Ebola outbreak - general thread #5

[Sonya610]

BBM. We absolutely do not know that is the case.

IMO with SEVENTY healthcare workers it surely IS the case. Also if that nurse had NOT been working around other patients wouldn't the hospital be SCREAMING about that from the rooftops? To show how CAREFUL they were and try to preserve a bit of their reputation? Yes, they would advertise that fact proudly and they have NOT done so.

On Sunday, officials confirmed that 26-year-old nurse Nina Pham had tested positive for the virus. More than 70 people who may have had contact with Duncan at the hospital were being monitored.

http://www.foxnews.com/health/2014/...d-healthcare-worker-at-dallas-hospital-tests/

 

[nrdsb4]

IMO with SEVENTY healthcare workers it surely IS the case. Also if that nurse had NOT been working around other patients wouldn't the hospital be SCREAMING about that from the rooftops? To show how CAREFUL they were and try to preserve a bit of their reputation? Yes, they would advertise that fact proudly and they have NOT done so.

If you are a nurse, you know that the number of people on a chart who are "caring" for a patient include MANY who never set foot near that patient. It's unlikely first of all that 70 people came into contact with Duncan's body fluids. Secondly, we have zero knowledge of any symptomatic health care worker working while ill.

I am a working RN in Dallas and am probably more upset about this than the average joe, and have a fair amount of anger working over a lot of issues. I know nurses who work in critical care at Presby, though I don't know who specifically has been working that unit. However, I'm going to work with facts as we know them and not jump to conclusions until I have facts to support my speculation. Right now there is no evidence whatsoever to think that these nurses were going from Duncan's bed to another patient's bed, exposing them to Duncan's body fluids. I'm worried about the people who are truly most at risk, and that is any caregiver who gave care before receiving proper PPE.

 

[nrdsb4]

BTW, I get phone alerts from WFAA in Dallas, and received notice of the second infection early this am. There will be a press conference at 0700 on this development. That would be CST I guess.

 

[Sonya610]

If you are a nurse, you know that the number of people on a chart who are "caring" for a patient include MANY who never set foot near that patient.

The initial question was whether the nurses/staff that HAD worked with Duncan had treated OTHER patients during or afterwards. Do we have any evidence that they did NOT treat other patients? We know they were all working during the casual monitoring period.

 

[nomoresorrow]

(BBM)

BBM. We absolutely do not know that is the case. We also need to remember that the one thing the CDC and WHO seems to be right about is that the disease is not easily spread until the patient is well into their symptoms. It's not coincidence that the two people who are now infected were people who did not interface with Duncan until he was extremely ill.

Listen, I'm all for staying calm and remaining positive in a [potential] crisis, however, I choose to do so knowing the facts, not by denying or minimizing them. The statement "not easily spread until the patient is well into their symptoms" is not true and, in my opinion, minimizes the reality in order to lessen people's fears, which is the wrong approach -- again, my opinion. The truth is that the virus is thought to be contagious when symptoms begin - not well into them. While the virus load may not be significantly high at that time, nevertheless, that does not equate to noncontagious.

MOO ~

 

[nomoresorrow]

Yep, second infected HC worker - heard it on the radio on my way home from work this morning. This is becoming a daily routine...

 

[nomoresorrow]

If you are a nurse, you know that the number of people on a chart who are "caring" for a patient include MANY who never set foot near that patient. It's unlikely first of all that 70 people came into contact with Duncan's body fluids. Secondly, we have zero knowledge of any symptomatic health care worker working while ill.

I am a working RN in Dallas and am probably more upset about this than the average joe, and have a fair amount of anger working over a lot of issues. I know nurses who work in critical care at Presby, though I don't know who specifically has been working that unit. However, I'm going to work with facts as we know them and not jump to conclusions until I have facts to support my speculation. Right now there is no evidence whatsoever to think that these nurses were going from Duncan's bed to another patient's bed, exposing them to Duncan's body fluids. I'm worried about the people who are truly most at risk, and that is any caregiver who gave care before receiving proper PPE.

I mean no disrespect but, as a nurse who claims to work with facts, the message that Ebola is not contagious until a person is "well into their symptoms" is not a fact and it is not a message I would want communicated to the general public (i.e., patients) by a health care worker. That could be lethal... JMO ~

 

[nomoresorrow]

World Health Organization:

"The patients become contagious once they begin to show symptoms. They are not contagious during the incubation period."

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

 

[nrdsb4]

I mean no disrespect but, as a nurse who claims to work with facts, the message that Ebola is not contagious until a person is "well into their symptoms" is not a fact and it is not a message I would want communicated to the general public (i.e., patients) by a health care worker. That could be lethal... JMO ~

I said "easily contagious." If it were easily contagious, we should have about 40 plus ill patients by now who came into contact with Duncan after he was symptomatic. Point being any nurse who was not symptomatic was very likely to not be infecting others. They were isolated as soon as they became symptomatic, so the risk to any patient they encountered prior to that is essentially nil. Unfortunately we have our own little science experiment inflicted upon us here, and the evidence that people are highly contagious before symptomatic and even immediately after a fever develops is not borne out. That in no way implies that protocol, whatever that means from day to day, is not immediately implemented when a potential infected person begins to show any symptoms at all.

 

[faw720]

Sounds like that hospital and possibly MANY others have a serious professional culture problem.

