Positive Ebola Test In Second Texas Health Worker 463
mdsolar tips news that a second healthcare worker at Texas Health Presbyterian Hospital has tested positive for the Ebola virus. Like the nurse who tested positive a few days ago, this worker was involved in providing care to Eric Duncan, the Liberian man who seems to have brought the virus into the country. The CDC is working to identify further exposures to the local community, though the Times says a second infection among the 70+ medical professionals who were around Duncan is not unexpected. The largest U.S. nurses union says a lack of proper protective gear and constantly changing protocols are to blame for exposures. Meanwhile, the World Health Organization says infection rates in West Africa are such that within a few months, they can expect 10,000 new Ebola cases a week. They also say the death rate for the current outbreak has risen to 70 percent.
Just tell me (Score:5, Funny)
Re:Just tell me (Score:4, Funny)
Reply hazy, try again.
Re:Just tell me (Score:5, Funny)
*shakes Soulskill*
Will someone just tell me if it's time to panic or not?
Re:Just tell me (Score:5, Insightful)
I mean, special permission flights for health workers, aid, etc could be set up for private charter flights as needed, but why are we allowing people from the infected countries to freely come and go in the US?
We're clearly not THAT ready in the US to handle this disease and it seems common sense to isolate that part of the world from general travel till things get under control.
Re:Just tell me (Score:5, Interesting)
simple. because those persons can go to a third country and then travel from there. it creates an impetus for persons from West Africa to simply try to evade such controls. this would of course worsen the situation, not improve it.
the world as a whole needs to be sending more resources to West Africa to fight the epidemic *there*. that is the only thing that will help stop this from becoming an actual pandemic.
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simple. because those persons can go to a third country and then travel from there. it creates an impetus for persons from West Africa to simply try to evade such controls. this would of course worsen the situation, not improve it.
the world as a whole needs to be sending more resources to West Africa to fight the epidemic *there*. that is the only thing that will help stop this from becoming an actual pandemic.
Your (GP) "solution" makes the problem exponentially worse for others and, here's the real kicker, it makes it worse for you too! People flying from country E with Ebola to country F without it and then the U USA are then exposing TWO flights worth of people instead of just one. Or N+1 vs just N since most flights may not be direct anyway. If I need to get back home, back to work or my family, I'll figure out a way. Three intracontinental flights, a bus trip and then another flight to get home? So be it.
You
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I don't know if West African transport systems keep the necessary records. Remember, also, that the US has shown itself not good at keeping track of people with names not in the Latin alphabet.
We can't shut down the infected area. It's much too big. If we try to seal it off, people who want to travel elsewhere will sneak out somehow and spread into neighboring countries, spreading the disease. If we let people travel out of the area, we can at least monitor them.
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http://www.forbes.com/sites/jv... [forbes.com]
Re:Just tell me (Score:5, Informative)
Too late. The second infected nurse flew from Ohio to Texas, while symptomatic. Which means that the infection could, theoretically, have been spread in both Ohio, and wherever her co-passengers went.
Forget quarantining areas. I think efforts should be focused on
- educating citizens on measures to reduce chances of exposure (hygiene)
- training medical personnel (the infected nurses are a disgrace to their hospital's procedures)
- purchasing equipment to deal with Ebola (better suits, gloves, etc...)
But hey, I'm just an engineer. I do not have constituents to please so that I keep my cushy job where I can trade the common good for personal perks. So if any of the above gets implemented, it will be later, as opposed two weeks ago.
As for panicking? There's never a time to panic. There is a time to punish the guilty, after the emergency has been dealt with. They can panic them, if they wish.
Re:Just tell me (Score:5, Interesting)
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If I remember correctly, both the two nurses were from the first visit, when it was just flu like symptoms. Also, she did clear her traveling with the CDC, which moves the onus of the flight on them not her.
Even if the CDC "cleared" her for travel she should of known better being a medical professional. She knew there was a chance she had ebola and was contagious and she choose to travel. The CDC didn't force her on that plane. Just because a government agency tells you something is "ok" doesn't mean you can turn your brain off and a absolved from all consequences of your actions.
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And if patient "0" hadn't made it to our shores at all...these two people wouldn't now be ill and in jeopardy.
Actually patient "0" is reported to have been a two year old child in the town of Guéckédou in Guinea.
Thomas Duncan's patient number was likely between 4,000 and 12,000.
