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

[wesw]

breaking news: rush Limbaugh said something ridiculous.

call me when he says something nice, or true, that ll be news

[Jarlaxle]

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

Bingo.

My sister is a nurse and my mother is a retired nurse and they both agree that this is par for the course for a doctor ignoring something written down by a nurse. (Maybe @W can confirm this?) It's just that, usually, the patient doesn't have ebola. This time he did.

My wife's best friend can confirm this...she's a nurse!

[Jarlaxle]

Tell me again why West Africa HASN'T been totally quarantined?

[Gob]

A top US health official has said a mistake was "clearly" made by staff treating a man who died of Ebola in Texas, resulting in one being infected.

The female health worker infected is in an isolation ward in stable condition, awaiting confirmation of her diagnosis.

Dr Tom Frieden, head of the Centers for Disease Control and Prevention (CDC), said a full inquiry would be made into how the transmission occurred.

He said 48 other people who may also have had contact were being observed.

The health worker at Texas Health Presbyterian Hospital wore full protective gear while treating Ebola victim Thomas Eric Duncan, health officials in Dallas say.

Duncan, who caught the virus in his native Liberia, died on Wednesday.

The current Ebola outbreak, concentrated in Liberia, Guinea and Sierra Leone, has resulted in more than 8,300 confirmed and suspected cases, and at least 4,033 deaths.

Dr Frieden said a full investigation would be conducted into how the infection had occurred

The CDC investigation, he told reporters, would focus on possible breaches made during two "high-risk procedures", dialysis and respiratory intubation.

Education and training of health workers would be stepped up, he said, and efforts would be made to reduce the number of staff treating Ebola cases.

Dr Daniel Varga, of the Texas Health Resource, said the health worker had worn a gown, gloves, mask and shield when providing care to Duncan during his second and final hospital admission.

Following a positive preliminary test for Ebola, follow-up tests on the infected health worker are due to be completed on Sunday.

Police are guarding the apartment complex where the woman lives in Dallas as decontamination work is carried out.

No details of her identity or position at the hospital have been given, in accordance with family wishes.

[wesw]

fellow in boston who visited Liberia is in isolation with symptoms as well.

while I understand the logic for not stopping travel to and from west Africa, I think we had better seriously consider doing so anyway

[oldr_n_wsr]

A top US health official has said a mistake was "clearly" made by staff treating a man who died of Ebola in Texas, resulting in one being infected.

So here we have the first ebola patient ever in the USA, and it's the fault of the nurses and/or doctors, who have never encountered this before.
The CDC probably published a "white paper" years ago on how to handle ebola patients which the hospital staff may, or may not have, consulted when this guy came in. If they did, which it seems they did as the nurse wore the recommended gear and got it anyway.
Maybe, just maybe, the CDC's "white paper" is lacking. That the protocol needs to be reviewed. That more training is needed, that a central "Uber Hospital" needs to be set up as who know where this is going to crop up and it is almost immpossible to train every staff member of every hospital, let alone get them all the equipment they need.

the simpler thing is to ban the travel of those coming out of those nations. And if not an outright ban, at least quarrentine them for the amount of time needed for them to not be infected. If infected, they get sent to the Uber Hospital for treatment. We used to have Ellis Island for immigrants coming over for just this kind of thing.

But no, we are battling this with thermometers at JFK. Well that makes me relax a little.

[Big RR]

Opening a quarantine center at each international marine and airport would be extremely expensive and should be a last resort. I'd be inclined to listen to the CDC about whether such drastic measures are needed; right now it seems like simple screening of arrivals can be effective and are sufficient.

[oldr_n_wsr]

I would guess that 90% of our international airports never get a flight from those countries affected. It's probably closer to 99% where only east coast international airports are in play (and maybe Ohare). If we coordinated with the flight carriers that do service those countries, it could be reduced even further to maybe 5 or 10 airports. Seems better than getting the thousands of hospitals throughout the USA to use a possibly flawed" or "not as good" containment procedure.

I still think quarantining all coming from those countries to be the best method. Or not allowing them to enter the USA.
Didn't Germany, France and the UK institute a ban?

