Ebola outbreak - general thread #2

[CARIIS]

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[Lyra500]

Donning protective gear IS the definition of " medical isolation". To be basically specific: the care of a person with Ebola and large amounts of body fluids needing to be cleaned or removed ( vomitus, diarrhea, blood) would include: Water and fluid proof disposable long sleeve gowns. fluid proof aprons, full face masks or N- 95 respirator masks with separate goggles, gloving with frequent glove changes, hair covers, and possibly shoe covers if there is a lot of body fluids gushing out such as blood, vomitus or diarrhea.

Gear has to be removed in a way so as not to expose the dirty side to the wearer, and it has to be changed frequently.
So, anyone reading this should be able to maintain a barrier field assuming that they know how to dress themselves, and remove clothing without touching the outer surfaces.

I read that those medical workers who have died whilst working in the isolation units are likely to have inadvertently picked up the virus from the outside of their PPE due to a lapse in procedure whilst undressing and then not showered washed before touching their face or mouth.

However, as others have said they could just as well have picked it up elsewhere during their time at home etc. I believe taxis have been identified as potential disease vectors due to virus left by sick passengers (hardly and ambulances available).

 

[Sonya610]

Head of the CDC says: "Though we might wish we can seal ourselves off from the world, there are Americans who have the right of return and many other people that have the right to enter this country," Dr. Thomas Frieden told a press conference. "We're not going to be able to get to zero risk no matter what we do unless we control the outbreak in West Africa."

http://www.foxnews.com/politics/201...atient-still-not-inclined-to-close-us-points/

They sure as heck could stop issuing visas to citizens of those countries without a VALID reason (visiting relatives, girlfriends, and tourism are NOT a valid reason). They could also revoke non-essential visas that were already issued and turn away folks holding those passports.

By not even TRYING to limit the non-essential travel from those countries because it would "hamper aid" they are just bs-ing about the real reasons.

His comment about "not getting zero risk UNLESS we control it in Africa" is another lie. It will NEVER be completely controlled (not anytime soon)! So he is saying don't take ANY steps regarding travel or anything else unless it can produce perfect results? If that were the case then all of the effort is pointless.

 

[Lyra500]

Medical staff don't have to deliberately touch the patients with their bare hands to get infected - it could just be a case of being totally weary at the end of a long heart-breaking day and inadvertently touching the outside of protective equipment whilst taking it off - and then wiping your face without thinking because you are pouring with sweat.

It could be going home in an infected taxi because you are simply too tired to take another step.

It could be that they are working in one of the areas where there is barely any personal protective equipment at all and people have to try and make do with what they have. Yet medics and nurses still turn up and try to do their best for the patients - I find that incredibly moving.

How about a challenge - why doesn't everyone try to get ready for bed tonight by taking their outer clothes off without touching the outside of them at any point? [We'll have to imagine the bits about watching several children and adults die horribly without being able to comfort them in the way we would want; moving their bodies and spending several hours basically wearing a huge plastic bag in incredible heat and humidity.]

It seems really easy to find fault with actions of individuals, medical staff, whole populations from thousands of miles away - there is that saying about walking a mile in other people's shoes before one can really understand.

 

[Lyra500]

They sure as heck could stop issuing visas to citizens of those countries without a VALID reason (visiting relatives, girlfriends, and tourism are NOT a valid reason). They could also revoke non-essential visas that were already issued and turn away folks holding those passports.

By not even TRYING to limit the non-essential travel from those countries because it would "hamper aid" they are just bs-ing about the real reasons.

His comment about "not getting zero risk UNLESS we control it in Africa" is another lie. It will NEVER be completely controlled (not anytime soon)! So he is saying don't take ANY steps regarding travel or anything else unless it can produce perfect results? If that were the case then all of the effort is pointless.

I have to say that is not my reading of what he is saying at all. Where does he say that we should not be doing anything?

Part of the reason the outbreak is not under control is that the rest of the world has been sitting on its' hands rather than helping to mount the campaign required to really have an impact.

He said we need to control the outbreak in Africa - that is absolutely true in my view. Closing your borders and sticking your head in the sand in the hope it all blows over is not an option.

