE WORKERS TO TREAT PATIENTS
IF THEY THINK TREATING THOSE
PATIENTS IS GOING TO RESULT IN
THEIR OWN DEATHS, CAN WE?

The caption changes to "Balancing expectations."

Keren says YOU
KNOW, IT IS A TOUGH QUESTION,
BUT I THINK WE NEED TO BACK UP
AND ASK: IS TREATING THESE
PATIENTS REALLY GOING TO RESULT
IN THEIR DEATHS?
I THINK PART OF THE PROBLEM WITH
EBOLA WAS THAT THE FOLKS THAT
WERE INFECTED, THE HEALTH CARE
WORKERS THAT WERE INFECTED IN
THE UNITED STATES WERE
UNDOUBTEDLY INFECTED DURING A
BREACH IN PROTOCOL.
BUT WE DIDN'T REALLY TALK ABOUT
THAT WHEN IT HAPPENED BECAUSE...
PERHAPS BECAUSE IT MAY HAVE
SEEMED LIKE PLACING BLAME ON
PEOPLE OR TELLING A HOSPITAL OR
A HEALTH CARE WORKER THAT THEY
WERE DOING SOMETHING WRONG.
IN REALITY, THE INFECTION OF THE
HEALTH CARE WORKERS WHO CARED
FOR THAT GENTLEMAN WHO DIED IN
DALLAS, THERE WAS A BREACH IN
PROTOCOL SOMEWHERE TO CAUSE
THAT.
IF UNIVERSAL PRECAUTIONS AND THE
ADDITIONAL PRECAUTIONS THAT WERE
TAKEN HAD GONE PERFECTLY, THIS
WOULDN'T HAVE HAPPENED.
SO HAVING THE MESSAGE OUT THERE
THAT USING THE PRECAUTIONS THAT
ARE AVAILABLE ACTUALLY WILL
PREVENT THE HEALTH CARE WORKER
FROM BECOMING INFECTED
HAVING THAT MESSAGE BE CLEAR
AND IT IS A TRUE MESSAGE IT'S
NOT PROPAGANDA -- HAVING THAT
MESSAGE BE CLEAR TO HEALTH
CARE WORKERS
IS KEY TO REASSURING THEM THAT
THEY CAN SAFELY CARE FOR SOMEONE
WITH A SEVERE INFECTION THAT IS
COMMUNICABLE.

Steve says I DON'T KNOW THIS
FOR SURE BUT I'M SPECULATING
HERE THAT PRESUMABLY THEY DON'T
FEEL, THE HEALTH CARE WORKERS
I'M TALKING ABOUT NOW, THEY
DON'T FEEL THEY HAVE ADEQUATE
SUPPORT OR SUPPLIES IN ORDER TO
GIVE THEM THAT COMFORT; IS THAT
POSSIBLE?

Keren says I THINK
IT'S POSSIBLE THAT PEOPLE FEEL
THAT WAY, YOU KNOW, IN THE STUDY
THAT YOU PRESENTED DATA FROM
EARLIER, 44 percent OF THE PEOPLE
SURVEYED FELT THEIR HOSPITAL
WASN'T PROPERLY EQUIPPED TO CARE
FOR A PATIENT WITH EBOLA, AND
MANY CAME FROM A HOSPITAL THAT
WAS AN EBOLA DESIGNATED
TREATMENT CENTRE SO THEY WERE
DEFINITELY EQUIPPED.
WHERE THE DEFICIT IS IN
KNOWLEDGE AND TRAINING.
AS SUSY SAID, MAKING SURE PEOPLE
ARE EQUIPPED DURING A TIME OF
CALM SO WHEN WE INEVITABLY NEED
TO SCALE UP EVALUATION AND
TREATMENT OF RETURN TRAVELERS
WHO MAY BE A THREAT WITH A
COMMUNICABLE DISEASE, THEN THE
MORE LIKELY WE ARE TO ACTUALLY
HAVE PEOPLE WHO ARE EQUIPPED TO
TAKE CARE OF THESE FOLKS WHEN
THE EPIDEMIC DOES STRIKE.

