Ebola outbreak - general thread #8

[XXXXXXXX]

1 Not sure I buy CNN's wild guess of the future as reliable.
2 Even if it is reliable, I don't see the problem. We are already treating the low end of that range or more, are working at far below capacity, and are better at it now than when we started.

You may not regard the CNN estimate as reliable. But as recently as September, Obama publicly stated that Ebola would NEVER reach the U.S.

That was proven wrong. My point is that Bellevue Hospital in NYC had to transfer all other ICU patients and even pediatric patients to other hospitals because they don't have enough STAFF to deal with one single Ebola patient along with other ICU and pediatric patients.

There are simply not enough medical staff in the U.S. to deal with multiple Ebola patients in a single facility at any one time. It's my understanding that in Dallas, that Presby asked for VOLUNTEERS to take care of patient zero.

There's just not going to be many VOLUNTEERS in the future considering the abysmal rate this is spreading in the U.S. and the fact that even the CDC keeps changing protocols every few days.

(modsnip)

 

[Woe.be.gone]

Prior point:
"Very interesting interview with Dr Fauci about quarantines, esp of HCW's returning to the US, and he made that point. In essence, you have someone who has bravely gone to fight this disease. Then they want to go home. Not sick. Yet we are saying they get jailed for weeks, and put in a less-than-decent setting, and can't go home until govt says so. "



Again, you're missing the issue. The current rule is that if you are a HCW returning from work in WAfrica, you get jailed in quarantine for 3 weeks. Period. They are ALREADY being treated as "special,"if you want to call it that.

This "special" handling already has forced them into lousy conditions, crappy treatment, no visitors or amenities, you get whatever we decide to give you (and do without whatever we don't feel like) and you can't leave. And when they left the US, they signed up for none of that.

So while quarantine is of benefit on one level, the question is whether the protocol they have created creates a climate in which the HCWs will decide that it's too onerous to go to WAfrica and help.

Your answer is to jail them in another country for the 21 days? Wonderful, that's even better. ~sarcasm alert~ Wait, maybe send them to Guantanamo! That'll keep them from our doors.

The point is, this is not a issue where we can act on one front, and ignore the other ramifications. You have people putting their lives on the line as volunteers, and getting crapped on as a reward. That doesn't fly very long.

I totally agree with this synopsis. There has to be a better way. The nurse, who was "released" today was not treated nicely imo.

 

[Woe.be.gone]

Okay, now I see I posted from way behind and there's a huge argument surrounding the treatment of the nurse.
Did everyone see the tent that was used to isolate her? No heat and that toilet! Come on people!

 

[SteveS]

<modsnip>

Nah. In the sense he obviously meant it, he's not been proven wrong. Not that I tend to trust any politician and their pronouncements.

But when he spoke that, we had already TREATED patients in the US that had been infected in WAfrica, so he wasn't saying we would never treat one here.

The sense of his message is that we won't have any sort of public outbreak of the disease, and so far that's been true. The hysteria, panic, and irrationality is off the charts, but the transmission of the disease itself is not.

Other than in the hospital during the treatment process, when the protocols for HCW safety were still being determined, ebola has never been transmitted to another person in the US, and those protocols have been revised and the disease has been contained despite those lapses. No one has caught it in public, and there's been no "outbreak" anywhere in the

(modsnip) But so far, at least this once, it's played out as predicted.

 

[jjenny]

Well I provided a link for my figures. I have not seen a link to yours.

Dr. Spencer is 24th staff member of Doctors without Borders to get Ebola. 13 died in the last 7 months.

"Twenty-four staffers working for Doctors Without Borders contracted Ebola during the ongoing outbreak - with 13 dying from the virus in the last seven months."

http://www.nydailynews.com/news/wor...ctors-borders-staffer-ebola-article-1.1986015

 

[chipmunk]

Sorry if this has been posted. http://www.burlingtonfreepress.com/.../vermont-public-health-announcement/18060701/

''A Vermont resident recently returned from West Africa and entered voluntary quarantine, showing no signs of Ebola symptoms.

"There is extremely low risk ... however we're going to take every precaution," said Vermont Gov. Peter Shumlin.

The person will be quarantined for 21 days.'''

I was wondering why this asymptomatic man is referred to as a patient. This is the man who falsely claimed to be a physician and was rejected as a worker by Doctors Without Borders. Although not known to have patient contact his actions leave open the possibility of psychological instability. This might be why he's referred to as a patient.