If the international system had taken the issue seriously when Guinea announced 59 dead (March 22) instead of August, Thomas Duncan wouldn't have been a patient. Calling him patient "0" makes false assumptions about the Atlantic or Mediterranean, i.e., that they afford us some sort of protection rather than just delaying the inevi
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Only if you need to be treated at Texas Health Presbyterian Hospital.
They've demonstrated themselves to be completely incompetent. Eric Duncan should have been transported to a hospital with the equipment and expertise to deal with quarantining highly infectious disease. The first Ebola case in the US, if you recall, was a doctor admitted to a hospital with staff and facilities prepared to handle it.
Re:Just tell me (Score:5, Insightful)
Only if you need to be treated at Texas Health Presbyterian Hospital.
They've demonstrated themselves to be completely incompetent. Eric Duncan should have been transported to a hospital with the equipment and expertise to deal with quarantining highly infectious disease.
In case anyone doubts this: ratio of "normal" patients vs. infected healthworkers
third world: ~ 10:1
Texas: 1:2
Re:Just tell me (Score:4, Insightful)
But you have to understand, how could the hospital make any money if they didn't send dozens of people into the patients room to all charge for 5 minutes of time (rounded up to the nearest whole day)? Look at any of the articles about "surprise hospital charges" to see that this is a real thing. So of course there are more infected staff per patient, the patient probably had 20-30 different people in their room on any given day.
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Sneaking across the USA-Africa border requires a very strong swimmer.
Re:Just tell me (Score:5, Interesting)
You haven't been to a hospital recently have you? Doctors aren't like Dr. House. They aren't looking for
zebras when 99.99% of their patients are horses. If you come in with a rare disease it can sometimes
take years to get a proper diagnosis. Also most hospitals in the US are private and understaffed so
taking time out to train everybody in every hospital to look for ebola and how to treat it is just not going
to happen as that would hurt their bottom line. That's assuming that a hospital even has someone on
staff that is qualified to do the training which I assume most hospitals don't. What really needs to
happen is the CDC needs to train 10 people and have those 10 people train 10 people, etc...
Let's say you are REALLY FAST and can keep doing this on a 3 day schedule, that means that it would
take 9 days to train 1000 people, 12 days to train 10000 people, etc.... IF you can keep up this
extremely tight schedule it would take over 21 days to train all the health care workers in the US.
That's assuming that the person 3 levels deep is actually trained well enough in 3 days to teach it
to the next level. Good luck with that.
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They aren't looking for zebras when 99.99% of their patients are horses. If you come in with a rare disease it can sometimes take years to get a proper diagnosis.
The words "specificity and sensitivity" immediately jump to my mind. ;-) Diagnosing a rare disease with non-specific symptoms? Good luck with that!
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Re: Diagnosing a rare disease with non-specific symptoms
Except for that one very specific symptom of traveling to Western Africa! That should be a bright red flag!
Re:Just tell me (Score:5, Insightful)
Except for that one very specific symptom of traveling to Western Africa! ... for now.
FTFY
We're working really hard to make sure that Ebola isn't the racist disease it is now. You see, being insensitive to one's place of birth is RACIST. Even the relatives of the dead guy are claiming RACISM at the Dallas hospital is why he died. So, we're focusing on useless measures just so we remain PC.
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You haven't been to a hospital recently have you? Doctors aren't like Dr. House. They aren't looking for zebras when 99.99% of their patients are horses. If you come in with a rare disease it can sometimes take years to get a proper diagnosis.
And yet they ask anyone but the African guy if they have been to other countries recently.
Not to mention that they hand out antibiotics like candy to people with unspecified symptoms - and then send them home. Understandable, because they can't keep him in emergency for ever, and there are no known problems with the overuse of the new Aspirin (facepalm).
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Re:Just tell me (Score:5, Insightful)
I don't know about that. Everyone in the West is constantly brainwashed into the idea that they can get this stuff for free and that they should get it for free and that it should be some kind of "right" like the right to a trial by jury.
People are used to not directly paying for this stuff. Americans are certainly inclined to devalue any free product or service. People in general seem to devalue everyone else's profession and get huffy when you actually expect them to pay.
Paying $100 for a nail spa: no problem.
Paying $50 for a doctors visit: Oh the humanity.
Doctors and nurses need to stop being lumped in with free government cheese before there is any hope that the general public will cherish them.
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Paying $100 for a nail spa: no problem.
Paying $50 for a doctors visit: Oh the humanity.
It's hard to change the way people think, you're better off just going with the flow. It would be awesome if people were logical, but they are not. And the sooner you understand that, the sooner you can make things better. Letting people mange their own finances for medical is the problem. People are not good at long term decisions. Tax them and make it a universal service. I'm not sure about the exact implementation, but no matter what you do, people will find a way to game the system.