Steve says SUSY, A DIFFICULT
BALANCING ACT.
ON THE OTHER HAND, HEALTH CARE
WORKERS HAVE AN EXPECTATION THAT
THEY'RE GOING TO BE SAFE WHEN
THEY TREAT PEOPLE WITH THESE
KINDS OF DISEASES; ON THE OTHER
HAND, THE PUBLIC CERTAINLY
EXPECTS HEALTH CARE WORKERS TO
DO THEIR JOBS AND HELP THEM IF
THEY'RE IN TROUBLE.
HOW DO YOU BALANCE THE COMPETING
INTERESTS THERE?

Susy says DEALING WITH
THE FIRST IS REALLY THE KEY,
MAKING SURE PEOPLE FEEL THAT
THEY'RE SUPPORTED AND THAT
THEY'RE SAFE.
THIS IS SOMETHING THAT WE'RE
GOING TO STRUGGLE WITH WITH ANY
EPIDEMIC AND WITH ANYTHING
THAT'S AN UNKNOWN THAT COMES UP
IN HEALTH CARE.
BUT IT CERTAINLY IS SOMETHING
THAT UNFORTUNATELY WE DON'T HAVE
A LOT OF GUIDANCE FROM OUR CODE
OF ETHICS AND OUR REGULATORY
BODIES.
THE CANADIAN MEDICAL
ASSOCIATION, FOR EXAMPLE, OR THE
CANADIAN NURSING ASSOCIATION, TO
HELP US MAKE THOSE DECISIONS AS
HEALTH CARE WORKERS, TRYING TO
BALANCE OUR OWN SAFETY AGAINST
OUR DUTY TO ACTUALLY PROVIDE
CARE FOR PATIENTS.
THERE'S A LOT OF AMBIGUITY
AROUND THAT.
I THINK PEOPLE HAVE TO DEAL WITH
THAT INTERNAL STRUGGLE BY
REACHING OUT FOR SUPPORT IN
THEIR AREA.

Steve says WHAT'S JOB ONE,
KEREN?
IT'S DO NO HARM, RIGHT?
DO NO HARM.
CAN YOU REALLY REFUSE TO TREAT A
PATIENT AND BE CONSISTENT WITH
DO NO HARM?

Keren says IT'S
HARD TO IMAGINE DOING THAT,
STEVE, BUT I THINK THE REALITY
IS, YOU KNOW, DURING THE EBOLA
EPIDEMIC, IN AFRICA PATIENTS
WERE TURNED AWAY FROM HEALTH
CARE CENTRES, FROM BIRTHING
CENTRES, FROM MALARIA TREATMENT
CENTRES WHEN THEY HAD SYMPTOMS
OF EBOLA, EVEN IF THEY DIDN'T
END UP HAVING EBOLA, MANY OF
THEM WERE TURNED AWAY AND DIED
BECAUSE OF THE EPIDEMIC EVEN
THOUGH THEY WEREN'T ACTUALLY
INFECTED WITH EBOLA.
IT'S HARD TO -- IT'S ALWAYS HARD
TO IMAGINE WHAT YOU WOULD...
IT'S HARD TO, YOU KNOW, WE CAN
IMAGINE WHAT WE MIGHT DO IN A
SCENARIO.
BUT WHEN THE SCENARIO ACTUALLY
HITS, IT MAY NOT ACTUALLY MATCH
WITH OUR HYPOTHETICAL REALITY.
I WOULD HOPE THAT HEALTH CARE
WORKERS WOULD TRY AND ABIDE BY
THE HIGH STANDARDS THAT THEY SET
FOR THEMSELVES, BUT I THINK WE
NEED TO HELP THEM TO DO THAT BY
PREPARING THEM WELL, EDUCATING
WELL, EDUCATING THEM WELL, AND
GIVING THEM CLEAR ACTIONABLE
INFORMATION DURING THE INTERIM
IN BETWEEN THESE SORTS OF
OUTBREAKS.

