Jeremy Hunt said in a statement to Parliament on Monday 5 January:
I know the whole House will join me in wishing Pauline Cafferkey well and commending her and her NHS colleagues for the exceptional bravery and compassion they showed in joining the battle against Ebola in Sierra Leone. The work done by Pauline and her colleagues is not just helping to save thousands of lives in Africa; it is protecting the UK from potentially disastrous consequences if the disease spreads beyond the countries where it has currently taken hold.
Mr Hunt explained the screening process that Ms Cafferkey went through. She was screened and cleared to depart from Sierra Leone on Sunday 28 December. She arrived at Heathrow after a connection in Casablanca at 3.50pm that day, where she was again screened in line with the protocols introduced at major airports and Eurostar terminals last October. As her temperature was within the acceptable range, she was cleared to fly home to Scotland.
Clinical experts have always been clear that the process will pick up a few active infections, but it also provides the best opportunity to ensure that returning staff know whom to contact, and this system worked.
While still at Heathrow, her reassessment was triggered because of concerns that she may have had an elevated temperature. She was reassessed and her temperature taken a further 6 times over 30 minutes. As her temperature was within the acceptable range, she was again cleared to travel.
Ms Cafferkey arrived in Glasgow at around 11.30pm on Sunday 28 December – she became feverish overnight and, in line with the public health advice that she had been given at Heathrow, she contacted local services. She was admitted to an isolation facility at the Brownlee unit in Gartnavel hospital in Glasgow at 8am on Monday 29 December and, after testing positive for Ebola she was transferred overnight to the Royal Free Hospital in London in a military plane.
Mr Hunt said:
Some have asked whether it was appropriate for Pauline to be allowed to travel on to Glasgow after she raised concerns about her health at Heathrow. The clinical advice on this is clear. Someone can contract Ebola only by coming into contact with the bodily fluids of an infected person – that means blood, vomit or diarrhoea – which becomes a risk when a patient is exhibiting feverish symptoms. Because she did not have a high temperature, the clinical judgment was made to allow her to continue her journey home.
However, we recognise that medical understanding of the disease is not complete, which is why we had already taken a number of precautionary steps that go further than strictly required by the clinical evidence. These include asking potential Ebola carriers to avoid crowded places and long journeys on public transport within the 21-day potential incubation period once they arrive back home. Existing guidance also bans any direct patient work for returning health care workers.
On that precautionary basis, guidance has been strengthened to ensure that anyone from a higher risk group who feels unwell will be reassessed. Advice will immediately be sought from an infectious diseases specialist and the passenger will be referred for testing, if appropriate.
Mr Hunt said that the screening centres at Heathrow were viewed on 1 January by chief medical officer Professor Sally Davies and public health minister Jane Ellison. All arrangements, including the revised protocols, were found to be working well.
We will continue to keep screening and logistical arrangements under review and look to improve or strengthen the process, as guided by expert clinical advice. It is important, however, to remember that the risk to the public of contracting Ebola from contact with someone carrying the virus remains very low indeed while they are not exhibiting any symptoms.
The critical point – this is the main purpose of the screening – is to ensure that potential Ebola carriers are identified and know how to ask for medical assistance the moment they display any feverish symptoms, so that they can then be isolated, tested and given full medical support as quickly as possible.
Parliament was also told how passengers on the flights that Ms Cafferkey took have been traced and contacted on a precautionary basis.
Protection of volunteers
Before any NHS workers are deployed to treatment centres, staff from UK-Med, which runs the NHS humanitarian register, review the clinical protocols and procedures and confirm that they are content that the centre meets appropriate standards. All UK-Med volunteers receive thorough training in the UK and in Sierra Leone before they treat any Ebola patients so that they know how to use their personal protective equipment and understand the nature of the work.
In the current case, Save the Children is conducting a review into its procedures to ensure that any lessons are learned.
The Secretary of State added that the UK has committed more than £230 million to fight Ebola in Sierra Leone:
We have sent more than 800 military personnel, 150 Department for International Development staff, 70 NHS staff through UK-Med and 64 Public Health England staff to fight the outbreak on the ground – a bigger contribution than any country in the world except for the United States.
The chief medical officer, Professor Dame Sally Davies, has always been clear that we are likely to see up to a handful of cases in this country, of which, very sadly, this is the first to be diagnosed. NHS England has procured personal protective equipment for each of the hazardous area response teams in England and has additionally arranged for 75,000 PPE suits to be procured for the NHS.
The government and health system has been practising Ebola resilience since 30 July and 16 ministerial Cobra meetings have been held, including 5 chaired by the Prime Minister:
Both the chief medical officer and the NHS England medical director, Professor Sir Bruce Keogh, are satisfied that at this stage we have made sufficient preparations. However, they stress that, although the risk to the public remains low, we must remain vigilant and be constantly prepared to adjust and improve our processes and protocols as this rapidly changing situation evolves.