‘An abundance of caution’ and Ebola in the US Healthcare System: What is the new normal?

Roosevelt General Hospital (RGH) is a small (24 bed) community hospital based in Portales, New Mexico, USA. RGH serves several towns and communities along the New Mexico/Texas border to include the enlisted and officer population of Cannon US Air Force Base as well as the civilian support and families for air force personnel. The area is also home to multiple retired and discharged military personnel who continue working in various roles as civilian contractors. As the care for the first US diagnosed patient with Ebola played out in neighbouring Texas (October 2014), a patient presented to the RGH clinic with a fever of unknown origin. Initially, there was a misunderstanding between the clinician and the patient regarding a recent international travel history. During the assessment, an ensuing discussion revealed that the patient had been in or near the area where the current West African Ebola outbreak is ongoing approximately 10 days before the onset of his fever. While it was later determined that the patient was not infected with Ebola, the fact that a potentially infected patient had entered the hospital and had been in close contact with visitors and clinicians alike was disturbing to staff and administration. The continued operation of this hospital was and remains critical to the communities served. This story focuses on a local effort to manage a local concern relying on recent and historical emergency planning and preparedness efforts.