Perfect is the enem
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Doctors and nurses need to stop being lumped in with free government cheese before there is any hope that the general public will cherish them.
If people didn't have to pay anything to go to the doctor then they would feel less resentment about the experience. The last thing you want when you're down is to be kicked. Remember how going to the doctor was back when you were a kid and someone else handled all the paperwork? Compare and contrast to how it is now. When health care is a guaranteed right, people go get health care when they need it, with the result that people aren't wandering around in poor health infecting other people and so on. By all
Re:Just tell me (Score:4, Interesting)
It's already a well known fact that many important professions like teachers, police officers, nurses, firefighters, paramedics, etc...
are not paid very well compared to how much they are needed but what's scary is how few there are. We have decent health care
in the USA but it would take very little to overwhelm them. Most cities have only 1 ambulance per 30000 people. It only takes a
very tiny disaster to deplete them. Heck, it doesn't even take a real disaster. Listening to the police scanner in my city, it's fairly
common to hear "status 0" which means that every available ambulance is already on a call. And forget worrying about isolation
rooms, in the USA we only have 3 hospital beds per 1000 people. Isolation rooms are several orders of magnitude smaller than
that as is proper equipment. We are completely unprepared for any type of mass illness.
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Re:Just tell me (Score:4, Insightful)
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Well, I will definitely disagree with you. Transporting the patient certainly entails risks, it's not a freebee. Yes, Texas Presbyterian was not particularly prepared but they were dealing with patient zero as far a de novo infections are concerned. It turns out to be non trivial to keep full protections up, technique is very, very important. Therefore, it's not surprising that folks on the bleeding edge of the problem might bleed a bit.
Now, if we have the same problem in a couple of months, then we hav
Re:NO (Score:4, Interesting)
Oh fer crying out loud. What do you want, Obama personally doing body cavity searches at the border? If he did that people like you (or others) would be screaming about an "irresponsible Administration" destroying businesses or trampling on your rights or whatever.
You CAN'T quarantine this. Those people are coming through Amsterdam or Frankfurt or Paris or London. Are you going to close all the borders?
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http://www.forbes.com/sites/jv... [forbes.com]
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Not yet.
Wait for the first one case not related to a previously known case, or the hundredth case, whichever comes first.
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Don't panic.
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We'll know whether to panic when that 21-day quarantine period is up. Unless the CDC is wrong about that period also.
Re:Just tell me (Score:5, Insightful)
Will someone just tell me if it's time to panic or not?
No, the conditions in that hospital were shockingly lax. From what I've been reading the hospital administration should be brought up on charges. At the very least that infected nurse should sue the pants off them. Notice that none of the people he was staying with caught it. You can only catch it by ingesting another persons bodily fluids. This disease prays on your concern for the sick. Those that care for the diseased are the ones at risk. As they get sicker and sicker, people deal with the mess and viola... If the hospital had even remotely followed proper procedures everyone would have been fine.
On the bright side, we have a drug that appears to work. There have not been clinical trials as of yet, but PBS had special on it over the weekend that most researchers seem to think that the mechanism is simple enough that they think it should "Just work" anyway. It's very hard for them to produce though. Extremely labor intensive. They literally have to inject virus into tobacco plants, wait days/weeks then extract the drug from them. But, on the bright side, they said that once a persons been inoculated their body will produce the antibodies on its own, so they can provide transfusions to others infected as long as the blood types a match. So it appears we may have this licked. Even if we only have enough drug to treat a few thousand people, they can give transfusions to others who can give them to even more people and so-on.
If it turns into a real mess, all it would take is Rich people fearing for their own lives to put up the money to start mass producing this drug. Also, it appears the Russians have a few drugs starting trails as well.
Re:Russians have a few drugs starting trails (Score:2)
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As they get sicker and sicker, people deal with the mess and viola...
And it's fricking hard to properly play a viola with latex gloves. Thus, contagion!
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Hold on to that optimistic viewpoint as long as you can. We do not need to incite panic here.
But recognize that the ebola death curve is exponential. Production and distribution of vaccines, and of antibodies by transfusion, is at best geometric, and more likely linear.
It will likely be possible to provide immunity to select communities of several hundred thousand souls. But there are more than seven billion humans on this planet and the math for a good general solution to ebola just will not pencil out.
