I think it needs to be emphasized, Ebola isn't highly contagious, but it is highly infectious. Hard to get, but hardly any contact with it will get you sick.
That team of people didn't include anybody to actually provide care to the sick patient. If that is where the breaches in protocol occur (as was the case in Spain and in TX), then that is where they need to step in. But sounds like the CDC is at least aware that further training is needed but stinks that this is how it had to come about. Like I said earlier, the infection protocols aren't necessarily in place to protect the health care worker from getting infected, but to protect other patients (who are likely immunocompromised) from the spread of germs from one patient to another. Since it is obvious that protocols weren't followed, I just hope that wasn't the case. The assurances that they know what they are doing and that Ebola isn't a threat to the US when there have been two examples of very huge mistakes being made on the one and only surprise case in the US is just very non-concerting. I am sure FEMA thought they had everything in order before Katrina too.
Not at all the same thing. FEMA's Director was a political appointment, and it was shown after the fact that those in charge had no relevant experience for the roles they were in. The Director of the CDC? Yeah... he has his shit together, and has a lot of experience in the field. http://www.cdc.gov/about/leadership/director.htm
I don't know how PPE works for diseases as infectious as Ebola, if there is a separate protocol or not, but there is a definite method to donning and removing it. Had it been me having to take care of that guy, I would have done some serious practice in my spare time and reviewed the protocols and adhered to them as Gospel. I can't imagine anyone actually having to care for someone with anything as infectious as Ebola and not being obsessive compulsive about every bodily fluid and how it is handled every step of the way.
I respectfully disagree as this is a discussion about being prepared to face some sort of threat and about how the response is carried out, not about a specific person's credentials. You work in network security, no? Helping to protect networks against threats? Would a team with all the certifications (sorry - not familiar with what they are) remain as impressive to you if they had a couple of known security breaches?
In fairness, no one could have been ready for Katrina. If you want to lay blame for that clusterfuck on anyone point your finger at the Corps of Engineers. Which raises an interesting comparison. The Corps is in charge of making sure things like Katrina don't happen. They obviously failed at that, so who is in charge of making sure we don't get Ebola spread all over the country? And is taking the temperature of people arriving at JFK from West Africa going to be helpful at all?
The only think I wish I could do with this situation is stop idiots from spreading misinformation on Social Media. People are fucking morons, they'll link something, asking if it is real instead of googling it and finding out themselves.
Not to distract from the Ebola conversation, but I wanted to correct you on Katrina. The Corp had requested funding to address structural issues in some of the levees around New Orleans before Katrina happened and the request was rejected by congress at least twice. I don't remember the exact dates, number of request etc. but the Corp tried to do it's job and was rebuffed by politics. This why our infrastructure in general is failing. The DOTs and the Corp are not getting nearly enough funding to address the issues with an aging infrastructure.
It'll be contained with minimal effect on first world countries. Every couple of years people freak out over some dumb shit. Mad Cow. SARS. Bird Flu. Nothing is going to happen.
I thought THIS was a pretty in depth article. I would assume National Geographic is reputable. Couple of excerpts: All indications do seem to point that in the case of the Dallas health care worker and the nurse in Spain both made errors while taking off their PPE. It certainly appears they have the situation well in hand to me.
If they made errors, then they need to be trained how to do it properly. I worked as a nurse in the ICU. If somebody with ebola had come into the hospital that I had been working at, then chances are pretty good that I would have been one that would have been taking care of him. Would I have known exactly how to do it? Probably not because I don't think that your staff at your community hospitals are receiving any specialized training. These nurses are on the frontlines and the fact that two (so far) have contracted it despite "best measures" being implemented is very scary. Let's hear from other people who have worked in hospitals how things can go awry between the "this is how you do it" to the actual "this is me doing it". I just disagree that it can be adequately handled at any hospital.
I mean, if I'm honest, when you said that you "couldn't imagine" removing your PPE incorrectly, I was a little bit surprised. I haven't actually worked on a floor in a while, but I can absolutely imagine myself or other staff not donning/doffing their PPE correctly, or ignoring other aspects of good infection control. There's always those stories about contaminated bottles of hand lotion, or long nails, fake nails, jewelry, ties, whatever, that are isolated as the source of nosocomial infections. And the highest level of PPE (in hospital, at any rate) that I've used is just your garden variety gown/gloves/mask, +/- face shield. Outside of patient care I've done a little bit of chemical/biological stuff, but never to a level that would be suitable for exposure to live agents. The PPE requirements for ebola are that much more stringent, and the vast majority of hospital staff aren't yet comfortable with it, which make mistakes that much more likely.
