A second nurse that cared for Duncan has tested positive for Ebola.
Yeah, they were talking about not having protocols in place for dealing with an infectious disease that's as virulent as ebola. CDC said something about creating a 'rapid response team' that's basically on call to immediately fly in if possible ebola cases are reported.
I know the hospitals around here are running crash training / retraining programs and drills to get nurses and other caregivers prepared to deal with ebola and I assume the CDC is working on getting materials and experts out to educate on this as well.
All in all, part of the reason why there shouldn't be a widespread outbreak of ebola in the first world.
Cue the chicken littles and smug 'told you so' people saying this just proves the outbreak can't be contained here in the US.
Can't be or might not be?
Outside the strawmen, I don't think anyone in this thread has said with absolute certainty that the outbreak can (or can't) be contained.
We basically seem to be haggling over price, so to speak. People with a scientific or health background are saying 'exceptionally unlikely' beyond a few pockets, and a first world health system should be fully capable of containing it to the point that it would almost take malice, not negligence, to spread beyond a few isolated pockets. There has been acknowledgement that there will be some infections, but they should burn out quickly.
On the other hand, there are some people pushing doom and gloom scenarios as likely and all that's doing is spreading fear and misunderstanding. Fear and misunderstanding serve to increase, not decrease the chances this will spread and trusting modern medicine to do what it's good at is the best outcome.
You've also got some smug people who point to every case as if it validates their doom and gloom scenario. Those people are just being silly geese.
What's interesting thus far is our only other confirmed cases are the people who cared for Duncan. I know we haven't hit the max incubation period yet, but we haven't heard of any of the major contacts while he was out of the hospital having Ebola yet. Assuming he went to the hospital the first day he starting showing symptoms, that puts us 20 days from when he started being contagious. He was home for 3 days before going back, putting us about 5 days from being hopefully out of the woods. Possibly he was a little smart and isolated himself at home?
When a deadly virus has been inside the same building that you live in, it's ok to be a little unnerved. It's the people that are freaking out in completely different states that need to get a grip.
So, I just googled out of curiosity, and as a comparison the WHO estimated 627,000 malaria deaths in 2012, and that's down 42% since 2000. While we need to work to keep it this way, Ebola is barely a blip in contagious disease deaths in Africa, let alone anywhere else.
Malaria is an especially special case because to really get the full picture of the toll of malaria you also need to consider sickle cell. As horrifying as sickle cell anemia is, there is real evolutionary pressure favoring it. Yeah, favoring it.
It's something like 200k new cases of sickle cell in Africa per year, and that number hasn't budged (nor will it, not for a long, long time) even with reductions in Malaria fatality.
Technically it would favor being a carrier for sickle cell due to the extreme oddity of that particular mutation. Human genes just haven't figured out how to make that happen yet, and the process for it involves a lot of wide spread death. There are similar theories about type O blood and the bubonic plague. Dunno if further research has done anything with that. All of this is to say humans have a way to survive these things even in the worst case.
Man, that second nurse lives in The Village, one of the more popular apartment complexes in Dallas. I have some friends who live there.
They're logical, smart people and even they are a bit freaked out by it.
I would be concerned if someone near me got it, not just because of the contagion risk (low), but because we'd probably have guys in smurf suits burning random dumpsters.
Man, that second nurse lives in The Village, one of the more popular apartment complexes in Dallas. I have some friends who live there.
They're logical, smart people and even they are a bit freaked out by it.
I would be concerned if someone near me got it, not just because of the contagion risk (low), but because we'd probably have guys in smurf suits burning random dumpsters.
Yeah, it's ok to be concerned in that situation.
If someone with ebola was being treated at my wife's hospital (which isn't out of the question before this plays out) I'd be more aware. If my mailman or a cashier at my grocery store came down with ebola, I'd be concerned. If the parent of one of my daughter's classmates came down with ebola, I'd be very concerned.
There are situations where it's absolutely reasonable to be concerned.
If you're 200 miles removed and there's no direct relationship with the infected? Not reasonable.
A national nurses union is decrying an absence of protocols at the Dallas hospital where a man died of Ebola and a nurse was infected while caring for him.
Leaders of the National Nurses Union read a statement Tuesday which they said represented concerns from a number of nurses that work at Texas Health Presbyterian in Dallas. The union officials declined to identify the Dallas nurses or say how many were participating in the statement.
But they were vociferous in citing a lack of protocols on the day that Thomas Eric Duncan was admitted with extreme symptoms of Ebola.
Among the flaws cited by the group included:
insufficient garb worn by the emergency personnel
the fact that Duncan was left "for hours" in a non-quarantined zone
that his lab samples were sent in the same way that normal specimens are sent
hospital official allowed nurses involved with Duncan to take care of other patients
other ways in which the hospital did not immediately react to the situation.
