I'm surprised there's been no thread about this...

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Lord Jim
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I'm surprised there's been no thread about this...

Post by Lord Jim »

Thousands have died, we've sent 3000 troops, and now we've had a badly bungled case here in the US...

The head of the CDC said Saturday that imposing a travel ban between the U.S. and West African countries dealing with the Ebola virus could worsen the outbreak that has killed over 3,000 people in five countries.

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

Frieden added that a travel ban could make it difficult to get medical supplies and aid workers to the affected regions in West Africa.

"We really need to be clear that we don't inadvertently increase the risk to people in this country by making it harder for us to respond to the needs in those countries," he said, "by making it harder to get assistance in and therefore those outbreaks would become worse, go on longer, and paradoxically, something that we did to try and protect ourselves might actually increase our risk."

Health officials have ruled out two potential Ebola cases in the Washington D.C. area, with Howard University Hospital in the District and Shady Grove Adventist Hospital in suburban Maryland confirming that patients who had been kept in isolation did not have the virus. A similar scare in New Jersey, when a passenger on a United Airlines flight from Brussels fell ill, also turned out not to be the virus.

Frieden said Saturday that officials are “beginning to see some progress” toward controlling the outbreak, “but it's going to be a long hard road.”

Frieden said that they've already gotten "well over" 100 inquiries on suspicious cases in recent months, with an uptick coming after the Dallas patient was diagnosed. Federal officials have said tests have been done on about 15 and all but one -- Duncan -- were false alarms.

Most of the cases don't involve travel to West Africa, "but we'd rather have a wider net cast," said Frieden. That way "we're more likely to find someone promptly if they did actually have exposure and they do actually have symptoms," he said.

The virus that causes Ebola is not airborne and can only be spread through direct contact with the bodily fluids -- blood, sweat, vomit, feces, urine, saliva or semen -- of an infected person who is showing symptoms.

The first person diagnosed with Ebola in the United Sates went to a Dallas hospital last week but was mistakenly sent home, despite revealing he was visiting from Liberia, before returning by ambulance days later.

"There were things that did not go the way they should have in Dallas," Dr. Anthony Fauci, infectious diseases chief at the National Institutes of Health, said Friday. "But there were a lot of things that went right and are going right."

Texas officials now are monitoring 50 people, 10 of whom they consider at high risk, who came into contact with the man, identified as Thomas Eric Duncan. They've had to quarantine four of them, and even had problems getting rid of the infectious waste left in the apartment where the patient stayed.

Texas health officials say Duncan is now in critical condition.

Dallas County Judge Clay Lewis Jenkins said during the Saturday press conference that he took the four to a new home where they will be quarantined for 21 days.

Jenkins, the county top elected official, urged Americans to show compassion for them, saying they are deeply concerned about the public’s health and are people “just like in your family.”
http://www.foxnews.com/politics/2014/10 ... us-points/

Here's a link to a lengthy but excellent analysis of how we got to where we are with this:

http://www.washingtonpost.com/sf/nation ... f-control/

We could have a real panic about this in this country, based partially on misinformation, but also based on the piss-poor confusing way that some of the "experts" go about explaining how this works...

For example, I saw a doctor who is supposedly knowledgeable about this interviewed on CNN yesterday, who said "we don't know" how long the Ebola virus can exist on a surface out side a body. If that's true, I find it stunning. They've been studying this disease intensely for forty years, and experiments to determine that aren't extremely complicated. (It was determined fairly soon after the scientific community began to focus on it that the HIV virus died within minutes in an air environment for example.)
Last edited by Lord Jim on Sun Oct 05, 2014 2:41 pm, edited 1 time in total.
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Econoline
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Re: I'm surprised there's been no posting about this..

Post by Econoline »

I'd like to believe that everything is all under control and there is nothing to worry about, but then I remember that this is fuckin' Dallas, goddamn Texas we're talkin' about here...the state that elected George W. Bush and Rick Perry and Ted Cruz and Louie Gohmert...

And why do I get the feeling that the the questions asked in the ER the first time Mr. Duncan came into the hospital (when they sent him home with some antibiotics, despite their having been told that he'd recently been in Liberia) were not considered of any importance because they were asked by a (female) nurse...? :arg
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Re: I'm surprised there's been no thread about this...

Post by BoSoxGal »

President Clinton was on The Daily Show recently, talking about how we need a multi-nation, intensive program with adequate funds to get this under control, ASAP.

WHO predictions are that if we don't, by January there will be more than 1 million cases of Ebola in West Africa and around the world, and it won't in future be something we only see occasionally in small outbreaks.

