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Ebola Comes To USA

#481
Hawaii Islander said:
The first case was not reported to the CDC immediately. The patient was sent home. The local hospital screwed up initially. It is very hard to point a finger at the CDC while ignoring the facts on the ground. There were specific problems with poor screening procedures, lack of coordination and poor infectious disease protection policies and implementation at the hospital long before CDC was even notified there was a potential Ebola patient being treated.
Click to expand...

Did you watch the hearings? This is not about Duncan, but the bumbling that followed. The CDC was fielding everything by phone, waiting for a confirmation before making an appearance in Dallas. Same reason the second nurse was given the green light to board a plane after showing symptoms. The hospital at least had the balls to apologize for what was an essential failure of the CDC to have clear guidelines for them to follow from the start. Every piece of evidence available to the public thus far points to the fact that the nurses did indeed follow protocol in dealing with his treatment once his exposure was confirmed. Mr. Frieden's stumbling over the exact question whether protocol was followed accurately doesn't exactly reassure the public that he is being honest.
 
#482
i was watching the House Energy and Commerce Committee on C SPAN.

Frieden & Dr Fauci in the hot seats.

I couldnt capture the whole statement in its entire context, coz i wrote it down real-time; but here's a statement by one the panel, a representative of California, said addressing Frieden:

"So, basically, you're trying to inform this committee with limited education and partial authority. Is that what you're saying?"

I could be hear gasps from other panelists. (or maybe it was the press/photographers)

Im certain he meant to say information instead of education. Talk about a Freudian slip! The look on Frieden's face was priceless. He responded with the expected rhetoric and meaningless jibber-jabber.
 
#483
petrus61 said:
Did you watch the hearings? This is not about Duncan, but the bumbling that followed. The CDC was fielding everything by phone, waiting for a confirmation before making an appearance in Dallas. Same reason the second nurse was given the green light to board a plane after showing symptoms. The hospital at least had the balls to apologize for what was an essential failure of the CDC to have clear guidelines for them to follow from the start. Every piece of evidence available to the public thus far points to the fact that the nurses did indeed follow protocol in dealing with his treatment once his exposure was confirmed. Mr. Frieden's stumbling over the exact question whether protocol was followed accurately doesn't exactly reassure the public that he is being honest.
Click to expand...

The hospital did not follow established protocols until late in the game. Had they done so, the few Ebola cases we have among caregivers would not have occurred in the first place. In short, the hospital did not do the right thing, for the patient, for their employees, or the public at large. I do agree that the CDC had a slower initial learning curve on what they anticipated would occur at area hospitals and their actual capabilities, but now that it is known corrections can be made. Improved communications between health care facilities and the CDC are crucial to dealing with any major health crises. I think the learning curve is becoming much more rapid and I anticipate a more robust response at all levels.
 
#485
Research at lunch hour turned up this concerning how this bug travels.

From one country that handled their outbreak correctly(Nigeria):
“However, Ebola VD could be spread through the following (as possible routes of infection):
Inhalation of contaminated air in hospital environment;”
Invalid Link Removed

From the CIDRAP website:
http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola

It appears the “aerosol” route has been suspected/known for some time but SCBA’s or air-supplying respirators are so much more costly for hospitals than facemasks or N-95’s especially if they have to be decontaminated or incinerated after use.
It is no wonder nurses and their unions are severely upset(putting it mildly)…..
 
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#486
Hawaii Islander said:
The hospital did not follow established protocols until late in the game. Had they done so, the few Ebola cases we have among caregivers would not have occurred in the first place. In short, the hospital did not do the right thing, for the patient, for their employees, or the public at large. I do agree that the CDC had a slower initial learning curve on what they anticipated would occur at area hospitals and their actual capabilities, but now that it is known corrections can be made. Improved communications between health care facilities and the CDC are crucial to dealing with any major health crises. I think the learning curve is becoming much more rapid and I anticipate a more robust response at all levels.
Click to expand...
http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola
It is not that they didn't follow the established protocols; rather the established protocols were WRONG.
 
