Ebola outbreak - general thread #4

[shotgun09]

The only thing I like in his suggestions, is adding an Infectious Disease Specialist in the room, to monitor all staff, to assist with PPE, and instruct. A " buddy system" if you will. As long as it's guaranteed, that is.

 

[trex]

I hate how angry this press conference is making me... :furious:

 

[popsicle]

WTOP ‏@WTOP 2m2 minutes ago
CDC's Tom Frieden: could have more positive tests of health care workers because of breaches in protective gear

 

[gngr~snap]

Did not work the last two days because that was her scheduled time off work ? Or did not work the last two days because she already felt ill? Wwas she 'self quarantining' those two days and staying home in a sick bed or out in town having lunch and such ?

ETA I'm just thinking away . Two days prior to Friday is Wednesday, the day Duncan died, correct? So she was working ( presumably ) with him until the end. Does that mean that his care team may have put in extra hours, WAY more hours than normal , because many caregivers did not want to treat him? Was she ' on call' or ' on duty' the entire time he was hospitalized? Which would knock your immune system low for sure. But I wonder if the last day she worked is the day he passed and then finally , they were given time OFF. Do the math. Am I thinking too much ?

My guess is she was scheduled off those 2 days. If I have a choice, I want 2 days together. I am guessing she was off Wed/Thur, had fever Fri and went in for testing...


All posts are MOO

 

[Sonya610]

Did not work the last two days because that was her scheduled time off work ? Or did not work the last two days because she already felt ill? Wwas she 'self quarantining' those two days and staying home in a sick bed or out in town having lunch and such ?

I am guessing was home sick for the two days, it takes a couple of days to get the Ebola results back, right? Which means she had symptoms and got tested two days ago and the results came in recently.

 

[shotgun09]

They need to Institute Level 4 at all hospitals now, and it is very costly....

 

[Brightbird]

Freidman is like a drone!!
So let me understand what he just said. She had extensive contact with Duncan , yet was considered low risk? What's high risk then?
I feel lime they have no idea how this occurred. Just assuming the nurse screwed up.

This is from Australia but I think it would be same as USA. High risk is considered-

​​Contacts with higher risk exposures have had direct contact with the patient or their bodily fluids.
-percutaneous (e.g. needle stick) or mucous membrane exposure to blood or body fluids of an EVD patient
-direct skin contact exposure to blood or body fluids of an EVD patient without appropriate personal protective equipment (PPE),
-laboratory processing of body fluids of suspected, probable, or confirmed EVD cases without appropriate PPE or standard biosafety precautions, or
-direct contact with a dead body without appropriate PPE

http://www.health.nsw.gov.au/Infectious/controlguideline/Pages/ebola-virus.aspx

 

[gngr~snap]

I just don't agree with this train of thought. Our medical professionals are less able to properly use PPE than those in Africa? Why are so many health care workers suddenly getting ebola?
What has changed recently???

All posts are MOO

 

[JeannaT]

Weird. When I first read the Google news headline article this morning, it said the worker was male, and was a 'hero' and was proud of being able to help an ebola patient.

That paragraph is now gone.

 

[hockeymom]

This is from Australia but I think it would be same as USA. High risk is considered-

​​Contacts with higher risk exposures have had direct contact with the patient or their bodily fluids.
-percutaneous (e.g. needle stick) or mucous membrane exposure to blood or body fluids of an EVD patient
-direct skin contact exposure to blood or body fluids of an EVD patient without appropriate personal protective equipment (PPE),
-laboratory processing of body fluids of suspected, probable, or confirmed EVD cases without appropriate PPE or standard biosafety precautions, or
-direct contact with a dead body without appropriate PPE

http://www.health.nsw.gov.au/Infectious/controlguideline/Pages/ebola-virus.aspx

Thank you for your response. That's what I would think but it sounds like this was what this nurse was doing yet she was still considered low risk. I'm confused.

 

[Sonya610]

Also just my opinion that it should not have taken this long for screening at airports to begin and/or 21 day quarantine for those incoming from west African countries considering the staggering numbers of cases and deaths via Ebola in that region, and the WHO admits that those are only the reported cases they know about and the numbers are likely much higher.