I can't help but think this is a case of prioritization. You yourself said you didn't have any time to get your normal shit done in a day, never mind learn the proper Ebola protocols, etc. So I imagine hospitals do what makes sense to them, and try and guess just how likely it is that they will have to deal with it, and plan accordingly. If the odds are pretty low, then they'd not train specifically for it. Let's face it, a hospital in Texas... I bet you they have their Hantavirus protocols down cold... but Ebola? Really? Who the hell expects to run across Ebola in Texas? But what happens if you swap Ebola for Anthrax? Do you have training for that? Or what about SARS? Or CA-MSRA? Surely hospitals must have basic infectious disease protocols that they SHOULD know, not just an Ebola-specific one? And surely Ebola isn't the worst case of infectious disease that they would face? I'd tend to think that any protocol put in place would handle Ebola and a whole host of others, once it's been diagnosed and the protocol put into effect. I'm of the opinion that hospitals could never have enough training in place to deal with every eventuality, and it's the CDC's place to come in and provide assistance to that hospital as required should a case arise. I don't see this current situation as any kind of failing of either the CDC or the hospital/nurse. I think they did the best they could given the situation, and are working to improve that. For all we know the nurse could have contracted it early on before it was properly diagnosed as Ebola, and applied a typical "flu protocol". I've read nothing that states that she contracted it after the protocols were put into place... I don't know... I just don't think there's any reason for hysteria at this point.
I am not claiming hysteria, I am in no way thinking that the US is going to experience an epic outbreak of West Africa proportions. I am claiming that the CDC is dropping the ball (or had been so far, this will shake them up) and it is putting people at risk. Namely putting the hospital nursing staff at risk. And heaven knows that I am highly protective of nursing staff because that job is harder than most people will ever realize. Add in the fears of something like ebola knowing that you may not be as safe as everybody is claiming? And yep, there are protocols. Do they get worked through regularly? Are they foolproof? Will everybody know what to do when shit hits the fan? Absolutely not. A local hospital just held a press conference about a patient admitted today who is being tested for ebola. Sure, it probably will be something like typhoid or malaria, but doesn't mean that those people who have been in contact aren't going to have a stressful couple of days. I feel for them.
I certainly never feared for my own safety and health when caring for somebody with the flu, so it's not a similar situation at all.
I certainly feel for the nurse...that's an awful situation, and I'm thankful that so far my safety is something I haven't needed to worry about, but I think it's interesting how the situation is affecting the hospital. The last I've heard Presby has closed its ED and it not accepting any new patients. Many people are canceling their appointments and labor/deliveries there. Nobody wants to step foot in that place. I don't feel sorry for the hospital. They'll bounce back and be just fine; it is one of the big ones in town and has a great reputation as an employer and hospital. I just think it's crazy because as far as I know no SARS scare or sensationalized news item has affected a large facility to this degree in such a short period of time. Two people came into our ED claiming that they have The Ebola.
Ahh, got it. Symptoms were different, high fever, nausea and vomiting, no respiratory so unlikely flu, coming from West Africa so probably another disease indigenous to that area.. But this info from the news report is certainly reassuring.... "KU Hospital has designated three intensive-care isolation rooms for Ebola patients. The rooms have negative-air-pressure ventilation systems, so air from the room won’t escape when the door is opened. As further protection, each isolation room has an anteroom; if its door is left open more than 30 seconds, an alarm sounds. Anyone going into the isolation room will suit up in an impermeable gown, gloves that go up to the forearms, booties, a surgical mask and a plastic face shield. About 15 nurses at KU Hospital have volunteered for special training in taking care of Ebola patients." Plus the patient has his own team of 6 doctors and nurses who won't take care of any other patients, makes me feel a little better. The hospital spokesperson said they had a scare 8 weeks ago (it was malaria) and really ramped up. This is my point....not all hospitals have these types of resources (the one I worked at didn't). Instead of telling patients that "any hospital" is capable of handling ebola, they need to turf people at risk to appropriate hospitals where these sorts of precautions can be taken. I am not calling for an all out panic, but I feel that they have underplayed the danger a bit which is a disservice.