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This isn't the first ebola outbreak West Africa has had. It's not an especially "fast moving" disease, either. And "soldier on to what may be a post apocalyptic world" is a great way not to spread panic</sarcasm>. In the developed world, we can contain ebola. If it spreads past the infected Texas healthcare workers, that wouldn't be good, but the world's not ending.
Reading your post, I'm reminded of a Slashdot poster during the housing crisis who said he was betting with his investments on sustain
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On the other hand, all the persons infected so far were people with known risk factors for ebola like travelling to ebola country or treating an ebola patient. Assume for a moment that one of these people managed to infect someone random. Are the symptoms going to get bad enough quickly enough that you get flagged as an ebola patient before you've had the chance to infect other people? My usual expectation would be like:
1. You're feeling a bit under the weather, but go to work away.
2. You feel rather crap w
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Re:Just tell me (Score:4, Insightful)
Actually, that's common advice good for flu as well (flu season's coming!).
Anyhow, the issue is that taking off PPE is actually the hardest part of the job - do it wrong and you've just nullified the entire reason for using PPE to begin with. It's a very careful dance of managing contaminated and non-contaminated surfaces, and screw it up and you're hosed.
(E.g., when removing gloves, the gloved hand should pinch the palm of the glove of the other hand (contaminated-contaminated contact) then use that as leverage to remove the glove. But now to remove the other glove, the exposed hand (which cannot touch anything contaminated! not even to run it against something!) must dig under the cuff the glove where it's uncontaminated and remove the glove that way. yeah, do you decontaminate your hands again to be sure, but still).
Now you have two uncontaminated hands, and need to remove your goggles and mask and hood by doing it from the back (less contamination, hopefully), and removing your suit requires touching the inside of the suit and pulling it off - you can't undo the zipper (contaminated).
Just one mis-step and you're hosed.
Re:Just tell me (Score:5, Interesting)
Let me translate that into real-world terms. Do NOT rub your eyes, nose, or mouth with the hand/s that have come in contact with Ebola infected bodily fluids.
While that's good advice, it's not completely correct. One does not have to "self-contaminate" to catch Ebola. Lab tests show a single droplet landing on your eye can cause an infection. It is well known that standard surgical masks, eye protection, gowns and gloves do not prevent transfer of Ebola from patients to their caregivers. The CDC techs working with Ebola use full containment suits with positive pressure ventilation and high performance respirators. They get 2 days of hand on-training on protocol. Reports in the MSM say the nurses infected in Tx were given a 20 minute training video and only gowns, shoe booties, gloves and a face shield. It's very possible that the infected Tx nurses didn't self-contaminate.
In addition, there's documented evidence of non-contact transmission between animals and primates. See http://healthmap.org/site/dise... [healthmap.org] The Ebola infection rate was 100% of the monkeys kept in the same room with infected pigs. There were no opportunities for direct contact between animals. There definitely are vectors for transmission of Ebola without any direct contact with bodily fluids.
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Are we still at "Go get a helmet" or have we graduated to "Put on the damn helmet"?
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So far we have a small handful of US infections - mostly related to one guy who brought it in the country and the healthcare workers who didn't follow appropriate protocols while working with him. (Some of that blame might lie on the CDC and the hospital's management - not all of it on the nurses.)
Contrast this with the 5% - 20% of people in the US who get the flu every year and the 200,000 who are hospitalized with flu-related complications. (Source [cdc.gov]) If you are panicked about Ebola then you should be run
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So far we have a small handful of US infections - mostly related to one guy who brought it in the country and the healthcare workers who didn't follow appropriate protocols while working with him. (Some of that blame might lie on the CDC and the hospital's management - not all of it on the nurses.)
Contrast this with the 5% - 20% of people in the US who get the flu every year and the 200,000 who are hospitalized with flu-related complications. (Source [cdc.gov])
Can we please stop comparing Ebola to the flu?
For starters, Ebola apparently has a 70% mortality rate. Additionally, Ebola kills people who are otherwise perfectly healthy. The flu does not.
The flu is a health concern, yes, but widespread infection of Ebola is a nightmare that would make (in Sierra Leone, "makes") most years' flu seasons look like a sneezing fit.
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For starters, Ebola apparently has a 70% mortality rate. Additionally, Ebola kills people who are otherwise perfectly healthy. The flu does not.
The flu kills tens of thousands of people every year. Ebola has so far infected two, and that was at a point where nobody knew how to handle it - today these two wouldn't have been infected.
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True for some flu variants, false for others. A bad flu is much more dangerous than Ebola, and absolutely kills healthy people in their prime.
