Ebola outbreak - general thread #5

[Sonya610]

I really don't think you could keep the families of all 48 contacts quiet. HIPAA laws cannot be violated by the health care team, but there is nothing preventing the families from releasing information, as we've seen time and again.

Not all 48, but the ones sharing the apartment? And the nurse daughter of Louise?

Something ain't right about that situation. They were VERY vocal a week ago, yet now utter silence.

 

[cady]

If I can not trust the US to protect our health then I certainly can not trust other countries to put protective measures in place and follow them.

Just remember......there is no Wizard of Oz. I still believe that we will get this under control, but there will be mishaps along the way. JMO

 

[Isabelle]

@AmandaNBC5: From Presbyterian: Emergency Dept still on divert. Hospital not cancelling elective surgeries, but doctors may cancel if they wish. @NBCDFW

WOW! DPH ER is on divert! I bet I would cancel my own elective surgery. Wonder if DPG ER has been disinfected per Ebola protocol since the first Ebola patient was seen there?

 

[popsicle]

Not all 48, but the ones sharing the apartment? And the nurse daughter of Louise?

Something ain't right about that situation. They were VERY vocal a week ago, yet now utter silence.

IMO lawsuit

 

[LaborDayRN]

Yep. Very disappointed in this nurse and in the system which didn't mandate she stay put. WTF.

I couldn't agree more

 

[okiedokietoo]

the definition of "panic" noun: a sudden overwhelming fear, with or without cause, that produces hysterical or irrational behavior, and that often spreads quickly through a group of persons or animals.
No where does it say that a person is in a state of panic when they question things

 

[Isabelle]

Hospitals need to set up one floor that cares for these patients only with the same staff that do not rotate out of that unit. That floor will have to have its own supply/exhaust system that does not enter any other area of the hospital. That floor will need an ante room that is closed off from patient area where supplies can be delivered so that delivery person does not enter the care area. Staff will need a room that is closed off from the patient care area that has its own air/exhaust supply where they can take breaks, have their meals and meals purchased from the cafeteria should be delivered to the floor ante room. All caregivers should be required to shower in an area not connected to the patient care area and should do this before leaving the floor to go home. Caregivers should not be able to leave the care area until their shift has ended. It's a lot, but it's doable.

 

[LaborDayRN]

The thanks button was not enough. You two just typed what I was about to.

I come from a family of nurses and my best friend is a retired nurse. I have so much respect for nurses, more than I do for doctors. With that said, none of the nurses I know would have been so irresponsible as to travel after caring for a patient like Duncan. Forced quarantine is necessary.

I couldn't agree more.

 

[SweetT]

Wonder how many of those docs on self monitoring have er rights at other hospitals or run a regular practice outside of the hospital?

 

[SCHMAE]

https://in.news.yahoo.com/says-w-af...till-expanding-geographically-125534583.html?

WHO says W.Africa Ebola outbreak still expanding geographically
ReutersReuters – Tue 14 Oct, 2014.

snipped

The number of Ebola cases in a vast outbreak in West Africa will go over 9,000 this week and the epidemic is still expanding geographically in Guinea, Sierra Leone and Liberia, the World Health Organization (WHO) said on Tuesday.

The death toll so far in the outbreak, first reported in Guinea in March, has reached 4,447 from a total of 8,914 cases, said WHO assistant director general Bruce Aylward.

BBM

That sounds like a roughly 50% mortality , right? I thought just a day or 2 ago, it was reported mortality had reached 90% in some locations. hmmm
What I'm seeing is nearly 4k people who could potentially give blood to save lives to the other patients, right?

 

[AlwaysShocked]

When I hear these statements being made about how "we don't want people to panic", I wonder what that statement means. In other words, what does "panic" mean, under these circumstances. Does it mean ripping one's clothes off and running wild in the streets, or what? Just asking.....

I would just like to see our "leaders" get PROACTIVE on this situation. It is well known that quarantine works very well in preventing the spread of communicable diseases. Quarantine laws have long been in place in the United States. Quarantine has been used effectively in our country at various times, beginning in 1918 during the "Spanish flu" pandemic, then extending to tuberculosis patients and polio patients throughout the years.


The Federal government along with State and County agencies have the means already in place to institute quarantine:

"Executive Orders specify the list of diseases for which federal quarantine is authorized, which is required by the Public Health Service Act. On recommendation of the HHS Secretary, the President may amend this list whenever necessary to add new communicable diseases, including emerging diseases that are a threat to public health.

Amendment to Executive Order 13295: Quarantinable Communicable Diseases
Federal Register Archives, signed April 4, 2003, amended by 13375 on April 1, 2005 and by 13674 on July 31, 2014."
http://www.cdc.gov/quarantine/specificlawsregulations.html


This latest patient was on an airplane one day before she entered the hospital, forgodsake. What if she coughed or sneezed onto her drop down tray? What if she used the bathroom?

Once she got off the plane in Dallas, that plane likely loaded up again within an hour! But so far at least, no one from the CDC is saying they are contacting all the people who were on the next flight of that plane, and the next one after that, etc.

It just sounds like these CDC people are not thinking ahead enough - at all. Yes, this CAN be contained at this stage, but SOMEBODY needs to be in charge and to make some tough decisions NOW. There is no vaccine and no cure for ebola. What else IS there BUT quarantine?

