What is the likelihood of it being spread via mail?
Not trying to scaremonger.
I work in a mailroom currently and people are having a freakout due to a letter that originated from one of the Ebola patients.
The chances are exceptionally low - possible (anything is possible) but you're probably just as likely to get infected by an unrelated person elsewhere as getting it from a letter a day or two after it was handled by a patient.
If you handled the letter immediately after it was licked and sealed by someone symptomatic with ebola, the chances are still very low but probably high enough to keep an eye on your temperature and overall well being.
So, not freak out territory, not really even concerned territory, but 'aware' territory is not unreasonable.
Yeah, from the information I've read about Ebola on the CDC website, it didn't seem likely. But then, my medical knowledge is limited to band aids and disinfectant.
I suspect most people are going to be fine unless they find themselves in the ER.
Airplane and casual contact seems not to be too huge a vector from the earlier discussion I had with jam. I suspect what's really going to happen is when this flu season hits hard, tons of people are going to be in the hospital under the suspicion they might have ebola... or hopefully just the flu or a head cold.
The flu, when you get it, is one of those things where you could, as the person who has it, verrrry easily suspect you have ebola, because it feels like you're about to fucking die. If you've never felt like you were dying, you've probably never had the flu. What most people think of the flu is usually just a cold. So I can see where the confusion will come from. Than the poor fucker that actually has ebola is going to show up, and it's going to spread from there.
I don't think the US is immune to an outbreak. I think, as a country, we're actually more susceptible to it compared to places like Europe or Canada because our healthcare prioritizes charging lots of money and going to the ER as a first resort. So you're going to have tons of sick people, and the dude who did get Ebola waiting until they're super infective and then showing up in the ER coughing, and puking on everyone and every thing.
not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
A person I know, who manages people that could potentially travel to Africa, keeps telling people that ebola can live for days on counter tops and shit.
Without question the Flu is worse than Ebola. Even in Liberia the Flu will probably kill more than Ebola this year! Get your flu vaccines everyone!
In other thoughts, I definitely agree that the letter is worth being cautious about, but only in that you should be a little cautious about anything originating in a hospital. For example, its probably more likely to be contaminated with MRSA, or Measles. Both of which are highly infectious, very dangerous, and far more durable than Ebola is.
Honestly its just making our for profit healthcare look as stupid as it is. It struggles along OK when your health is your own problem, but will stagger to its knees in a true crisis where your health is EVERYONES problem. Now, Ebola isn't infectious enough to really reach those levels barring extreme malicious idiocy, but all you need is a population of sick poor people who can't go to the doctor and suddenly you have 500 cases from them sitting surrounded by their families in cramped inner city apartments while they die. Now, Americans aren't culturally like the people in West Africa. A majority do believe in disease, and are terrified of it, so the number of exposures would be lower (noone is going to be laying their hands on an Ebola patient who is bleeding out) but a lack of proper, free healthcare does render us at greater risk.
Re: the nurse taking the flight. Obviously the whole thing with her calling the CDC, reporting a mildly elevated temperature, and not being told not to fly is a fairly huge procedural fuck up. No matter how low a risk, if it can be avoided all together for minimal effort it really should have been avoided.
But as she wasn't even hot enough to properly qualify as a fever, the risk to that plane is extremely low. Remember that Duncan's family who were home caring for him for a number of days of serious symptoms, as yet seem to be fine. The peak of infectivity seems to be pretty much just at the point it kills you.
A nurse should pretty much know not to fly when she has a coworker who just came down with Ebola. An abundance of caution in contamination control is something they teach you in nursing school. Heck, a nurse who'd fly when she is at any risk of having Ebola is the same nurse who would not properly scrub down a room after an MRSA patient. Who goes to a family reunion when you are at risk of having EBOLA! I certainly wouldn't be inviting her to my next BBQ!
edit - My other comment about people who are saying that it is airborne, or surface borne etc would be that if it is so infectious, why are there so few cases? Are you saying that like, 97% of people are immune and completely asymptomatic etc while also not being infectious? If so many are immune, why is the disease even still active? If it is airborne, why is the rate of geographical spread so slow? The flu is airborne. Once this years virus infects say, 1000 people, there will then be 100,000,000 infections within a month. Why hasn't Ebola been like that? Ebola is what it always has been. A lethal, terrifying disease which becomes highly contagious to those immediately around you when you begin to die due to MASSIVE viral loads in your blood and vomit, while being only vaguely infectious before due to low levels of the virus in your saliva and waste.
When you're part of the working poor, and you've already bought tickets, which already cost a lot of money, to go see your family that you only see once every 5 years, you often don't rationalize it like that.
If the hospital or the federal government had offered to reimburse her, she would probably be more than happy to oblige. I'm pretty sure she aired her concerns to her supervisor and her supervisor probably told her tough shit, that's not their problem.
