Ebola: Planning Considerations for Human Services Programs

Publication Date: November 3, 2014

For managers and staff at human services serving children and families, the recent reports of patients with Ebola Virus Disease in the United States can be understandably concerning. Human services programs are encouraged to use this fact sheet to support staff, clients, and communities.

What is Ebola?

Ebola is a serious illness caused by the Ebola virus. Ebola symptoms include fever greater than 101.5°F and severe headache, muscle pain, vomiting, diarrhea, stomach pain, or unexplained bleeding or bruising. Symptoms may appear anywhere from 2 to 21 days after exposure, although 8 to 10 days is most common.

How is Ebola Spread?

Ebola virus is spread through direct contact with the blood or body fluids (including but not limited to feces, saliva, sweat, urine, vomit, and semen) of a person who is sick with Ebola. The virus in blood and body fluids can enter another person’s body through broken skin or unprotected mucous membranes in, for example, the eyes, nose, or mouth.

  • Ebola virus is not spread through air or water, or by any food approved for consumption in the U.S.
  • If someone is not sick with Ebola, you cannot get Ebola from touching him or her.
  • A person who has been exposed to Ebola but does not have symptoms is not infectious.

Who is at Risk?

Health workers and the family and friends in close contact with Ebola patients are at highest risk because they may come in contact with the blood or body fluids of sick patients, for example, by changing sheets after an ill person has vomited.

What Are the Implications of Ebola for Human Services Programs?

Ebola can have implications for human services programs in terms of:

  • Supporting staff,
  • Ensuring continuity of operations,
  • Supporting public health outreach efforts,
  • Assisting community members who are asked to stay at home by public health officials,
  • Mitigating stigma associated with the disease, and
  • Addressing the fears of children served by programs

Supporting Program Staff

Both Ebola virus disease itself and the fear of Ebola can negatively affect human services programs at the community level. Even in communities where no individuals have become sick or been exposed, extensive media coverage of Ebola may cause staff to experience anxiety or concern. Providing staff fact-based messages about Ebola can help mitigate staff distress or worry.

Staff should continue to use good infection control practices. The same steps that prevent the spread of many other diseases help to prevent Ebola transmission. Frequent hand washing and proper cleaning of surfaces and equipment are key to reducing or eliminating the transmission of Ebola and other communicable diseases, such as influenza, hepatitis, and Enterovirus-D68.

Staff should wear gloves in cases where they may come into contact with blood or bodily fluids (e.g., treating a scrape), and these gloves should be removed and disposed of properly to avoid contact.

Program management can provide staff with resources to support coping and emotional well-being.

The Disaster Distress Helpline (1-800-985-5990) provides immediate crisis counseling to people concerned about Ebola virus reports. The helpline can also be accessed at http://disasterdistress.samhsa.gov/ Visit disclaimer page and TTY for Deaf individuals: 1-800-846-8517.

Ensure Continuity Planning

In the unlikely case that a program employee has contact with an Ebola patient, these employees may be asked by public health authorities to stay at home for 21 days. Programs should review their Continuity of Operations Plans and staffing plans to ensure adequate coverage, if needed.

Staff absences represent the primary challenge to most human services programs. Absences may be related to staff asked to stay at home, or may be caused by worried employees who fear exposure to Ebola in the workplace. Effective risk communication can help prevent unnecessary absences from work due to fear of Ebola.

Support Public Health Outreach

Human services agencies can partner with public health agencies to deliver accurate risk communication to communities at higher risk. Human services agencies, particularly those that serve West African immigrant communities, may have community contacts and cultural competence that can augment public health authorities’ efforts to provide helpful messaging to prevent the spread of Ebola, ease fears, and combat stigma.

Assisting People Staying at Home Following Possible Exposure

In communities where Ebola cases have occurred, public health authorities may ask potentially exposed individuals to remain at home for up to 21 days. Human services programs can play a vital role in mitigating the social and economic burden of 21 days at home and away from work—a burden that can be particularly heavy on lower income workers who do not have paid time off. Support for individuals and families remaining at home can both ease distress for the family and promote better adherence, thus protecting the public.

Areas for community human services agencies to consider regarding individuals asked to remain at home due to possible exposure:

  • How will individuals and families get food, medicine, and other basic needs?
  • Are there programs or resources that can provide assistance for those with significant lost earnings?
  • For community and faith-based organizations that provide help, are there available sources of funding to support those activities?
  • For those who receive means-tested benefits programs, what waivers or other steps can help ensure that there is no loss of benefits due to recertification, work requirements, or other barriers?

Many ACF programs have flexibilities or waivers specific to emergency situations. These flexibilities or waiver authorities may be able help State, Tribal, Territorial, local, and other grantees develop plans to support those asked to stay at home by public health authorities, if there are potentially exposed individuals in your communities. For technical assistance if you have questions, contact your Regional Program Office or ACF Regional Administrator.

Reduce Stigma

Stigma can occur when people associate an infectious disease with a population, even though not everyone in that population or from that region is specifically at risk for the disease. Individuals and families who have connections to West Africa may experience stigma from their communities. This stigma may also extend to individuals who have recently traveled to West Africa and/or to individuals that have had contact with an Ebola patient, or who live in an apartment building or neighborhood where Ebola cases have occurred.

Human services programs should stress that Ebola is caused by a virus – not a person – and that the virus is difficult to transmit (i.e., it is not airborne). They should also be cautious of the images and messages that they share in order to avoid reinforcing negative stereotypes.

Programs that serve families with ties to West Africa can be helpful as a source of support and community connection. Additionally, programs can remind families who have traveled in affected countries to see their family physician if they are sick and to tell their doctor where they have traveled.

In the unlikely case that a child or staff member is asked to stay at home on isolation, programs should stress that if an individual does not develop Ebola symptoms during the 21-day monitoring period they do not have Ebola and pose no risk when they return afterwards.

Reduce Children’s Fears

Even young children may be exposed to media reports or overhear adults discussing Ebola. Programs that provide direct services to children, youth, and families can provide frontline staff with the following steps to support children’s coping with Ebola-related fears:

  • Be cautious about discussing Ebola where children may overhear. Limit children’s exposure to media reports on the disease.
  • If children have questions on their own, make time to listen to their concerns and answer their questions.
  • Be honest and accurate. Answer questions based on the facts.
  • Speak in a calm tone of voice. Use reassuring words. Reinforce that parents, program staff, and other adults in the child’s life work together to keep children safe and healthy.
  • Keep all explanations age-appropriate.
  • Be clear about the differences between images they may have seen of West African countries and the situation in the United States.
  • Reinforce hand washing and other disease prevention steps that children can take themselves. Good hygiene steps are not only beneficial for children’s health, they also help children feel empowered and able to make a difference.

Where Can I Learn More?

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