Re:Just tell me (Score:4, Informative)
Can we please stop comparing Ebola to the flu?
For starters, Ebola apparently has a 70% mortality rate. Additionally, Ebola kills people who are otherwise perfectly healthy. The flu does not.
Some flus are absolutely more deadly for healthy people. Part of what made the 1918 flu pandemic so deadly was that it could induce a cytokine storm resulting in multiple organ failure. Since the release of cytokines is an inflammatory immune response, the better your immune system the worse off you are. Thus a young, fit person with a healthy immune system is more at risk than an infant with a undeveloped immune system, or an elderly person with a failing one.
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If you are panicked about Ebola then you should be running down the street screaming about the flu. (Hopefully running down the street to get your flu shot.)
I see you are new to this planet. Let me help you. Humans do not panic over the things most likely to kill them (heart disease, cancer, etc.). They panic over the things least likely to kill them (ebola, terrorism, sharks in tornadoes, etc.).
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Re:Just tell me (Score:5, Insightful)
Contrast this with the 5% - 20% of people in the US who get the flu every year and the 200,000 who are hospitalized with flu-related complications.
I don't understand this "Oh, if you are scared of ebola, why aren't you scared of [insert other ailment that kills $bignum people each year]?" logic. Everyone knows that heart disease and cancer and falling off a ladder kill more Americans than ebola right now. So what?
Right now, ebola is not a serious threat to western countries because: 1. It is not airborne (if someone sneezes across the room, you're not gonna get ebola from it), 2. it is not communicable except when the infected is suffering from symptoms, and the symptoms are so severe that the infected person will land in a hospital very quickly, away from the general populace, and 3. we (supposedly) have protocols in place to prevent an infected person from infecting others once he his hospitalized. Obviously, #3 needs some refinement, but I think we'll see that soon.
The reason that ebola is so scary is that if it mutates to become airborne, it is going to become really, really hard to control. As in, you could get ebola just as easily as you could get the flu. And it's currently spreading like wildfire in West Africa, and in that environment, the virus could make that mutation! That is why we need to get really serious about ebola, really quickly. Not because of what ebola is right now, but because of how deadly it might become.
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Virus mutations aren't my specialty but from what I've read Ebola mutating to become airborne isn't a high probability. "Airborne Ebola" stories seem to crop up on conspiracy theory sites (e.g. "The CDC is lying to us and Ebola really spreads via air... WE'RE ALL GONNA DIE!!!") and media outlets that want to scare their viewers/readers ("Next up: Celebrity Doctor X tells us how Ebola becoming airborne will make it THE WORST PLAGUE MANKIND HAS EVER SEEN!!!").
Caution is certainly warranted. If you are a hea
Re:Just tell me (Score:4, Interesting)
No, it didn't. It was "some sort" of droplet transmission by monkeys in adjacent cages.
That is NOT -- repeat, NOT -- "airborne" transmission.
And no, it didn't go through the ventilation system; it was later learned that sick monkeys sneezing while they were being transported past well monkeys did indeed transmit the virus in this case.
It was also a completely different strain than the one we are talking about.
Airborne transmission occurs when an infectious agent is able to cling to particulates in the air and ride air currents for significant amounts of time, over significant distances, through ventilation systems, etc., long after the infected person who expelled the virus is no longer in the area.
Droplet transmission is NOT "airborne" transmission. It is projecting bodily fluids directly onto a well person in close quarters...usually less than 3 feet, but under optimal conditions, perhaps further. That is still not airborne transmission.
Furthermore, coughing/sneezing is probably one of the least effective ways to spread Ebola, even via droplets. Blood, feces, and vomit are the primary ways this will be spread. Yes, virus "could" be in saliva, mucous, semen, etc. But that's not the primary way Ebola spreads.
Airborne transmission would be very bad, but the Ebola virus is too large to spread this way. It would have to shed about 75% of its genome to be small enough for airborne transmission in sub-5um droplet nuclei that could ride on particulates. And if it did that, it wouldn't be "Ebola" anymore -- it would be something very different; perhaps still deadly, perhaps not, and so much different from what we are talking about right now that it is next to meaningless to discuss.
So, in closing: no, Ebola is not airborne.
Re:Just tell me (Score:4, Interesting)
Droplets are the big issue, small enough not to be visible to the naked eye, but with a range of 1-2m (3m if the wind blows hard).
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This is the problem with our news delivery system.
We get information in real time... However we rarely ever get quality information, and digging to get the quality information is very difficult.
