DALLAS (AP) — As Thomas Eric Duncan’s health deteriorated, nurses Amber Joy Vinson and Nina Pham were at the Ebola patient’s side.
They wore protective gear including face shields, hazardous materials suits and protective footwear as they inserted catheters, drew blood and dealt with his body fluids. Still, the two somehow contracted Ebola from the dying man.
As health officials try to figure out how that happened, the nurses’ cases have brought new scrutiny to national Ebola protocols that had never before been put to the test at a general hospital. Authorities are examining whether those guidelines need to be rewritten.
A nurse at Texas Health Presbyterian Hospital, Briana Aguirre, said on NBC’s “Today” show that nurses and other employees were asking their supervisors what they should be doing.
“Our infectious disease department was contacted to ask, ‘what is the protocol?’” Aguirre said. “And their answer was, ‘We don’t know. We’re going to have to call you back.’”
Aguirre, who did not deal directly with Duncan but helped take care of Pham, said the protective gear they were provided left the neck exposed.
“In the second week of an Ebola crisis at my hospital, the only gear they were offering us at that time, and up until that time, is gear that is allowing our necks to be uncovered,” Aguirre said. “I just flat out asked several infectious disease nurses, I asked the CDC, ‘Why? Why would I be wearing three pairs of gloves, three pairs of booties, a plastic suit covering my entire body and then leave my neck hanging out this much so that something can potentially go close to my mouth or nose?”
Texas Health Presbyterian had no immediate response to Aguirre’s comments. It had said earlier Thursday it followed federal guidelines in treating Duncan and “sought additional guidance and clarity.”
The federal Centers for Disease Control and Prevention protocols for Ebola recommend nurses use personal protective equipment such as gloves, goggles, face shields and fluid-resistant gowns — as Vinson and Pham did. They also recommend diligent cleaning and disinfection.
Online, the CDC has sought to clarify the Ebola protocols in a health care setting, adding specifics on a website about double-gloving and restricting the number of caregivers involved. These are recommendations, not requirements. More than 75 people were identified as being involved in Duncan’s care.CDC director Dr. Tom Frieden has cited a “breach in protocol” that allowed Pham to be infected while she cared for Duncan in the intensive care unit, but has not specified the nature of that breach. He did however note that some of the nurses at Texas Health Presbyterian inadvertently violated the CDC protocols by wearing too much protective gear.
“These are good, dedicated people who worried about themselves and their families and they were trying to protect themselves better, but in fact by putting on more layers of gloves or other protective clothing, it becomes much harder to put them on, it becomes much harder to take them off. And the risk of contamination during the process of taking these gloves off gets much higher."

That’s true for several different areas of the body,” Frieden said Wednesday.
Pham, 26, has been getting treatment at the Dallas hospital. Dallas County Judge Clay Jenkins said she will be taken Thursday to the National Institutes of Health in Bethesda, Maryland, which has one of four biocontainment units in the United States. Texas Health officials said Wednesday that Pham was in good condition and it wasn’t immediately clear why she’s being moved.
Vinson, 29, who tested positive Wednesday, has been transferred to a high-level biohazard infectious disease center at Emory University Hospital in Atlanta.
Texas Health Presbyterian said in its statement that Duncan was moved directly to a private room and isolated. It said staffers wore “appropriate personal protective equipment” as recommended by the CDC at the time, and that when the CDC issued updates, the hospital followed its guidelines.