ETA
Time to reread Stephen Kings, The Stand

[Big RR]

oldr--if it were only that easy; certainly few airports have direct flights to those areas, but I would bet the majority of travelers fly connections through other airports--like London, Amsterdam, Copenhagen, Frankfurt, Rome, Athens, maybe even some far east airports when headed for the US west. So, I would bet every major airport gets at least some travelers from those regions, or people exposed to them in transit. Your plan would involve a close check of each passport and then quarantines based on some sort of rules based on travel from those regions or exposure to people on their flight and then impose an immediate quarantine, needing facilities at most airports.

ETA: As for travel bans of other countries, I don't think this is actually what occurred. some countries, like the UK, have banned direct travel to/from some affected countries, but not banned persons travelling to and from those countries via connections from entering.

[Econoline]

Why travel bans will only make the Ebola epidemic worse:

Taking airline panic one step further, another idea floating around these days is to just close off West Africa to the rest of the world. Allow Ebola to fester over there, and keep people safe over here.

In opposing this idea, public health experts unanimously agree: sealing borders will not stop Ebola spread and will only exacerbate the crisis in West Africa — and heighten the risk of a global pandemic.

There are three reasons why it's a crazy idea. The first is that it just won't work. In CDC Director Tom Freiden's words, "Even when governments restrict travel and trade, people in affected countries still find a way to move and it is even harder to track them systematically." In other words, determined people will find a way to cross borders anyway, but unlike at airports, we can't track their movements.

The second is that it would actually make stopping the outbreak in West Africa more difficult. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said, "To completely seal off and don't let planes in or out of the West African countries involved, then you could paradoxically make things much worse in the sense that you can't get supplies in, you can't get help in, you can't get the kinds of things in there that we need to contain the epidemic."

Some have suggested a half-measure: close borders allowing exceptions for doctors, aid workers, and medical supplies only. The problem with this idea is that responses to humanitarian crises are not well-organized affairs. They're chaos. A bureaucratic regime that systematically screens who can go in and out of affected countries would only slow down or make impossible the much-needed relief. Plus, many aid workers — like reserve staff for Doctors Without Borders — would be responsible for booking their own tickets to get to the affected region. How would they do this then? And how long would it take to get them over there?

The third reason closing borders is nuts is that it will devastate the economies of West Africa and further destroy the limited health systems there. The World Bank already estimates this outbreak could cost West African economies up to $33 billion. That's a lot for any country, but especially when you're talking about some of the world's poorest. World Health Organization director Margaret Chan reminded us that 90 percent of any outbreak's economic costs "come from irrational and disorganized efforts of the public to avoid infection."

http://www.vox.com/2014/10/13/6964633/t ... reak-virus

[oldr_n_wsr]

"To completely seal off and don't let planes in or out of the West African countries

How about just those coming out. OR quarantine those that want to come here. You don't have ebola after x amount of time, fine. If you do, we will treat you.

determined people will find a way to cross borders anyway

Might I suggest our border with Mexico.

World Health Organization director Margaret Chan reminded us that 90 percent of any outbreak's economic costs "come from irrational and disorganized efforts of the public to avoid infection."

Might I suggest that the WHO make an effort to reduce the chaos of those wishing to go to the effected countries and help. I would thinkjk they would be front and center on this given their name (maybe they are, but I have not heard them mentioned in new reports on this)

[Guinevere]

No one in MA has ebola.

And I do think the question is fairly directed at the hospital. Two ebola-infected physicians came back to the US for treatment, survived, and did not cause any secondary infections in the health-care workers who treated them. Why can some facilities perform adequately, and others fail?

And frankly, after spending so much of this year in hospitals with Mom, I'm not in the least surprised. She received sterling, top of the line care at Yale. At another CT metro hospital not within the Yale system, the physicians and the health care team were levels below. I don't think they were any less caring, but they had less resources, and perhaps people who were not as skilled. The differences were crystal clear and rather frightening. Every patient should get and deserves the gold standard of care, and its obviously not available.

[oldr_n_wsr]

No one in MA has ebola.
.

Wasn't there an MA doctor who was suspected of having ebola and broke protocol and went for a car ride to get some soup?

Every patient should get and deserves the gold standard of care, and its obviously not available.

