With no end to Ebola crisis in sight, CDC teams prepare for the long haul

The Ebola outbreak has forced the Centers for Disease Control and Prevention into overdrive. It has deployed more than 100 staff members to West Africa to help stop the spread of the disease. Hundreds of other employees are working at the agency’s emergency operations center in Atlanta. More are helping to set up quarantine stations at airports around the United States. And still more are taking on extra work so the agency remains prepared for outbreaks of other diseases.

The life-or-death nature of the work, coupled with the enormous political and logistical pressures, would take its toll on anyone. But, with no end to the Ebola outbreak in sight, the CDC team must be prepared for the long haul.

“People are working tirelessly. They are giving up weekends, nights, family time and other extracurricular activities that I think are important to their personal well-being,” said Ted Pestorius, management officer for the CDC’s National Center for Emerging and Zoonotic Infectious Diseases. He recently — and a bit ironically — came to Washington for a conference on federal employees’ health and well- being, something he says he committed to doing months ago.

During normal times, Pestorius tries to promote a better work environment through engaging employees and encouraging supervisors to communicate and recognize staff members’ accomplishments. He’s intent on boosting his center’s ho-hum scores on the Federal Employee Viewpoint Survey.

But these days, he finds himself reminding his staff, whom he describes as “overachievers, hyperachievers and superachievers,” that they need to take care of themselves too.

“Part of my role is to try to tell people, ‘Go home. Stop. Take the weekend off. Disengage. Spend time with your family. Take leave,” he said.

“I personally volunteered to go overseas for the month of December so my staff can have time off,” he said.

‘You can’t help others if you’re not well’

So far, the CDC has rotated staff overseas so that no one stays in West Africa longer than a month. Before being deployed, there is “lots and lots of engagement and training,” Pestorius said. And when they come back, “lots and lots of active engagement on their personal health and wellbeing” follows.

Upon return, the CDC expects staff to go through an employee assistance program that includes both mental and physical screening, including a check for a fever or other signs of an Ebola infection.

No employee has shown symptoms, Pestorius said. But the agency makes sure returning staff members know how to isolate themselves, and who to notify, should it happen. In an emergency, they would go to Emory University Hospital in Atlanta, he said. It successfully has treated health care workers who got Ebola after being deployed in West Africa. None were affiliated with the CDC.

Returning employees are more likely to have suffered emotionally and need to talk about it, Pestorius said.

“They’ve seen extraordinary situations, literally people dead in the streets,” he said, adding that he received counseling through the same program after “an extraordinarily scary moment” during a past deployment in which he witnessed violence overseas.

Even at the CDC, “there is some fear associated with [the Ebola virus],” Pestorius said, so the agency prepares staff in Atlanta to welcome back returning colleagues. It may be as simple as telling them they don’t have to be afraid if their coworker used a water fountain, he said.

Being a cheerleader

Leaders from Director Tom Frieden on down “are acutely aware of the extraordinary efforts they’re receiving,” Pestorius said. Small thanks come in the form of food brought to the operations center, since employees staffing it cannot leave during their shift. Personally, Pestorius said he offers plenty of “thank you’s,” to all staff, in recognition of the team effort.

“I have every intention of doing my absolute best to recognize as many people as possible,” he said. “When someone gets deployed to the [emergency operations center], the person who remains back has to do twice the work. They haven’t been deployed, but they are also acutely engaged.”

This is just the third time that the CDC has activated its emergency operations center 24/7. It did it in 2005, during Hurricane Katrina, and in 2009, in response to an outbreak of H1N1, sometimes called the swine flu. Those crises were relatively brief, with clearly defined ends. But the CDC will consider the Ebola crisis contained when there are 21 days without a new diagnosis of the disease in West Africa. Unlike during those other times, Pestorius says he cannot see the end in sight.

“We know it’s going to take an awful lot of time to turn that curve,” he said. “We can’t pull a product off the market. We can’t deploy a vaccine. Right now, we can’t offer some semblance of a cure. We can just do education, isolation and the absolute best that we can.”

In the long term, Pestorius said, he would like the CDC to deploy a historian to record what happened as a way to commemorate employees’ efforts.

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