There was some concern over what his intentions were.

 

[Sweet Fox]

Okay, now I see I posted from way behind and there's a huge argument surrounding the treatment of the nurse.
Did everyone see the tent that was used to isolate her? No heat and that toilet! Come on people!

That is factually not true. The tent, which has been approved by the CDC, was located within the climate controlled hospital building. Moreover, she had computer access, use of her cell phone, reading material (magazines, newspaper) and requested and has received take-out food and drink.

Oh yeah, compared to her stay in Africa, the conditions of her quarantine in NJ must have been sheer hell.

 

[bessie]

Got a question about the rules? Contact a mod or admin.

 

[concernednetizen]

He's from rutland vermont, which is waaaaay to close to home, and cannot be avoided by my family, should the worst happen. I have no idea who it is or where he is being kept, but I really want to know. http://http://www.rutlandherald.com/article/20141028/THISJUSTIN/141029957

 

[SStarr33]

NJ Ebola quarantine policy embraced by Nobel Prize-winning doctor

http://www.nj.com/politics/index.ss...e_un_is_embraced_by_2011_nobel_prize_win.html

LOL

 

[gitana1]

At present, there are more than 3,200 MSF staff working on Ebola in West Africa. The total number of people who have worked in Ebola projects since MSF began its intervention last March is significantly higher. To date, 24 MSF staff have contracted Ebola and 13 have died.

http://www.doctorswithoutborders.org/article/q-msf’s-ebola-response-and-protocols#5

Thank you for this. So doing the math, if 24 Doctors Without Borders staff have contracted Ebola out of 3200 staff working on the cases in West Africa, then less than 1% of their workers have contracted the virus. Let's compare that with the US. If 50 people worked on Mr. Duncan, and 2 contracted the virus, that's 4%. So it looks like medical staff overseas have better protocols than we have employed. I'm still not understanding why we quarantine a nurse coming from there but not our staff treating victims here?

As to those stating the CDC don't know what they're doing, well, the recent protocols they are advising we use came from Doctor's Without Borders. And those protocols have better odds than ours.

I don;t think the quarantine of one and not the others is logical. I think it is political and not rational.

 

[SophieRose]

http://www.doctorswithoutborders.org/article/q-msf’s-ebola-response-and-protocols

How many MSF staff members have been infected with Ebola in the field, and why were they infected given the precautions taken?

At present, there are more than 3,200 MSF staff working on Ebola in West Africa. The total number of people who have worked in Ebola projects since MSF began its intervention last March is significantly higher. To date, 24 MSF staff have contracted Ebola and 13 have died. Ten have survived, and one, our colleague now in New York, is in treatment. Twenty-one of the 24 have been national staff, people who live in the country in which they were working (national staff make up the vast majority of MSF staff around the world). Three were international staff, or &#8220;expats.&#8221;

 

[SStarr33]

Thank you for this. So doing the math, if 24 Doctors Without Borders staff have contracted Ebola out of 3200 staff working on the cases in West Africa, then less than 1% of their workers have contracted the virus. let's compare that with the US. If 50 people worked on Mr. Duncan, and 2 contracted the virus, that's 4%. So it looks like medical staff overseas have better protocols than we have employed. I'm still not understanding why we quarantine a nurse coming from their but not our staff treating victims here?

As to those stating the CDC don't know what they're doing, well, the recent protocols they are advising we use came from Doctor's Without Borders. And those protocols have better odds than ours.

I don;t think the quarantine of one and not the others is logical. I think it is political and not rational.

There are scientists who disagree. Why take the chance?

 

[jjenny]

NJ Ebola quarantine policy embraced by Nobel Prize-winning doctor

http://www.nj.com/politics/index.ss...e_un_is_embraced_by_2011_nobel_prize_win.html

LOL

My feelings exactly.

 

[annahanna]

How many of the 240 that you cited or from doctors without Borders? According to their statements, only three. Are you aware how many healthcare professionals from poor Third World countries are currently treating Ebola victims?