 

[Isabelle]

I think New Orleans Charity Hospital should reopen to care for Ebola infected patients. Graduates of Charity School of Nursing, Tulane and LSU schools of medicine residents and teaching staff could do it! I would work with them in a heartbeat! Damn Katrina ruined it for everyone.

ETA: Charity has a contagion building and it is separate from any other part of the facility.

 

[nrdsb4]

WOW! DPH ER is on divert! I bet I would cancel my own elective surgery. Wonder if DPG ER has been disinfected per Ebola protocol since the first Ebola patient was seen there?

From what we have been told, they've been on divert for a while. Came off briefly, then went back on divert. If I had to guess, and I absolutely am guessing, they can't get staffing.

 

[nrdsb4]

That sounds like a roughly 50% mortality , right? I thought just a day or 2 ago, it was reported mortality had reached 90% in some locations. hmmm
What I'm seeing is nearly 4k people who could potentially give blood to save lives to the other patients, right?

BBM
I made that comment a few days ago, and it was wisely pointed out that due to that area's struggles with marlaria and HIV, there would have to be some really vigorous testing in place first. Don't know how long it would take to get that in place.

 

[Isabelle]

From what we have been told, they've been on divert for a while. Came off briefly, then went back on divert. If I had to guess, and I absolutely am guessing, they can't get staffing.

Or no one wants to go there.

 

[Sonya610]

Uhm, that first sentence is a HUGE generalization. South America is a huge continent, and while there are extremely poor areas it is not at all like the areas of Africa where the outbreak is occurring. Have you ever even been to any South American country??? :facepalm:

Well let us hope the leaders in South America have WATCHED what happened in Dallas and SHUT DOWN TRAVEL FROM FOLKS that have been in infected areas!

 

[SCHMAE]

B/c conditions in S. America aren't much better than w. Africa...generalized comment obviously. This fact coupled with the fact that we basically do not have a southern boarder is a recipe for disaster.

People crossing are already bringing in various diseases, and this would be no different.

Wow, great point.

 

[CuriousGuy]

When I hear these statements being made about how "we don't want people to panic", I wonder what that statement means. In other words, what does "panic" mean, under these circumstances. Does it mean ripping one's clothes off and running wild in the streets, or what? Just asking.....

I would just like to see our "leaders" get PROACTIVE on this situation. It is well known that quarantine works very well in preventing the spread of communicable diseases. Quarantine laws have long been in place in the United States. Quarantine has been used effectively in our country at various times, beginning in 1918 during the "Spanish flu" pandemic, then extending to tuberculosis patients and polio patients throughout the years.


The Federal government along with State and County agencies have the means already in place to institute quarantine:

"Executive Orders specify the list of diseases for which federal quarantine is authorized, which is required by the Public Health Service Act. On recommendation of the HHS Secretary, the President may amend this list whenever necessary to add new communicable diseases, including emerging diseases that are a threat to public health.

Amendment to Executive Order 13295: Quarantinable Communicable Diseases
Federal Register Archives, signed April 4, 2003, amended by 13375 on April 1, 2005 and by 13674 on July 31, 2014."
http://www.cdc.gov/quarantine/specificlawsregulations.html


This latest patient was on an airplane one day before she entered the hospital, forgodsake. What if she coughed or sneezed onto her drop down tray? What if she used the bathroom?

Once she got off the plane in Dallas, that plane likely loaded up again within an hour! But so far at least, no one from the CDC is saying they are contacting all the people who were on the next flight of that plane, and the next one after that, etc.

It just sounds like these CDC people are not thinking ahead enough - at all. Yes, this CAN be contained at this stage, but SOMEBODY needs to be in charge and to make some tough decisions NOW. There is no vaccine and no cure for ebola. What else IS there BUT quarantine?

IMO the word panic is being used to infer you are an uneducated simpleton that just doesn't understand medicine if you are worried at all over this. You must trust us, your government, implicitly. If you're worried and are "panicking" you must be a tinfoil hat donning rube.

 

[nrdsb4]

Hospitals need to set up one floor that cares for these patients only with the same staff that do not rotate out of that unit. That floor will have to have its own supply/exhaust system that does not enter any other area of the hospital. That floor will need an ante room that is closed off from patient area where supplies can be delivered so that delivery person does not enter the care area. Staff will need a room that is closed off from the patient care area that has its own air/exhaust supply where they can take breaks, have their meals and meals purchased from the cafeteria should be delivered to the floor ante room. All caregivers should be required to shower in an area not connected to the patient care area and should do this before leaving the floor to go home. Caregivers should not be able to leave the care area until their shift has ended. It's a lot, but it's doable.

I was talking to another nurse about this a few days ago. Because normally in an ICU, a nurse is in and out of her patient's room all dang day. When you have a patient with special precautions, it's a major ordeal to gown and regown multiple times per day. With the danger taking the PPG off seems to present with ebola, we were speculating that the safest route would be to have nurses working shorter shifts, but never leaving the room until they were done for the day, then do the massive decontaminating, take off a layer, decontaminate, take off a layer, etc.

We were just speculating, as neither of us has ever worked in this kind of environment. Again, I wonder how the Emory staff did it?

 

[nrdsb4]

Or no one wants to go there.

No doubt.