Ebola outbreak - general thread #4

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FlamingoLady said:
Random thoughts this morning:

1. The older I get, the more I realize no good deed goes unpunished.
2. Supposedly this newest case, the healthcare worker, was infected due to a "breach in protocol." So, yes, by all means, let's get to work on some new "protocols". On the same note, supposedly each state can do whatever they want in treating Ebola patients. There's no one "in charge" so to speak. Well show me one state, country, village, etc...that's been successful and let's do what they do! Until then, I'm not believing a dam* thing I hear.
3. The temperature screenings at airports (a new "protocol") are a symbolic gesture, at best. And the problem with that is when symbolic gestures take the place of effective measures, we're all screwed.
4. Until this country lays aside their political correctness and gets people in places of authority with some spine, you will not see positive outcomes, IMO.
5. Finally, let's hope we can get our shi* together regarding this virus before troops start coming home infected, and make no mistake about it, there will be military men and women infected. Or will they even be able to come back for treatment? Who knows what "protocols" will have been developed by then.
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I haven't finished catching up yet, but just had to applaud this
 
monkey222 said:
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.
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I have been searching for one - let me know if you run into blog twitter etc
 
monkey222 said:
First I have heard of "explosive" diarrhea. Ever.
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LOL. Explosive, projectile, we have very descriptive terms in medicine. It basically refers to anything that can hit the wall...
 
chipmunk said:
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.
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Reminders are good. I mean, at this point: where 1 becomes 2 and 2 become 4... Etc. might as well go back to step one and re learn it. There is a lot at stake..
 
Hiandmighty said:
Really? You are serious! :thinking: I guess it's a medical term-- we use the phrase all the time: " was it explosive diarrhea" lol.
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No kidding. Wish I'd never had to witness it, but alas, as a RN, I've seen it way too many times.
 
nrdsb4 said:
No kidding. Wish I'd never had to witness it, but alas, as a RN, I've seen it way too many times.
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I had C. Diff with Campylobacter at the same time.... Wish I had never experienced it.... :OMG:

(Joking aside, I did actually wonder if I was going to die...)
 
Hiandmighty said:
Really? You are serious! :thinking: I guess it's a medical term-- we use the phrase all the time: " was it explosive diarrhea" lol.
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This may even be an understatement!

"You know at Emory they had two patients here. A doctor told a staff meeting at the peak, when they were treating those two patients, they were generating up to 40 bags of medical waste a day. And what then? You know, every hospital has procedure Anderson. Every -- practically every hospital in the country hires outside contractors to take care of the trash in the case of Ebola waste."

40 bags!!!

and Writebol wasn't even vomiting... I find that so hard to believe... She verified it though...

"N. WRITEBOL: Yes, I mean it just makes you really weak and the fever and the headache, for me that was always a sign of feeling malaria. And I think that's a sign for most people that, you know, you get this fever, you get this headache, you're weak, and your muscles ache everywhere.*

So, you know, those are some signs of malaria. It's also signs of Ebola. I mean, you are weak, you've got a fever. You might feel nauseated and as the disease progresses there is diarrhea. There of course, you know, it's a hemorrhagic virus and so there's the possibility of some bleeding.

COOPER: Were you throwing up as well because, I mean again its fluids which is the big concern, you know, there is report this person may have thrown up in the ambulance heading into the hospital? Was that part of what do you experienced?

N. WRITEBOL: No, thankfully I never threw up."
http://edition.cnn.com/TRANSCRIPTS/1410/01/acd.02.html

All posts are MOO
 
Gosh, I took the weekend off to spend with my daughter who came home from Clemson (adore her) and looks like i have missed developments.
Going to try and catch up now.
Unbelievable.
JMO
 
I've stayed away from this topic...

Coming back with what I hope are two non-controversial theoretical questions-

I don't know if there are any other RNs or MDs here who were trained before Personal Protective Equipment was widely available and precautions were supposed to be standardized for health care workers according to types of transmission, etc., but I was.
We were taught that people in the USA with extremely rare and deadly diseases ( Marburg and Ebola being two of the probably six studied, along with Smallpox) could be safely isolated in their home with other members of their household and treated with supportive measures until they either got well or died. It was the best we had to offer prior to the 1980's, when AIDS changed how healthcare workers protect themselves against blood-borne pathogens.

Is there a possibility that the patient home model of isolation can be tried again? One doctor, 2-3 nurses going to the home in full isolation gear. The hospitals stay free of the disease carriers, the majority of staff are never exposed... and generally, the diseases ARE a matter of supportive care measures only. Nothing much can be done until an antiviral med. specific to Ebola is developed, or a vaccine proves to be effective and is cleared by the FDA to be given to the non-ill public.

Second thing- WHY do we not have a strong Surgeon General of the U.S. in place?
I know the Surgeon General's role is not subservient to the POTUS's role. He or she has the right to state health policy and to make health policy. I saw this happen once in my adult lifetime, when Dr. C. Everett Koop was Surgeon General. That doctor, may he RIP, could have been a leader in this mess. He would have established centers for possible and confirmed infected persons to go to, and established new protective guidelines in other areas. He cared about the American people and our health.
I'm not seeing much of that now, just people talking over one another and no one is really right.

Where are the leaders of health care? I ask this with a very heavy heart, and a fear that we have not seen anything like what's coming.
 
SeekingJana said:
I've stayed away from this topic...