So they are 2 people in the US known to be sick from this, there is a containment policy that is improving. There are 300,000,000 million people in the US.
Yes it is scary, because if you get it there is a high mortality rate, and it does spread fairly easily.
But it doesn't spread like the flu. And thousands of Ameri
journalism is dead, capitalism killed it (Score:3)
Then we went to cable, which doesn't have the same regulation, removing the public service programming mandate. From that point everything was dri
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In comparison, a spike through the head is probably MORE common and almost certainly more deadly. Should we be avoiding anything spiky at all whatsoever? No. Just be careful around spiky things.
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good advice in general (Score:2)
And Texas Presbyterian hospital.
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Of you have to ask others if it's time to panic, then it's not.
P.S. Even if others say it IS time to panic, expand your definition of "others" carefully. I have been variously told that I have swine flu, that eggs are killer-bacteria in a shell, that bird flu is going to wipe us all out, the seas are rising, the sky is falling, etc. etc. etc.
If you have to ask, it's not important. If you have to choose who you ask to get the answer you want, it's even less important.
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So don't ever again go to a hospital. Because they are again becoming the places of death.
Right?
Well, something to think about. That elective procedure you were thinking of having done during Spring Break or Summer vacation? It might be wise to reschedule it for the upcoming December break, before ebola makes things crazy busy at the hospital.
There is currently no effective test to tell whether a person's presenting symptoms are from ebola or from the flu. None seem likely in the near future. That means
But flights from West Africa are OK? (Score:4, Insightful)
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Because it causes panic in the target countries, they flee through porous borders and spread the disease more. Other countries think the problem is fixed, never bother screening at airports or other border crossings and they still get in anyway.
How about this for a counter-question: Why aren't we quarantining Texas?
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Why aren't we quarantining Texas?
I've been asking this for years.
Texas was ready to secede from the USA, maybe now is a good time.
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Why would we want to? How would that help? I mean, beyond the theatrical power of showing politicians waving their arms around?
The man who caused the Texas outbreak came from London. Before that Belgium. If there were more flights then we would actually know whom to screen instead of having to screen everybody who comes into the country.
Heck, they are talking about screening people coming into my hometown airport. While we have a large west African population we have no direct flights there.
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Why?
Because the loss in economic activity that would result would kill more people than Ebola.
The Flu will still kill more people in Africa this year that Ebola. Keep that in mind.
A terrified public is very profitable for CNN/FOX/CBS My personal favorite were the stories of people rising from the dead. lol
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Why?
Because the loss in economic activity that would result would kill more people than Ebola.
Economic activity ??? This is what you get when profit is the driving force in the "health care industry".
Now is the time to make the whole nations health the priority.
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"One of the best?" Meaning, there's a good hospital or two there somewhere that they send you if you have some rare cancer? Great. But the fact is, Texas is 33rd in health spending out of 50. They've cut and cut and cut. The US has on a national basis, mostly in the last 10 years, but red states of course more than most.
Re:But flights from West Africa are OK? (Score:5, Funny)
Well, now that we've had 3 cases in the Dallas area, we might actually see the US-Mexico border secured... ...by the Mexican government.
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You mean Los Zetas?
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goes to show (Score:2, Insightful)
This goes to show how much we rely on so-called experts in this area and they have no fucking clue what they're doing. The CDC, the NIH should have been all over that hospital. This is not a lab experiment, and until they can come up with the protocols to assure healthcare workers safety then they need to start quarantining all people who come in contact with a contagious patient or sending them to a standardized facility where the risks to the public can be minimized.
Re:goes to show (Score:5, Insightful)
That's just so wrong.
Pray tell, what jurisdiction does CDC or NIH have to be "all over" anything? None whatsoever. NIH is a research establishment. CDC is essentially a federal health department that has jurisdiction nowhere (maybe in DC?). There are no standardized facilities that you refer to. A research lab is not a clinical facility. Just because a lab is set up to handle highly infectious diseases doesn't make it a place where you can treat people.
The experts in this area are doing just fine, working with shit that makes Ebola look like a seasonal allergy, at facilities that are set up for that. Those people are usually not MDs, there's zero reason for them to be MDs. They're biologists of various sorts.
Demonstrably, no infectious disease experts were in charge at the facility/facilities where the health workers got infected. So your point that experts are unreliable is entirely moot. There were no experts in charge to start with.
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hrm, looks like CDC has powers to quarantine, but generally for national entry and interstate travel. within states i'm thinking it serves in an advisory capacity for state and local authorities. States rights baby.
