Ebola outbreak - general thread #5

[Isabelle]

excellent point. I think research has been done which shows we are CONSTANTLY and unconsciously touching our faces.

One really has to be "in the zone" to be safe when caring for contagious patients. I also have a concern with one element of PPE, gloves. It really bugged me when I worked in NICU years ago that the non sterile boxed gloves we used were made in Pakistan. Not implying they would be better if made in USA, but maybe there would be better controls. And don't get me started on powdered gloves, who knows what that powder cr*p was. It burned my nose and eyes and floated all over.

 

[Ladylub]

I suspect DPH will have more that 2 cases among staff. Being an RN, if I were a patient at the hospital I would be fighting to get out and might leave AMA. Hopefully they are not floating caregivers as is so often done. That is a major concern, IMO.

Yesterday I heard a paramedic say he picked up a patient earlier with chest pains from a business ( manager called). The patient asked where they would be taken saying if Presby Ill take my chances of driving myself to another hospital.

 

[nrdsb4]

One really has to be "in the zone" to be safe when caring for contagious patients. I also have a concern with one element of PPE, gloves. It really bugged me when I worked in NICU years ago that the non sterile boxed gloves we used were made in Pakistan. Not implying they would be better if made in USA, but maybe there would be better controls. And don't get me started on powdered gloves, who knows what that powder cr*p was. It burned my nose and eyes and floated all over.

On my nursing forum, a nurse who has worked extensively in Africa (not this round) said that the gloves would often tear as you put them on or took them off. That's a breach right there. I've had the same problem with "clean gloves," though fortunately not with sterile ones. It also seems that the latex free gloves are sturdier.

 

[Isabelle]

The eyes are one of those things that I truly wonder a lot about.

How many times in our lives have we been talking with someone in an excited discussion, and the person basically spit on you. Not a lot of course, but enough to notice where you would back away from them. If an infected person did that and it got in your eye, I honestly think that could be where some of the strange cases of catching it has come from.

You are so right. Gross, I know, but i have seen many spots on the face of my cell phone that I know are droplets from myself. BTW any phone is one of the most contaminated items that exists. They are just plain filthy!

 

[STANDREID]

This is starting to remind me of And the Band Played On except with much worse potential consequences.

 

[Hatfield]

On my nursing forum, a nurse who has worked extensively in Africa (not this round) said that the gloves would often tear as you put them on or took them off. That's a breach right there. I've had the same problem with "clean gloves," though fortunately not with sterile ones. It also seems that the latex free gloves are sturdier.

I totally agree about the tearing. I actually buy and go through many boxes of the latex kind because I use them when cleaning up after my dog poops + pees in the house (he is getting old and wont listen to us anymore).

I am absolutely amazed at how often I tear them. I have started to put on double gloves about a year ago.

 

[Isabelle]

On my nursing forum, a nurse who has worked extensively in Africa (not this round) said that the gloves would often tear as you put them on or took them off. That's a breach right there. I've had the same problem with "clean gloves," though fortunately not with sterile ones. It also seems that the latex free gloves are sturdier.

I have had many tear and have had a few with holes in them. I would double glove when providing wound care to HIV patients. My worse was quadriplegic in a home living situation with multiple wounds to feet, back of legs and sacrum. I never had any help, this was home health. I finally asked to be reassigned as I was having difficulty holding his legs up with one hand and wound care with the other. Never again! My message to nurses, never ever do anything that might compromise your well being. Get help or refuse.

 

[Sonya610]

Yes, that's getting close. But remember that airborne particles can also float far from the source. If ebola was spread by airborne route (consider chicken pox which could be spread from aisle 7 to an unsuspecting victim in aisle 9), it would change EVERYTHING in terms of how easily it is contracted to how patients are isolated, etc. The people trying to minimize the difference between droplet and airborne transmission don't seem to realize the implications of an airborne virus.

Thank you for explaining that in a pleasant common sense manner. The folks without medical backgrounds simply did not choose that career, it doesn't mean they/we are less intelligent or that we can't grasp the concepts when the explanation is clear.

Often medical terms use a "different language" but that doesn't mean the concepts are difficult to explain.

 

[Sophieandme]

Second health care worker tests positive in Dallas.

http://www.nbcnews.com/storyline/eb...alth-care-worker-tests-positive-ebola-n226161

Saw a conference on Youtube with a Dr. speaking who had headed up the response to a previous Ebola outbreak in a remote village. He mentioned several times that infected HCW's are (unfortunately) amplifiers.

 

[nrdsb4]

Thank you for explaining that in a pleasant common sense matter. The folks without medical backgrounds simply did not choose that career, it doesn't mean they are less intelligent or that they can't grasp the concepts when the explanation is clear.

Of course they can understand. What I said was that "Joe Schmo doesn't get to define medical terms." There is a good reason for that. But sure, I think most of us posting here are intelligent, mature and capable of understanding pretty much anything the medical experts can throw at us.

 

[oh_gal]

I'm frankly confused as to why so many blame the CDC for this situation in Dallas.