I've been in that position, nursing is particularly bad because of the continuity of care they need to be part of, too, on top of that. They get shit on by everyone, literally and figuratively. Your house is on fire and your kid is badly hurt? No one to replace you? Too fucking bad.
not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
When you're part of the working poor, and you've already bought tickets, which already cost a lot of money, to go see your family that you only see once every 5 years, you often don't rationalize it like that.
If the hospital or the federal government had offered to reimburse her, she would probably be more than happy to oblige. I'm pretty sure she aired her concerns to her supervisor and her supervisor probably told her tough shit, that's not their problem.
I've been in that position, nursing is particularly bad because of the continuity of care they need to be part of, too, on top of that. They get shit on by everyone, literally and figuratively. Your house is on fire and your kid is badly hurt? No one to replace you? Too fucking bad.
I agree you might want to go, but you're a nurse. You know there is a potential risk albeit a small one. You know a coworker became ill. You are really going to spread that risk to your family? I certainly wouldn't. I wouldn't go to a family re-union if I had the flu!
She checked with the cdc, they're the authority, they said go ahead so she did. She wasn't presenting anything more than a slightly elevated temperature, and checked with the people who are supposed to be experts before she left.
She checked with the cdc, they're the authority, they said go ahead so she did. She wasn't presenting anything more than a slightly elevated temperature, and checked with the people who are supposed to be experts before she left.
just about any other time I'd be on board with you.
except when your fellow nurse that you were working with at the exact same time and under the exact same circumstances came down with ebola.
So I guess the nursing staff should only sometimes listen to the cdc?
I have treated a patient during the most contagious part of his illness.
My fellow nurse, using the exact same methods I used has come down with the disease.
I now have a fever, which is the first symptom of this disease.
travel to family reunion, y/n?
It's good that she went to the CDC. It's bad that the CDC fucked up (good job experts). But maybe, she should have looked at the circumstances (the exact same cirumstances that led to her coworker getting ebola) and not gone on the flight.
I think the family would understand the valid excuse of "I probably literally have ebola"
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
I don't know.
I'd like to think that if I felt I could have caught ebola I would have (very sadly) sat out the flight.
but honestly, it would take me over a year to save up that much money.
I'm also chicken shit and would have quit my hospital job before treating a patient with a highly contagious/fatal disease.
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
Well, I've already thoroughly blamed the hospital, the US medical industry, and the CDC in other posts so moving on to blame the nurse for making what I think is an odd decision isn't exactly a race to the bottom. Many people had huge investment in making sure that nurse didn't get on a plane. Those people all failed in their jobs. Now, I'm not even sure she was actually on the plane when she knew she had a fever. In fact, I'm pretty sure she had no detected Fever until after she flew back. She should have been told not to fly, the government should have stepped in to provide support, as should her employer.
My comment is simply this. You are a nurse. You understand contagion control better than anyone else in the hospital. In any half decent hospital, making sure things are sterile is a massive part of your job. You have SEEN what happens when contagion control fails, with outbreaks of diarrhea etc. You know you worked with an Ebola patient, and you know that your contagion control failed and a coworker became sick. The CDC says "Oh yeah, it's fine for you to fly about. No worries! Well, other than you might have Ebola, just make sure to check your temperature twice a day". You are going to a family re-union, to meet with young children and the elderly, who are also people you love. Do you REALLY get on that plane and fly to see them?
I'm a physicist by background. If I had been part of some massive radioactive isotope cleanup effort, and a coworker had been poisoned by it due to failure of protocol, and I was being monitored for side effects which could be lethal to those around me I would not go to a family reunion. I would stay at home and check my temperature 20 times a day rather than the proscribed twice.
Her lack of caution in this points to her not understanding important aspects of disease control. Her lack of understanding of those aspects points to the hospital not emphasizing them. Her hospital not emphasizing them points to structural failings in the system. The problems are all part of the same problem. A good nurse would have known the CDC worker who told her to fly was full of shit, and that going to a family reunion was a terrible idea in the first place. She wouldn't even have needed to ask. And a good CDC worker would have told her not to fly, and especially not to fly to a family reunion!