Steve says SURE.
SUSY, LET ME PUT A DIFFERENT
STUDY TO YOU.
THIS ONE IS FROM YORK
UNIVERSITY.
AND IT LOOKED AT MEDIA COVERAGE.
AND IT WAS DURING -- IT'S NOT
THE EBOLA, IT WAS H1N1 OUTBREAK
IN CHINA AND IT FOUND THAT
COVERAGE OF THE OUTBREAK HELPED
INFORM PEOPLE AND SLOWED THE
SPREAD. MEDIA ACTING CONSTRUCTIVELY
I KNOW THAT IS IMPOSSIBLE TO
BELIEVE BUT IT ACTUALLY DOES
HAPPEN.
WHEN IT COMES TO HEALTH CARE
WORKERS, COULD MORE COVERAGE
ACTUALLY HAVE AN ADVERSE EFFECT?

The caption changes to "In the eye of the Media."

Susy says IT'S A
REALLY INTERESTED QUESTION.
I DO THINK THE MEDIA PLAYS AN
IMPORTANT ROLE, A VERY IMPORTANT
ROLE, AND IT REALLY IS AN
IMPORTANT ROLE IN TRANSPARENCY.
THE MESSAGE WE GET OUT THERE BY
MEDIA SHOULD BE VERY CONSISTENT
WITH WHAT WE'RE TELLING OUR
STAFF IN THE HOSPITAL.
I MEAN, IT'S NOT GOING TO DEAL
WITH EVERYONE'S, YOU KNOW,
ISSUES, INDIVIDUAL ISSUES WHERE
THEY'RE WORKING AND I THINK
THAT'S WHERE YOU HAVE TO BE VERY
CAREFUL WHAT THAT BROAD MESSAGE
IS COMPARED TO WHAT'S BEING SAID
WITHIN HOSPITALS WHERE AN
APPROACH MIGHT BE SLIGHTLY
DIFFERENT FROM ANOTHER HOSPITAL
BECAUSE THAT'S THE WAY IT HAS TO
WORK.
BUT ULTIMATELY, EDUCATION AND
AWARENESS -- I DON'T LIKE THE
WORD EDUCATION A LOT OF TIMES,
IT'S MORE AWARENESS AND
UNDERSTANDING OF WHAT THE RISKS
ARE.
IT'S IMPORTANT TO GET OUT THERE
WHATEVER MEDIUM YOU USE.

Steve says WELL, EXCEPT THAT...
KEREN, TO YOU ON THIS ONE.
WE IN CANADA WE'RE ALL
SCRUPULOUSLY RESPONSIBLE IN ALL
OF OUR COVERAGE AROUND EBOLA.
HE SAYS WITH HIS TONGUE A LITTLE
BIT IN HIS CHEEK BUT
WHEN I LOOK AT WHAT HAPPENED
SOUTH OF THE BORDER AND THE
CABLE STATIONS DOWN THERE HOW
THEY COMPETED WITH EACH OTHER,
IN AN ORGY OF -- ALMOST THEY
WERE DESPERATE IT
SEEMED, TO HAVE A CASE IN THE
UNITED STATES TO TALK ABOUT SO
THEY COULD HAVE THEIR 24-7 MUSIC
AND BANNER HEADLINES AND SO
FORTH.
HOW CONSTRUCTIVE WAS THE MEDIA'S
ROLE IN ALL OF THAT?