Maybe Mother Nature has found her way to wipe out the scourge that is humankind.

eta: Ebola has a 70% mortality rate; with meds available in the US, if we have enough, we might do better than that. But 70% worldwide - that would slow down global climate change.
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Re: I'm surprised there's been no thread about this...

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eta: Ebola has a 70% mortality rate; with meds available in the US, if we have enough, we might do better than that. But 70% worldwide - that would slow down global climate change.
But a large part of that 70% mortality rate (in earlier outbreaks it's been more like 40%, even in the Third World countries where it's happened) has to do with the fact that the areas where the outbreak is concentrated have access to potable water, (the number one thing needed for patient support care for this virus, since massive dehydration through vomiting and diarrhea are two of its major features) and basic sanitation, (essential to containing the virus' spread) that are roughly on a par with what was available in Medieval Europe...

The mortality rate in developed Western Countries, where replacement fluids, decent sanitation and modern patient care are readily available would be much lower than 70% (or even 40%), even without a vaccine.

Plus our modern infrastructure, (transportation, communication, available personnel and facilities, etc.) would make containing the spread of the virus a vastly less challenging task.

So if you're hoping for this to cause a 70% die-off in industrialized countries, I'm afraid you're going to be disappointed... 8-)

Many of the very factors that cause us to have a large "carbon footprint" are exactly the same things that we would reply upon to avoid that kind of plague scenario. The ones who will be bear the worst effects of this are those living in areas that have pretty much the smallest "carbon footprints"...(in fact that's what's happening right now.)
Last edited by Lord Jim on Sun Oct 05, 2014 7:09 pm, edited 2 times in total.
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Re: I'm surprised there's been no thread about this...

Post by BoSoxGal »

Darn!
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Re: I'm surprised there's been no thread about this...

Post by Econoline »

Meanwhile.....

‘Pro-Life’ Sociopath Todd Kincannon [Former executive director of the South Carolina GOP]Has Simple Solution For Ebola: Execute All Patients
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Some things are just too bizarre to comment on, because there's no sane response except for speechlessness.




But I guess bombing and destroying Texas might...

Naw. Not gonna go there.
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Re: I'm surprised there's been no thread about this...

Post by Lord Jim »

Econo, I have to tell you that I'm not inclined to accept you "Texas Theory" for the series of screw ups here...

Prior to this first case being discovered in the US, I really doubt that there were many major hospitals in the US, (Red state, Blue State or Purple State) that had "look for Ebola" at the top of their diagnostic protocol radar screen...

I think it's entirely possible that this could have been bungled pretty much anywhere. "The good news" (if you want to call it that) that has come from this, is one would expect that with all the intensive publicity and heightened awareness this case has brought, it's far less likely that it will be handled this badly again.

In fact if anything, In the wake of this, I expect most hospitals and public safety officials may act with too much caution rather than too little...

"Every under-reaction causes and equal and opposite over-reaction"...

It's the American Way... 8-)



(And of course the converse is also true: "Every over-reaction causes an equal and opposite under-reaction"...that's how the experience of the Iraq War led to three years of doing nothing about Syria, for example...)
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Re: I'm surprised there's been no thread about this...

Post by BoSoxGal »

I dunno . . . it takes a special kind of stupid to send home a man who is sick and advised you he's just returned from a visit to ebola-stricken Liberia.

That's Texas-sized stupidity/negligence.
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Re: I'm surprised there's been no thread about this...

Post by wesw »

just sounds like an arrogant doctor to good to bother with anything a nurse wrote down

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Re: I'm surprised there's been no thread about this...

Post by Jarlaxle »

bigskygal wrote:I dunno . . . it takes a special kind of stupid to send home a man who is sick and advised you he's just returned from a visit to ebola-stricken Liberia.

That's Texas-sized stupidity/negligence.
Did he actually TELL them that?
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Re: I'm surprised there's been no thread about this...

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I don't believe this narrative about the doctor ignoring the nurse is accurate, at least not based on what's in the public record; as I posted from an article in another thread:
On Thursday, the hospital, Texas Health Presbyterian Hospital in Dallas, released a statement essentially blaming a flaw in its electronic health records system for its decision to send the patient — Thomas E. Duncan, a Liberian national visiting his girlfriend and relatives in the United States — home the first time he visited its emergency room, Sept. 25. It said there were separate “workflows” for doctors and nurses in the records so the doctors did not receive the information that he had come from Africa.