Jurisdiction be damned (Score:2)
The CDC should have been all over the hospital jurisdiction or no jursdiction. People's lives are on the line.
It's quite evident that in the US there are people who can handle ebola. These people were not in Texas, and the stupid hospital admins did not realize that they needed the help. Regardless of that, it's been demonstrated that help has to be forced upon any hospital handling Ebola whether they like it or not.
--PM
Re: (Score:2)
IOW, according to you lawlessness is fine and dandy as long as "lives are on the line". Think of the children, too.
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Take a deep breath....
First of all the health care workers involved were monitoring their temperatures so the got isolated quickly and before they where highly contagious. Sending the patients to facilities trained for this is probably a good idea but then you still have the risks involved in transport. Finally I have to admit that I fear this a case where the CDC did send the right instructions but they failed in not knowing what what the Hospital did not know. They might have sent instructions to use full
If we can't rely on procedures with ONE patient.. (Score:2)
...what gives us any reason to believe that these procedures will work with more than one patient or even significantly more?
If containment requires much more stringent procedures, facilities and protection than what was used in Dallas, it somehow seems even less reassuring because the more complex the protocol the harder it is to scale.
I've never been worried about the disease so much as I have this kind mindset that seems to be promoted about how "hard" the disease is to spread "if you follow procedures".
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Really have you read the latest from the dumbfuck running the CDC? Would you consider the Washington Post [washingtonpost.com] a good source of information?
“We did send some expertise in infection control,” Thomas Frieden said during a news conference Tuesday. “But I think we could, in retrospect, with 20/20 hindsight, have sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed.”
Inept and incompetent and I'm sorry but a mia culpa isn't going to cut it.
Re:Citation needed? (Score:5, Insightful)
Really have you read the latest from the dumbfuck running the CDC? Would you consider the Washington Post [washingtonpost.com] a good source of information?
“We did send some expertise in infection control,” Thomas Frieden said during a news conference Tuesday. “But I think we could, in retrospect, with 20/20 hindsight, have sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed.”
Inept and incompetent and I'm sorry but a mia culpa isn't going to cut it.
You do realize that this basically translates to "Yeah, we should have known those Texan hicks couldn't handle a case of the flu, let alone Ebola."
Comment removed (Score:3)
Re:Seriously, the nurses have a point. (Score:4, Informative)
Average is closer to $70k for an RN, which puts them in the to 15% of all wage earners in the US.
The rest is true, though. It's a pretty hectic job, and corporations will look for any market advantage (LVNs, overworked residents, image over process, etc.).
These two patients are different. (Score:2)
At this rate (Score:2)
Aboujt 1 /week. I think more people are killed by hammers than Ebola.
Re:At this rate (Score:4, Insightful)
Unless you consider that we're doubling the number of cases every week, not increasing by 1. In which case we've got about 26 weeks left before the entire US population is infected or dead.
I'm just counting down the white people (Score:2)
If the Onion is right, I think we're still like 46 white people away from a cure.
This Hospital is in No Way Unique (Score:5, Insightful)
The failures of this hospital in dealing with a novel and gravely serious situation are in no way indicative of remarkably incompetent individuals or sub-standard hospital policies.
Even the most complete training cannot provide experience. Day to day work in a hospital is boring and routine, and when faced with the unknown people are going to fall back on that routine, not what they were trained to do briefly and long ago. Nurses who haven't dealt much with explosive diarrhea or projectile vomiting won't have practice being meticulous about preventing splatter on every part of their skin or porous clothing. Simply telling someone to be careful and then sending them off unsupervised and unaided isn't terribly effective.
Hospitals cannot afford to maintain a full wardrobe of gear to deal with even one Ebola patient throughout the course of treatment, nor are they set up to dispose of that gear at the rate it piles up after use. Adequate supplies will need to be provided on a reactive (not proactive) basis. Protocols, however, simply assume that the gear is there and ready to be used by people well versed in their use. It doesn't do any good to have well thought out procedures in place if it isn't possible or practical to implement them.
People who blame the nurses, or the hospital, or the patient are holding them up to an unreasonable standard. These people are not special. They're not clowns and they're not villains. They're just normal folk reacting the way normal folk will, and neither the CDC nor anyone else has some magic wand to wave to prevent this exact same scenario from playing out the next time. It's unfortunate, but it is manageable and we should focus on making sure the right lessons are learned from it.
