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Ottawa readies Ebola response team, provinces designate treatment centres

On Oct 15 2014, volunteers pack boxes of supplies to help in the fight against the ebola crisis in Liberia. Boxes of gowns, masks and face shields were loaded into a container that will head to Halifax where it will be shipped by boat to the west African country.

Fred Lum/The Globe and Mail

Ottawa has a team of infectious disease experts on standby and the majority of Canadian provinces have designated specific Ebola treatment centres as this country tries to prepare for a killer virus that has now infected two U.S. nurses, raising serious questions about whether the average North American hospital can safely treat Ebola patients.

(Read The Globe's primer on West Africa's Ebola outbreak)

Health Minister Rona Ambrose said Wednesday evening that if Ebola makes its way to Canada, the Public Health Agency of Canada would send a crew of epidemiologists and other experienced outbreak managers to help halt the spread of the virus, something the U.S. Centers for Disease Control and Prevention now admits it should have done in a more robust manner after the first case of Ebola was diagnosed in Dallas last month.

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Meanwhile, every province from Alberta to Nova Scotia – with the exception of Ontario – has already selected two or more designated hospitals where health-care workers are supposed to receive extra training to treat possible Ebola patients.

At least one British Columbia health authority has designated a hospital, and Ontario is in the process of choosing its designated hospitals now, according to the province's Health Minister.

The Canadian approach is an acknowledgment that not all hospitals can cope with Ebola patients, a reality underscored by the apparent bungling at the Dallas hospital that treated the first patient diagnosed with Ebola in the U.S. – Thomas Eric Duncan, a Liberian national who died of the disease.

Two nurses who cared for Mr. Duncan have now tested positive for the virus and one is being transferred to the specialized Atlanta hospital that has successfully treated other Ebola patients repatriated from West Africa, where the epidemic continues to rage.

Infectious-disease experts said Wednesday that tapping some hospitals as treatment centres makes sense, so long as staff at other hospitals and health-care facilities are trained to flag patients with Ebola symptoms and a history of travel to the Ebola-affected region.

"Every hospital needs to have a basic ability to ask the questions and isolate somebody while they're figuring out what to do next," said Michael Gardam, the director of infection prevention and control at the University Health Network in Toronto.

But, he added, not every hospital has the experience or equipment to treat Ebola.

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"It requires training and then more training and then engaging the staff to figure out what doesn't work and then more training and practice and practice and practice," Dr. Gardam said. "It's going to be hard for every hospital in Canada to do that."

Toronto Western, one of the four hospitals that make up the University Health Network, has already been designated as the receiving hospital for any Canadian aid workers who contract Ebola while treating patients in Sierra Leone, Guinea and Liberia, the countries hardest hit by the outbreak.

However, the province has yet to designate hospitals for regular patients. "We are looking at and considering designating hospitals in Ontario should a case be found to be positive for Ebola, how that might best be treated … it's certainly a decision that we'll be making in the coming days," Ontario Health Minister Eric Hoskins told reporters Wednesday.

Ontario is also poised to the be the last of five selected provinces to be ready to run rapid, preliminary lab tests for Ebola. Quebec, British Columbia and Alberta all have the capability now; Nova Scotia is expected to by next week. Preliminary positives would still have to be sent to the National Microbiology Lab in Winnipeg.

As far as designated hospitals go, one has been selected in the Fraser Health Authority in B.C., four have been tapped in Alberta, one in Manitoba and two each in Saskatchewan, Quebec, New Brunswick and Nova Scotia. Prince Edward Island and Newfoundland and Labrador did not respond to The Globe's inquiry.

There have been more than two dozen suspected cases of Ebola in Canada, all of which have proven to be false alarms. Quebec says it has seen 11 such cases and Ontario says it has seen eight. The Public Health Agency of Canada says the National Microbiology Lab has conducted tests for 25 possible Ebola patients. The agency's numbers differ slightly, saying there have been 10 cases from Quebec, 10 in Ontario, one in Saskatchewan and four in Alberta.

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With a report from Adrian Morrow

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Kelly Grant is a health reporter with The Globe and Mail. More

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