A nurse asking whether or not she should fly, is like a nurse wondering if now is a good time to clean. It's always a good time to clean, and if you need to ask, you shouldn't get on a plane.
edit - So in more reading she did fly with a very low grade fever. And the CDC worker who told her that was OK should literally be whipped through the streets as an example to others. The nurse has no actual 'blame', but I do question her logic. All actors involved in this need to do a better job going forward. This is the early stage of a potential infection. This is the stage where if someone calls you up and says "Err, I think I might be sick because I watched someone with Ebola on the TV and now I have a fever" then you still show up at their house in helicopters and whisk them off to isolation. Because there are only like 100 people to watch and you can afford to be overly cautious.
edit2 - And I'm back to assigning her some blame. Now that I think about it, she called the CDC and they said, well don't worry, you probably don't have Ebola. She does however know she has a fever. She is a nurse. She knows people don't just get fevers on a lark. If you don't have Ebola, then you likely have the flu. And you know what every nurse should know? That if you have the flu, traveling on a plane to meet with children and the elderly is UTTERLY stupid. A random person, sure, I'll forgive them that. But traveling with a fever if you are a nurse is like an IT security specialist emailing a Nigerian prince his bank details. 'Don't infect others if you are sick' is nursing school 101. Hell, it's nursing school 001. She should know about this crap. It's her job. If she worked at target stacking shelves, and accidentally crushed herself at home when she poorly loaded some shelves by stacking all the heavy stuff on the top shelf then I would say, "regardless of how little you earn, you know better than that. It's literally your job to know that"
Apologies for all my edits. I just find this situation frustrating. Poor performance here will kill people, likely not from Ebola, but from other preventable diseases and lack of vaccines when people lose faith in medical advice and instead turn to Jenny McCarthy. I understand that the nurse isn't really to blame here. She's at the very bottom of the blame totem pole, but I just wish that she, as an individual actor who could have made a much smarter decision had done so. Everything else (other than rage at the CDC worker) is asking a big organization to change which is hard. Asking one person to be smarter, just once about a situation she knows a huge amount about, shouldn't be that hard.
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imdointhisI should actually stop doin' this.Registered Userregular
I'm in Cleveland.
I swear to god if i see one vehicle with UMBRELLA CORP on it i'm going racoon city.
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
Well, I've already thoroughly blamed the hospital, the US medical industry, and the CDC in other posts so moving on to blame the nurse for making what I think is an odd decision isn't exactly a race to the bottom. Many people had huge investment in making sure that nurse didn't get on a plane. Those people all failed in their jobs. Now, I'm not even sure she was actually on the plane when she knew she had a fever. In fact, I'm pretty sure she had no detected Fever until after she flew back. She should have been told not to fly, the government should have stepped in to provide support, as should her employer.
My comment is simply this. You are a nurse. You understand contagion control better than anyone else in the hospital. In any half decent hospital, making sure things are sterile is a massive part of your job. You have SEEN what happens when contagion control fails, with outbreaks of diarrhea etc. You know you worked with an Ebola patient, and you know that your contagion control failed and a coworker became sick. The CDC says "Oh yeah, it's fine for you to fly about. No worries! Well, other than you might have Ebola, just make sure to check your temperature twice a day". You are going to a family re-union, to meet with young children and the elderly, who are also people you love. Do you REALLY get on that plane and fly to see them?
I'm a physicist by background. If I had been part of some massive radioactive isotope cleanup effort, and a coworker had been poisoned by it due to failure of protocol, and I was being monitored for side effects which could be lethal to those around me I would not go to a family reunion. I would stay at home and check my temperature 20 times a day rather than the proscribed twice.
Her lack of caution in this points to her not understanding important aspects of disease control. Her lack of understanding of those aspects points to the hospital not emphasizing them. Her hospital not emphasizing them points to structural failings in the system. The problems are all part of the same problem. A good nurse would have known the CDC worker who told her to fly was full of shit, and that going to a family reunion was a terrible idea in the first place. She wouldn't even have needed to ask. And a good CDC worker would have told her not to fly, and especially not to fly to a family reunion!
A nurse asking whether or not she should fly, is like a nurse wondering if now is a good time to clean. It's always a good time to clean, and if you need to ask, you shouldn't get on a plane.
We may be operating in the valley between the responsible "Don't panic!" messaging and the need to stress that this is a really fucking dangerous virus. The nurse, who is professionally exposed to a variety of contagious environments in her day job, is being told that with the right precautions there is nothing to worry about. When she checks about a worrisome symptom, she is told not to panic by the supposedly expert staff at the CDC.
It's easy for us to say, "What the fuck?" After all, another nurse did get this disease. But we are also being told that this could only happen if she didn't follow proper procedures, not because this is a seriously dangerous virus from a strain that's doing strange things (like migrating across an entire continent in Africa for the first time). There's way too much checklist following right now, when there does need to be more measured uncertainty and paranoia, at least among the experts and front-line medical staff.
Your background probably understand scientific method and cause and effect and breaks things down into logical units.
I wish I could say the same for nurses and doctors. I've had nurses and doctors prescribe to the "god will make everything right in the end, he's working through me" in their method of treatment. There's no prerequisite to be scientific in that field.
not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
Your background probably understand scientific method and cause and effect and breaks things down into logical units.
I wish I could say the same for nurses and doctors. I've had nurses and doctors prescribe to the "god will make everything right in the end, he's working through me" in their method of treatment. There's no prerequisite to be scientific in that field.
