Ebola outbreak - general thread #3

[SStarr33]

Maybe in that photo. But in reality, the nurse who caught it was given a suit that was not impervious to liquids.

There are health care workers marching in protest in the streets in Spain.

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At least here in the U.S. it is certainly the obligation of the employer to provide workers with appropriate protective gear. It is part of the OSHA laws. Often the worker himself may not know exactly what type of protective gear they need. The burden to know what is required for each situation rests on the employer.

But it sure does behoove a worker to educate him/herself as to what is required. Some employers are known for cutting corners when and where they can.

According to the CDC, level 4 is overkill.

 

[SStarr33]

Someone is lying to us:

Today

http://www.theatlantic.com/health/a...-without-human-touch/381152/?single_page=true

Crystal Johnson, a nurse at Emory University Hospital in Atlanta who has worked with three Ebola patients in the U.S., including Dr. Kent Brantly and Nancy Writebol, both of whom recovered from the disease, describes the gear she has to wear.

“We wear disposable undergarments, scrubs, and socks, and we have a set of shoes that we only use during this time,” she says. “Full Tyvek, with booties, a helmet with a hood, and also an apron. Double gloves. And tape up everything.”

August 16

http://www.nytimes.com/2014/08/16/health/hospitals-in-the-us-get-ready-for-ebola.html


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.”

The C.D.C. says that health care workers treating Ebola patients need only wear gloves, a fluid-resistant gown, eye protection and a face mask to prevent becoming infected with the virus.

 

[Sonya610]

[h=1]Spain to kill dog of Madrid woman with Ebola[/h]
Authorities said in a statement Tuesday that available scientific knowledge indicates there's a risk the dog could transmit the deadly virus to humans.

That is sickening. I guess killing helpless pets make the authorities feel like they are "doing something useful".

If that policy were here in the U.S. then some people (animal lovers) would NOT report symptoms or exposure.

 

[faw720]

On their 4pm newscast the DFW local NBC news says that they are updating the Dallas Ebola status on their website as they receive additional information. For anyone interested, the link is http://www.nbcdfw.com/

 

[Gardenlady]

Our news is saying they are in hospital for observation rather than them actually having Ebola, but maybe we are behind the times.

My reading of the Spanish article is the same as what your news says. It says the others are admitted and isolated but are without fever.


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[Gardenlady]

Other nurse suspected of having Ebola has second test come back negative:

http://elpais.com/m/politica/2014/10/07/actualidad/1412666827_708666.html

Edit - apparently she had diarrhea and stress, but never fever. They considered her exposed or at risk, but isolated and have been monitoring her to be safe.

The husband continued to be isolate and monitored, as well as a Nigerian traveller whose test returned negative Monday (his second test is expected Weds).

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[SweetT]

Other nurse suspected of having Ebola has second test come back negative:

http://elpais.com/m/politica/2014/10/07/actualidad/1412666827_708666.html

Edit - apparently she had diarrhea and stress, but never fever. They considered her exposed or at risk, but isolated and have been monitoring her to be safe.

The husband continued to be isolate and monitored, as well as a Nigerian traveller whose test returned negative Monday (his second test is expected Weds).

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Why do these take a couple days yet the man puking on a flight they determined within a few minutes to an hour?

 

[Gardenlady]

Why do these take a couple days yet the man puking on a flight they determined within a few minutes to an hour?

I think the test doesn't take a couple of days, they wait a few days in between the first and the second (confirmatory) test.




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[Gardenlady]

Also interesting from the El Pais article - the nurse is receiving serum from an anonymous, previously infected Ebola patient.


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[BirdycatNY]

Bill for Ebola Adds Up as Care Costs $1,000 an Hour, By Alex Wayne - Bloomberg News

http://www.bloomberg.com/news/2014-10-07/bill-for-ebola-adds-up-as-care-costs-1-000-an-hour.html

 

[SweetT]

That is sickening. I guess killing helpless pets make the authorities feel like they are "doing something useful".