Keren says YOU
KNOW, I THINK IT HELPED CREATE A
STATE OF HYSTERIA THAT THEN
SPILLED OVER INTO POLITICIANS'
WILLINGNESS TO MAKE STATEMENTS
AND TAKE ACTIONS THAT WERE
ULTIMATELY REALLY DETRIMENTAL IN
SORT OF CREATING THIS CLIMATE OF
FEAR AMONG HEALTH CARE WORKERS
AND THE PUBLIC.
I THINK A LOT OF FOLKS ARE
WORRIED THAT THINGS ARE SORT OF
HEADING THAT WAY WITH THE
CURRENT ZIKA EPIDEMIC IN SOUTH
AND CENTRAL AMERICA.
I THINK THE MEDIA PLAYS A REALLY
IMPORTANT ROLE HERE IN KEEPING A
MEASURED TONE.
I THINK AS SUSY SAID
TRANSPARENCY IS KEY.
FREQUENT AND TRUTHFUL UPDATES
ABOUT WHAT WE KNOW AND WHAT WE
DON'T KNOW.
ACTIONABLE INFORMATION.
IT'S VERY IMPORTANT.
I HAVE TO TELL YOU, STEVE, THE
MEDIA CANNOT DO THAT WITHOUT
CLEAR, SOLID, FREQUENT MESSAGING
FROM THE TOP, AND THAT MEANS
THAT PUBLIC HEALTH AUTHORITIES
NEED TO BE REALLY ON TOP OF
MESSAGING WHEN IT COMES TO
INFORMING THE MEDIA AND
INFORMING THE PUBLIC DURING
THESE SORTS OF OUTBREAKS.

Steve says DID THEY NOT DO THAT
DURING THE EBOLA OUTBREAK?

Keren says I THINK
A LOT OF PEOPLE WOULD ARGUE THAT
THE MESSAGING WAS INCONSISTENT,
IT WAS OFTEN LATE TO THE GAME,
AND ALLOWED FOR PEOPLE TO SORT
OF COME UP WITH THEIR OWN
HYPOTHESES ABOUT HOW THINGS WERE
GOING AND WHAT THE BEST WAY WAS
TO DO THINGS.
THERE WERE SOMETIMES ALSO
CONFLICTING MESSAGES COMING FROM
DIFFERENT PARTS OF THE SAME
AGENCY.
SO I THINK IN THESE KINDS OF
SITUATIONS IT'S REALLY
CONFUSING, IT REALLY DISRUPTS
PUBLIC TRUST IN PUBLIC HEALTH
AUTHORITIES AND IT'S REALLY THE
LAST THING WE NEED TO HAVE
HAPPEN DURING AN EPIDEMIC.

Steve says SUSY, HOW DO WE MAKE
HEALTH CARE WORKERS, LET'S
PREPARE FOR THE FUTURE, HOW DO
WE MAKE THEM FEEL MORE SECURE ON
THE JOB, WHEN THE NEXT EPIDEMIC
HITS, AND IT WILL, BECAUSE THEY
ALWAYS DO?

The caption changes to "Preparing for the future."

Susy says IT COMES
BACK TO WHAT WE STARTED OFF
TALKING ABOUT AND THAT'S MAKING
SURE WE HAVE THE PLANNING AND
TRAINING IN PLACE BETWEEN
EPIDEMICS.
NOT TAKING A REACTIONARY
APPROACH BUT A PROACTIVE
APPROACH.
MAKING SURE PEOPLE KNOW WHAT
THEIR RESPONSIBILITIES ARE,
WHAT'S OUT THERE TO SUPPORT
THEM, AND HOW TO DEAL WITH THESE
KINDS OF THINGS.
YOU KNOW, I KIND OF BELIEVE THAT
HAVING, YOU KNOW, SOME SORT OF
CLEAR CENTRE OF EXCELLENCE OR
SOME PLACE WHERE PEOPLE KNOW
THEY CAN RELY ON THE INFORMATION
AND PEOPLE ARE PREPARED AND
TRAINED TO DEAL WITH THESE KINDS
OF EPIDEMICS MIGHT BE A WAY TO GO.

Steve says WILL THAT MATTER?
I ASK THAT BECAUSE WE LIVE IN AN
AGE WHERE EVERYONE IS
MISTRUSTFUL OF INSTITUTIONS,
INCLUDING HEALTH CARE WORKERS, I
ASSUME, WHO DON'T NECESSARILY
THINK, JUST BECAUSE THEY HEAR IT
FROM, IN THE STATES, THE C.D.C.
OR SURGEON GENERAL OR HERE IN
ONTARIO FROM OUR COMPARABLE
AUTHORITIES, DOESN'T MEAN
THEY'RE GOING TO BELIEVE IT.
WHAT DO YOU THINK?

