UK Ebola Preparedness — House of Commons, 2015-01-05
Topic: Health
Jeremy Richard Streynsham Hunt (Conservative, Centre-right): With permission, Mr Speaker, I would like to make a statement about the UK’s Ebola preparedness and the care being given to Pauline Cafferkey, the NHS nurse being treated for Ebola at the Royal Free hospital in London I know the whole House will join me in wishing Pauline well and commending her and her NHS colleagues for the exceptional bravery and compassion they showed in joining the battle against Ebola in Sierra Leone. The work done by Pauline and her colleagues is not just helping to save thousands of lives in Africa; it is protecting the UK from potentially disastrous consequences if the disease spreads beyond the countries where it has currently taken hold. Alongside 69 other NHS volunteers from UK-Med, Pauline spent Christmas on the front line of this vital battle. This House and this country owe them and other colleagues from Public Health England, the Department for International Development, the Foreign Office and the Ministry of Defence an enormous debt of gratitude You will appreciate, Mr Speaker, that for reasons of patient confidentiality I cannot go into great detail about Pauline’s current medical condition. However, I have this morning spoken to Dr Mike Jacobs, an expert in infectious diseases who is leading the team of doctors and nurses caring for Pauline at the Royal Free. As has been reported, Pauline’s condition has deteriorated to a critical state, although she stabilised yesterday and continues to receive the best possible care. She said in Sierra Leone that she hoped her loved ones would be proud of her. Well, she should know today that the whole country is proud of her for her bravery and dedication to the service of others. She stands, quite simply, for the very best of NHS values I wish to turn to the issue of screening and why Pauline continued her journey from Heathrow to Glasgow. Having worked in Sierra Leone for six weeks caring for Ebola patients, she was screened and cleared to depart on her exit from Sierra Leone on Sunday 28 December. She arrived at Heathrow after a connection in Casablanca at 3.50 pm that day, where she was again screened in line with the protocols introduced into major airports and Eurostar terminals last October. As her temperature was within the acceptable range, she was cleared to fly home to Scotland. Clinical experts have always been clear that the process will pick up a few active infections, but it also provides the best opportunity to ensure that returning staff know whom to contact, and this system worked. While still at Heathrow, her reassessment was triggered because of concerns that she may have had an elevated temperature. She was reassessed and her temperature taken a further six times over 30 minutes. As her temperature was within the acceptable range, she was again cleared to travel Pauline arrived in Glasgow at around 11.30 pm on Sunday 28 December and was driven home. She became feverish overnight and, in line with the public health advice that she had been given at Heathrow, she contacted local services. She was admitted to an isolation facility at the Brownlee unit in Gartnavel hospital in Glasgow at 8 am on Monday 29 December. A blood sample tested positive for Ebola at the NHS Lothian testing facility that afternoon, so she was transferred overnight to the Royal Free in a military plane, arriving at 8 am on Tuesday 30 December Some have asked whether it was appropriate for Pauline to be allowed to travel on to Glasgow after she raised concerns about her health at Heathrow. The clinical advice on this is clear. Someone can contract Ebola only by coming into contact with the bodily fluids of an infected person—that means blood, vomit or diarrhoea—which becomes a risk when a patient is exhibiting feverish symptoms. Because she did not have a high temperature, the clinical judgment was made to allow her to continue her journey home However, we recognise that medical understanding of the disease is not complete, which is why we had already taken a number of precautionary steps that go further than strictly required by the clinical evidence. These include asking potential Ebola carriers to avoid crowded places and long journeys on public transport within the 21-day potential incubation period once they arrive back home. Existing guidance also bans any direct patient work for returning health care workers On that precautionary basis, we have, as of last Monday, strengthened our guidance to ensure that anyone from a higher risk group who feels unwell will be reassessed. Advice will immediately be sought from an infectious diseases specialist and the passenger will be referred for testing, if appropriate. The screening centres at Heathrow were viewed at first hand on 1 January by the chief medical officer and the Minister with responsibility for public health and all arrangements, including the revised protocols, were found to be working well We will continue to keep screening and logistical arrangements under review and look to improve or strengthen the process, as guided by expert clinical advice. It is important, however, to remember that the risk to the public of contracting Ebola from contact with someone carrying the virus remains very low indeed while they are not exhibiting any symptoms. The critical point—this is the main purpose of the screening—is to ensure that potential Ebola carriers are identified and know how to ask for medical assistance the moment they display any feverish symptoms, so that they can then be isolated, tested and given full medical support as quickly as possible For that reason, on a precautionary basis, Public Health England has been making contact with passengers on the flight that Pauline was on from Casablanca to Heathrow, and has been working with Moroccan colleagues to trace additional UK passengers on the flight from Freetown to Casablanca to make sure that they know what to do if they start exhibiting symptoms consistent with Ebola. I can inform the House that Health Protection Scotland has made contact with all the passengers on the London to Glasgow flight, and Public Health England has made contact with all UK-based passengers who travelled on the flight from Casablanca to London. I would like to thank British Airways and Royal Air Maroc for their assistance in this process The safety of our volunteers is our first priority. Before any NHS workers are deployed to treatment centres, staff from UK-Med, which runs the NHS humanitarian register, review the clinical protocols and procedures and confirm that they are content that the centre meets appropriate standards. All UK-Med volunteers receive thorough training in the UK and in Sierra Leone before they treat any Ebola patients so that they know how to use their personal protective equipment and understand the nature of the work. In the current case, as the House would expect, Save the Children is conducting a review of its procedures to ensure that any lessons are learned The House will want to be reassured about the overall state of UK preparedness for Ebola. This country was the first in Europe to screen arrivals from high-risk places in west Africa, and numerous countries have since asked for information on how we did this. We have committed more than £230 million to fight the disease in Sierra Leone. We have sent more than 800 military personnel, 150 Department for International Development staff, 70 NHS staff through UK-Med and 64 Public Health England staff to fight the outbreak on the ground—a bigger contribution than any country in the world except for the United States The chief medical officer, Professor Dame Sally Davies, has always been clear that we are likely to see up to a handful of cases in this country, of which, very sadly, this is the first to be diagnosed. NHS England has procured personal protective equipment for each of the hazardous area response teams in England and has additionally arranged for 75,000 PPE suits to be procured for the NHS We have been practising Ebola resilience since 30 July and have had 16 ministerial Cobra meetings in total, including five chaired by the Prime Minister. Both the chief medical officer and the NHS England medical director, Professor Sir Bruce Keogh, are satisfied that at this stage we have made sufficient preparations. However, they stress that, although the risk to the public remains low, we must remain vigilant and be constantly prepared to adjust and improve our processes and protocols as this rapidly changing situation evolves I would like to place on record my thanks to colleagues in the Scottish Government and the UK Government, to the authorities in Sierra Leone and Morocco, to NHS England and to the NHS doctors and nurses at both Gartnavel hospital and the Royal Free for their dedication and hard work over the past few days. I would also like to pay tribute to the dedicated PHE staff who set up the new screening process so rapidly, and thank Border Force staff for their assistance Our thoughts are with Pauline Cafferkey today, but I know all of us are also thinking about her friends and colleagues and the many UK NHS and other personnel working in Sierra Leone right now. They can be reassured that we have no greater priority than their safety, and I commend this statement to the House.