But on Friday evening, the hospital effectively retracted that portion of its statement, saying that “there was no flaw” in its electronic health records system. The hospital said “the patient’s travel history was documented and available to the full care team in the electronic health record (E.H.R.), including within the physician’s workflow.”
http://www.nytimes.com/2014/10/04/us/co ... .html?_r=0

Maybe somebody has another source, but I don't get from that the existence of some sort of exchange between a doctor and a nurse where the nurse is raising a red flag and the doctor is ignoring it...I really don't see where that hypothesis is coming from...Where are you getting that from?

What I get from that is that the computerized system spit out the fact that the guy came from Liberia, for both the nurses and the doctors...

Along with everything else on his form...

Assuming there wasn't something in that form that put "LIBERIA-WARNING- POSSIBLE EBOLA CASE" in big red letters, I think what happened here was basic human nature...(there's nothing I've seen that indicates the fact this guy had come in from Liberia was anything more than one other minor line item in a patient intake form with 40 other line items, along with his zip code and cell phone number...Does somebody here have other information?)

You're looking at symptoms that could fit a dozen different things, including a mild case of the flu:
abrupt fever, headache, joint and muscle aches, sore throat, and weakness
http://www.cbsnews.com/news/ebola-how-t ... -symptoms/

That's pretty much how I feel when I have the flu...

Unless the system is set up in a way to raise a red flag notice/connection between these symptoms and the country the person traveled from why would Ebola even be on the radar screen?

I really think that's the core of how this happened....There was no alert system in place to put these two things together...(And on top of that, we know the guy wasn't being forthcoming about his Ebola exposure)

A doctor in that situation, where in his or her experience these symptoms 90% of time mean a minor case of the flu (especially in an otherwise healthy appearing 40 year old) is going to think "go home, drink lots of orange juice, take a couple of aspirin and get some rest", not "Everybody get in their hazmat suits and put this man in isolation"....

Based on what we know at the moment, I see no reason to fault the doctor in this situation...

And as I said before the "good news "about this is that presumably those red-flag connections have been inputted into the "E.H.R" at hospitals around the country...

That plus the additional publicity should help prevent a recurrence of what happened here...
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Re: I'm surprised there's been no thread about this...

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Those symptoms could be the flu...for that matter, aside from joint aches, that's about how I felt when I had food poisoning.
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Re: I'm surprised there's been no thread about this...

Post by Lord Jim »

With those symptoms, the guy could have had a hangover...
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Re: I'm surprised there's been no thread about this...

Post by BoSoxGal »

Um . . . okay . . .

It's not as if the CDC had put out warnings to US hospitals about what to look for, and I'm sure Liberian nationals visit the ER at Texas Methodist by the hundreds or even thousands.

Yeah, no stupidity or negligence at all. :loon
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Lord Jim
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Re: I'm surprised there's been no thread about this...

Post by Lord Jim »

It's not as if the CDC had put out warnings to US hospitals about what to look for
I have no information showing that this was flagged on the forms the doctors received...do you?

I also have no information that if it wasn't, that the failure to have that in the system was unique to this hospital, or to hospitals in Texas or hospitals in red states. Do you?
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Re: I'm surprised there's been no thread about this...

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And, yet again: did he TELL them he was Liberian? It's not like he was wearing a sandwich board.
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Re: I'm surprised there's been no thread about this...

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Jarlaxle wrote:And, yet again: did he TELL them he was Liberian? It's not like he was wearing a sandwich board.
Apparently that much was on the form Jarl, though there's no indication as to whether there was anything prominent about it...

To continue from my last post:

I also have no information that suggests that whatever "stupidity or negligence" that took place wouldn't have taken place at any other hospital in the country. Do you?
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Re: I'm surprised there's been no thread about this...

Post by rubato »

The only real bungle was that the G-20 took so long and did so little to send medical and humanitarian assistance when the outbreak started. Now, there is an opportunity to mobilize resources and contain it before it gets a lot worse.

4,000 cases in more than six months is a relatively slow spreading disease and the fact that a majority of victims are women family members, 75%, suggests that there are means of containment if we reduce transmission to caregivers.

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Re: I'm surprised there's been no thread about this...

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The CDC sent out a 6 page alert to all US hospitals in mid-September.

Mr. Duncan advised the hospital he was a Liberian national recently arrived from Liberia the first time he was seen in the ER and sent home by the hospital.

By the way, apparently the hospital - and thus the CDC - 'lost' the other passenger in the ambulance that brought Duncan to the hospital the second time, when he was vomiting profusely and highly contagious.
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Re: I'm surprised there's been no thread about this...

Post by Lord Jim »

I'm hoping @W will weigh-in with her take on this...
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