"Were protocols breached?" said union spokeswoman Rose Ann DeMoro, "There were no protocols."
"These nurses are not well protected. They're not prepared to handle Ebola or any other pandemic," said DeMoro. "We are deeply alarmed."
DeMoro said the nurses who had come forward were afraid to reveal their identities "because of a culture of threat in the hospitals."
Tuesday night, Texas Health Presbyterian issued a statement in response to the nurses' charges.
"Patient and employee safety is our greatest priority and we take compliance very seriously. We have numerous measures in place to provide a safe working environment, including mandatory annual training and a 24-7 hotline and other mechanisms that allow for anonymous reporting. Our nursing staff is committed to providing quality, compassionate care, as we have always known, and as the world has seen firsthand in recent days. We will continue to review and respond to any concerns raised by our nurses and all employees."
Also Tuesday, the nation's top disease-fighting agency acknowledged Tuesday that federal health experts failed to do all they should have done to prevent Ebola from spreading from a Liberian man who died last week in Texas to the nurse who treated him.
Agency Director Tom Frieden outlined a series of steps designed to stop the spread of the disease in the U.S., including increased training for health care workers and changes at the Texas hospital where the virus was diagnosed to minimize the risk of more infections.
A total of 76 people at the hospital might have had exposure to Thomas Eric Duncan, and all of them are being monitored for fever and other symptoms daily, Frieden said.
That figure confirmed an Associated Press report on Monday that nurse Nina Pham was among about 70 hospital staffers who were involved in Duncan's care after he was hospitalized, based on medical records provided by Duncan's family.
The announcement of the government's stepped-up effort came after top health officials repeatedly assured the public over the last two weeks that they were doing everything possible to control the outbreak by deploying infectious-disease specialists to the hospital where Duncan was diagnosed with Ebola and later died.
"I wish we had put a team like this on the ground the day the patient - the first patient - was diagnosed. That might have prevented this infection. But we will do that from today onward with any case anywhere in the U.S.," Frieden said.
Frieden described the new response team as having some of the world's leading experts in how to care for Ebola and protect health care workers. They planned to review everything from how the isolation room is physically laid out, to what protective equipment health workers use, to waste management and decontamination.
This is part of why I don't want a large scale effort moved over to Africa - our hospitals are very hit or miss in terms of contagion control, and there's a good possibility of major events if we had any sort of large group coming back that needed treatment.
This is pretty much my worry about the situation too. Ebola can be controlled in the first world. It's not a magic virus. We know what it does, and how to stop it spreading. We can do a 95% quality job of this with just good information that...
i) Viruses exist, and can kill you. Bodily fluids are FULL of viruses so stay away from them.
ii) Plenty of masks, gloves and alcohol handwashing gels for healthcare workers and others who want them
iii) The knowledge that if you get sick, you should isolate yourself as best you can
iv) Good precautions around those who die from the disease
This should be our goal for Africa, you get to that, then the disease will die out in a month (not that this will be trivial, it will take a serious response by national agencies who are willing to use good infection control themselves). However, a modern US hospital with 1 case to deal with should not be aiming for 95%. They should be able to achieve absolutely no chance of any follow on infection. 2 shows that they must have systematic failings in their protocol. Now, they are clearly still doing a 95% good job, so this shouldn't be infecting large numbers, but thats not our goal here. They need to not take in further patients with infectious disease, and have a full review of their protocols. The problem is the US for profit hospital system, and the massive variety in the quality of contagion control. The patient, when there are such small numbers of them, should have been handled by an experienced CDC team who flew in specifically for this. 2 follow on cases is AWFUL for a modern hospital. You could do better than that with 19th century technology combating a Measles patient.
This is pretty much my worry about the situation too. Ebola can be controlled in the first world. It's not a magic virus. We know what it does, and how to stop it spreading. We can do a 95% quality job of this with just good information that...
i) Viruses exist, and can kill you. Bodily fluids are FULL of viruses so stay away from them.
ii) Plenty of masks, gloves and alcohol handwashing gels for healthcare workers and others who want them
iii) The knowledge that if you get sick, you should isolate yourself as best you can
iv) Good precautions around those who die from the disease
This should be our goal for Africa, you get to that, then the disease will die out in a month (not that this will be trivial, it will take a serious response by national agencies who are willing to use good infection control themselves). However, a modern US hospital with 1 case to deal with should not be aiming for 95%. They should be able to achieve absolutely no chance of any follow on infection. 2 shows that they must have systematic failings in their protocol. Now, they are clearly still doing a 95% good job, so this shouldn't be infecting large numbers, but thats not our goal here. They need to not take in further patients with infectious disease, and have a full review of their protocols. The problem is the US for profit hospital system, and the massive variety in the quality of contagion control. The patient, when there are such small numbers of them, should have been handled by an experienced CDC team who flew in specifically for this. 2 follow on cases is AWFUL for a modern hospital. You could do better than that with 19th century technology combating a Measles patient.