Coming back with what I hope are two non-controversial theoretical questions-

I don't know if there are any other RNs or MDs here who were trained before Personal Protective Equipment was widely available and precautions were supposed to be standardized for health care workers according to types of transmission, etc., but I was.
We were taught that people in the USA with extremely rare and deadly diseases ( Marburg and Ebola being two of the probably six studied, along with Smallpox) could be safely isolated in their home with other members of their household and treated with supportive measures until they either got well or died. It was the best we had to offer prior to the 1980's, when AIDS changed how healthcare workers protect themselves against blood-borne pathogens.

Is there a possibility that the patient home model of isolation can be tried again? One doctor, 2-3 nurses going to the home in full isolation gear. The hospitals stay free of the disease carriers, the majority of staff are never exposed... and generally, the diseases ARE a matter of supportive care measures only. Nothing much can be done until an antiviral med. specific to Ebola is developed, or a vaccine proves to be effective and is cleared by the FDA to be given to the non-ill public.

Second thing- WHY do we not have a strong Surgeon General of the U.S. in place?
I know the Surgeon General's role is not subservient to the POTUS's role. He or she has the right to state health policy and to make health policy. I saw this happen once in my adult lifetime, when Dr. C. Everett Koop was Surgeon General. That doctor, may he RIP, could have been a leader in this mess. He would have established centers for possible and confirmed infected persons to go to, and established new protective guidelines in other areas. He cared about the American people and our health.
I'm not seeing much of that now, just people talking over one another and no one is really right.

Where are the leaders of health care? I ask this with a very heavy heart, and a fear that we have not seen anything like what's coming.
Click to expand...

I think I heard that the candidate for Surgeon General hasn't been confirmed yet???
 
LinasK said:
I think I heard that the candidate for Surgeon General hasn't been confirmed yet???
Click to expand...
Yes, I know there's a " hold up" but isn't this the time when we need the leadership of the Surgeon General in place? Confirm him conditionally, let him work with health care policy and the press and public with a conditional confirmation, whatever.
There has to be some provision to get a strong health leader in this country established and on his feet running, doesn't there? :)
 
SeekingJana said:
Yes, I know there's a " hold up" but isn't this the time when we need the leadership of the Surgeon General in place? Confirm him conditionally, let him work with health care policy and the press and public with a conditional confirmation, whatever.
There has to be some provision to get a strong health leader in this country established and on his feet running, doesn't there? :)
Click to expand...

Yes!!
 
I concur -look at the craziness the news is having/casuing. This is simple - its all new- there are going to be mistakes -- its a learning curve, they will be bumps, a couple more people will get infected, not being mean its how humans learn systems improve, for some reason the media thinks that the whole system is a mess cause there have been mistakes - there will continue to be. Is it gonna go out of control in civilized nations, IMO, no there are a whole host of varibles, IMO, that are huge (that are not here) in what is going on there.

I am sure people over there pass away from a cold, the flu, a really bad cut etc.

Media IMO needs to focus on the differnces, just in the whole picture - they are immenly important -IMO they contribute more to what has happened to those poor people over there than the virus itself-- it is all the surrounding contiions that have permitted it to fester, grow and kill

media needs to chill IMO- work on educating not freaking the country out!!!



https://www.google.com/?gws_rd=ssl#q=how+many+people+die+in+car+accidents+every+day+

FlamingoLady said:
****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.
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I really hope they are not going to blame the nurse affected here....... Maybe they should lay the blame at authorities, who weeks ago did not take seriously this threat of ebola travelling into other countries, and therefore a man from an outbreak area in West Africa was able to enter the US and wander around..

I shake my head in frustration when I read that the screening for people coming from West Africa is going to involve taking their temperatures and asking questions such as " have you been near anyone who may have ebola" ...........seriously.......this trust that humans are going to tell the truth is ridiculous. Anyone who has worked in customs/immigration at the airport or watched any of the custom related shows on tele knows that people lie......a lot!

And what if someone does say yes, and they have a fever!!!! are they going to then isolate all those on the plane? could be a night mare..............why not just stop flights from these countries until it is contained. I don't get it.

Re the recent scare we had here with the nurse in Cairns, I read today that she has been let out of hospital since her 2nd test came back negative. (I thought I read somewhere that the recommendation was 3 tests!) While I do not want to seem like I am putting her down, that is not the case at all, I take my hat off to her to do what she has done. Most people wouldn't. And from what I have read she was extra particular with safety concerns.....................however one thing that came out of this situation ,was that there was an uproar on social media, current affairs programs, other feedback due to her returning from dealing very extensively with ebola patients in Africa, and upon returning to Australia, straight after may I add, she was only isolated in her home (with a flatmate!)........the authorities didn't even know she had been near ebola patients when she re entered Australia......it was the Red Cross protocol that she remain isolated in her home. Huge uproar and rightly so.

So hopefully plans have been put in place that all organizations with people working with ebola patients, be they medics, volunteers etc, give a list ofnames to authorities and when they return to Australia they must be put in some form of official isolation.

99% of the general public here I would say would actually rather they were put in isolation OVER THERE first for the incubation period. Makes absolute sense, but of course think $$$ are talking. Hopefully this will be rectified when these isolation units are built.

Cairns hospital and Townsville hospital, the city I am in and next city south of Cairns, are the main hospitals that deal with patients from outlining islands and New Guinea. We are talking the Torres Strait Islands, Solomon Island, remote aboriginal island communities and of course New Guinea where in parts they still live in primitive tribes. Emergency patients are always sent to Cairns and TOwnsville. If ebola was to get into one of those communities you are talking a total disaster, it would spread like wildfire and there living conditions are very basic.
 
Paulette said:
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.
Click to expand...

Who is going to call an emergency room to report their fever if they know they will be taken into a concentration camp (which is what you are describing)?
 
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