My comment is simply this. You are a nurse. You understand contagion control better than anyone else in the hospital. In any half decent hospital, making sure things are sterile is a massive part of your job. You have SEEN what happens when contagion control fails, with outbreaks of diarrhea etc. You know you worked with an Ebola patient, and you know that your contagion control failed and a coworker became sick. The CDC says "Oh yeah, it's fine for you to fly about. No worries! Well, other than you might have Ebola, just make sure to check your temperature twice a day". You are going to a family re-union, to meet with young children and the elderly, who are also people you love. Do you REALLY get on that plane and fly to see them?
Honestly, you're giving far too much credit to the average floor nurse. My wife works on an oncology unit, where it is pretty important to practice high-end sterile technique and the nurses there fail at it all the time.
My comment is simply this. You are a nurse. You understand contagion control better than anyone else in the hospital. In any half decent hospital, making sure things are sterile is a massive part of your job. You have SEEN what happens when contagion control fails, with outbreaks of diarrhea etc. You know you worked with an Ebola patient, and you know that your contagion control failed and a coworker became sick. The CDC says "Oh yeah, it's fine for you to fly about. No worries! Well, other than you might have Ebola, just make sure to check your temperature twice a day". You are going to a family re-union, to meet with young children and the elderly, who are also people you love. Do you REALLY get on that plane and fly to see them?
Honestly, you're giving far too much credit to the average floor nurse. My wife works on an oncology unit, where it is pretty important to practice high-end sterile technique and the nurses there fail at it all the time.
I guess so, then I suppose I should send my blame remnants up the chain and say, that at this stage of an outbreak noone should be near that patient who doesn't understand basic hygiene practices to the level where you assume that if you didn't JUST clean it yourself, it is literally made of Ebola. A nurse who would fly with a fever, should never have been given the chance to approach the patient.
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
Well, I've already thoroughly blamed the hospital, the US medical industry, and the CDC in other posts so moving on to blame the nurse for making what I think is an odd decision isn't exactly a race to the bottom. Many people had huge investment in making sure that nurse didn't get on a plane. Those people all failed in their jobs. Now, I'm not even sure she was actually on the plane when she knew she had a fever. In fact, I'm pretty sure she had no detected Fever until after she flew back. She should have been told not to fly, the government should have stepped in to provide support, as should her employer.
My comment is simply this. You are a nurse. You understand contagion control better than anyone else in the hospital. In any half decent hospital, making sure things are sterile is a massive part of your job. You have SEEN what happens when contagion control fails, with outbreaks of diarrhea etc. You know you worked with an Ebola patient, and you know that your contagion control failed and a coworker became sick. The CDC says "Oh yeah, it's fine for you to fly about. No worries! Well, other than you might have Ebola, just make sure to check your temperature twice a day". You are going to a family re-union, to meet with young children and the elderly, who are also people you love. Do you REALLY get on that plane and fly to see them?
I'm a physicist by background. If I had been part of some massive radioactive isotope cleanup effort, and a coworker had been poisoned by it due to failure of protocol, and I was being monitored for side effects which could be lethal to those around me I would not go to a family reunion. I would stay at home and check my temperature 20 times a day rather than the proscribed twice.
Her lack of caution in this points to her not understanding important aspects of disease control. Her lack of understanding of those aspects points to the hospital not emphasizing them. Her hospital not emphasizing them points to structural failings in the system. The problems are all part of the same problem. A good nurse would have known the CDC worker who told her to fly was full of shit, and that going to a family reunion was a terrible idea in the first place. She wouldn't even have needed to ask. And a good CDC worker would have told her not to fly, and especially not to fly to a family reunion!
A nurse asking whether or not she should fly, is like a nurse wondering if now is a good time to clean. It's always a good time to clean, and if you need to ask, you shouldn't get on a plane.
We may be operating in the valley between the responsible "Don't panic!" messaging and the need to stress that this is a really fucking dangerous virus. The nurse, who is professionally exposed to a variety of contagious environments in her day job, is being told that with the right precautions there is nothing to worry about. When she checks about a worrisome symptom, she is told not to panic by the supposedly expert staff at the CDC.
It's easy for us to say, "What the fuck?" After all, another nurse did get this disease. But we are also being told that this could only happen if she didn't follow proper procedures, not because this is a seriously dangerous virus from a strain that's doing strange things (like migrating across an entire continent in Africa for the first time). There's way too much checklist following right now, when there does need to be more measured uncertainty and paranoia, at least among the experts and front-line medical staff.
The virus isn't doing strange things. It is behaving perfectly normally. Every single case is perfectly logical, and the transmission pattern is precisely as we would expect. The only oddity has been the fact that we're seeing that US hospitals aren't doing good contagion control. Now, they are doing well enough to stop an outbreak over time, but not anywhere near well enough to have zero percolation.