#488
sissy kathy said:
http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola
It is not that they didn't follow the established protocols; rather the established protocols were WRONG.
Click to expand...


It appears that it depends on who you are listening to. According to nurses who work at the hospital

http://www.cnn.com/2014/10/15/health/texas-ebola-nurses-union-claims/index.html

protocols were NOT followed. The charges are specific. The hospital responses that CDC protocol were followed are not convincing. I work for a large organization. I will believe the stories of the ground troops with names behind the claims over anonymous bureaucrat any day of the week.
 
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#489
We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.


The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.


papr_0.jpg


http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
 
#490
Johnny Crab said:
Research at lunch hour turned up this concerning how this bug travels.

From one country that handled their outbreak correctly(Nigeria):
“However, Ebola VD could be spread through the following (as possible routes of infection):
Inhalation of contaminated air in hospital environment;”
Invalid Link Removed

From the CIDRAP website:
http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola

It appears the “aerosol” route has been suspected/known for some time but SCBA’s or air-supplying respirators are so much more costly for hospitals than facemasks or N-95’s especially if they have to be decontaminated or incinerated after use.
It is no wonder nurses and their unions are severely upset(putting it mildly)…..
Click to expand...


After carefully reading the CIDRAP linked article and a few of it's cited sources, I'm not finding a claim of aerosol transmission. The article is taking the issue with the uncertainty of aerosol and addressing the inadequacy of the ill fitting masks. No strong claim of aerosol transmission is made in any of those sources.
 
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#491
skychief said:
We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.


The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.


papr_0.jpg


http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
Click to expand...

"Potential" is the key word. The article is saying that better equipment should be used in the spirit of erring on the side of caution.

Certainly I agree that these suits should be immediately made available at every hospital.

Notice that it is the unions asking for better protective gear. This is not uncommon in my work experience. I certainly don't hear press conferences from hospitals saying it will be done 'tomorow'.
 
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#492
skychief said:
We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.


The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run. {picture}

http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
Click to expand...

I'm glad to see someone read the article, AND got the point; rather than ignoring it.
 
#493
redwookie said:
It appears that it depends on who you are listening to. According to nurses who work at the hospital

http://www.cnn.com/2014/10/15/health/texas-ebola-nurses-union-claims/index.html

protocols were NOT followed. The charges are specific. The hospital responses that CDC protocol were followed are not convincing. I work for a large organization. I will believe the stories of the ground troops with names behind the claims over anonymous bureaucrat any day of the week.
Click to expand...
I don't doubt the statements made by the health care workers. I am saying whether the protocols were followed or not is immaterial as they were insufficient. See my last reference or SkyChief's last reference, both agree that the protocols are insufficient. Further, SkyChief's reference is dated 17 SEP; more than a week before Mr. Duncan was admitted for treatment.
 
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#495
redwookie said:
After carefully reading the CIDRAP linked article and a few of it's cited sources, I'm not finding a claim of aerosol transmission. The article is taking the issue with the uncertainty of aerosol and addressing the inadequacy of the ill fitting masks. No strong claim of aerosol transmission is made in any of those sources.
Click to expand...

We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.

Being at first skeptical that Ebola virus could be an aerosol-transmissible disease, we are now persuaded by a review of experimental and epidemiologic data that this might be an important feature of disease transmission, particularly in healthcare settings.
 
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#497
skychief said:
We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.

Being at first skeptical that Ebola virus could be an aerosol-transmissible disease, we are now persuaded by a review of experimental and epidemiologic data that this might be an important feature of disease transmission, particularly in healthcare settings.
Click to expand...
That was not CIDRAP's position. It was an editorial that Breitbart took from the CIDRAP site and made a claim that it was CIDRAPS position. CIDRAP has since spoken out against the Breitbart and Inquisitr articles that made such a claim. I posted the link earlier in this thread. So did other people who commented on this thread.
 