If that policy were here in the U.S. then some people (animal lovers) would NOT report symptoms or exposure.

I'd load up my pets with food and water and pray I got back to them.. It beats certain death for them at least

 

[Isabelle]

Husband of ebola patient makes internet plea to save his dog

http://elpais.com/elpais/2014/10/07/inenglish/1412696221_462332.html

Oh so sad.

 

[SeekingJana]

Good distinction between airborne and aerosolized.


BBM
However, I think it can be risky to compare Ebola Zaire's stability in the past to this current outbreak. From NPR:

Ebola Is Rapidly Mutating As It Spreads Across West Africa
(snipped)

For starters, the data show that the virus is rapidly accumulating new mutations as it spreads through people. "We've found over 250 mutations that are changing in real time as we're watching," Sabeti says.

While moving through the human population in West Africa, she says, the virus has been collecting mutations about twice as quickly as it did while circulating among animals in the past decade or so.

"The more time you give a virus to mutate and the more human-to-human transmission you see," she says, "the more opportunities you give it to fall upon some [mutation] that could make it more easily transmissible or more pathogenic."

http://www.npr.org/blogs/goatsandso...dly-mutating-as-it-spreads-across-west-africa
________

According to the WHO, there have been 6,574 cases in this outbreak as of Sept. 23rd, as opposed to only 2300-2400 cases of all Ebola strains (excluding Reston) from 1976 through 2013. That's quite an explosion of human to human transmissions which will likely increase the number of mutations. That's unsettling, IMO.

http://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6339a4.htm?s_cid=mm6339a4_w

I took my figures about the current stability of the Ebola strain in W. Africa straight from the CDC guy in the press conference today. He says that the strain infecting people in W. Africa is stable and has been stable, and is decreasing in number of affected individuals instead of increasing. IDK whether we are talking about 2 different strains of Ebola virus or not.
And I don't know if the guy was putting some kind of spin on what he said, either. It's possible, but it would be extremely unwise to do if the CDC wants to be credible in the eyes of the educated public.

 

[Oceans]

Husband of ebola patient makes internet plea to save his dog

http://elpais.com/elpais/2014/10/07/inenglish/1412696221_462332.html

This is heartbreaking. Finally a goodhearted person who cares for people and pets. I hope his dog will be saved!

 

[SweetT]

http://www.dallasnews.com/ebola/hea...leaning-at-schools-affected-by-ebola-case.ece

So sad "Guererro, who is Castro’s boss, said he ordered the haz-mat suits from the district’s supply warehouse out of extra caution for his workers. Guerrero said he was compelled to buy them because he contracted polio in 1996, when he was a DISD custodial field supervisor. He cannot walk and uses a wheelchair."

This is inexcusable if you ask me..

 

[Redux]

http://www.dallasnews.com/ebola/hea...leaning-at-schools-affected-by-ebola-case.ece

So sad "Guererro, who is Castro’s boss, said he ordered the haz-mat suits from the district’s supply warehouse out of extra caution for his workers. Guerrero said he was compelled to buy them because he contracted polio in 1996, when he was a DISD custodial field supervisor. He cannot walk and uses a wheelchair."

This is inexcusable if you ask me..

Really, if no one else gets infected despite all these missteps, it will be a miracle.

Custodians to clean it up? Certainly they wouldn't have the training to know exactly how to prevent themselves from getting infected, would they? Why wouldn't you hire a clean up crew that would know how to handle it correctly.

And then to possibly be firing these two gentlemen. Ugh.

 

[SeekingJana]

Someone is lying to us:

Today

http://www.theatlantic.com/health/a...-without-human-touch/381152/?single_page=true

Crystal Johnson, a nurse at Emory University Hospital in Atlanta who has worked with three Ebola patients in the U.S., including Dr. Kent Brantly and Nancy Writebol, both of whom recovered from the disease, describes the gear she has to wear.