I personally believe the lack of travel restrictions was well thought out. Fact is when Ebola started hitting Western Countries there would be a HUGE surge in research dollars and effort put towards fighting it and developing a possible vaccine.

If it only effected people in West Africa well then....not so much of a concern for first world countries kwim?

So there likely was well thought out reasoning that lead to the decision to NOT impose travel restrictions, a motive to rapidly increase research funding is the mildest reason in my mind, less "humanitarian" reasons also seem like possible motivators.

 

[Lyra500]

WTOP ‏@WTOP 2m2 minutes ago
CDC's Tom Frieden: could have more positive tests of health care workers because of breaches in protective gear

Please could you clarify (not in the US) - did he say breaches in protective gear or protective protocols? (Thanks!)

I am wondering about the following potential causes:

• Inadvisable 'economising' resulting in sub-standard PPE
• Inadvisable 'economising' resulting in provision of insufficient PPE (i.e. lower level of protection)
• Local protocols not providing all of the required steps to minimise risk
• Local training did not provide workers with adequate guidance on required infection control actions.
• Staff have not followed guidance scrupulously

 

[jjenny]

Thank you for your response. That's what I would think but it sounds like this was what this nurse was doing yet she was still considered low risk. I'm confused.

She was using PPE according to CDC guidelines. Which is why she was not considered high risk.

 

[popsicle]

Breaking News ‏@BreakingNews 7m7 minutes ago
CDC: Nurse who tested positive for Ebola unable to identify a breach in protocol

 

[Brightbird]

Thank you for your response. That's what I would think but it sounds like this was what this nurse was doing yet she was still considered low risk. I'm confused.

I'm not quite sure, but the way I read it is that high risk is direct contact with body fluids - so without any barrier. Perhaps a health professional can clarify. I need to go to sleep. It's 2:30 Monday morning here!

 

[jjenny]

Please could you clarify (not in the US) - did he say breaches in protective gear or protective protocols? (Thanks!)

I am wondering about the following potential causes:

• Inadvisable 'economising' resulting in sub-standard PPE
• Inadvisable 'economising' resulting in provision of insufficient PPE (i.e. lower level of protection)
• Local protocols not providing all of the required steps to minimise risk
• Local training did not provide workers with adequate guidance on required infection control actions.
• Staff have not followed guidance scrupulously

Dallas hospital is just a regular hospital. Not specifically designed for Ebola patients. So they were not using biosafety level 4 precautions. Which CDC apparently thinks is perfectly adequate. But it would appear not.
Since this nurse got infected.

 

[hockeymom]

I get the feeling the healthcare worker was in the low risk group because there was no evidence that she had been breached. That group of 48 are self monitoring, which she did. So if she thought there was no breach initially, how will she identify a breach now?

 

[shotgun09]

He continues to subliminally blame the nurse....and I am crying here. Our government, the CDC, may have to step up and supply equipment and training at every hospital in this country. It's costly, but it's happening peeps

 

[popsicle]

Please could you clarify (not in the US) - did he say breaches in protective gear or protective protocols? (Thanks!)

I am wondering about the following potential causes:

• Inadvisable 'economising' resulting in sub-standard PPE
• Inadvisable 'economising' resulting in provision of insufficient PPE (i.e. lower level of protection)
• Local protocols not providing all of the required steps to minimise risk
• Local training did not provide workers with adequate guidance on required infection control actions.
• Staff have not followed guidance scrupulously

Breach of protocol

 

[1&2&3]

This is maddening! After reading the sheet of information on how to put on and take off a PPE, it was evident to me, a layman, the hospital is treating this like a normal isolation case.

What have we heard is the only thing to disinfect yourself or things around you with? Bleach! In the information sheet, it says after disrobing, wash your hands with soap and water or sanitizer. No, no, no! And I am sorry, but I do not think the hospital provided bleach to clean yourself up with. From the beginning, I have doubted this hospital and their isolation procedures.

I am so sorry for this nurse who was not offered proper coverage for treating a patient with this monster disease. A breach of protocol? No, a hospital watching their pennies!