I used to work in a healthcare environment. A lot of my worry about ebola springs from knowing just how dysfunctional even the "top ranked" hospitals are these days. The free market has left the American medical system in a pretty bad state during normal functioning, so it's hard to be optimistic that it will all come magically together in an emergency because of our First Worldness.
And one thing to understand about the United States at this point of time is that, while we have no shortage of highly paid experts, we've spent the last few decades overworking our medical support staff while requiring them to get additional training and certifications on their own dime, served by "entrepreneurs" whose major qualifications are that they can cheaply and quickly deliver Continuing Education Credit courses. Since it won't be the CDC scientific staff emptying bed pans, this is a major issue when it comes to major outbreaks.
This is pretty much my worry about the situation too. Ebola can be controlled in the first world. It's not a magic virus. We know what it does, and how to stop it spreading. We can do a 95% quality job of this with just good information that...
i) Viruses exist, and can kill you. Bodily fluids are FULL of viruses so stay away from them.
ii) Plenty of masks, gloves and alcohol handwashing gels for healthcare workers and others who want them
iii) The knowledge that if you get sick, you should isolate yourself as best you can
iv) Good precautions around those who die from the disease
This should be our goal for Africa, you get to that, then the disease will die out in a month (not that this will be trivial, it will take a serious response by national agencies who are willing to use good infection control themselves). However, a modern US hospital with 1 case to deal with should not be aiming for 95%. They should be able to achieve absolutely no chance of any follow on infection. 2 shows that they must have systematic failings in their protocol. Now, they are clearly still doing a 95% good job, so this shouldn't be infecting large numbers, but thats not our goal here. They need to not take in further patients with infectious disease, and have a full review of their protocols. The problem is the US for profit hospital system, and the massive variety in the quality of contagion control. The patient, when there are such small numbers of them, should have been handled by an experienced CDC team who flew in specifically for this. 2 follow on cases is AWFUL for a modern hospital. You could do better than that with 19th century technology combating a Measles patient.
I used to work in a healthcare environment. A lot of my worry about ebola springs from knowing just how dysfunctional even the "top ranked" hospitals are these days. The free market has left the American medical system in a pretty bad state during normal functioning, so it's hard to be optimistic that it will all come magically together in an emergency because of our First Worldness.
And one thing to understand about the United States at this point of time is that, while we have no shortage of highly paid experts, we've spent the last few decades overworking our medical support staff while requiring them to get additional training and certifications on their own dime, served by "entrepreneurs" whose major qualifications are that they can cheaply and quickly deliver Continuing Education Credit courses. Since it won't be the CDC scientific staff emptying bed pans, this is a major issue when it comes to major outbreaks.
That is certainly a concern
along with the fact that damn near every hospital in the country was built by a lowest bidder and maintained by people making minimum wage who are basically the same as most people. Go to work, do whatever someone asks me to, no more no less.
which is generally fine!
unless you're in a hospital setting and MORE needs to be done to maintain a clean setting.
Our local hospital (which I will not name due to massive ongoing lawsuits) is a cesspool. It is horrible in almost every concievable way.
My firm (which I will also not name) was contracted to do a series of inspections (we were eventually laid off because we were costing them too much money (i.e. our recommended fixes would have cost them too much money)). We found over 5,000 examples of health and/or safety violations in a hospital less then 5 years old.
this is a picture of two holes in a wall. If you bent down, you could see directly into the room on the interior side of the wall.
this room is their 'sterile lab'.
I highly doubt this has been fixed.
I wouldn't be at all surprised to discover that 90% of the hospitals in the country are run in a similar manner.
And do you think in a non profit driven system someone who said they came from an Ebola outbreak country could get sent home with 103 fever?
I think we will find that the patient's insurance (reports say he wasn't insured) mattered when it came to both their level of treatment and how much attention they got from physicians. There have been a lot of bad habits and structural defects that have arisen from the decades of cuts and penny pinching that have arisen from the way we fund medical care.
And do you think in a non profit driven system someone who said they came from an Ebola outbreak country could get sent home with 103 fever?
I don't think it's beyond the realm of possibility. People are bad at their job / make mistakes everywhere.
My dad - with some of the best insurance in the world - nearly died because the world class hospital he went to thought an infection in his foot was treatable with a prescription to antibiotics. You'll find similar stories all over both inside and outside of the US.