“We wear disposable undergarments, scrubs, and socks, and we have a set of shoes that we only use during this time,” she says. “Full Tyvek, with booties, a helmet with a hood, and also an apron. Double gloves. And tape up everything.”

August 16

http://www.nytimes.com/2014/08/16/health/hospitals-in-the-us-get-ready-for-ebola.html


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.”

The C.D.C. says that health care workers treating Ebola patients need only wear gloves, a fluid-resistant gown, eye protection and a face mask to prevent becoming infected with the virus.

A hospital facility ( or other facility dealing with infectious disease process) can CHOOSE to implement isolation safety measures which go beyond the written standard guidelines. The guidelines are the MINIMUM recommended CDC standard. This has always been the case.

This does not mean that ANYONE is or was lying about anything. I learned isolation and personal protective measures at a Level One Trauma Center hospital in Atlanta ( no longer a Level One trauma center, but it was at the time) which far exceeded anything I had learned outside the metro Atlanta area.

The absolute irony of it is that I contracted a SARS- like respiratory illness ( this is what my pulmonologists and infectious disease specialists told us it was like but not confirmed by labs) from an immigrant outpatient and almost died ( was in the hospital for over a week with oxygen, antibiotics, and barely conscious for days) despite the rigorous isolation precautions set up for in-patients.
I really have wondered how that tiny elderly lady was able to walk around, as she was there for an out-patient test only- it was a tough go for me, and I was in my early 30's, very healthy and a lifelong non-smoker.

 

[SStarr33]

A hospital facility ( or other facility dealing with infectious disease process) can CHOOSE to implement isolation safety measures which go beyond the written standard guidelines. The guidelines are the MINIMUM recommended standard. This has always been the case.

This does not mean that ANYONE is or was lying about anything. I learned isolation and personal protective measures at a Level One Trauma Center hospital in Atlanta ( no longer a Level One trauma center, but it was at the time) which far exceeded anything I had learned outside the metro Atlanta area.

The absolute irony of it is that I contracted a SARS- like respiratory illness ( this is what my pulmonologists and infectious disease specialists told us it was like but not confirmed by labs) from an immigrant outpatient and almost died ( was in the hospital for over a week with oxygen, antibiotics, and barely conscious for days) despite the rigorous isolation precautions set up for in-patients.
I really have wondered how that tiny elderly lady was able to walk around, as she was there for an out-patient test only- it was a tough go for me, and I was in my early 30's, very healthy and a lifelong non-smoker.

Um, these are the same facility.

 

[SweetT]

Really, if no one else gets infected despite all these missteps, it will be a miracle.

Custodians to clean it up? Certainly they wouldn't have the training to know exactly how to prevent themselves from getting infected, would they? Why wouldn't you hire a clean up crew that would know how to handle it correctly.

And then to possibly be firing these two gentlemen. Ugh.

Yea they can spend a million dollars on the ebola family but not for the school where hundreds of innocent children go... Someone needs to do something these guys were in over their heads imo
They were just trying to do a good job and be safe about it.

 

[SeekingJana]

Um, these are the same facility.

I saw that they were both Emory- based. The last set of comments you quoted stated clearly that the hospital is now following CDC guidelines, which are not as strict as whar Emory initially instituted.
This means, in case someone doesn't understand why there is a difference, that Emory initially had a more complicated isolation and personal protective device set up than the CDC guidelines call for.

To be honest, the more steps involved, the more chance for human error. People have to be taught and then practice how to apply and remove every layer of PPD they are wearing. In the best case teaching scenario I've been in as an RN, the PPD is covered with a brightly colored powdered dye, so when/ if a break in isolation technique occurs, the practice is visibly obvious and can be corrected before it becomes a habit.

In practice, each time a person applies and removes PPD in an isolation situation, they have ONE chance to get it done correctly. No matter if they have been working 12 hours straight or have just come on duty. Nothing replaces knowledge gained through practice and personal vigilance.