Due to how both our healthcare system and how our very government (federal/state/local) is set up, the responsibility for implementing protocols lies with the state and local health departments and the facilities themselves. The CDC is not a police force. It cannot enforce rules even if it had the manpower to do so. The CDC regularly issues advisories, etc regarding ALL kinds of communicable diseases. Whether there is follow through or not is the responsibility of the states/localities and facilities, unfortunately.

Those who wish to blame the CDC and say it should do more should follow through on that by pressuring your elected officials to earmark more funds for the CDC and to legislate to expand it's function. Or vote for candidates who support such expansion and more robust funding.

I have a sneaking suspicion though that the segment of the public who want to blame CDC are the same segment of the public that objects to most all federal oversight of absolutely anything ("too much regulation!") and are the same who are in favor of budget cuts to things like public health.

Some need to ask themselves what on earth the state and local health departments down in Texas were doing over the summer when CDC was already warning about future Ebola cases, and already had information regarding protocols out. I know they did because I saw them at the practice I worked at last summer. After all, if the "ideal" way to deal with problems is at the state and local level rather than the federal, then why weren't they carrying out their responsibility down there? And why wasn't this facility training it's staff in preparation? one would think the free market would dictate that it's in the facility's interest to protect it's workers (an thus it's profit), no?

Can't have it both ways.


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I don't know if I necessarily "blame" the CDC (unless it is for putting information out there that is misleading), as much as I blame health officials who look to the CDC as some type of god, when it comes to safety and direction in matters like this.

 

[Hatfield]

Saw a conference on Youtube with a Dr. speaking who had headed up the response to a previous Ebola outbreak in a remote village. He mentioned several times that infected HCW's are (unfortunately) amplifiers.

I have watched quite a few mini-documentaries on the the health care workers over in Africa helping the patients.

Wow. I have the utmost respect for what they are doing and I pray for them. It looked very scary to me, and especially some of the clinics that were outside in makeshift type hospitals. I kept wanting to yell out to them..."Watch out for that stuff right there". They are literally surrounded with danger.

I also pray for anybody in the health care industry. My wife took care of a paraplegic person as a job and I learned how difficult the job is, and how it takes a certain type of person that can be in the field.
I pray for all the nurses and doctors because I know they sincerely try to help people and it is a very hard job.

 

[nrdsb4]

I will join in the hats off to anyone willing to take care of an ebola patient. Even if you have the perfect environment, it would still be scary. Even the very best nurses make mistakes, and I have certainly made my fair share. I would really be terrified of screwing up here when the PERSONAL stakes are also so high.

Based on the press conference, it seems clear they are totally expecting more of the "75" to be infected. I don't know how they are going to be able to handle those kinds of numbers. It makes me feel really sick inside.

 

[SCHMAE]

At some point will nurses and doctors refuse to treat patients because they feel so unprepared and have no faith in the ' protocol ' they've been told is safe?

 

[nrdsb4]

At some point will nurses and doctors refuse to treat patients because they feel so unprepared and have no faith in the ' protocol ' they've been told is safe?

ABSOLUTELY yes.

 

[SCHMAE]

https://fbcdn-sphotos-f-a.akamaihd...._=1420751091_99e6b04f144ac711afea185c43a589e3

https://www.facebook.com/LaHealthDe...6961108650086/861559897190200/?type=1&theater

LA department of health's facebook page.

ETA , is this picture leaving out a few things?

 

[jjenny]

Anybody know if they are monitoring the hazmat people?

I don't know, but hazmat people were well suited up.
Unlike, apparently, the nurses.

 

[SStarr33]

Just thinking out loud here. I'm sure current immune status has something to do with the number of days for symptoms to present. However, it seems logical to me that if you take two people with similar immune systems and inoculate them with different amounts of the virus, the person who is inoculated with more virus will show symptoms sooner than the one who had a low dose. If this is the case, could it take longer for Duncan's family to show symptoms than the nurses?

Any thoughts from those in the know?

 

[cady]

I don't know, but hazmat people were well suited up.
Unlike, apparently, the nurses.

Maybe my anger is misplaced, but it just makes me furious that the nurses (who seem to be at greatest risk) are treated by their employer as "dime a dozen" nobodies. The institution has a serious obligation to protect the caregivers.....at all costs. JMO

 

[nrdsb4]

Just thinking out loud here. I'm sure current immune status has something to do with the number of days for symptoms to present. However, it seems logical to me that if you take two people with similar immune systems and inoculate them with different amounts of the virus, the person who is inoculated with more virus will show symptoms sooner than the one who had a low dose. If this is the case, could it take longer for Duncan's family to show symptoms than the nurses?

Any thoughts from those in the know?

Don't know for sure, but that seems perfectly logical, which is why I keep re-iterating that they are not out of the woods yet. Also, the lower "dose" of exposure might be enough for a healthy person's immune system to completely conquer.

I know more about modes of transmission than specifics on this virus and how it acts once in the body; perhaps someone more knowledgeable can comment.