Dallas was one (exceptional to be fair) data point, and is insufficient evidence to support sweeping claims about the quality of profit / non-profit care. Either way.
I'm not saying things are exactly the same for a person without insurance as with it, but I don't think this particular incident is the one that proves it.
And do you think in a non profit driven system someone who said they came from an Ebola outbreak country could get sent home with 103 fever?
I think we will find that the patient's insurance (reports say he wasn't insured) mattered when it came to both their level of treatment and how much attention they got from physicians. There have been a lot of bad habits and structural defects that have arisen from the decades of cuts and penny pinching that have arisen from the way we fund medical care.
Treating physicians and nurses in an ER generally don't know or care what kind of insurance a patient has (or if they don't have insurance at all). It's someone else's problem.
I'm speculating, but his race and possibly language barrier (depending on how well he spoke English) were likely a bigger factor in his treatment or lack thereof than his ability to pay for treatment.
If you accept a single point of failure in that the fact he came from Liberia wasn't understood / relayed to the physician, it's completely believable that the doctor told him to go home, get some rest, and take some Tylenol for his 103* fever. Which is probably the same thing the doctor would tell most any otherwise healthy adult who shows up at the ER with a 103* fever.
I'm starting to understand why my micro professor runs his class like a deathcamp with the intentional goal of failing half the nursing students. I thought the policy of "only nurses who are "----" this smart" was kind of harsh but now I see the wisdom in it.
And do you think in a non profit driven system someone who said they came from an Ebola outbreak country could get sent home with 103 fever?
I think we will find that the patient's insurance (reports say he wasn't insured) mattered when it came to both their level of treatment and how much attention they got from physicians. There have been a lot of bad habits and structural defects that have arisen from the decades of cuts and penny pinching that have arisen from the way we fund medical care.
Treating physicians and nurses in an ER generally don't know or care what kind of insurance a patient has (or if they don't have insurance at all). It's someone else's problem.
I'm speculating, but his race and possibly language barrier (depending on how well he spoke English) were likely a bigger factor in his treatment or lack thereof than his ability to pay for treatment.
If you accept a single point of failure in that the fact he came from Liberia wasn't understood / relayed to the physician, it's completely believable that the doctor told him to go home, get some rest, and take some Tylenol for his 103* fever. Which is probably the same thing the doctor would tell most any otherwise healthy adult who shows up at the ER with a 103* fever.
The biggest points of failure, in terms of accidental exposure, occurred after he was admitted. And I've seen enough studies about the disparities in care between the insured and uninsured to highly doubt that attending physicians, at least, do not know about a patient's insured status. It will definitely matter when deciding how to prescribe drugs or whether to admit a patient, in that there's no point in offering a treatment plan that the patient cannot afford.
Physicians should know about insurance because if you can't pay for the medicine you don't take the medicine. The ones who don't care just prescribe whatever they want and send a huge bill
Marty: The future, it's where you're going? Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
I've personally gone without medicine because of cost a couple times.
Once I was fine, and once I went (back) to the hospital (yes, sadly, that hospital) where they gave me the exact same medicine they prescribed me for about 1/50th the cost (go figure).
This is pretty much my worry about the situation too. Ebola can be controlled in the first world. It's not a magic virus. We know what it does, and how to stop it spreading. We can do a 95% quality job of this with just good information that...
i) Viruses exist, and can kill you. Bodily fluids are FULL of viruses so stay away from them.
ii) Plenty of masks, gloves and alcohol handwashing gels for healthcare workers and others who want them
iii) The knowledge that if you get sick, you should isolate yourself as best you can
iv) Good precautions around those who die from the disease
This should be our goal for Africa, you get to that, then the disease will die out in a month (not that this will be trivial, it will take a serious response by national agencies who are willing to use good infection control themselves). However, a modern US hospital with 1 case to deal with should not be aiming for 95%. They should be able to achieve absolutely no chance of any follow on infection. 2 shows that they must have systematic failings in their protocol. Now, they are clearly still doing a 95% good job, so this shouldn't be infecting large numbers, but thats not our goal here. They need to not take in further patients with infectious disease, and have a full review of their protocols. The problem is the US for profit hospital system, and the massive variety in the quality of contagion control. The patient, when there are such small numbers of them, should have been handled by an experienced CDC team who flew in specifically for this. 2 follow on cases is AWFUL for a modern hospital. You could do better than that with 19th century technology combating a Measles patient.
I used to work in a healthcare environment. A lot of my worry about ebola springs from knowing just how dysfunctional even the "top ranked" hospitals are these days. The free market has left the American medical system in a pretty bad state during normal functioning, so it's hard to be optimistic that it will all come magically together in an emergency because of our First Worldness.