Susy says IT'S
SOMETHING WE'LL HAVE TO GRAPPLE
WITH MOVING FORWARD,
UNFORTUNATELY.

Steve says KEREN, WHERE ARE YOU
ON THAT?

Keren says YOU
KNOW, I THINK IT'S CRITICALLY
IMPORTANT THAT WE PREPARE, AS
SUSY SAID, IN BETWEEN EPIDEMICS
AND DO WHAT WE CAN TO HELP
HEALTH CARE WORKERS REALLY USE
UNIVERSAL PRECAUTIONS WE HAVE IN
PLACE WITH THE SAME LEVEL OF
CARE WITH THE PATIENTS THAT THEY
SEE BETWEEN EPIDEMICS AS THE
PATIENTS THEY SEE DURING
EPIDEMICS.
ULTIMATELY, I THINK WE'RE GOING
TO BE SEEING MORE AND MORE OF
THESE KINDS OF IMPORTED DISEASES
OR DISEASES IN RETURN TRAVELERS
THAT ARE COMMUNICABLE AND THAT
DO POSE A THREAT TO US, AND WE
NEED TO BE ABLE TO DEAL WITH
THOSE SORT OF BEFORE THEY COME
IN, NOT JUST TO CREATE A PLAN
SORT OF REACTIVELY AFTER THEY
BEGIN.
SO, YEAH, THAT'S -- I CAN'T
REALLY ADD THAT MUCH TO WHAT
SUSY SAYS.
I THINK PREPARING IN BETWEEN
EPIDEMICS IS REALLY WHERE THE
KEY IS.

Steve says LET'S FINISH UP ON
THIS THEN.
IF THEY DO, THE AUTHORITIES,
THAT IS, ON BOTH SIDES OF THE
BORDER, ALL OF WHAT YOU'RE
TALKING ABOUT HERE -- WE STARTED
WITH A SURVEY THAT SAID 25 percent OF
WORKERS SAID IT WAS ETHICAL TO
REFUSE TO PROVIDE TREATMENT TO
PEOPLE SUFFERING FROM EBOLA.
WHAT WOULD YOU LIKE TO SEE THAT
NUMBER, KEREN, MORE REASONABLY AT?

The caption changes to "Connect with us: tvo.org, YouTube, Facebook, Instagram, and Twitter, @theagenda"

Keren says I MEAN,
I'D LOVE TO SEE IT AT ZERO.
ZERO WOULD SAY TO ME THAT PEOPLE
UNDERSTAND THAT THE UNIVERSAL
PRECAUTIONS WE HAVE IN PLACE
WORK AND KEEP THEM SAFE AND THEY
HAVE THE SUPPORT THEY NEED TO
STAY AT THE HOSPITAL IF THEY
FEEL UNSAFE GOING HOME AND
POTENTIALLY EXPOSING THEIR
FAMILIES TO SOMETHING WHICH THEY
WERE EXPOSED IN THE HOSPITAL,
THAT IF THEY BECOME SICK, THEIR
HEALTH CARE WILL BE COVERED,
THEIR DISABILITY WILL BE
COVERED.
I WOULD LOVE TO SEE HEALTH CARE
WORKERS IN THE UNITED STATES
FEEL THAT SORT OF SUPPORT FROM
THEIR INSTITUTIONS AND FROM
THEIR GOVERNMENT AGENCIES.

The caption changes to "Katie O'Connor, @KA_OConnor"

Steve says GREAT.
MY THANKS TO BOTH OF YOU FOR
THIS DISCUSSION TONIGHT.
VERY HELPFUL.
DR. KEREN LANDMAN IN ATLANTA,
GEORGIA; DR. SUSY HOTA FROM
U.H.N. HERE IN TORONTO.

Keren says THANK
YOU, STEVE.

Susy says THANK YOU.

Watch: Ebola Effects