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
Nobody at that wage level could say without lying that they would just toss those tickets. it's just nonsense.
The only thing I would be worried about are the vectors that she infected herself with (her hands - but presumably she washed those at some point before hitting the airport - and whatever part(s) of her face she touched her hands to) Person sitting next to her on the plane? Not really concerned about. Any airline or restaurant staff who, say, cleaned-up a napkin she used? A bit of concern about.
Nurses are taught not to make diagnoses. Continuity of care again. Yes they should, but again, think about it like a person who just worked a 12 hour shift.
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
A big problem in my experience, having known several nurses and residents, is that infection control and osha policies aren't given much of a priority. Sure you get instruction on it, but its not in a lot of cases a huge priority compared to, say, getting rounds done on time, not having pts wait long periods of time, etc. American medical care is run like a factory, especially in hospitals, and especially in emergency services The nurses and doctors are paid decently, but condititions are bad, hours are long, you are expected to work sick (if you can stand you are expected to work and many facilities have little to no procedure for procuring fill ins or backup for sick employees that often have specialty training that is not easily replaceable. ). If you have the misfortune to be a medical resident you also get to work hours that would be outright illegal in any other field.
The virus isn't doing strange things. It is behaving perfectly normally. Every single case is perfectly logical, and the transmission pattern is precisely as we would expect. The only oddity has been the fact that we're seeing that US hospitals aren't doing good contagion control. Now, they are doing well enough to stop an outbreak over time, but not anywhere near well enough to have zero percolation.
I'm pretty sure that Libera & Sierra Leone have not been in a state of perpetual Ebola epidemic since the dawn of the disease's discovery.
It's doing different things, even if 'different' is calibrated in social terms rather than biochemical terms.
The virus isn't doing strange things. It is behaving perfectly normally. Every single case is perfectly logical, and the transmission pattern is precisely as we would expect. The only oddity has been the fact that we're seeing that US hospitals aren't doing good contagion control. Now, they are doing well enough to stop an outbreak over time, but not anywhere near well enough to have zero percolation.
I'm pretty sure that Libera & Sierra Leone have not been in a state of perpetual Ebola epidemic since the dawn of the disease's discovery.
It's doing different things, even if 'different' is calibrated in social terms rather than biochemical terms.
It made it to a major city. The usual history of the disease is that someone in a village catches it, it burns through the village, the outbreak dies. This time it got to a city of a million people and an international airport. So yeah, it's a social thing.
Self-righteousness is incompatible with coalition building.
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MayabirdPecking at the keyboardRegistered Userregular
this is a seriously dangerous virus from a strain that's doing strange things (like migrating across an entire continent in Africa for the first time).
Another important thing to remember about nursing is that it is currently seen as as flight to safety field. That means there are thousands, if not millions, of people who were or would rather be teachers, office assistants and factory workers who have become nurses for the job security.
It's not a calling for the scientifically aware. It's a job with crappy hours and lousy conditions that just happens to buck the trend by being in demand with livable wages. Add to this that "nurse" is an extremely broad term that can encompass everyone from Nursing Assistants with a few weeks of training to Nurse Practitioners who have a doctorate and can, in some places, practice medicine independent of a physician.
Your background probably understand scientific method and cause and effect and breaks things down into logical units.
I wish I could say the same for nurses and doctors. I've had nurses and doctors prescribe to the "god will make everything right in the end, he's working through me" in their method of treatment. There's no prerequisite to be scientific in that field.
that is terrifying.
I know.
... I know.
I've heard a nurse explain to a patient that dialysis is god's miracle work, allowing her more time to spend with her family, when they were discussing her options while her kidneys were shutting down.
Such a fundamental understanding of dialysis and the biblical god and how they work!
I know it's difficult to tell patients shit they don't want to hear, but that kind of shit is inexcusable.
not a doctor, not a lawyer, examples I use may not be fully researched so don't take out of context plz, don't @ me
The reason someone got infected, even with the protocol in place, is because most of these people have probably never put the gear on and taken it off. If they have, they've done it once. Most of these folks have a pdf explaining how to put the shit on and a dusty closet that no one opens.
We need a mobile response team visiting every hospital in the country and doing hands-on training on donning and removing the gear. But we can't afford that shit and don't want to pay for it.
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Yeah, from the information I've read about Ebola on the CDC website, it didn't seem likely. But then, my medical knowledge is limited to band aids and disinfectant.
Airplane and casual contact seems not to be too huge a vector from the earlier discussion I had with jam. I suspect what's really going to happen is when this flu season hits hard, tons of people are going to be in the hospital under the suspicion they might have ebola... or hopefully just the flu or a head cold.