And one thing to understand about the United States at this point of time is that, while we have no shortage of highly paid experts, we've spent the last few decades overworking our medical support staff while requiring them to get additional training and certifications on their own dime, served by "entrepreneurs" whose major qualifications are that they can cheaply and quickly deliver Continuing Education Credit courses. Since it won't be the CDC scientific staff emptying bed pans, this is a major issue when it comes to major outbreaks.
That is certainly a concern
along with the fact that damn near every hospital in the country was built by a lowest bidder and maintained by people making minimum wage who are basically the same as most people. Go to work, do whatever someone asks me to, no more no less.
which is generally fine!
unless you're in a hospital setting and MORE needs to be done to maintain a clean setting.
Our local hospital (which I will not name due to massive ongoing lawsuits) is a cesspool. It is horrible in almost every concievable way.
My firm (which I will also not name) was contracted to do a series of inspections (we were eventually laid off because we were costing them too much money (i.e. our recommended fixes would have cost them too much money)). We found over 5,000 examples of health and/or safety violations in a hospital less then 5 years old.
this is a picture of two holes in a wall. If you bent down, you could see directly into the room on the interior side of the wall.
this room is their 'sterile lab'.
I highly doubt this has been fixed.
[/img]snip[/img]
I wouldn't be at all surprised to discover that 90% of the hospitals in the country are run in a similar manner.
"Essentially any hospital in the country can take care of Ebola. You don't need a special hospital room to do it," Dr. Tom Frieden, current Director of the U.S. Centers for Disease Control and Prevention, said Oct.
This is what the man in authority is telling me, so it must be true
This is pretty much my worry about the situation too. Ebola can be controlled in the first world. It's not a magic virus. We know what it does, and how to stop it spreading. We can do a 95% quality job of this with just good information that...
i) Viruses exist, and can kill you. Bodily fluids are FULL of viruses so stay away from them.
ii) Plenty of masks, gloves and alcohol handwashing gels for healthcare workers and others who want them
iii) The knowledge that if you get sick, you should isolate yourself as best you can
iv) Good precautions around those who die from the disease
This should be our goal for Africa, you get to that, then the disease will die out in a month (not that this will be trivial, it will take a serious response by national agencies who are willing to use good infection control themselves). However, a modern US hospital with 1 case to deal with should not be aiming for 95%. They should be able to achieve absolutely no chance of any follow on infection. 2 shows that they must have systematic failings in their protocol. Now, they are clearly still doing a 95% good job, so this shouldn't be infecting large numbers, but thats not our goal here. They need to not take in further patients with infectious disease, and have a full review of their protocols. The problem is the US for profit hospital system, and the massive variety in the quality of contagion control. The patient, when there are such small numbers of them, should have been handled by an experienced CDC team who flew in specifically for this. 2 follow on cases is AWFUL for a modern hospital. You could do better than that with 19th century technology combating a Measles patient.
I used to work in a healthcare environment. A lot of my worry about ebola springs from knowing just how dysfunctional even the "top ranked" hospitals are these days. The free market has left the American medical system in a pretty bad state during normal functioning, so it's hard to be optimistic that it will all come magically together in an emergency because of our First Worldness.
And one thing to understand about the United States at this point of time is that, while we have no shortage of highly paid experts, we've spent the last few decades overworking our medical support staff while requiring them to get additional training and certifications on their own dime, served by "entrepreneurs" whose major qualifications are that they can cheaply and quickly deliver Continuing Education Credit courses. Since it won't be the CDC scientific staff emptying bed pans, this is a major issue when it comes to major outbreaks.
That is certainly a concern
along with the fact that damn near every hospital in the country was built by a lowest bidder and maintained by people making minimum wage who are basically the same as most people. Go to work, do whatever someone asks me to, no more no less.
which is generally fine!
unless you're in a hospital setting and MORE needs to be done to maintain a clean setting.
Our local hospital (which I will not name due to massive ongoing lawsuits) is a cesspool. It is horrible in almost every concievable way.
My firm (which I will also not name) was contracted to do a series of inspections (we were eventually laid off because we were costing them too much money (i.e. our recommended fixes would have cost them too much money)). We found over 5,000 examples of health and/or safety violations in a hospital less then 5 years old.
this is a picture of two holes in a wall. If you bent down, you could see directly into the room on the interior side of the wall.
this room is their 'sterile lab'.
I highly doubt this has been fixed.
[/img]snip[/img]
I wouldn't be at all surprised to discover that 90% of the hospitals in the country are run in a similar manner.
"Essentially any hospital in the country can take care of Ebola. You don't need a special hospital room to do it," Dr. Tom Frieden, current Director of the U.S. Centers for Disease Control and Prevention, said Oct. 2.
