Ebola outbreak - general thread #4

[musicaljoke]

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.

My daughter is doctor working in tropical diseases in one of the hospitals in Toronto. She commented that it might be more important to stock up on insect repellent. While the US media is focused on Ebola, the real threat of Chikungunya is getting almost no press. It's much like Dengue fever, and can leave life-long painful symptoms.

It has never shown up in the Americas until a case last year. Since then, there have been 700,000 cases and the range is expanding.

So, while you are out shopping, pick up some insect repellent before the price goes through the roof.

http://www.examiner.com/article/new-cdc-model-predicts-spread-of-chikungunya-virus-the-united-states

 

[jjenny]

The airplanes, two are outfitted, are owned by a company, not the Govt.


http://www.stripes.com/news/if-infe...fly-out-of-africa-on-special-charter-1.307742

I think helicopters would be used for transport within US.

 

[Elley Mae]

Does anyone really think that hospitals will be accepting Ebola patients if they start showing up in emergency rooms? Just look at Dallas Presbyterian & the hit they took!

So...where will the Ebola patients go? Ebola hospitals away from towns? Who will take care of them seeing that the nurse who cared for Duncan is infected? I see the medical community shying away from this virus.

From the link I posted above.

“I don’t think every hospital has the facilities or the wherewithal, or for that matter the desire to care for Ebola patients,” Dr. Morse said.

 

[chipmunk]

No doubt it has been very quiet. I'm not sure reporters know the location of the house that Louise & her family are staying in, but enough of a description was provided that it probably wouldn't be much of a problem to find providing someone was very familiar with the Dallas area. It has been described as an upscale, gated community, with no nearby neighbors. This is only a guess but I'm thinking a lake lot on either Grapevine Lake or Lake Lewisville.

I personally don't think it's a good idea to give media and the public the names of infected or possibly infected. One key to successful outcome for patients is to seek testing very early before complications set in. They must get in early before the disease carried to others. (Patients may shed less virus at this point, I think).
Some people are going to hesitate, lie or not go for care at all if they know their name and their families' names are going to be splashed about in the media.

This would have to assume trust in the facilities testing and treating patients and the public has confidence procedures will protect the public.
Let's hope we get to that point. It may take a few months however.

 

[Elley Mae]

They can't stay away. If a patients shows up in the ER, hospital is obligated to treat the patient.

Not that I don't agree but Presbyterian Hospital is no longer accepting patients, through the emergency room anyway.

 

[Elley Mae]

Rawlings said the patient's dog, still inside the apartment, will soon be sent to a new location to await a reunion with its owner. There were no plans to euthanize the dog as Spanish officials did in a case last week, he said.

http://www.usatoday.com/story/news/nation/2014/10/12/texas-health-care-worker-ebola/17147449/

 

[musicaljoke]

Does anyone really think that hospitals will be accepting Ebola patients if they start showing up in emergency rooms? Just look at Dallas Presbyterian & the hit they took!

When SARS was a problem, all hospitals in Ontario screened patients at the door and masked/gloved/diagnosed/isolated everyone who had symptoms that could even remotely be SARS. The protocol worked well to stop the transmission of SARS in medical settings. I remember thinking that all the effort came too late, but it was highly successful for a disease that was transmitted through airborne particles. I feel more confident that hospitals and the Public Health Department can put into place a protocol that will protect their workers from Ebola, than I was when SARS was here.

 

[Sophieandme]

Has this article been posted? If not, gives a lot of detail on Thomas Eric Duncan's treatments, progression of his symptoms, etc.

The agonizing last days of the first Ebola patient in the US
By Associated Press
October 11, 2014 | 4:07pm

http://nypost.com/2014/10/11/the-agonizing-last-days-of-the-first-us-ebola-patient/

 

[chipmunk]

Yah, that's what I was thinking... The loss of the work force. That plus a restriction on air travel has nearly bankrupted Liberia, a country that was struggling anyway after many years of civil war.