The flu, when you get it, is one of those things where you could, as the person who has it, verrrry easily suspect you have ebola, because it feels like you're about to fucking die. If you've never felt like you were dying, you've probably never had the flu. What most people think of the flu is usually just a cold. So I can see where the confusion will come from. Than the poor fucker that actually has ebola is going to show up, and it's going to spread from there.
I don't think the US is immune to an outbreak. I think, as a country, we're actually more susceptible to it compared to places like Europe or Canada because our healthcare prioritizes charging lots of money and going to the ER as a first resort. So you're going to have tons of sick people, and the dude who did get Ebola waiting until they're super infective and then showing up in the ER coughing, and puking on everyone and every thing.
And occasionally mutters about it being airborne.
Sigh.
In other thoughts, I definitely agree that the letter is worth being cautious about, but only in that you should be a little cautious about anything originating in a hospital. For example, its probably more likely to be contaminated with MRSA, or Measles. Both of which are highly infectious, very dangerous, and far more durable than Ebola is.
Honestly its just making our for profit healthcare look as stupid as it is. It struggles along OK when your health is your own problem, but will stagger to its knees in a true crisis where your health is EVERYONES problem. Now, Ebola isn't infectious enough to really reach those levels barring extreme malicious idiocy, but all you need is a population of sick poor people who can't go to the doctor and suddenly you have 500 cases from them sitting surrounded by their families in cramped inner city apartments while they die. Now, Americans aren't culturally like the people in West Africa. A majority do believe in disease, and are terrified of it, so the number of exposures would be lower (noone is going to be laying their hands on an Ebola patient who is bleeding out) but a lack of proper, free healthcare does render us at greater risk.
A nurse should pretty much know not to fly when she has a coworker who just came down with Ebola. An abundance of caution in contamination control is something they teach you in nursing school. Heck, a nurse who'd fly when she is at any risk of having Ebola is the same nurse who would not properly scrub down a room after an MRSA patient. Who goes to a family reunion when you are at risk of having EBOLA! I certainly wouldn't be inviting her to my next BBQ!
edit - My other comment about people who are saying that it is airborne, or surface borne etc would be that if it is so infectious, why are there so few cases? Are you saying that like, 97% of people are immune and completely asymptomatic etc while also not being infectious? If so many are immune, why is the disease even still active? If it is airborne, why is the rate of geographical spread so slow? The flu is airborne. Once this years virus infects say, 1000 people, there will then be 100,000,000 infections within a month. Why hasn't Ebola been like that? Ebola is what it always has been. A lethal, terrifying disease which becomes highly contagious to those immediately around you when you begin to die due to MASSIVE viral loads in your blood and vomit, while being only vaguely infectious before due to low levels of the virus in your saliva and waste.
If the hospital or the federal government had offered to reimburse her, she would probably be more than happy to oblige. I'm pretty sure she aired her concerns to her supervisor and her supervisor probably told her tough shit, that's not their problem.
I've been in that position, nursing is particularly bad because of the continuity of care they need to be part of, too, on top of that. They get shit on by everyone, literally and figuratively. Your house is on fire and your kid is badly hurt? No one to replace you? Too fucking bad.
I agree you might want to go, but you're a nurse. You know there is a potential risk albeit a small one. You know a coworker became ill. You are really going to spread that risk to your family? I certainly wouldn't. I wouldn't go to a family re-union if I had the flu!
She checked with the cdc, they're the authority, they said go ahead so she did. She wasn't presenting anything more than a slightly elevated temperature, and checked with the people who are supposed to be experts before she left.
just about any other time I'd be on board with you.
except when your fellow nurse that you were working with at the exact same time and under the exact same circumstances came down with ebola.
If we're relying on everyone being smart (we're not) to control the spread of ebol we're fucked anyway.
I have treated a patient during the most contagious part of his illness.
My fellow nurse, using the exact same methods I used has come down with the disease.
I now have a fever, which is the first symptom of this disease.
travel to family reunion, y/n?
It's good that she went to the CDC. It's bad that the CDC fucked up (good job experts). But maybe, she should have looked at the circumstances (the exact same cirumstances that led to her coworker getting ebola) and not gone on the flight.
I think the family would understand the valid excuse of "I probably literally have ebola"
You just want to see your family, you get paid maybe $15 an hour. You spent $700 a few months ago for tickets, you decided to save $100 and not get the insurance because you don't have all that much money.
What would you do? You're saying in a forum on the internet you would stay home. The cynic in me says you'd say, "fuck it, I just spent nearly a grand to go visit my family, it's just a little head cold and fever and the CDC doesn't seem to think it's a worry, I'll just be super careful."
I work around nurses every day, you become desensitized to this shit. Everyone thinks they have cancer and are dying when they come to see you at the clinic/hospital. But then you factor in the "being a poor person" to the equation and you can't just take a wash on that money and no one gives a shit about you... so you can see where this is an issue.