 

[ClaireNC]

Pretty good article with a timeline of Duncan's movements and some notes on conditions in West Africa. Of course, there are variations on Duncan's story but I think this article is worth posting.
http://www.cbsnews.com/news/ebola-outbreaks-long-winding-path-to-us-shores/

 

[P.Falk]

Not sure if this has been mentioned already. But how long do you think it will be before ISIL decides that it's easier to get someone on a plane headed for the U.S. with Ebola than explosives? If they've got people willing to blow themselves up in the name of Allah, why not infect themselves with a deadly pathogen? Scary thought.

 

[Sonya610]

I have to say that is not my reading of what he is saying at all. Where does he say that we should not be doing anything?

Head of the CDC says: "Though we might wish we can seal ourselves off from the world, there are Americans who have the right of return and many other people that have the right to enter this country," Dr. Thomas Frieden told a press conference. "We're not going to be able to get to zero risk no matter what we do unless we control the outbreak in West Africa."

He is saying there is NO POINT in restricting travel because it won't create "zero risk", well nothing does, including the attempts to control the spread in Africa!

According to his logic which states the U.S. shouldn't even try to limit travel "because it won't produce zero risk" could be taken a step further to say there is no point trying to slow down the progress in Africa because that won't produce a "zero risk" either.

Or take it a step further and say we shouldn't try to treat infected individuals because there is no guarantee they will survive, and why bother doing something if the results aren't 100% guaranteed?

 

[song22]

http://www.washingtonpost.com/sf/national/2014/10/04/how-ebola-sped-out-of-control/?hpid=z1

Fantastic piece from the Washington Post.

 

[Lyra500]

He is saying there is NO POINT in restricting travel because it won't create "zero risk", well nothing does, including the attempts to control the spread in Africa!

According to his logic which states the U.S. shouldn't even try to limit travel "because it won't produce zero risk" could be taken a step further to say there is no point trying to slow down the progress in Africa because that won't produce a "zero risk" either.

With respect, I think that 'step further' requires an interpretation of what was said with which I disagree.

I will paste the bit you quoted below but bold it slightly differently.:

Head of the CDC says: "Though we might wish we can seal ourselves off from the world, there are Americans who have the right of return and many other people that have the right to enter this country," Dr. Thomas Frieden told a press conference. "We're not going to be able to get to zero risk no matter what we do unless we control the outbreak in West Africa."

There seems to be a school of thought in the USA that all you need to do is get people from West Africa banned from entering America and that will sort everything out. I believe the Head of the CDC is refuting this view.

So he is saying tinkering with border closures (or anything else of that ilk) is not the way to reduce risk and is not the answer, controlling the outbreak in Africa is the way to do that.

Nigeria and Senegal have shown that to be the case - controlling the outbreak with effective Public Health contact tracing, monitoring and isolation for those who test positive is the only way to deal with this.

Unfortunately, none of the three remaining countries have the resources to do this on their own, because the outbreak was already well established before the cause was even identified, at least two of them are coming out of a hugely damaging civil war and are therefore lacking in infrastructure, healthcare personnel and equipment. So they need support with equipment and personnel to do what they need to - if they are not supported then I agree, this outbreak will not be controlled and whether we like it or not, with or without border controls, we will all remain at a certain degree of risk. There is the potential for the disease to mutate, to move to other poor populous countries like India and China and even to become endemic.

The clock is ticking and the global community needs to act on this to save us all from what has the potential (however remote) to turn into a global catastrophe.

 

[fabvab]

Because of HIPAA laws, they obligated to tell us if any of the people Duncan stayed with come down with Ebola? We've been told they have been moved to a house, but how do we really know if that is true? Just asking.

 

[effervescent]

I know. Yet I'm still seeing some who think they're experts suggest the use of a spray. Guess they're too lazy to use gloves. The RN who attended my mom didn't know bleach doesn't kill C-diff. I had to train her. I bought the right solution and had them use it.

Yes, it does when properly diluted to the correct ratio. I am a part-time housekeeper in a hospital and that is what we use first, then we go over everything with the correct germicide. In fact, C Diff rooms are the only rooms where we use bleach - it's the first line of defense in cleaning. Not bleach spray either... we use pre-made wipes, made especially for this purpose. I am curious what you brought in for them to use, and why any hospital would even allow this. They should have the proper germicides already and what we use is not available to the general public.