What if Europe, Australia, etc put air restrictions on people originating in Texas?

--------------------

Doctors and nurses don't break sterile field anyway. They do things already like take gloves off inside out and put compromised protecting clothes in bio hazard bags anyway. They don't need to be taught this. They are already taught this.

Personally I believe either the current garments aren't bio safe from Ebola or this virus spreads more easily than CDC estimated.... We will have to see how far this goes....

Cause, you just know another 1 or 2 of Duncan's family members are going to get diagnosed with it.... :cow: they certainly werent wearing any sterile garments....

Thank you. I defer to the well trained nurses and docs on infection control procedures. I guess Dr Brantly felt he should point out the inside out method as a reminder. That the gear are uncomfortable, cumbersome, mistakes easy when you're under stress. He was saying stay calm and work slowly.

 

[Zuri]

Does anyone really think that hospitals will be accepting Ebola patients if they start showing up in emergency rooms? Just look at Dallas Presbyterian & the hit they took!

So...where will the Ebola patients go? Ebola hospitals away from towns? Who will take care of them seeing that the nurse who cared for Duncan is infected? I see the medical community shying away from this virus.

The medical community can't shy away from Ebola as they don't have a choice. There are systems in place in most every ER, as required by JCAHO, to treat exposures and communicable illnesses. Reverse Isolation rooms as well. I think patient education is paramount in a situation like this so the majority of people know what the procedures are for treatment. Those hospitals not equipped to deal with Ebola can isolate and transfer patients to larger, more well equipped hospitals. This happens in trauma cases all the time. JMV

 

[Yoda]

:thud:

The head of the African Development Bank expressed concern on Saturday that some donors responding to the Ebola crisis were repackaging aid money, funneling it away from other areas in need in the three countries at the center for the epidemic.

In an interview, Donald Kaberuka said moving funds from already allocated development projects in Liberia, Guinea and Sierra Leone was unhelpful in the long term and make their rebuilding harder.


"I have told donors that I hope what they are announcing is additional resources because if it isn't ...once (Ebola) is gone we will have no resources to build health care systems and continue reconstruction," Kaberuka told Reuters on the sidelines of meetings in Washington of the International Monetary Fund and World Bank.


"We need to put new money on the table," he said, adding that he feared that once the crisis eased countries would be left without funding for development projects earmarked before Ebola arrived.

1. There is no WE. It is us, giving your countries billions of dollars.
2. I do not want a time out, but I am sure other heads are exploding around the world after reading this.

moo
http://news.yahoo.com/ebola-funds-not-repackaged-aid-africa-bank-chief-072224137--business.html

 

[gngr~snap]

I think helicopters would be used for transport within US.

Air Life Georgia 5 out of McCollum airport, refused to transport Dr. Brantly saying that there was no way to decontaminate helicopter and pilot would not be able to have seperate air containment system.
All other life flight followed suit. That is why he and Writebol were transported by land...
All posts are MOO
ETA: Also helicopter landing area requires patient to be transported through hospital. The containment unit at Emory is seperate...
They are also a privately owned company and can say "no" as some rules do not apply to them.

 

[Paulette]

They can't stay away. If a patients shows up in the ER, hospital is obligated to treat the patient.

I'm suggesting that another option will be put in place rather than allow Ebola infected people into the hospital. It's just crazy to allow anyone to walk into an emergency room full of people & unprotected staff. Imagine all the people the infected person could transmit the virus to. I suggest Ebola camps far from town with a wide circumference guarded by the army - no in, no out. The person calls the emergency room to report their fever, an ambulance shows up at the persons home & they're whisked off to a mobile trailer to check them out. Positive, off to the camp. Negative, take them to the hospital. Sounds good to me.

We're under the assumption that we have rights, like going to an emergency room at our leisure. That can be over-ridden by a Governor or medical Dr.

