Bleach was everywhere.
Jugs of it. Canisters of disposable bleach wipes.
The so-called containment suite at Rush University Medical Center was stocked with bleach, ready to kill the Ebola virus should it come to Chicago. If an Ebola patient undergoing treatment at the facility vomits, hospital staff will douse the vomit with bleach, throw towels on it, pick up the towels with tongs and throw the mess away in a red plastic medical waste bag. That bag gets a bleach shower before being put into another red bag that is sealed and sprayed with bleach.
The double-bagged, infectious material then is loaded into a cardboard drum and rolled out to the hospital dock.
Rush used the "containment suite" when it admitted its first suspected Ebola patient, who traveled from Liberia to Chicago and reported nausea and diarrhea Hospital staff ended up not testing the patient for Ebola, releasing him from isolation after he showed improvements and no signs or symptoms of the virus.
The suspected Ebola case that wasn't served as a test for the Near West Side hospital. There haven't been any confirmed cases of Ebola in Chicago, but officials at Rush, along with three other hospitals trained to treat critical illnesses and infectious diseases, say they're ready to treat a patient with the potentially deadly virus. Rush ripped up carpeting, erected walls and closed off a hallway on the 10th floor in four days to create a 2,500-square-foot containment suite modeled after isolation units at Emory University Hospital and the University of Nebraska Medical Center, where Ebola patients have been treated and recovered, and staff members have stayed safe from infection.
Rush's suite housed three existing patient rooms designed and intended to care for patients with highly infectious diseases. Other space was repurposed into a staff dressing room full of protective gear, a medical storage equipment room and a staff conference room.
"You don't have to have a special unit. You have to have a plan on how you're going to deal with patients that are really sick," said Dr. Omar Lateef, associate chief medical officer at Rush. "We were always known as a hospital that can manage complex, critical illness really well."
A suspected Ebola patient might arrive at Rush for treatment in a number of ways, from walking into the facility to being transported by ambulance from home, a community hospital or even the airport, said Dr. Dino Rumoro, chairman of Rush's department of emergency medicine.
Then the patient would answer questions about symptoms, recent travel to or contact with someone who has recently traveled to to Guinea, Sierra Leone and Liberia, where the Ebola outbreak is widespread, to determine the risk of exposure.
If the patient's travel history and symptoms-ranging from fever to diarrhea to vomiting-are consistent with a risk for Ebola, the patient is evaluated further by a physician and infectious disease doctor. Emergency room nurses and doctors in contact with the patient put on protective equipment including a face shield, gown and two layers of gloves, he said.
If there is no alternative diagnosis for the Ebola-like symptoms, the hospital's core team of 10 physicians, 30 nurses and two technicians would be alerted, Lateef said.
The patient would lay down in a body bag much like a sleeping bag and be wrapped up in a cocoon of sheets and blankets. The bag is zipped up to the patient's neck and the patient's face is covered with a mask, Rumoro said. Security officers sweep the hallway and clear a path as the patient is taken to the containment suite. An environmental clean-up crew follows to take care of any leaks or spills of infectious body fluids such as vomit with bleach and towels.
The patient gets out of the body bag upon arrival in the patient room of the containment suite. For now, this is where the patient would stay until the diagnosis is confirmed, the patient is treated and recovers-or doctors reach a different diagnosis and the patient is deemed virus-free. Next come the needles. Blood samples are taken and sent to the state health department for initial Ebola testing and to the Centers for Disease Control and Prevention in Atlanta for confirmation. Results from CDC typically take 24 to 48 hours, the Chicago Department of Public Health said.
No visitors are allowed. All the patient would see are pairs of eyes belonging to doctors and nurses dressed head to toe in fluid-resistant protective gear complete with a hood, face shield, respirator, gown, two pairs of gloves, leg and boot covers.
A few feet away, an infectious disease specialist sits in a chair, monitoring healthcare workers in the room where the biggest threat of infection and contamination lies. Ebola is spread through direct contact with blood or body fluids such as urine, vomit, feces, saliva and sweat or objects like needles and syringes that have been contaminated, according to the CDC.
A line of red tape divides the tile floor where doctors and nurses who had contact with the patient carefully peel off their protective gear on one side, toss the disposable pieces into the trash and step over the line to indicate they went from dirty to clean. They leave the room wearing their scrubs to take a shower.
"We have to be prepared from the front door to the back door. I think we're as prepared as any other hospital could be," said Rumoro. "I think people will hope we never see a case. Nobody wants to face a dangerous disease if you don't have to. If we had to, we would do a good job."