"Though you should probably pick a room without a bigass hole in the wall", Frieden went on to say.
There really isn't anything a special room is going to do for Ebola. Mostly special isolation rooms are just kept at a slightly negative pressure and have 100% of their exhaust vented, sometimes through UV light compartments meant to kill off micro organisms. As Ebola doesn't have an airborne transmission vector it won't really do much other than reinforce the gravity of the situation.
When a place literally has holes in the walls of its labs I don't exactly have confidence in them not cutting corners elsewhere like proper equipment sterilization and garment disposal
+5
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Zavianuniversal peace sounds better than forever warRegistered Userregular
There really isn't anything a special room is going to do for Ebola. Mostly special isolation rooms are just kept at a slightly negative pressure and have 100% of their exhaust vented, sometimes through UV light compartments meant to kill off micro organisms. As Ebola doesn't have an airborne transmission vector it won't really do much other than reinforce the gravity of the situation.
except for the explosive diarrhea and vomiting that's transmitted all over the room
There really isn't anything a special room is going to do for Ebola. Mostly special isolation rooms are just kept at a slightly negative pressure and have 100% of their exhaust vented, sometimes through UV light compartments meant to kill off micro organisms. As Ebola doesn't have an airborne transmission vector it won't really do much other than reinforce the gravity of the situation.
except for the explosive diarrhea and vomiting that's transmitted all over the room
There really isn't anything a special room is going to do for Ebola. Mostly special isolation rooms are just kept at a slightly negative pressure and have 100% of their exhaust vented, sometimes through UV light compartments meant to kill off micro organisms. As Ebola doesn't have an airborne transmission vector it won't really do much other than reinforce the gravity of the situation.
except for the explosive diarrhea and vomiting that's transmitted all over the room
The larger point is that the American healthcare system may not actually be set up for a genuine contagious outbreak, and its financial/structural imperatives may make it much more difficult to switch gears in an emergency than even a Third World national health system. I've seen firsthand that even the nation's best hospitals are ailing, so it wouldn't surprise me to see them start to fall apart when faced with a real-world stress test.
That's not to say that we're all going to die from ebola. The most likely outcome is that the virus will be contained. But people really need to start thinking about what it means to have a medical system that can barely handle the nation's normal health needs, much less a sustained crisis.
There really isn't anything a special room is going to do for Ebola. Mostly special isolation rooms are just kept at a slightly negative pressure and have 100% of their exhaust vented, sometimes through UV light compartments meant to kill off micro organisms. As Ebola doesn't have an airborne transmission vector it won't really do much other than reinforce the gravity of the situation.
except for the explosive diarrhea and vomiting that's transmitted all over the room
Right they should definitely be isolated in a room immediately, but it doesn't really need to be a special isolation room.
yes, they shouldn't be put in a regular room such as an open area of the ER, they should be put in...an isolation room
An isolation room is a special thing. A thing that most hospitals don't have many of. As far as I can tell there is no advantage to be had isolating an ebola patient in an isolation room versus a normal patient room.
This is about procedure, not specialized care facilities.
Marty: The future, it's where you're going? Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
+1
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Zavianuniversal peace sounds better than forever warRegistered Userregular
There really isn't anything a special room is going to do for Ebola. Mostly special isolation rooms are just kept at a slightly negative pressure and have 100% of their exhaust vented, sometimes through UV light compartments meant to kill off micro organisms. As Ebola doesn't have an airborne transmission vector it won't really do much other than reinforce the gravity of the situation.
except for the explosive diarrhea and vomiting that's transmitted all over the room
Right they should definitely be isolated in a room immediately, but it doesn't really need to be a special isolation room.
yes, they shouldn't be put in a regular room such as an open area of the ER, they should be put in...an isolation room
An isolation room is a special thing. A thing that most hospitals don't have many of. As far as I can tell there is no advantage to be had isolating an ebola patient in an isolation room versus a normal patient room.
This is about procedure, not specialized care facilities.
The advantage is that you don't expose other patients and healthcare workers to the patient because they are...isolated. That should be the procedure, isolate the infected patient ASAP as in IMMEADITELY, not letting them wait for hours in an open ER room. It's very clear now that regular hospitals like the one in Dallas are not equipped or prepared to handle Ebola in terms of isolating Ebola patients.
"There was no protocol, there was no system..." - Dallas nurse:
I don't know quite what I'm failing to communicate here or where this is breaking down, but...
There are ways to isolate a patient without requiring a special isolation room which costs tens of thousands of dollars more to build and operate.
Yes, Paladin, they shouldn't have a roommate.
