Dallas health officials have had a hard time finding a contractor willing to clean out the apartment where Liberian Ebola victim Thomas Duncan had been staying, and the sheets and towels he used remain bagged up there, Texas Health Commissioner Dr. David Lakey said Thursday.
But the cleaning delay may be part of a larger problem,
The New York Times reported Friday, as hospitals say they do not know what to do with Ebola waste because federal agencies are issuing conflicting guidance about getting rid of materials that are contaminated with blood and other bodily fluids from Ebola patients, which could spread the disease.
Lakey said officials have encountered "a little bit of hesitancy" in seeking a firm to clean and sanitize the apartment, and the bedding and other laundry remains bagged in plastic in the apartment a week after Duncan fell ill.
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A company has been hired to do the work soon, and county officials visited the apartment without protective clothing on Wednesday night.
The cleanup company was turned away Thursday night,
CNN reports, because it does not have proper permits to transport hazardous waste on Texas highways.
"The permit is being processed through DOT (the Department of Transportation) because it is a special permit," said Brad Smith of The Cleaning Guys, CNN reported. "This is a unique situation. Once awarded, our hazmat teams will be allowed back inside to do their jobs."
Meanwhile, hospitals are concerned that if the Ebola virus spreads, hazardous waste could pile up and they would not have a way to dispose of it.
Dr. Jeffrey Duchin, who chairs the Infectious Diseases Society of America's Public Health Committee,
told Reuters that most hospitals in the United States do not have incinerators or large sterilizers, or autoclaves, to handle the soiled linens, syringes, and protective gear that comes from caring for an Ebola patient.
Further, Sean Kaufman, president of Behavioral-Based Improvement Solutions in Atlanta told Reuters that Ebola waste must be sterilized before it is transported so that waste haulers are protected and that the material would not be used "for nefarious purposes."
Duchin said he does not know if Texas Health Presbyterian Hospital, which is treating Duncan, has an incinerator or autoclave, but if it doesn't, "they are going to have to find a temporary solution for managing infectious waste. That puts the hospital in a very difficult situation."
Two different federal agencies have differing guidelines for handling the Ebola-contaminated waste. The Centers for Disease Control and Prevention says hospitals should treat the items like any other biohazards that are considered "regulated medical waste," and to put them in leak-proof containers and dispose of them the same way.
The Department of Transportation, however, says Ebola is a Category A infectious agent capable of killing people and animals, not "regulated medical waste."
Cynthia Quarterman, the administrator of the U.S. Department of Transportation's Pipeline and Hazardous Material Safety Administration, told Reuters her agency is "working on how we can clarify even further for hospitals, for the public, what the appropriate transportation should be."
The cleaning delay came following reports that up to 100 people may have had contact with Duncan, who came from Liberia to visit family in Dallas, reports The Times.
Duncan arrived in the United States on Sept. 19, and was not showing any symptoms. However, on Sept. 25, when he was first taken to the Texas Health Presbyterian Hospital, he was sent home with antibiotics, even though he and a companion told a nurse that had traveled from Liberia, where the Ebola virus is rampant.
At the apartment, Duncan had been sweating and suffering from diarrhea, and vomited in the apartment complex' parking lot when he was being taken back to the hospital.
Four family members, including a woman who told CNN that she told hospital workers twice Duncan had been to Liberia, one of her children, and two nephews, remain in isolation and are being monitored for symptoms.
They are under a communicable disease control order after they failed to comply with an order to stay home, and if the order is violated, criminal charges could be filed.
President Barack Obama on Thursday called Dallas Mayor Mike Rawlings to pledge whatever federal resources are needed to treat Duncan and to keep the disease from spreading.