 

[passionflower]

Brantly will never know exactly how he caught the Ebola virus, although he suspects it happened during an all-night shift when he admitted two extremely sick patients into the Ebola isolation unit. Both died within hours.

The virus swiftly carried Brantly to the edge of death. His fever reached 105; he vomited blood and battled diarrhea and nausea. He could barely breathe.

Brantly soon became the first human to receive an experimental Ebola drug called ZMapp, which Samaritan's Purse had arranged to get to him in Liberia. From the moment he became ill, he didn't step out of his house until he was flown to Emory University Hospital in Atlanta on a specially equipped plane.

 

[Sonya610]

Not sure if this has been mentioned already. But how long do you think it will be before ISIL decides that it's easier to get someone on a plane headed for the U.S. with Ebola than explosives? If they've got people willing to blow themselves up in the name of Allah, why not infect themselves with a deadly pathogen? Scary thought.

I seriously doubt if they would. There are MANY ways to cause mass panic and make a big statement in the U.S., the terrorists are very familiar with the possibilities and they are all better than having their guys contract Ebola.

Look up black market surface to air missiles (many can be shoulder launched by one person). Now THOSE would cause mass mayhem in the U.S. and everyone knows they would be darn easy to smuggle in and use near U.S. airports. They are prevalent in parts of the Middle East undergoing conflict.

 

[ClaireNC]

Question for the medical professionals among us. Ebola is still highly contagious after the person has died. Is this something that is true or common with other viruses? Just curious.

 

[Footwarrior]

,

This Frontline report on the Ebola outbreak shows the difficulties facing those trying to stop the epidemic:

http://www.pbs.org/wgbh/pages/frontline/ebola-outbreak/

Some further comments on this show. Those fighting the epidemic in Sierra Leone are incredibly brave. The team going from village to village tracking down cases is no longer wearing protective gear because it scares the villagers. Their only protection is keeping a few feet of distance between themselves and patients that are almost certainly infected.

The job has been made much harder by the spread of conspiracy theories. Rumors are being spread that Ebola doesn't exist and that the doctors are taking people away to steal their blood. Infected persons are hiding from the medical teams, assuring that the rest of their family will be infected. Or traveling to other villages further spreading the disease. The spread of conspiracy theories and urban legends is assuring the spread of the disease.

 

[SCHMAE]

,

Some further comments on this show. Those fighting the epidemic in Sierra Leone are incredibly brave. The team going from village to village tracking down cases is no longer wearing protective gear because it scares the villagers. Their only protection is keeping a few feet of distance between themselves and patients that are almost certainly infected.

The job has been made much harder by the spread of conspiracy theories. Rumors are being spread that Ebola doesn't exist and that the doctors are taking people away to steal their blood. Infected persons are hiding from the medical teams, assuring that the rest of their family will be infected. Or traveling to other villages further spreading the disease. The spread of conspiracy theories and urban legends is assuring the spread of the disease.

Wow, what a nightmare

 

[popsicle]

ian bremmer ‏@ianbremmer 2h2 hours ago
How contagious is Ebola? Less than you'd think. (NPR)
https://pbs.twimg.com/media/BzL1xHlCMAInxlf.jpg

 

[Sonya610]

Or traveling to other villages further spreading the disease. The spread of conspiracy theories and urban legends is assuring the spread of the disease.

Another article (can't recall link) mentions that in many areas it is customary to take the dead back to their birth village for burial. This meant bodies were being transported long distances (sometimes to nearby countries) in taxi cabs and pick up trucks and then handled/buried by folks in that village spreading the outbreak to all sorts of places.

Also regarding families that hide the infected, one documentary had a group of nurses marching down the street of a village yelling "If one person in the family gets sick the WHOLE FAMILY WILL DIE" through a bull horn!

She was yelling that in English so I like to think it was a translation problem and she wasn't actually saying that in their native language without the caveat stating unless the person gets treatment. If they are telling people that it is an automatic death sentence for the WHOLE FAMILY then of course people will go into denial and hide sick family members, they are being told they are all dead either way.

 

[ClaireNC]

http://www.washingtonpost.com/sf/national/2014/10/04/how-ebola-sped-out-of-control/?hpid=z1

Fantastic piece from the Washington Post.

This is an excellent article. Thanks for posting it! I encourage anybody interested in learning more about the virus to read it, especially the "Stages of hemorrhagic fever" section within the article.