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Texas Ebola Hospital Executive: 'We Fell Short' in First Response

An executive of the hospital where the first U.S. Ebola death occurred describes the initial response and staffers' morale since two nurses fell sick.

The Texas hospital where the first person diagnosed with Ebola in the U.S. died and two nurses were infected “fell short of our own expectations” at the beginning of the crisis but will “bounce back,” one of the facility’s executives told NBC News on Friday.

Dr. Daniel Varga, chief clinical officer and senior vice president at Texas Health Resources, said it’s still unclear how nurses Nina Pham and Amber Vinson were infected while caring for Thomas Eric Duncan, a Liberian man who died of Ebola on Oct. 8.

He had come to Texas Health Presbyterian Hospital with symptoms, only to be sent home with medication; he returned two days later and was admitted, but even then caregivers did not don full protective clothing until Ebola was confirmed.

Varga apologized to Congress Thursday for how the hospital handled the cases.

On Friday, he talked to NBC News about the hospital's initial response, Vinson's travel to Cleveland and back after she cared for Duncan and how hospital staffers who also treated him are doing.

Here are excerpts from the interview:

NBC News’ Kate Snow: Is this hospital getting an unfair amount of blame?

Dr. Daniel Varga: We have accountability in this particular situation. There are things we could've handled better, you know the places where we didn't perform up to our expectation have devastated us. Mr. Duncan's death was really hard on staff and everybody at Presby and Texas Health Resources, and then right after that we're looking at the double punch of Nina and Amber both getting ill.

Snow: Amber traveled. Should the hospital have told her not to travel?

Varga: We coordinated all of that activity with the county and in terms of monitoring, essentially our role … (was) to make sure we had an accurate and comprehensive list of folks who might've been contacts. And most of the monitoring has actually been done by the county.

Snow: Do you wish you had had better guidance on travel to give your employees?

Varga: You know, the guidelines have been pretty fluid of late, and I guess actually wouldn't really call the guidelines, the recommendations have been pretty fluid, and I think there’s some of it that’s science. And some of it is being built to deal with the public’s concern, science or no science. So I think you have to expect in a situation like this that those things are going to be very fluid.

Snow: The public perception right now in this country is that this hospital failed at every turn.

Varga: I think that’s an unfair characterization. I think there's two really important things to understand. There's a big difference between diagnosing Ebola and treating Ebola. I think Presby has done a great job of managing Ebola patients, both Mr. Duncan and Nina, here in our hospital they've gotten exceptional care. … The diagnosing Ebola piece was one where we fell short of our own expectations there. … For the first time in the history of the United States, somebody with Ebola walked in the front door, and we missed that.

Snow: Was the protective gear adequate?

Varga: So the personal protective equipment we had in place meets and met the CDC guidelines for diseases where you have to implement contact and droplet precaution. Clearly the protection was inadequate for Nina and for Amber. I got two sick nurses. And you can't explain that away.

Snow: Do you know now how perhaps they were infected?

Varga: We don’t. … They're both experienced nurses, they both knew what they were doing. Everything we can see relative to documentation is that they absolutely followed the PPE guidelines that they had and did them religiously.

Snow: What do you wish you'd done differently as a hospital?

Varga: I think our learning on this is that communication and dissemination of information is critical, but you really have to train, you have to simulate, you have to reinforce to really make sure that when the first one happens you've got a high enough level of awareness to actually deal with it. On the Hill yesterday, one of the congressman who is former military was raising this issue of combat readiness. You know, one of the things most combat units, I would assume, have is a mix of combat veterans, people who've actually been there in harm’s way, and other folks who are new but highly trained and been in a lot of simulation.

Unfortunately in our world, this was a scenario where there are no combat veterans, everybody is new.

Snow: How confident are you that the 75 hospital workers who had contact with Duncan are gonna be okay?

Varga: I'm very confident. I think that we have a small cohort of folks who were you know caregivers from the ED through the first of October that live in a high-risk exposure cohort right now. The good news is that that window is about running out and we're hopeful for that. We think and are fairly confident that all of the folks after the first of October had everything they needed from the standpoint of protective equipment to be secure.

Snow: Are the staff frustrated? Are they angry that the outside world isn't seeing them in the best light? What’s the mood?

Varga: I think you've seen all five levels of grieving here. We've had several moments of gut punches here. Everybody grieved and was devastated when Duncan passed away. And right as people were kinda getting their feet again around that, one of our own, Nina, comes in and then Amber and so these folks have taken some body blows, but they're great people. They're incredibly dedicated, really smart, really effective health care workers here, our doctors, our nurses, all of the caregivers involved.

They're tired right now. They do resent you know, kind of constant negative coverage, but they're resilient, they're gonna bounce back, get a long weekend's worth of sleep and be back in the saddle, so Presby will bounce back just fine.