Twenty-three MSF staff have been infected with Ebola since March, seven of whom have recovered. The vast majority of these infections were found to have occurred in the community.
MSF/DWB
http://www.doctorswithoutborders.org/our-work/medical-issues/ebola

I am aware that many healthcare workers from poor third world countries are treating Ebola patients. I know that many organizations like the Red Cross, WHO, Doctors Without Borders, Samaritan's Purse and others are working diligently to train local health care workers and provide upgraded facilities. This is a breakdown of their current staffing in the specific countries:
MSF Staff on the Ground (as of October 21, 2014)
Guinea: 54 international, approximately 360 national (+48 from Ministry of Health)
Liberia: 109 international, around 1,241 national
Sierra Leone: 107 international, around 1,417 national
Total: 270 international, around 3,018 national
MSF/DWB
http://www.doctorswithoutborders.org/our-work/medical-issues/ebola

* Doctors Without Borders/Médecins Sans Frontières (MSF) does not separately publish (or I could not find) numbers of trained health care workers in country vs support personnel. However, it is well known, and published on their site, that DWB/MSF internationally recruits only highly trained and qualified healthcare workers for field work. They prefer to hire support personnel locally. It is also known that the pool of qualified health care workers in Guinea, Liberia, and Sierra Leone has been decimated by disease. It is likely that 10% or less of their medical personnel are local. Therefore, Doctors Without Borders likely has less then 300 doctors and nurses on the front lines. ***Of those 300 likely healthcare workers, they have reported that 23 have contracted Ebola with 16 dying from it. Although it is a very small sample and probably not statistically significant, their mortality rate is 70%. The US mortality rate for US acquired infections is 0%.

***The 10% estimate is my educated opinion based on medical staffing and support information that I have access to but can not link here. In this setting, I will state that it is my opinion only.

 

[chipmunk]

So "voluntary" is simply government speak for "mandatory." (And I'm not doubting you - it sounds exactly like what we should expect from our govt these days.) Got it.

Putting aside whether quarantine for asymptomatic HCWs is necessary or not, the wording may make a difference for those like Kaci, RN. If the term voluntary home self monitoring or required home self monitoring (with enforcement if needed) makes people agreeable why not use these words. Sometimes it's just semantics and the psychological aspect of not wanting to be ordered to do something.

 

[gitana1]

NJ Ebola quarantine policy embraced by Nobel Prize-winning doctor

http://www.nj.com/politics/index.ss...e_un_is_embraced_by_2011_nobel_prize_win.html

LOL

Ok. So why isn't everyone demanding that the health care workers here be quarantined after working on Ebola patients as well?

Our system of protocols is simply not better. No evidence of that at all. The fact that so many people from DWB are handling such patients and not contracting the virus tells me we have something to learn from them - not the other way around.

Further, Nigeria, which stopped the virus in its tracks, depsite being a populous third world country with poor sanitation, isolated and monitored but did not quarantine. Their success in eradicating the disease was due from help by WHO, the US CDC, the Nigerian CDC and strong leadership.
http://www.who.int/mediacentre/news/ebola/20-october-2014/en/
http://news.nationalgeographic.com/news/2014/10/141024-ebola-nigeria-outbreak-lessons-virus-health/
http://www.washingtonpost.com/poste...es-wont-stop-ebola-from-spreading-in-the-u-s/

 

[nrdsb4]

Who were those "tons" of people from outside the hospital? His family quarantined themselves against him. The only one I know for sure is the homeless guy.

There were 43 contacts who were monitored after contact with a symptomatic Mr. Duncan before he was admitted to Presby Dallas. None were infected. That does not count the 75 HCW who were also put on a watch list.

 

[gitana1]

There are scientists who disagree. Why take the chance?

My problem is with hysteria and the reasons behind it. If there is a consensus that quarantine is necessary to stop the spread, which I see no evidence of, then employ it for all health care workers, not just those on the front lines coming back from Africa. That's selective and ludicrous, IMO and points to something other than science as a basis for it.

 

[SStarr33]

Ok. So why isn't everyone demanding that the health care workers here be quarantined after working on Ebola patients as well?

Our system of protocols is simply not better. No evidence of that at all. The fact that so many people from DWB are handling such patients and not contracting the virus tells me we have something to learn from them - not the other way around.

Further, Nigeria, which stopped the virus in its tracks, depsite being a populous third world country with poor sanitation, isolated and monitored but did not quarantine. Their success in eradicating the disease was due from help by WHO, the US CDC, the Nigerian CDC and strong leadership.
http://www.who.int/mediacentre/news/ebola/20-october-2014/en/
http://news.nationalgeographic.com/news/2014/10/141024-ebola-nigeria-outbreak-lessons-virus-health/
http://www.washingtonpost.com/poste...es-wont-stop-ebola-from-spreading-in-the-u-s/

I'm good with the quarantine.