Ebola outbreak - general thread #4

[Really?]

L

Yes, but not just for this. I have been putting together food, medicine, gloves, masks etc, to last hubby and dogs for at least 2 to maybe 3 months.

Between our open borders, ISIS, the Taliban, natural disasters (we're in earthquake country), and now this, I think it is prudent now more then ever to do so. Supplies are starting to go into back order status, for instance, I wanted to send my daughter a house warming present for her new apartment in San Francisco of a water Bob. It fits in one's bathtub and holds enough water for 2 people for up to a month. But the price went up 40% and is now on back order in a matter of days!

I read today, that Dupont and several other manufacturers were trying to increase production of gloves and masks.

I hear ya. I'm in NJ and have been thinking about stock piling bleach.....I'll have to make a list.

 

[hockeymom]

Harvard Vanguard Medical Center in Braintree is being quarantined and a patient isolated outside the facility with a possible case of Ebola, officials said.
The patient recently traveled to West Africa, and is being isolated based on his medical complaints, fire officials said.

http://www.bostonglobe.com/metro/2014/10/12/ebola/z3DybKoXBg0XjPO6m5yVgK/story.html

I must have read an updated version of this,as what I read said the man was at the medical center filling a prescriptopn and someone must have realized after he was leaving that he had symptoms and had recently been in West Africa. They chased him down in the parking lot.
If this is true,it is maddening that someone would knowingly walk around potentially spreading a deadly disease!! Ypu know you have recently been in the effected zone and you are sick,its not rocket science. This is why we should restrict travel. People are not self monitoring. I hope its just another false alarm.

 

[trex]

The biosafety levels referred to in that document apply to laboratories where people work with the actual virus/bacteria/microorganism and do not apply to hospitals. The CDC has separate guidelines for hospitals which are available here.

From lab to hospital does not change the undeniable scientific fact that this is a BSL-4 and SHOULD be handled the exact same way as in a lab.

The only difference is instead of it being in a test tube or Petri dish in a highly controlled environment, it's in an actual walking breathing mobile human host who is not so highly controlled. Which to me is much more frightening.

 

[saba]

Been checking in all day- thanks for all the news and comments. Here's the latest on the Boston incident:

Harvard Vanguard Medical Associates Statement
Posted on October 12, 2014 by Harvard Vanguard
A patient who had been to Liberia presented himself today at the Harvard Vanguard Medical Associates Braintree practice complaining of headache and muscle aches. Out of an abundance of caution we immediately notified authorities and the patient was securely removed from the building and put into an ambulance now headed to Beth Israel Deaconess Medical Center. The building was closed briefly but has now re-opened. We are working closely with the Department of Public Health who will determine next steps.



http://blog.harvardvanguard.org/2014/10/harvard-vanguard-medical-associates-statement/

 

[Lyra500]

The road map now includes figures for seven affected countries (since USA and Spain have now had cases).

It can be found in the left hand menu on the following page:

http://www.who.int/csr/disease/ebola/en/

I believe someone was questioning whether Nigeria had really managed their outbreak. I do not think there is any reason to think they have not and it is a really impressive achievement. They did some serious contact tracing and monitoring - really serious.

In Nigeria, all 891 contacts have now completed 21-day follow-up (362 contacts in Lagos, 529 contacts in Port Harcourt). A second EVD-negative sample was obtained from the last confirmed case on 8 September (32 days ago).

 

[Hiandmighty]

Sounds like the Dallas hospital has already taken a financial hit and yes, it will be a disaster for them financially if this nurse doesn't do well. Of course, the nurse is the most important factor here, and her health, but it is supremely foolish MOO to not see the reality that no one is going to want to go the "the Ebola hospital" for anything medical...

Not to mention some doctors might only do surgery at THAT hospital, so they will have to scramble to get privileges at other facilities...

There is a giant functional fallout here....

 

[Ladylub]

So I've only been able to read here have not watched any press conferences. Reading here when I have a few minutes. When I go to listen to the presser later should I have have coffee since my brain seems to be sleeping today, popcorn for entertainment of umms and other things they clearly have no clue about or dripping springs vodka bc it is only going to tick me off. With bad info and blaming care worker and not protocols that seem rather lax for dealing with a deadly virus.

 

[cuffem]

L


I hear ya. I'm in NJ and have been thinking about stock piling bleach.....I'll have to make a list.

I have a bin full of boxes of surgical masks and gloves,that a friend gave me some years ago. I knew I would need them one day.

 

[Muffet]

From lab to hospital does not change the undeniable scientific fact that this is a BSL-4 and SHOULD be handled the exact same way as in a lab.

The only difference is instead of it being in a test tube or Petri dish in a highly controlled environment, it's in an actual walking breathing mobile human host who is not so highly controlled. Which to me is much more frightening.