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#498
Talking to my nursing friends, they are unimpressed with the Ebola gear and training provided to them so far. And I live in the heart of Chicago surrounded by world-class hospitals.


Oct 6th
Nurses union: U.S. hospitals not prepared for Ebola patients
National Nurses United says hospitals must upgrade emergency preparations
October 6, 2014
As international agencies fight to contain the Invalid Link Removed amid reports that a Invalid Link Removed infected with the deadly virus, a survey of registered nurses reveals most believe their hospitals aren't prepared to handle patients with Ebola.
Although the Centers for Disease Control and Prevention (CDC) last month issued Invalid Link Removed, 80 percent of nurses surveyed by the National Nurses United said their hospitals haven't provided them with a policy regarding potential admissions of patients infected by Ebola. The survey involved 700 registered nurses at more than 250 hospitals in 31 states.
The survey also revealed that:
  • Eighty-seven percent report their hospitals haven't educated them on Ebola
  • One-third say their hospitals don't have a sufficient supply of eye protection (face shields or side shields with goggles) and fluid resistant/impermeable gowns
  • Nearly 40 percent say their hospitals don't have plans to equip isolation rooms with plastic-covered mattresses and pillows and discard all linens after use
  • More than 60 percent say their hospitals fail to reduce the number of patients they must care for to accommodate caring for an "isolation" patient
As a result of the survey results, the union called on all U.S. hospitals to implement a full emergency-preparedness plan for Ebola and other infectious diseases. In addition to sufficient staffing, those plans must include full training of hospital workers on proper protocols for responding to outbreaks and adequate supplies of personal protective equipment, according to the union's statement.

Invalid Link Removed

Oct 15th
Dallas nurses allege 'no protocol, no system' in treatment of Ebola patient
[Invalid or Expired Link Removed]
 
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#499
redwookie said:
"Potential" is the key word. The article is saying that better equipment should be used in the spirit of erring on the side of caution.

Certainly I agree that these suits should be immediately made available at every hospital.

Notice that it is the unions asking for better protective gear. This is not uncommon in my work experience. I certainly don't hear press conferences from hospitals saying it will be done 'tomorow'.
Click to expand...

They still need to be used 100% properly or they won't be effective. Advanced training is just as critical. Most facilities simply don't have staff who able to perform these tasks.
 
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#500
Hawaii Islander said:
That was not CIDRAP's position. It was an editorial that Breitbart took from the CIDRAP site and made a claim that it was CIDRAPS position. CIDRAP has since spoken out against the Breitbart and Inquisitr articles that made such a claim. I posted the link earlier in this thread. So did other people who commented on this thread.
Click to expand...

I think either you didn't read the entire article, or misunderstood its meaning. Those paragraphs were were copied/pasted verbatim from this CIDRAP article by Lisa M Brosseau, ScD, and Rachael Jones, PhD | Sep 17, 2014:

http://www.cidrap.umn.edu/news-pers...ers-need-optimal-respiratory-protection-ebola

Its rather lengthy, and it must be read completely to glean the pertinent information regarding the aerosol transmission of Ebola virus. Nowhere in the article do they make the claim that infection occurs from aerosol transmission, only suggest that, from data available to them, the possibility of aerosol transmission should not be dismissed. Here's the summary:

"To summarize, for the following reasons we believe that Ebola could be an opportunistic aerosol-transmissible disease requiring adequate respiratory protection:

  1. Patients and procedures generate aerosols, and Ebola virus remains viable in aerosols for up to 90 minutes.
  2. All sizes of aerosol particles are easily inhaled both near to and far from the patient.
  3. Crowding, limited air exchange, and close interactions with patients all contribute to the probability that healthcare workers will be exposed to high concentrations of very toxic infectious aerosols.
  4. Ebola targets immune response cells found in all epithelial tissues, including in the respiratory and gastrointestinal system.
  5. Experimental data support aerosols as a mode of disease transmission in non-human primates.
  6. Risk level and working conditions suggest that a PAPR will be more protective, cost-effective, and comfortable than an N95 filtering facepiece respirator."
 

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