October 13, 2014 -- Updated 2131 GMT (0531 HKT)
(CNN) -- In a matter of days, they transformed from caretakers into patients.
The two women live thousands of miles apart, but the first known Ebola cases contracted outside Africa during this outbreak have one striking similarity: Both were health care workers, caring for someone infected with the deadly virus.
As a nurse in Dallas and a nurse's assistant in Madrid fight for their lives, a key question looms: Are people who are putting themselves in harm's way to care for Ebola victims receiving the training and equipment they need?
No, says Zenei Cortez, vice president of National Nurses United.
"It's really a disaster waiting to happen," she told CNN's "The Lead with Jake Tapper" on Thursday.
The union is pushing for more equipment, training and education for nurses, Cortez said. A survey of 1,900 nurses by the union found that 76% said their hospital had not communicated any policy for the potential admission of patients infected by Ebola.
"We want the best protection there is, for us and our patients."
CDC chief blames protocol breach
As authorities confirmed that the Dallas nurse had contracted Ebola, the Centers for Disease Control and Prevention's top official was quick to point to a breach in protocol.
The nurse was identified by CNN affiliate WFAA as Nina Pham. Shehad cared for Thomas Eric Duncan, who contracted Ebola in Liberiaand died of the illness at the hospital.
Dr. Tom Frieden, director of the CDC, told reporters that it's still unknown how the infection occurred, only that a "breach in protocol" for treating a patient happened.
Frieden said state and federal health officials are re-examining those protocols, including the removal of protective gear after contact with an Ebola patient and if it might be helpful to spray virus-killing solution on workers as they leave an isolation unit. He said Monday that the nurse is "clinically stable."
Frieden said he wasn't pointing fingers, but trying to pinpoint what happened.
"Stopping Ebola is hard," he said, and the CDC will do anything possible to protect health care workers.
Frieden said he would not be surprised if there were additional cases among those who cared for Duncan, but he said that so far, no one is showing symptoms. "We hope we will not have additional cases among health workers," he said.
The CDC is "doubling down" on outreach and training to increase awareness of Ebola and make sure U.S. hospitals "think Ebola," he said.
Hospitals should be skilled at taking travel histories of people who show Ebola symptoms and should isolate those who have been to Liberia, Sierra Leone or Guinea, Frieden said. The CDC is also planning more hands-on training at hospitals and outreach to health departments.
Husband of infected nurse's assistant writes scathing letter
The nurse's assistant in Spain with Ebola remains in critical condition and is having trouble breathing, authorities said. The European Centre for Disease Control and Prevention said the hospital where Teresa Romero Ramos is being treated doesn't meet all the standards set for centers capable of Ebola care.
In a scathing letter, Javier Limon, her husband, said she received only 30 minutes of training in putting on protective gear and called for the resignation of Madrid's regional health minister over how the case has been handled.
"Please explain to me how one puts on a protective suit, since unfortunately my wife doesn't have a master's degree in that," Limon wrote in a letter distributed by a family spokeswoman. "Teresa had 30 minutes or a little more to learn how to do so through a colleague."
He fired back at criticism that the family had gone on vacation.
"No one told us that we couldn't do what we did, because the protocol did not tell us that we could not do that," Limon wrote. "Now I know that in other countries they quarantine health care workers after treating an Ebola patient. Even though I am only a welder, I understand that if we had done this my wife would possibly not be battling between life and death."
Is the U.S. prepared?
President Barack Obama wants federal authorities to immediately take further measures to ensure that health care workers are able to follow protocols for treating Ebola patients. He met with senior administration members at the White House on Monday afternoon for an update on its response to the Dallas case and the broader effort to make sure the country is prepared to handle an outbreak.
Of the thousands of hospitals in the United States, only four have been training for years to deal with highly infectious diseases such as Ebola: Emory University Hospital in Atlanta, the Nebraska Medical Center in Omaha, the National Institutes of Health in Maryland and Rocky Mountain Laboratories in Montana.
"They have the management, the processes, the implementation in place that if an Ebola patient comes in, just right away they know what to do," said Gavin Macgregor-Skinner, who teaches public health preparedness at Penn State University.
But if someone with symptoms of Ebola shows up at any other hospital, as Duncan did, the hospital might not be ready.
"It may not be that every single hospital is in fact prepared for this," said David Sanders, associate professor of biology at Purdue University.
"We may have to think about regional centers that are best prepared to deal with Ebola patients."
Another step in the battle is screening.
On Saturday, passengers arriving from the three countries hardest hit by Ebola -- Liberia, Sierra Leone and Guinea -- started getting special screening, including having their temperatures taken, at New York's John F. Kennedy International Airport.
Washington's Dulles, Newark, Chicago's O'Hare and Atlanta airports will begin screening Thursday.
CNN's Ashley Fantz and Elwyn Lopez contributed to this report.
Source: http://edition.cnn.com/2014/10/13/health/ebola-crisis/
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