The airline should have offered her a refund since it was a medical emergency. The hospital should have stepped in and covered the cost. The CDC should have done their job. The federal government should have picked up the tab to make sure an outbreak didn't happen.
All of those actors fucked up. The one we should be least worried about is the nurse, she did everything she was told to do. I honestly blame the hospital, they should've set up programs for people who might be infected after all the other shit "did you make plans? We'll take care of it for you, don't worry, it's our duty"
But nope, race to the fucking bottom, and these kinds of attitudes towards employees and coworkers and random people you don't know just perpetuate that kind of nonsense.
I don't know.
I'd like to think that if I felt I could have caught ebola I would have (very sadly) sat out the flight.
but honestly, it would take me over a year to save up that much money.
I'm also chicken shit and would have quit my hospital job before treating a patient with a highly contagious/fatal disease.
Well, I've already thoroughly blamed the hospital, the US medical industry, and the CDC in other posts so moving on to blame the nurse for making what I think is an odd decision isn't exactly a race to the bottom. Many people had huge investment in making sure that nurse didn't get on a plane. Those people all failed in their jobs. Now, I'm not even sure she was actually on the plane when she knew she had a fever. In fact, I'm pretty sure she had no detected Fever until after she flew back. She should have been told not to fly, the government should have stepped in to provide support, as should her employer.
My comment is simply this. You are a nurse. You understand contagion control better than anyone else in the hospital. In any half decent hospital, making sure things are sterile is a massive part of your job. You have SEEN what happens when contagion control fails, with outbreaks of diarrhea etc. You know you worked with an Ebola patient, and you know that your contagion control failed and a coworker became sick. The CDC says "Oh yeah, it's fine for you to fly about. No worries! Well, other than you might have Ebola, just make sure to check your temperature twice a day". You are going to a family re-union, to meet with young children and the elderly, who are also people you love. Do you REALLY get on that plane and fly to see them?
I'm a physicist by background. If I had been part of some massive radioactive isotope cleanup effort, and a coworker had been poisoned by it due to failure of protocol, and I was being monitored for side effects which could be lethal to those around me I would not go to a family reunion. I would stay at home and check my temperature 20 times a day rather than the proscribed twice.
Her lack of caution in this points to her not understanding important aspects of disease control. Her lack of understanding of those aspects points to the hospital not emphasizing them. Her hospital not emphasizing them points to structural failings in the system. The problems are all part of the same problem. A good nurse would have known the CDC worker who told her to fly was full of shit, and that going to a family reunion was a terrible idea in the first place. She wouldn't even have needed to ask. And a good CDC worker would have told her not to fly, and especially not to fly to a family reunion!
A nurse asking whether or not she should fly, is like a nurse wondering if now is a good time to clean. It's always a good time to clean, and if you need to ask, you shouldn't get on a plane.
edit - So in more reading she did fly with a very low grade fever. And the CDC worker who told her that was OK should literally be whipped through the streets as an example to others. The nurse has no actual 'blame', but I do question her logic. All actors involved in this need to do a better job going forward. This is the early stage of a potential infection. This is the stage where if someone calls you up and says "Err, I think I might be sick because I watched someone with Ebola on the TV and now I have a fever" then you still show up at their house in helicopters and whisk them off to isolation. Because there are only like 100 people to watch and you can afford to be overly cautious.
edit2 - And I'm back to assigning her some blame. Now that I think about it, she called the CDC and they said, well don't worry, you probably don't have Ebola. She does however know she has a fever. She is a nurse. She knows people don't just get fevers on a lark. If you don't have Ebola, then you likely have the flu. And you know what every nurse should know? That if you have the flu, traveling on a plane to meet with children and the elderly is UTTERLY stupid. A random person, sure, I'll forgive them that. But traveling with a fever if you are a nurse is like an IT security specialist emailing a Nigerian prince his bank details. 'Don't infect others if you are sick' is nursing school 101. Hell, it's nursing school 001. She should know about this crap. It's her job. If she worked at target stacking shelves, and accidentally crushed herself at home when she poorly loaded some shelves by stacking all the heavy stuff on the top shelf then I would say, "regardless of how little you earn, you know better than that. It's literally your job to know that"
Apologies for all my edits. I just find this situation frustrating. Poor performance here will kill people, likely not from Ebola, but from other preventable diseases and lack of vaccines when people lose faith in medical advice and instead turn to Jenny McCarthy. I understand that the nurse isn't really to blame here. She's at the very bottom of the blame totem pole, but I just wish that she, as an individual actor who could have made a much smarter decision had done so. Everything else (other than rage at the CDC worker) is asking a big organization to change which is hard. Asking one person to be smarter, just once about a situation she knows a huge amount about, shouldn't be that hard.
I swear to god if i see one vehicle with UMBRELLA CORP on it i'm going racoon city.
