Ebola outbreak - general thread #7

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Does anyone other than me think it is strange that we haven't heard any update on Amber since she arrived in Atlanta? I'm worried about her.
 
I've been having a hard time discerning what things have happened when in relation to things like did Amber fly the first time before or after Nina was diagnosed with ebola, and when did monitoring of various people start and so forth. So I've started putting together a timeline. And in the process, I've read some shocking things that I'm not sure if they've been brought to light.

When Duncan went to the hospital the second time -- in the ambulance -- he was very ill, lots of vomiting. Admitted with suspected ebola. Left to sit in the presence of many other people before finally being isolated. Okay, we know all that. Here's a couple things I didn't know:

The hospital did not immediately test him for ebola. They spent two days doing other tests first. They knew they had a possible ebola case, but didn't test for ebola right away? Really?
http://keranews.org/post/2nd-dallas-nurse-ebola-arrives-atlanta-treatment
http://news.yahoo.com/ebola-patient-thomas-eric-duncan-dies-at-dallas-hospital-201613535.html
http://www.dallasnews.com/news/metr...elay-may-have-violated-federal-guidelines.ece

During the two days from his admission on Sept 28 until the ebola confirmation on the 30th, healthcare workers at the hospital were not wearing any special PPE, just the standard gown gloves & mask. (WHAT????)
Only after the positive ebola test 2 days later did they start following the CDC's prior (inadequate) PPE guidelines.
http://thescoopblog.dallasnews.com/...r-two-days-while-treating-ebola-patient.html/

The HCW who treated him during those 2 days without PPE were either not being monitored at all or were considered low-risk. (I'm having trouble finding definitive info on whether they were being monitored.) That why they were free to go on cruises and get on places and fly around the country.

On Sept. 29, the hospital shipped Duncan's blood to the state lab in Austin for ebola testing. I can't find any info about how it was shipped or how it was handled in Austin or any monitoring of anyone in the Austin lab.
http://www.dallasnews.com/news/metr...elay-may-have-violated-federal-guidelines.ece

The Texas hospital has a machine that can be used to test for ebola and get results within an hour. They didn't use it because of stupid bureaucratic regulations. The machine is used by the military in Africa and has a better than 90% accuracy rate.
http://www.defenseone.com/threats/2...creening-machine-military-using-africa/96713/

When Amber was diagnosed with ebola, she was not one of the people being monitored for ebola, which included only people who had contact with Duncan prior to his hospitalization.
http://www.chron.com/news/houston-t...-hospital-worker-contracted-Ebola-5817785.php

The lab worker departed on the cruise ship on Oct 12 -- before being notified of required monitoring. So this lab worker who handled Duncan's lab samples wasn't even under monitoring until more than 3 days after Duncan died.
http://abcnews.go.com/Health/hospit...la-samples-caribbean-cruise/story?id=26263642


There is so much "too little too late" going on here that it boggles the mind. They took too long (IMO) to start contact tracing. They took too long to actually test him for ebola. They took too long to isolate him. They took too long to start wearing PPE, and when they finally did it was inadequate. They took too long to start monitoring HCWs who cared for him. They didn't monitor a lot of people they should have. Monitoring didn't involve much of anything beyond self-checking temp twice a day. They took too long to start requesting travel restrictions on people who are self-monitoring. IMO, they still haven't restricted travel sufficiently.

They consider "low-risk" a lot of people that I would have to consider to be "high-risk." It almost seems as if any HCWs who cared for him prior to his diagnosis weren't considered at any significant risk simply because he hadn't yet had a confirmed diagnosis. Just like they didn't wear PPE when he was admitted, but merely routine gloves/gown/mask from his admission until his diagnosis -- even though he was suspected to have ebola.

I don't think this could have been handled worse if they had been trying to.
 
SStarr33 said:
Check out this story. Buried about half way in is a story that there is someone at Baylor who screened positive for ebola, but the actual test is not back yet:

http://thescoopblog.dallasnews.com/...t-ebola-patient-asked-to-limit-movement.html/

ETA, wait, not sure I read that right. Maybe the test is done?
Click to expand...

My interpretation is they are waiting on actual rest results. She met the criteria for someone who potentially may have ebola,so further testing had to be done.
They seem to be keeping it under the radar though.
 
Isabelle said:
Not sure what to think of the appointment of Ron Klain. How will he know he is being handed bullch*t while trying to do the job. That's like letting the cashier at a store be in charge of nursing policy and procedure. I just don't know what to think.
Click to expand...

I don't think that he needs a medical background to coordinate info and tasks of different agencies. I do hope he has reputable SCIENTISTS i.e., Dr. Fauci of NIH, as advisors. If he is able to articulate what is proven to be factual without embellishment, to the general public, he will be doing his job. JMO
 
I didn't see where this has already been posted, sorry if I missed it.


http://mashable.com/2014/10/16/texas-nurses-ebola-protective-gear/

Texas Ebola Nurses Wore Too Much Protective Gear

CDC director Dr. Tom Frieden has cited a "breach in protocol" that allowed Pham to be infected while she cared for Duncan in the intensive care unit, but has not specified the nature
of that breach. He did however note that some of Texas Health Presbyterian Hospital nurses inadvertently violated the CDC protocols by wearing too much protective gear.

"These are good, dedicated people who worried about themselves and their families and they were trying to protect themselves better, but in fact by putting on more layers of gloves or other protective clothing, it becomes much harder to put them on, it becomes much harder to take them off," Frieden said Wednesday.
"And the risk of contamination during the process of taking these gloves off gets much higher. That's true for several different areas of the body," he added.
Click to expand...
 