It is probably not feasible to have a BSL-4 area in every hospital, and transportation of patients to one is also problematic.

But ITA that we need to stop talking about and treating it as carelessly as we have and accepting inadequate treatment, isolation, and PPE protocols when and where the highest ones possible can be implemented.

I also agree that we need to restrict flights to allow only those necessary for aid and use real quarantines. Not doing so is inexcusable and makes those who refuse to take these critical measures complicit in the consequences of every uncontrolled escape of the virus that ensues, imo.

 

[faw720]

So I've only been able to read here have not watched any press conferences. Reading here when I have a few minutes. When I go to listen to the presser later should I have have coffee since my brain seems to be sleeping today, popcorn for entertainment of umms and other things they clearly have no clue about or dripping springs vodka bc it is only going to tick me off. With bad info and blaming care worker and not protocols that seem rather lax for dealing with a deadly virus.

I recommend the vodka!

 

[jjenny]

It is probably not feasible to have a BSL-4 area in every hospital, and transportation of patients to one is also problematic.

But ITA that we need to stop talking about and treating it as carelessly as we have and accepting inadequate treatment, isolation, and PPE protocols when and where the highest ones possible can be implemented.

I also agree that we need to restrict flights to allow only those necessary for aid and use real quarantines. Not doing so is inexcusable and makes those who refuse to take these critical measures complicit in the consequences of every uncontrolled escape of the virus that ensues, imo.

US has transported at least five patients (that we know of) from Africa. Surely we can figure out how to transport them to these hospitals from within US.

 

[Zuri]

They are pretty darn SURE the saliva and mucus from infected individuals contains the virus. So yes, when folks cough, sneeze, or sometimes just speak and throw off tiny bits of spit/mucous that can be contagious. Or likely when they touch their face or use the bathroom (without sanitizing their hands) and then handle the lettuce at the grocery store, or the gas pump as you are waiting to fill up, etc...

They are using the technical definition of "airborne" to mislead folks.

The flu spreads often via droplets through the air, but it isn't technically "airborne" since it depends on coughing or sneezing to project that infected droplet of mucus or spit. The virus can't fly around in the air all by itself (although some viruses can), so it isn't technically "airborne".

That obviously does NOT mean that you can't get the flu virus if someone 3 feet away sneezes on you and you get hit with infected specs of mucus, or if they sneeze on an object or use a tissue and you touch that object/tissue while the virus is alive.

The whole thing about "this is NOT airborne" is a bit misleading.

Check out the 4th picture down in this NYT's article:

http://www.nytimes.com/2014/10/13/us/texas-health-worker-tests-positive-for-ebola.html?_r=0

The person in the background has on PPE and the gown looks awfully flimsy. You can see through it! Wonder if that is the same PPE the infected nurse wore.....

I agree Sonya that there are a lot of semantics and not clear definitive statements being released to the public. Technically, Ebola is not an airborne virus, but just as you stated, respiratory droplets containing the virus, in a sneeze for example, can travel 6 feet in diameter. Those droplets, if inhaled by another person, entering through the mucus membranes of the nose or mouth, can indeed infect another person. The CDC has emphasized "direct contact" with bodily fluids such as blood, stool, sweat, urine, vaginal secretions, seminal fluid, which may narrow down the scope of contamination, but the fact that the virus is able to live on surfaces is alarming.

The isolation gown, mask, face shield, goggles, hair net and gloves that are pictured in the article are typical for what we wear in isolation rooms, ER trauma etc. The gowns have a water resistant repellant on them to minimize risk of exposure. However, the scrubs on underneath and shoes, if not fully covered, do absorb bodily fluids. IMO, that gear would not be adequate to protect any healthcare worker from Ebola.

I could not agree more with those who are offended by the comments made about the nurse(s) exposed and now being treated and isolated. For the CDC to think that any of the caregivers would be considered low risk is just ridiculous. I commend her bravery for doing her job and not refusing to care for Mr. Duncan.

In circumstances like this, there is an unwritten rule, that nurses who have no children, have grown children, older or younger who are not married and have not started families, are the nurses who "volunteer" to take care of potentially "harmful to self" patients. It is very selfless and they put themselves in "harm's way" to protect their fellow nurses. I have seen this happen over and over throughout 32 years of nursing critical patients.

I pray that all of the selfless caregivers do not contract Ebola and that proper equipment and dress are plentiful. JMV

 

[Muffet]

US has transported at least five patients (that we know of) from Africa. Surely we can figure out how to transport them to these hospitals from within US.

My understanding is that every transport was done by the single plane we have equipped for it. :/

I'm 100% for finding creative and safe alternatives.

Then, we could assign a highly prepared hospital for every region.

