The 2014 Ebola outbreak has brought discussions of global public health, bioethics, drug and vaccine trials, and disaster response into the public discourse with rare and sustained urgency. Most agree it is essential to stem the spread of the virus at its epicenter in West Africa; a joint statement from the American Hospital Association, American Medical Association and American Nurses Association stating that  “an enhanced focus on the part of the United States and the international community to contain the outbreak in West Africa is fundamental to stopping the spread of this virus.”


Yet the outbreak continues, with some  arguing that there is not enough employer support for health care professionals who want to volunteer.  “This heroism is remarkable and reflects a deep humanitarian instinct. It calls for validation, not discouragement, by healthcare institutions,” write scholars from three top US academic medical centers (AMCs) in a pre-publication editorial posted on the blog of PLOS Medicine.


The authors, including Berman Institute faculty member Maria Merritt, address the pro and con arguments for facilitating service in Ebola regions and conclude that, “The concerns that may motivate hospitals to discourage volunteers do not outweigh the countervailing considerations. At a minimum, institutions ought not to impede service; ideally, they would promote it.”


Merritt is joined on the opinion by Michelle M. Mello of Stanford Law School and School of Medicine, Department of Health Research and Policy, and Scott D. Halpern of the Perelman School of Medicine at the University of Pennsylvania.


“First and most obviously, facilitating the deployment of medical personnel to affected regions in the near future could make the difference between turning the tide of the epidemic and forfeiting the opportunity to avert regional and even global catastrophe,” they write.


The authors outline the minimum and ideal responses that AMCs should take. “At a minimum, institutions should not impede employees from fulfilling their perceived professional duties to help the sick and, thereby, to do their part in responding to a global public health emergency.”


“Ideally, institutions would go farther and actively promote HCPs’ service by enabling them to go as employees and preserving the full net of supports and protections this status confers in the U.S., including travel insurance, worker’s compensation coverage, and pay.”


Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR) has issued ‘guidance regarding Ebola Virus Disease (EVD) and international travel’, which says that the office generally “strongly advises against all travel for faculty, staff, students and trainees to Liberia, Guinea and Sierra Leone. All faculty, staff, students and trainees should evaluate the necessity of travel and delay nonessential travel until the CDC Level-3 Travel Advisory is lifted.”


The authors of the editorial for PLOS Medicine do acknowledge alternatives. “Some hospitals might step forward as primary centers of care for Ebola patients domestically while others focus on facilitating HCPs services’ abroad.” Johns Hopkins Hospital is one of six treatment centers designated by the Centers for Disease Control & Prevention’s to receive Ebola patients.

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Leah Ramsay

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