That's why a few ebola centers should be set up equipped with a people and eqipement needed to handle this correctly. You think when coming up with a budget last year at the hospital in Texas thlose in charge in getting equipment even thought about what money should go toward ebola equipment/staff training?

We are talking about the very first ebola patient to make it into the USA. The very first of anything usually upsets a lot of things that were just standard day to day operations.

I don't there are/were many hospitals that would have done a better job.

[Big RR]

You think when coming up with a budget last year at the hospital in Texas thlose in charge in getting equipment even thought about what money should go toward ebola equipment/staff training?

No but I hope training for dealing with highly infectious diseases and funds for disseminating CDC alerts were provided for in any budget. That makes sense even if ebola was never a threat.

[Guinevere]

No, wow, such misinformation.

The MA doctor is a volunteer who contracted ebola, came home and was cured then sent home to MA (from another facility in the US, I forget exactly where - the Midwest I think), had flu-like symptoms so he was sent to the Worcester hospital and put in isolation, found to only have the flu. A second MA doc also contracted the disease, was sent to Emory, and also recovered and is back home and fine.

Another man this weekend, who had been in West Africa wasn't feeling well, called and was told to drive to a local health care clinic, stay in his car, and an ambulance came to take him to the Brigham. He was transferred by people in full protective gear and remained in isolation until tests came back. He also only had the flu.

[Guinevere]

And that still ignores that fact that three US citizens were treated for Ebola in this country, all survived, and no one contracted secondary infections. IT can be done. The hospital in Texas didn't do it right.

[Econoline]

[oldr_n_wsr]

I think all involved here were caught off guard.

"First contact scenario". Guy comes in to the ER and says he has a fever (aka transmitting stage). Triage nurse takes his temp wearing nothing but rubber gloves. He has 103F and nurse takes history and says he's from liberia. Does that set off sirens? Don't know. Does the nurse even know about Liberia and about the epidemic there? Even if she does, she has been exposed. Maybe no fluids went between the two, maybe it did. (he rubs his eye/noe/mouth then something else then she touches it.)

And anyone else who had contact with this guy while he had a fever but before he made it to the hospital has been exposed. Ambulance driver, EMT. They respond and have no clue that this guy might have ebola.
And isn't one of the ambulance guys in quarantine now for possible exposure?

Seems a major setup of quarantine area need to be set aside with all the latest and greatest and anyone and eveyone from those countries gets to spend the duration there. Plum Island might be a candidate. They did animal disease thingie there. They probably have most of the equipment needed already. And the feds are closing that animal reserach facility down and moving it to middle america (Kansas?) anyway.

[oldr_n_wsr]

And that still ignores that fact that three US citizens were treated for Ebola in this country, all survived, and no one contracted secondary infections. IT can be done. The hospital in Texas didn't do it right.

I only counted two people in your previous post. The third had the flu.

I don't contend it can't be done right, and maybe they didn't do it right. I am saying that even the best of plans and procedures, things happen. The ma patients seem to have known they might have ebola (at least the first one did) so right away, he probably alerted those who first saw him of that fact. The texas liberian only said he came from liberia. I would think in todays climate that would set off alarms in the staff/hospital, but not for the first case.

[Gob]

US health officials are seeking 132 people who flew on a plane with a Texas nurse on the day before she came down with symptoms of Ebola.

The second person infected in the US, Amber Vinson, 29, fell ill on Tuesday.

Both she and nurse Nina Pham, 26, had treated Liberian Thomas Eric Duncan, who died a week ago in Dallas.

A nurses' union has said those treating Duncan were not given full protection and had parts of their skin exposed

More than 70 healthcare workers who may have come in contact with him at the hospital are being monitored for symptoms, the hospital's director has said.

Meanwhile, the UN's Ebola mission chief says the world is falling behind in the race to contain the virus, which has killed more than 4,000 in West Africa.

On Wednesday, the US Centers for Disease Control and Prevention (CDC) said it wanted to interview the passengers on Frontier Airlines flight 1143 from Cleveland, Ohio, to Dallas, Texas on 13 October.

It said it was taking the measure "because of the proximity in time between the evening flight and first report of illness the following morning".