 

[okiedokietoo]

http://fas.org/programs/bio/biosafetylevels.html
Federation of American Scientists
Biosafety Level Information BSL-4, Biosafety Level 4

Info on what is done going in and out of lab. Also how the walls, floors, and ceilings of the facility are constructed to form a sealed internal shell.
And map on site of BSL-4 lab locations in US.
And "yes" this is about Labs but this is the list of diseases for Level 4:
"Viruses assigned to Biosafety Level 4 include Crimean-Congo hemorrhagic fever, Ebola, Junin, Lassa fever, Machupo, Marburg, and tick-borne encephalitis virus complex (including Absettarov, Hanzalova, Hypr, Kumlinge, Kyasanur Forest disease, Omsk hemorrhagic fever, and Russian Spring-Summer encephalitis"

 

[Sophieandme]

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.

ITA

http://nypost.com/2014/10/11/the-agonizing-last-days-of-the-first-us-ebola-patient/
snipped
By evening, Duncan was suffering from explosive diarrhea, abdominal pain, nausea and projectile vomiting.

BBM

 

[monkey222]

Thanks Okeydokey2. Developments moving so fast. We are sleuthers, foremost. And good at that. Do any of you know of a forum of virologists, infectious disease specialists that are discussing this now? This is simply crazy how CDC slipped, IMO. Thx.

 

[FlamingoLady]

I'm suggesting that another option will be put in place rather than allow Ebola infected people into the hospital. It's just crazy to allow anyone to walk into an emergency room full of people & unprotected staff. Imagine all the people the infected person could transmit the virus to. I suggest Ebola camps far from town with a wide circumference guarded by the army - no in, no out. The person calls the emergency room to report their fever, an ambulance shows up at the persons home & they're whisked off to a mobile trailer to check them out. Positive, off to the camp. Negative, take them to the hospital. Sounds good to me.

We're under the assumption that we have rights, like going to an emergency room at our leisure. That can be over-ridden by a Governor or medical Dr.

****And this is exactly what I see happening.**** There have already been news reports bashing the US for how it has been handling the flights coming in with suspected cases (which have turned out to be negative, thankfully). We continue to pull up to the gate and take the "patient" off into the terminal. It looks like the case here at LAX today was handled "correctly". The plane was taken to a far westside gate, away from crowded terminal. The lady has since been ruled as "not having Ebola symptoms and sent for a psych evaluation." But, YES!!! Ebola patients will not be treated at hospitals, IMO. It will be M.A.S.H. type facilities. I also think that healthcare, communities, our civil rights, and humanity as we know it will really be tested. I AM NOT TRYING TO SOUND ALL CRAZY...Just look at how people act over the Day After Thanksgiving sales. Look how people act if something is being given away for free. Look how people freak out over a shortage of flu shots. It will not take much for people to act their way into a militarized lockdown situation. Of course all this is my opinion only. No, I don't even own a tin foil hat.

 

[monkey222]

First I have heard of "explosive" diarrhea. Ever.

 

[WVWoman]

Guess the county or state of Texas will be picking up all this person's medical bills -- it should be a workers compensation claim since she was exposed on the job.

http://www.foxnews.com/health/2014/10/12/8-infants-test-positive-for-tb-at-texas-hospital/

I wonder since you said that who,will be picking up the tab for this new mess.:gaah: TB in delivery ward a Not going to ANY hospital unless I know for sure I'll die otherwise! MOO
Health authorities also raised to 860 the number of infants possibly exposed at Providence Memorial Hospital. The hospital says it passed the first inspection by federal health authorities and inspectors will return in December

 

[okiedokietoo]

There are four high-level biocontainment patient care units in the U.S. The Nebraska Medical Center (10-bed biocontainment unit), St. Patrick Hospital in Missoula, Montana, the National Institutes of Health in Maryland and Emory University Hospital in Atlanta.
Nebraska is set up with same kind of precautions that you would see in a biosafety level 4 lab. Assume other 3 are also.