We may be operating in the valley between the responsible "Don't panic!" messaging and the need to stress that this is a really fucking dangerous virus. The nurse, who is professionally exposed to a variety of contagious environments in her day job, is being told that with the right precautions there is nothing to worry about. When she checks about a worrisome symptom, she is told not to panic by the supposedly expert staff at the CDC.
It's easy for us to say, "What the fuck?" After all, another nurse did get this disease. But we are also being told that this could only happen if she didn't follow proper procedures, not because this is a seriously dangerous virus from a strain that's doing strange things (like migrating across an entire continent in Africa for the first time). There's way too much checklist following right now, when there does need to be more measured uncertainty and paranoia, at least among the experts and front-line medical staff.
I wish I could say the same for nurses and doctors. I've had nurses and doctors prescribe to the "god will make everything right in the end, he's working through me" in their method of treatment. There's no prerequisite to be scientific in that field.
that is terrifying.
Honestly, you're giving far too much credit to the average floor nurse. My wife works on an oncology unit, where it is pretty important to practice high-end sterile technique and the nurses there fail at it all the time.
If you're not capable of determining your own circumstances, you should be nowhere near a communicable disease of this nature.
and don't worry, we're not just shitting on her, we're shitting on everyone! because in this particular case, everyone deserves it!
except maybe the first nurse/doctor who did follow what little protocol was in place and didn't fly anywhere.
Should I be concerned?
I usually keep my seat-armrest licking to a minimal. And I only engage in scat play domestically.
I guess so, then I suppose I should send my blame remnants up the chain and say, that at this stage of an outbreak noone should be near that patient who doesn't understand basic hygiene practices to the level where you assume that if you didn't JUST clean it yourself, it is literally made of Ebola. A nurse who would fly with a fever, should never have been given the chance to approach the patient.
The virus isn't doing strange things. It is behaving perfectly normally. Every single case is perfectly logical, and the transmission pattern is precisely as we would expect. The only oddity has been the fact that we're seeing that US hospitals aren't doing good contagion control. Now, they are doing well enough to stop an outbreak over time, but not anywhere near well enough to have zero percolation.
Nobody at that wage level could say without lying that they would just toss those tickets. it's just nonsense.
The only thing I would be worried about are the vectors that she infected herself with (her hands - but presumably she washed those at some point before hitting the airport - and whatever part(s) of her face she touched her hands to) Person sitting next to her on the plane? Not really concerned about. Any airline or restaurant staff who, say, cleaned-up a napkin she used? A bit of concern about.
sadly, you're already infected =(
I've been wondering this myself.
I know hospitals have them. Hell, all the local fire stations and EMS stations have them too.
A big problem in my experience, having known several nurses and residents, is that infection control and osha policies aren't given much of a priority. Sure you get instruction on it, but its not in a lot of cases a huge priority compared to, say, getting rounds done on time, not having pts wait long periods of time, etc. American medical care is run like a factory, especially in hospitals, and especially in emergency services The nurses and doctors are paid decently, but condititions are bad, hours are long, you are expected to work sick (if you can stand you are expected to work and many facilities have little to no procedure for procuring fill ins or backup for sick employees that often have specialty training that is not easily replaceable. ). If you have the misfortune to be a medical resident you also get to work hours that would be outright illegal in any other field.
I'm pretty sure that Libera & Sierra Leone have not been in a state of perpetual Ebola epidemic since the dawn of the disease's discovery.
It's doing different things, even if 'different' is calibrated in social terms rather than biochemical terms.
It made it to a major city. The usual history of the disease is that someone in a village catches it, it burns through the village, the outbreak dies. This time it got to a city of a million people and an international airport. So yeah, it's a social thing.
It didn't actually migrate. It's been there. Antibodies towards the Zaire strain of Ebola (the one spreading right now) were found in a fruit bat in Ghana, a couple countries over from the afflicted area, in 2008.
Here's the native range of that species, Eidolon helvum:
And no matter where it's from, it's always delicious raw.
It's not a calling for the scientifically aware. It's a job with crappy hours and lousy conditions that just happens to buck the trend by being in demand with livable wages. Add to this that "nurse" is an extremely broad term that can encompass everyone from Nursing Assistants with a few weeks of training to Nurse Practitioners who have a doctorate and can, in some places, practice medicine independent of a physician.
I know.
... I know.
I've heard a nurse explain to a patient that dialysis is god's miracle work, allowing her more time to spend with her family, when they were discussing her options while her kidneys were shutting down.
Such a fundamental understanding of dialysis and the biblical god and how they work!
I know it's difficult to tell patients shit they don't want to hear, but that kind of shit is inexcusable.
We need a mobile response team visiting every hospital in the country and doing hands-on training on donning and removing the gear. But we can't afford that shit and don't want to pay for it.