In recent weeks, C.D.C. officials have said repeatedly that any hospital in the United States can safely provide care for a patient with Ebola by following their exacting infection-control procedures and isolating the patient in a private room with an unshared bathroom.
“What’s needed to fight Ebola is not fancy equipment,” Dr. Frieden said in a message posted during a Twitter chat with concerned members of the hospital staff. “What’s needed is standard infection control, rigorously applied.”
Nancy E. Foster, the vice president of quality and patient safety policy at the American Hospital Association, agreed that gloves, gown, face mask and eye protection are “perfectly fine” and called the C.D.C. guidance the “best advice.”
But Dr. Michael V. Callahan, an infectious disease specialist at Massachusetts General Hospital who has worked in Africa during Ebola outbreaks, does not think it is wrong for hospitals to opt for more protective equipment.
The minimal precautions recommended by the C.D.C. “led to the infection of my nurses and physician co-workers who came in contact with body fluids,” Dr. Callahan said. “I understand the desire to maintain absolute protection in U.S. hospitals.”
Dr. Justin Fairless, an emergency physician in Tulsa, Okla., said that health care workers in Africa “are wearing the highest level of protection, but the C.D.C. recommendation lets us go down to the lowest level of protection.”
Dr. Fairless is considering buying his own air-purifying respirator to pair with a head-to-toe coverall. “I am not comfortable going to see an Ebola patient wearing a paper mask that doesn’t cover my entire face,” he said.
He is hardly alone. In recent weeks, several hospital workers have expressed concerns, asking why head coverage is not necessary and suggesting their emergency department doctors would get hard-to-tear hooded suits.
Dr. David Kuhar, the health care and worker safety team leader for C.D.C.’s Ebola response, argued that caring for patients in Africa is “very different” from caring for those in a hospital in the United States.
“In a field setting, there may be many patient beds close together, as well as behind you,” he said. “It would be very difficult, or impossible, to predict when you may be exposed to infectious bodily fluids, so you might want equipment to cover your back and head, to protect your exposure.”
Yet until recently, the health care workers tending to Dr. Kent Brantly and Nancy Writebol, the aid workers infected with Ebola in Liberia, were outfitted in head-to-toe protective suits at Emory University Hospital in Atlanta — which in no way resembles an African field hospital.
On Wednesday, Dr. Phyllis E. Kozarsky, a professor of medicine and infectious diseases at Emory, disclosed that the nurses had shed their full-body gear and were following “what C.D.C. guidance says for the management of these patients.”
High-tech protective gear may pose dangers of its own, experts noted. It may be difficult to remove a hood or respirator, for instance, without accidentally touching the wearer’s face or eyes, giving the virus an entry point.
Hospitals purchasing head-to-toe gear may find another unforeseen risk: cleaning it.
“It’s easier to grab a new disposable than to repeatedly clean the nooks and crannies of devices,” said Dr. Mark D. Rowland, medical director of epidemiology for St. Francis Health System in Tulsa.
What sort of protective equipment to wear, and who should wear it and when, is only one of the most pressing of dozens of logistical issues now facing hospitals. Already, triage nurses at some hospitals are asking emergency room patients about recent travel to Guinea and Sierra Leone.
Those with fevers or other suspicious symptoms probably do not have Ebola, said Dr. Melvin Weinstein, chief of infectious diseases at Rutgers Robert Wood Johnson Medical School. But now, he said, “we have had to think about how to transport blood specimen to the lab” and keeping technicians safe.
On Aug. 5, more than 5,400 health care professionals were called into a briefing about Ebola hosted by the C.D.C.
Hospital administrators and infection control specialists asked dozens of questions. Is the virus in breast milk or semen? (Yes to both.) Can the soiled linens of an Ebola patient be cleaned off-site without spreading the virus? (Unknown.)
In response, agency officials are scrambling to develop additional guidance on handling laundry, patient waste and the bodies of any American patients killed by Ebola.
“Just in case,” Dr. Kuhar said.
I was making noise. Sorry.
