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Anatomy of a health alert: An Ebola case timeline

Luke Hendry, QMI Agency

Julie Craig, a senior technologist for point-of-care testing in the laboratory of Belleville General Hospital, holds a container similar to that which held specimens from a suspected Ebola virus patient in Belleville, Ont., on October 30, 2014. (Luke Hendry/QMI Agency)

Julie Craig, a senior technologist for point-of-care testing in the laboratory of Belleville General Hospital, holds a container similar to that which held specimens from a suspected Ebola virus patient in Belleville, Ont., on October 30, 2014. (Luke Hendry/QMI Agency)

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BELLEVILLE, Ont. — A masked and sick-looking man leaned against the emergency department's triage desk.

It was about 3:30 a.m. Oct. 13. Signs at the hospital doors routinely ask sick people to don masks before entering.

Yet Belleville General Hospital triage nurse Chris Wilson had an inexplicable hunch this wasn't an ordinary case.

"I instantly asked him about travel outside the country," said Wilson.

The man said he'd been to Sierra Leone -- a country ravaged by an outbreak of the Ebola virus.

Wilson's training kicked into high gear.

Here is a timeline of how the eastern Ontario small town hospital reacted upon learning they might have Canada's first Ebola case:


Registered nurse Chris Wilson touches his safety goggles at Belleville General Hospital in Belleville, Ont., on October 23, 2014. Feedback from Wilson and others about the limitations of the personal protective equipment as he worked with a patient suspected of carrying the Ebola virus has helped his employer, Quinte Health Care, to improve protection for workers. Other hospitals are now requesting such knowledge. (Luke Hendry/QMI Agency)

Monday, Oct. 13

3:35 a.m. - Wilson briefed staff, called for supplies and moved all other patients to the far side of the waiting room.

Wilson put on his protective clothing and prepared for isolation duty.

The man, they would learn, had been part of a Royal Canadian Air Force mission to Freetown to deliver personal protective equipment (PPE) for health workers.

Wilson said had "some active symptoms" but was not seriously ill. He was co-operative and understanding.

3:40 a.m. - Wilson reported the case to Hastings Prince Edward Public Health as required by law.

They would track the patient's previous movements and identify anyone who could have been in contact with him.

Hospital chief of staff Dr. Dick Zoutman, who had treated patients with a similar illness, woke Dr. Michael de la Roche, chief of infection control. He rushed in from a cottage an hour's drive away. Other staff were also notified.


Julie Craig, a senior technologist for point-of-care testing in the laboratory of Belleville General Hospital, holds a container similar to that which held specimens from a suspected Ebola virus patient in Belleville, Ont., on October 30, 2014. While concerned for her own health, she said, her main worry was for the patient. (Luke Hendry/QMI Agency)

Mark Coulter had become Quinte Health Care's director of diagnostic services only six days earlier.

Coulter said he "was double-checking, triple-checking — even quadruple-checking at times — that all safety procedures were being followed." He readied his team in the hospital's newly completed and improved laboratory.

Down in the observation room, Wilson was sweating. His protective outfit was hot and limited his movement. It was the first time it had been used outside of training.

The patient had a low-grade fever but "rock-solid steady" vital signs.

Everyone believed he probably didn't have Ebola, but no unnecessary risks were taken.

"The moment you let your guard down is when you make a mistake," Wilson said.

6:15 a.m. - Senior lab technologist Julie Craig tried not to worry as she drove to work.

"I was thinking of the patient, wondering, 'What would that be like: lying there and everyone's focused on you and the potential of whether you have this?'"

Lab manager Gina Hendrick gave Craig a container with a hot-pink label she'd marked "SUSPECT EBOLA." The test for Ebola had to be done at the National Microbiology Laboratory in Winnipeg.

7:30 a.m. - Registered nurse Kim Wegrzyn reported for her morning shift and discovered she'd be relieving Wilson in isolation.


Registered nurse Kim Wegrzyn sits inside the emergency department observation room where Belleville General Hospital staff isolated an air force serviceman suspected of having the Ebola virus in Belleville, Ont., on October 30, 2014. She and nurse Chris Wilson worked alternating shifts to minimize the number of staff who would be exposed if the man had the illness - which tests later showed he didn't. (Luke Hendry/QMI Agency)

"It's something as an emerg nurse that you know could happen, but you can never fully prepare yourself for the actual event," she said.

She and Wilson agreed to alternate 12-hour shifts, sparing other nurses from possible exposure.

Wegrzyn said their protective equipment left some areas of the body exposed.

They photographed and documented problems with the clothing and kept working.

9:30 a.m. - Social media rumours — many of them inaccurate — started making the rounds.

But everything phoning journalists wanted to know still hinged on a sample that was in the hospital lab.

12:00 p.m. - The potential for serious illness remained, but there was little Dr. Andrew Samis could do for the isolated man, describing his charge as "more of a prisoner of our hospital."

Samis volunteered to be the only doctor working with the isolated patient.

3:00 p.m. - A special courier picked up the lab specimen and pulled onto Canada's busiest highway — and smack into Thanksgiving Monday traffic.


Emergency registered nurse Laura Moores wears personal protective equipment for treating patients with such infectious diseases as Ebola virus at Belleville General Hospital in Belleville, Ont., on October 30, 2014. (Luke Hendry/QMI Agency)

Tuesday, Oct. 14

Morning - The sample left Toronto's Pearson International Airport Tuesday morning for Winnipeg.

The patient sat with only his phone and a hospital computer for company. Staff ordered him takeout food.

4:00 p.m. - National lab started tests.

10:30 p.m. - Diagnostics director Mark Coulter received an e-mail from the Winnipeg lab. Dr. de la Roche summoned Wilson.

"My anxiety just sort of shot up," the nurse recalled.

"I just want you to know they're negative," de la Roche said, and they headed for the patient.

"He was relieved ... but he didn't really show a lot of emotion," Wilson said.

He was still ill, though, and would remain under observation overnight.

11:30 p.m. - Communications director Susan Rowe announced the test result in a press release.

That night, the World Health Organization issued a recommendation that patients be tested a second time.


Registered nurses Jeannette Indewey, left, and Karen Davy, put on personal protective equipment during a training exercise for treating patients with such infectious diseases as Ebola virus at Belleville General Hospital in Belleville, Ont., on October 30, 2014. Quinte Health Care has improved protection for workers based on feedback from staff who treated a patient suspected of having Ebola in October. The corporation is now sharing that knowledge with other hospitals. (Luke Hendry/QMI Agency)

Wednesday, Oct. 15

10:00 a.m. - After debate, doctors ordered a second test out of caution.

Afternoon - Local, provincial and national authorities ruled the second test hadn't been needed. The patient would soon be free to leave.

"I made sure he was not going to end up paying for his parking, given that he showed up and we locked him up, basically," Samis said.

The second lab result, received later Thursday afternoon, was also negative.

It was finished. Both the patient and the health system had passed their tests.

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