New federal guidelines for health care workers stress practice and rituals in taking off protective gear while contacting Ebola patients. The Centers for Disease Control and Prevention issued the far more detailed guidance Monday night after two nurses became infected while taking care of Thomas Eric Duncan in Dallas.
The CDC had first issued Ebola guidelines to U.S. hospitals in 2008 and updated them just this past August, but the infections of nurses Nina Pham and Amber Vinson show they were not clear enough, CDC Director Dr. Thomas Frieden told reporters Monday night.
"Anybody who is going to work with them is going to be trained in and demonstrate competency in anything they are going to be putting on and taking off," Frieden said. "Second, no skin may be exposed when PPE (personal protective equipment) is worn," he added. Every nurse, doctor or technician putting on or taking off PPE must be watched by another trained expert.
"We need to increase the margin of safety," Frieden said. He described it as an almost ritualistic approach. Gear must be wiped down with a virus-killing wipe before it comes off, and everyone will be told to take a shower after they get the PPE off, he said.
It's not so much which particular equipment is used, says Frieden. More important is that it is used correctly. Health care workers are at especially high risk of catching Ebola because they are in very close contact with patients who are vomiting, sweating profusely and suffering diarrhea from the virus. Virus-laden droplets can get onto hands and into the eyes, nose and mouth if caregivers don't take the gear off precisely.
"The enhanced guidance is centered on three principles: All healthcare workers undergo rigorous training and are practiced and competent with PPE, including taking it on and off in a systemic manner; No skin exposure when PPE is worn; All workers are supervised by a trained monitor who watches each worker taking PPE on and off," CDC said in a statement.
Read MoreThe key to containing Ebola
"All patients treated at Emory University Hospital, Nebraska Medical Center and the NIH Clinical Center have followed the three principles. None of the workers at these facilities have contracted the illness."