The World Health Organization has admitted that it botched attempts to stop the now-spiraling Ebola outbreak in West Africa, blaming factors including incompetent staff and a lack of information.

http://www.cbsnews.com/news/ebola-o...ganization-admits-bungling-response-to-virus/

It noted that the heads of WHO country offices in Africa are "politically motivated appointments" made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan.

WHO said it was "particularly alarming" that the head of its Guinea office refused to help get visas for an expert Ebola team to come in and $500,000 in aid was blocked by administrative hurdles.

read more at link
..............................

What a damn shame, but let's just throw more money at it, what the hell.
 
Texas Hospital Worker Who Handled Ebola Samples is on the Carnival Magic

Posted on October 17, 2014 by Jim Walker

ABC News reports that a Dallas health care worker who handled clinical specimens from Ebola-infected Thomas Duncan is on a Caribbean cruise aboard the Carnival Magic.

The cruise line says that the female worker is allegedly being "self-quarantined" and is being monitored for signs of infection. She apparently has no symptoms yet...

http://www.cruiselawnews.com/2014/1...ndled-ebola-samples-is-on-the-carnival-magic/
 
hockeymom said:
Maybe someone with medical background can explain this to me. Nina has been downgraded from good to fair. Is there a universal way a hospital evaluates someones status? Are their specified criteria or is it subjective? I thought the Drs in the presser were very vague as to why she was downgraded. I almost got the impression they wanted to say that they differed from Pres. Hosp.,but wouldn't do that.
Alos has their been an update on Amber today?
Click to expand...

There are some guidelines put out by the American Hospital Association for reporting a patient's medical state: http://www.uclahealth.org/main.cfm?id=646

Undetermined: Patient awaiting physician assessment.
Good: Vital signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.
Fair: Vital signs are stable and within normal limits. Patient is conscious but may be uncomfortable. Indicators are favorable.
Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.
Critical: Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.
Treated and released: Received treatment but not admitted.
Treated and transferred: Received treatment. Transferred to a different facility.

So it sounds like going from good to fair, would indicate that she is experiencing pain or discomfort. Poor Nina. On the other hand, the level of "comfort" seems to be subjective and could vary from hospital to hospital. So she might not be experience any more discomfort than she was in Dallas, but just that the NIH might have a different way of measuring discomfort.
 
SteveS said:
Obviously the problem is the immense CDC stupidity that has been on display at almost every turn.

The problem isn't with the care-givers, who followed instructions, took an abundance of caution, and did everything they were instructed (and beyond) by the CDC's supposed "experts." They were told to check in daily, watch for symptoms, and that they weren't contagious unless they had a temp of 100.4 or higher, and yet Amber double- and triple-checked to make sure it was okay to take her return flight when she had a fever of only 99.5.

If they get someone in charge who actually has a clue, it appears to me like there wouldn't be a problem. Let's recognize that hospitals using their own protocols like Emory, NIH, and the one in Nebraska have had no problem keeping care-givers safe or containing problems through multiple cases.

As far as the idea to quarantine everyone with contact for 21 days, while it seems easy, it's not practical, especially given the fact that the ones at greatest risk are the caregivers not others. With that sort of 21-days-for-all-no-matter-what format, you couldn't really treat ebola patients on an ongoing basis, as each and every caregiver would have to be almost permanently isolated and work about 10 days on a patient after which they sat out for 21. Or else, they work with ebola patients and NEVER have contact with the outside world. Either way, you'd quickly run out of nurses willing to help, under that sort of setup.
Click to expand...

But the problem, is, in part, due to the actions of the healthcare workers. How do I say this, without coming across that I am "bashing" them? They are medical professionals who have had contact with a patient who has died from Ebola. They should, at the very least, be self-quarantined in their houses for 21 days, not mingling with the general public. After 21 days, if you've got no symptoms or fever, then have at it.
 
SStarr33 said:
Check out this story. Buried about half way in is a story that there is someone at Baylor who screened positive for ebola, but the actual test is not back yet:

http://thescoopblog.dallasnews.com/...t-ebola-patient-asked-to-limit-movement.html/

ETA, wait, not sure I read that right. Maybe the test is done?
Click to expand...

Sounds like she is another "low risk" person who was self-monitoring but the CDC doesn't have her name on a list? She has symptoms and has either been in contact with someone who has ebola or has been in west Africa recently. :thinking:

She has not tested positive yet
 
Elley Mae said:
The World Health Organization has admitted that it botched attempts to stop the now-spiraling Ebola outbreak in West Africa, blaming factors including incompetent staff and a lack of information.

http://www.cbsnews.com/news/ebola-o...ganization-admits-bungling-response-to-virus/

It noted that the heads of WHO country offices in Africa are "politically motivated appointments" made by the WHO regional director for Africa, Dr. Luis Sambo, who does not answer to the agency's chief in Geneva, Dr. Margaret Chan.

WHO said it was "particularly alarming" that the head of its Guinea office refused to help get visas for an expert Ebola team to come in and $500,000 in aid was blocked by administrative hurdles.

read more at link
..............................

What a damn shame, but let's just throw more money at it, what the hell.
Click to expand...

Sounds familiar.
 
atthelake said:
Every cycle has a control to make sure that it has been done properly

Sent from my SCH-S720C using Tapatalk 2
Click to expand...

Yes, but they are inspected (I hope) by individual states. Who knows if the calibration is correct or if the workers/inspectors are conscientious? I would not want my state to take the risk.
 
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