 

[lawstudent]

While people have probably noticed that I'm not too worried about ebola, I think it's pretty clear that if the US or any country had a massive epidemic of any serious disease, it would overwhelm the healthcare system. As much as people don't think cost should matter, it obviously does, and we are never going to have facilities lying around empty in preparation for a huge jump in patient numbers. There would be a lot of chaos, which accompanies all epidemics. There wouldn't be enough beds and doctors and resources, and people would be panicking and doing ridiculous things. That's just life - in this country, all we can do is bank on our sanitation/prevention systems to take care of the diseases that plague other societies, and hope a more easily transmittable virus doesn't surface. Viruses by their nature always try to find a way to survive every prevention effort, unfortunately.

 

[Hiandmighty]

When your DH is a doctor, as mine is, or your sister is a RN or your SIL is a RN and your friends are all first line medical personnel, yes Ebola gets worrisome and real.

 

[jjenny]

My understanding is that every transport was done by the single plane we have equipped for it. :/

I'm 100% for finding creative and safe alternatives.

Then, we could assign a highly prepared hospital for every region.

If they can equip the plane, surely they can equip a helicopter? If they haven't thought of this, they should have.
I knew full well that all hospitals aren't ready to take care of Ebola patients, and clearly they aren't.
Surely CDC can figure it out?

 

[jjenny]

While people have probably noticed that I'm not too worried about ebola, I think it's pretty clear that if the US or any country had a massive epidemic of any serious disease, it would overwhelm the healthcare system. As much as people don't think cost should matter, it obviously does, and we are never going to have facilities lying around empty in preparation for a huge jump in patient numbers. There would be a lot of chaos, which accompanies all epidemics. There wouldn't be enough beds and doctors and resources, and people would be panicking and doing ridiculous things. That's just life - in this country, all we can do is bank on our sanitation/prevention systems to take care of the diseases that plague other societies, and hope a more easily transmittable virus doesn't surface. Viruses by their nature always try to find a way to survive every prevention effort, unfortunately.

Looks like one patient (Mr. Duncan) is going to have enormous cost on the hospital. All the new patients that are not going to come, ER is not accepting patients, nurse that got infected, etc.
That's only one patient. Yet we are refusing to prevent more people like Mr. Duncan from coming into US from West Africa.
What will it end up costing us in the end?

 

[passionflower]

When your DH is a doctor, as mine is, or your sister is a RN or your SIL is a RN and your friends are all first line medical personnel, yes Ebola gets worrisome and real.

Same here, my family is medical also........and 1 grandson in a big university...........GOD help us all..........

 

[trex]

It is probably not feasible to have a BSL-4 area in every hospital, and transportation of patients to one is also problematic.

But ITA that we need to stop talking about and treating it as carelessly as we have and accepting inadequate treatment, isolation, and PPE protocols when and where the highest ones possible can be implemented.

I also agree that we need to restrict flights to allow only those necessary for aid and use real quarantines. Not doing so is inexcusable and makes those who refuse to take these critical measures complicit in the consequences of every uncontrolled escape of the virus that ensues, imo.

I know it's probably unrealistic to think that *every* hospital could get the correct biohazard suits, isolations and such needed to contain the ultimate spread of the virus, but at the very least if they can manage to spend a few extra $$$ on those hospitals/wards here in the US such as Dallas, to expedite the better suits/isolations (even if they have to set up something temporary and rearrange a bit) for the right now patients where they are needed most... Yes one has passed and we have a sick nurse unfortunately so it's already hit that hospital, but if they can urgently get the correct supplies/measures in place right now before it potentially spreads farther.. It's worth going for it. I know there's the chance that other cases will pop up (as people are traveling to and from our country until/if they restrict/monitor travel a LOT more, totally agree with you there), like it sounds is happening in the Harvard area with a potential case popping up.. But if they can manage to step up their game where it matters now... Might save a grisly looking future of the spread in the states. And stop pointing fingers everywhere else, but act like their lives depend on it instead, because, well they do.

 

[Muffet]

If they can equip the plane, surely they can equip a helicopter? If they haven't thought of this, they should have.
I knew full well that all hospitals aren't ready to take care of Ebola patients, and clearly they aren't.
Surely CDC can figure it out?

Same here. But we're stuck between can and will - on this and a lot of other things.
We can't even get them to do the most obvious things.

Notice the difference between the response when Dr Brantley was brought in... From the plane (did you see the inside?) to the police escort to Emory, to the measures Emory took.

But now, since we have experienced an unexpectred case, AND they acknowledge that we have over 100 people flying in from those three counties every day, what do they do?

INSTEAD OF restricting travel to those necessary for aid, they choose to tell us the measures used for Brantly aren't necessary.

...And when a nurse is infected because we don't use them, it's gotta be her fault.

Half of us here could manage this thing better, because we would focus on the virus, without worrying about politics or PR, etc.