Some interesting viewing, somewhat related: http://www.ted.com/talks/atul_... [ted.com] http://thedailyshow.cc.com/vid... [cc.com]
Re:Virus burn out? (Score:4, Informative)
The problem is that in the real outbreak areas (parts of west Africa, especially Liberia) there simply isn't enough protective gear to go around, let alone facilities or trained personnel to use them. In many places they are doing triage, sending patients home who they know to have Ebola because there simply isn't room. Now, if two trained nurses wearing most of the necessary protective gear got sick treating a patient in a modern hospital setting, how do you think average people are going to do treating their sick family members? At that point, things spiral rapidly out of control, which is exactly what we've seen in those regions and is why the WHO says if they don't get more beds, supplies, and doctors in place soon we'll see more than a million infections before the end of January.
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Agreed, this is a horrible problem and the numbers are increasing in terms of infections and deaths in Africa. The biggest issue with other nations is complacency in believing that local and national health officials can handle it when it spreads outside of Africa. It's clearly being proven not the case in Texas and in Spain with healthcare workers getting infected. I'm not sure the WHO even has the resources to combat this.
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This is what has happened in the past.
The difference this time is that it has not limited itself to small isolated villages. It has hit multiple large cities. If this thing is going to burn out – rather than be stomped out – we have yet to see the real carnage.
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Hinterland. Nuff said :)
Re:their own fault (Score:5, Insightful)
Ah yes, lets blame the victims, the very people who were trying to help a very sick, very dangerous man while he lay in a hospital bed dying.
What the fuck is wrong with you!?
If AIDs or hepatitis were anywhere near as communicable you would see a mass exodus from the medical profession: working with sick people would be a death sentence waiting to happen. You can work with, live with, eat with, share a bathroom with, even fuck (with appropriate protection) people who have HIV or hepatitis without contracting it and you can do so for years if you're careful. We've now had 2 out of a team of perhaps 60 who cared for Duncan get sick. Does that sound equivalent to you?
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Re:their own fault (Score:5, Interesting)
Please do not simplify such a grave topic.
There are innumerable communicable diseases in the world, including the US. Many of these infectious diseases have very serious health consequences, also including those in the US. As such, there are numerous (and sometimes onerous) regulations put in place by the public and private sectors to educate and prepare those who are at the front line.
The most basic form is something called universal precautions, which should be observed with EVERY patient you come in contact with. Essentially the goal is to treat every patient's bodily fluid as if it is contaminated, thereby protecting yourself from unknown diseases that the patient may have, and preventing spreading of nosocomial diseases to an otherwise healthy patient. If a patient is known to be infected, additional precautions are put in place in accordance with the communicability of the infection. These include everything from gowns and gloves, all the way to pressurized rooms, N95 respirators, and the so called "space suits". Used appropriately, these are excellent barriers to the spread of disease.
I guarantee those involved with Mr. Duncan's care were certified in all of the above, and once diagnosed Mr. Duncan was almost certainly triaged appropriately. Additionally, the hospital should have ample stock of all of the above equipment -- it is used on a daily basis in the hospital with or without ebola. So the question becomes, how did subsequent infections occur. There must have been a breakdown somewhere in the above steps, whether it was the hospital providing faulty facilities, faulty precautionary equipment, or faulty usage of said equipment. YOU nor I can say nothing more -- we do not know where the blame lays. (Also, run through your mental exercises again keeping in mind that there were no infections in Atlanta or Nebraska, other sites that have taken care of ebola patients). Just take a deep breath and stay civil.
Sauce: I am a doctor who has worked with the sickest of the sick here in the US. I have seen hospitals error, gloves break, and an incredible number of health care professionals misuse equipment and ignore precautions.
As an aside, health care professionals are always at the front line of these things and always at risk of the worst. A very sizable number of physicians, if they are being honest, will admit to inadvertently sticking themselves with a dirty needle or scalpel (myself included). The risk of communicable diseases, very serious pathologies, are small but not inconsequential. I personally know doctors who have died form AIDS, and radiologists with myeloproliferative disorders. Do you remember the AIDS epidemic in the 1980's, especially before anyone knew the etiology? Where was the mass exodus in the 80s? With all the fear in society, physicians and health care professionals were still compelled to treat anyone sick. Despite this, from my anecdotal experience, more doctors are leaving medicine because of increasing litigation, oppressive malpractice laws and increasing malpractice insurance, rather than fears of communicable diseases.
And a bit of advice: although the treatment of hepatitis and HIV have improved over the years (and very solid evidence that HIV is innately becoming less virulent, another interesting story in and of itself), I would recommend not sharing needles or playing with infected fluids of others.