This is about this quote "You don't need a special hospital room to do it," Dr. Tom Frieden, current Director of the U.S. Centers for Disease Control and Prevention, said
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Outside the strawmen, I don't think anyone in this thread has said with absolute certainty that the outbreak can (or can't) be contained.
We basically seem to be haggling over price, so to speak. People with a scientific or health background are saying 'exceptionally unlikely' beyond a few pockets, and a first world health system should be fully capable of containing it to the point that it would almost take malice, not negligence, to spread beyond a few isolated pockets. There has been acknowledgement that there will be some infections, but they should burn out quickly.
On the other hand, there are some people pushing doom and gloom scenarios as likely and all that's doing is spreading fear and misunderstanding. Fear and misunderstanding serve to increase, not decrease the chances this will spread and trusting modern medicine to do what it's good at is the best outcome.
You've also got some smug people who point to every case as if it validates their doom and gloom scenario. Those people are just being silly geese.
They're logical, smart people and even they are a bit freaked out by it.
Technically it would favor being a carrier for sickle cell due to the extreme oddity of that particular mutation. Human genes just haven't figured out how to make that happen yet, and the process for it involves a lot of wide spread death. There are similar theories about type O blood and the bubonic plague. Dunno if further research has done anything with that. All of this is to say humans have a way to survive these things even in the worst case.
I would be concerned if someone near me got it, not just because of the contagion risk (low), but because we'd probably have guys in smurf suits burning random dumpsters.
Yeah, it's ok to be concerned in that situation.
If someone with ebola was being treated at my wife's hospital (which isn't out of the question before this plays out) I'd be more aware. If my mailman or a cashier at my grocery store came down with ebola, I'd be concerned. If the parent of one of my daughter's classmates came down with ebola, I'd be very concerned.
There are situations where it's absolutely reasonable to be concerned.
If you're 200 miles removed and there's no direct relationship with the infected? Not reasonable.
Full copy+paste here
Better hop on an airplane
i) Viruses exist, and can kill you. Bodily fluids are FULL of viruses so stay away from them.
ii) Plenty of masks, gloves and alcohol handwashing gels for healthcare workers and others who want them
iii) The knowledge that if you get sick, you should isolate yourself as best you can
iv) Good precautions around those who die from the disease
This should be our goal for Africa, you get to that, then the disease will die out in a month (not that this will be trivial, it will take a serious response by national agencies who are willing to use good infection control themselves). However, a modern US hospital with 1 case to deal with should not be aiming for 95%. They should be able to achieve absolutely no chance of any follow on infection. 2 shows that they must have systematic failings in their protocol. Now, they are clearly still doing a 95% good job, so this shouldn't be infecting large numbers, but thats not our goal here. They need to not take in further patients with infectious disease, and have a full review of their protocols. The problem is the US for profit hospital system, and the massive variety in the quality of contagion control. The patient, when there are such small numbers of them, should have been handled by an experienced CDC team who flew in specifically for this. 2 follow on cases is AWFUL for a modern hospital. You could do better than that with 19th century technology combating a Measles patient.
Ugh
I used to work in a healthcare environment. A lot of my worry about ebola springs from knowing just how dysfunctional even the "top ranked" hospitals are these days. The free market has left the American medical system in a pretty bad state during normal functioning, so it's hard to be optimistic that it will all come magically together in an emergency because of our First Worldness.
And one thing to understand about the United States at this point of time is that, while we have no shortage of highly paid experts, we've spent the last few decades overworking our medical support staff while requiring them to get additional training and certifications on their own dime, served by "entrepreneurs" whose major qualifications are that they can cheaply and quickly deliver Continuing Education Credit courses. Since it won't be the CDC scientific staff emptying bed pans, this is a major issue when it comes to major outbreaks.
That is certainly a concern
along with the fact that damn near every hospital in the country was built by a lowest bidder and maintained by people making minimum wage who are basically the same as most people. Go to work, do whatever someone asks me to, no more no less.
which is generally fine!
unless you're in a hospital setting and MORE needs to be done to maintain a clean setting.
Our local hospital (which I will not name due to massive ongoing lawsuits) is a cesspool. It is horrible in almost every concievable way.
My firm (which I will also not name) was contracted to do a series of inspections (we were eventually laid off because we were costing them too much money (i.e. our recommended fixes would have cost them too much money)). We found over 5,000 examples of health and/or safety violations in a hospital less then 5 years old.
this is a picture of two holes in a wall. If you bent down, you could see directly into the room on the interior side of the wall.
this room is their 'sterile lab'.
I highly doubt this has been fixed.
I wouldn't be at all surprised to discover that 90% of the hospitals in the country are run in a similar manner.