Perhaps the superiors are OFFENDED when their underlings make suggestions? Because they are smarter and better educated so if they didn't think of it first then it isn't a good idea? And/or they take all suggestions/ideas from lower staff members as a lack of respect for their position and are insulted?

Not sure if I am explaining clearly, but hopefully some know what I mean.

I think you have hit the nail on the head. In my long life I have had dealings with numerous doctors. Some are quite compassionate, caring, & are willing to respond to my requests & ideas. Others are just flat out arrogant & condescending. Matter of fact, just look at the NBC news team that was in voluntary isolation. It was Dr. Snyderman who broke quaranteen, not any other members of the crew.

 

[Brightbird]

I said "easily contagious." If it were easily contagious, we should have about 40 plus ill patients by now who came into contact with Duncan after he was symptomatic. Point being any nurse who was not symptomatic was very likely to not be infecting others. They were isolated as soon as they became symptomatic, so the risk to any patient they encountered prior to that is essentially nil. Unfortunately we have our own little science experiment inflicted upon us here, and the evidence that people are highly contagious before symptomatic and even immediately after a fever develops is not borne out.

This is what I've been thinking the last few days as well.

 

[nrdsb4]

What I would like to know is the following:

According to some of these reports, the nurses were not given the proper PPE until 3 days after admitting Duncan.

I will be interested in learning whether or not any nurse who became part of the team AFTER that time, when the "proper" PPG arrived, is one of the nurses now infected. For that matter, do they even now actually have the proper supplies?

At my endoscopy clinic, personnel are very interested in NOT having body fluids flung on them, ebola or no. We have plastic masks which are worn by personnel which completely cover the entire face and ears. The neck is not exposed when gowned and masked. How is it that Presby ebola crew wasn't given this equipment at minimum? I'm gobbsmacked.

 

[Lato]

Updated....CNN article on 2nd Healthcare Worker Tests Positive for Ebola in Dallas.....7:26 am

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html?hpt=hp_t1

 

[Sonya610]

I think you have hit the nail on the head. In my long life I have had dealings with numerous doctors. Some are quite compassionate, caring, & are willing to respond to my requests & ideas. Others are just flat out arrogant & condescending. Matter of fact, just look at the NBC news team that was in voluntary isolation. It was Dr. Snyderman who broke quaranteen, not any other members of the crew.

And another worrying thing (from a patient perspective) is there are a LOT of not that common problems that can be fatal for an individual, if the protocol in this Ebola situation was so terribly incompetent what about the multitude OTHER conditions that only kill patients?

The nurse's union is up in arms over this and screaming from the rooftops because in THIS RARE situation the lack of preparedness and knowledge can and is threatening to KILL NURSES instead of just patients!

 

[popsicle]

Updated....CNN article on 2nd Healthcare Worker Tests Positive for Ebola in Dallas.....7:26 am

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html?hpt=hp_t1

After yesterday's PC..I figured this was coming. CDC sending a huge team there...just take the patients out now and let the hospital gets its house in order.

 

[nrdsb4]

According to the nurse's union:

"The protocols that should have been in place in Dallas were not in place, and that those protocols are not in place anywhere in the United States as far as we can tell," National Nurses United Executive Director RoseAnn DeMoro said Tuesday night. "We're deeply alarmed."

Well, we know that there are indeed a few hospitals where that is not correct. But they are generally probably spot on. Think of all the small community hospitals in the US. We seem to think that an infected person would logically only be in a big city with all the state of the art technology. We needed the wake up call Presby is providing us, but clearly it comes rather late.

 

[nrdsb4]

After yesterday's PC..I figured this was coming. CDC sending a huge team there...just take the patients out now and let the hospital gets its house in order.

I do agree that they need to call it a day on trying to handle ebola at this hospital. Is it feasible to transfer any potentially infected caregiver to the vicinity of the four units which can handle them? I think if I had taken care of Duncan, I might be in my car on the way to Atlanta, quite frankly. I'm not one to panic, but I think if anyone is entitled, it is any caregiver who came into direct contact with Duncan after 09/28.

 

[nomoresorrow]

(BBM)

I said "easily contagious." If it were easily contagious, we should have about 40 plus ill patients by now who came into contact with Duncan after he was symptomatic. Point being any nurse who was not symptomatic was very likely to not be infecting others. They were isolated as soon as they became symptomatic, so the risk to any patient they encountered prior to that is essentially nil. Unfortunately we have our own little science experiment inflicted upon us here, and the evidence that people are highly contagious before symptomatic and even immediately after a fever develops is not borne out. That in no way implies that protocol, whatever that means from day to day, is not immediately implemented when a potential infected person begins to show any symptoms at all.

Yes certainly do and, for that, my heart goes out to you and to every HC worker who, in my opinion, are the real heroes for doing what you do. And, as you say, if it were easily contractible, many more would have it, but the reality is that 2 nurses do have it now and there, unfortunately, is still time on the clock (calendar) for more potential diagnoses. I pray that is not the case.

 

[faw720]

I do agree that they need to call it a day on trying to handle ebola at this hospital. Is it feasible to transfer any potentially infected caregiver to the vicinity of the four units which can handle them? I think if I had taken care of Duncan, I might be in my car on the way to Atlanta, quite frankly. I'm not one to panic, but I think if anyone is entitled, it is any caregiver who came into direct contact with Duncan after 09/28.

I just had this very same thought.

 

[Lato]

http://www.nbcnews.com/watch/live-v...n-second-ebola-healthcare-worker-322485827772

NBC News.....stand by for live video