I think we will find that the patient's insurance (reports say he wasn't insured) mattered when it came to both their level of treatment and how much attention they got from physicians. There have been a lot of bad habits and structural defects that have arisen from the decades of cuts and penny pinching that have arisen from the way we fund medical care.
I don't think it's beyond the realm of possibility. People are bad at their job / make mistakes everywhere.
My dad - with some of the best insurance in the world - nearly died because the world class hospital he went to thought an infection in his foot was treatable with a prescription to antibiotics. You'll find similar stories all over both inside and outside of the US.
Dallas was one (exceptional to be fair) data point, and is insufficient evidence to support sweeping claims about the quality of profit / non-profit care. Either way.
I'm not saying things are exactly the same for a person without insurance as with it, but I don't think this particular incident is the one that proves it.
Treating physicians and nurses in an ER generally don't know or care what kind of insurance a patient has (or if they don't have insurance at all). It's someone else's problem.
I'm speculating, but his race and possibly language barrier (depending on how well he spoke English) were likely a bigger factor in his treatment or lack thereof than his ability to pay for treatment.
If you accept a single point of failure in that the fact he came from Liberia wasn't understood / relayed to the physician, it's completely believable that the doctor told him to go home, get some rest, and take some Tylenol for his 103* fever. Which is probably the same thing the doctor would tell most any otherwise healthy adult who shows up at the ER with a 103* fever.
I'm starting to understand why my micro professor runs his class like a deathcamp with the intentional goal of failing half the nursing students. I thought the policy of "only nurses who are "----" this smart" was kind of harsh but now I see the wisdom in it.
The biggest points of failure, in terms of accidental exposure, occurred after he was admitted. And I've seen enough studies about the disparities in care between the insured and uninsured to highly doubt that attending physicians, at least, do not know about a patient's insured status. It will definitely matter when deciding how to prescribe drugs or whether to admit a patient, in that there's no point in offering a treatment plan that the patient cannot afford.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
.... what?
He's saying that physicians who don't know squat about insurance prescribe stuff that won't be covered and costs 800 bucks a month.
Sometimes they do this anyway, but being fucking clueless doesn't help.
But this doesn't have anything to do with ebola.
I completely misunderstood that too.
Thanks @Regina Fong for clarifying.
I've personally gone without medicine because of cost a couple times.
Once I was fine, and once I went (back) to the hospital (yes, sadly, that hospital) where they gave me the exact same medicine they prescribed me for about 1/50th the cost (go figure).
"Essentially any hospital in the country can take care of Ebola. You don't need a special hospital room to do it," Dr. Tom Frieden, current Director of the U.S. Centers for Disease Control and Prevention, said Oct.
This is what the man in authority is telling me, so it must be true
"Though you should probably pick a room without a bigass hole in the wall", Frieden went on to say.
except for the explosive diarrhea and vomiting that's transmitted all over the room
http://houston.cbslocal.com/2014/10/15/nurses-union-ebola-patient-left-in-open-area-of-er-for-hours/
Oh that's right, we don't have one.
Right they should definitely be isolated in a room immediately, but it doesn't really need to be a special isolation room.
Better to not have one than to have the one Obama tried to nominate.
There was no episode where Doogie Houser MD became surgeon general, Obama.
yes, they shouldn't be put in a regular room such as an open area of the ER, they should be put in...an isolation room
That's not to say that we're all going to die from ebola. The most likely outcome is that the virus will be contained. But people really need to start thinking about what it means to have a medical system that can barely handle the nation's normal health needs, much less a sustained crisis.
An isolation room is a special thing. A thing that most hospitals don't have many of. As far as I can tell there is no advantage to be had isolating an ebola patient in an isolation room versus a normal patient room.
This is about procedure, not specialized care facilities.
Doc: That's right, twenty five years into the future. I've always dreamed on seeing the future, looking beyond my years, seeing the progress of mankind. I'll also be able to see who wins the next twenty-five world series.
The advantage is that you don't expose other patients and healthcare workers to the patient because they are...isolated. That should be the procedure, isolate the infected patient ASAP as in IMMEADITELY, not letting them wait for hours in an open ER room. It's very clear now that regular hospitals like the one in Dallas are not equipped or prepared to handle Ebola in terms of isolating Ebola patients.
"There was no protocol, there was no system..." - Dallas nurse:
http://www.breitbart.com/Breitbart-TV/2014/10/15/Nurses-We-Were-Told-to-Call-Authorities-for-Ebola-Protocol
There are ways to isolate a patient without requiring a special isolation room which costs tens of thousands of dollars more to build and operate.
Yes, Paladin, they shouldn't have a roommate.
This is about this quote "You don't need a special hospital room to do it," Dr. Tom Frieden, current Director of the U.S. Centers for Disease Control and Prevention, said
Because it's true.