Ebola coming to the US

[scrub-jay]

Ebola coming to the US

I think there needs to be training WITH LEVEL 4 PPE GEAR! I disagree with you on residents. I think it's fair for a resident to say "I'm not sure I can do an intubation safely with this gear on a hemorrhagic patient" Like the CDC director said "there can be no room for error on these patients" Residents always have room for error, that is why they work under supervision. These patients need the best care possible.

[scrub-jay]

The news is pissing me off. They barely cover the vaccines and treatments coming out...but instead focus on the blame game and the OMG -- we're all going to die!!!!

[PrincessFiona]

Weird. Quick Reply didn't work for me.

Frankly, there is blame to go around.

Thomas knows Frieden. His comment to me as things got started was that this was going to be a major fuck up under his management. I believe the nurse's version of events.

New treatments and vaccines? Sure, it'd be nice to hear about. In the meantime, we are dealing with an Ebola strain that appears to have a 70% mortality rate. We have two new patients, one of whom was on a flight before being isolated. This is no flu. Yes, people die from complications of the flu every year, but we do have vaccines and treatments for complications. Ebola is basically supportive care at this point. We have every right to be nervous about this and to try to figure out where things broke down so that we can manage the situation better. At this point, there is no vaccine and treatments are extremely limited.

Kris

[JDAZ11]

I think there needs to be training WITH LEVEL 4 PPE GEAR! I disagree with you on residents. I think it's fair for a resident to say "I'm not sure I can do an intubation safely with this gear on a hemorrhagic patient" Like the CDC director said "there can be no room for error on these patients" Residents always have room for error, that is why they work under supervision. These patients need the best care possible.

This!

My DH and I were talking about this last night. There was a pretty large influx of patients with CDJ at his training institution and many of the residents chose to give up cases. My DH said it was great for him because he got a bunch more experience. But I think it should be their choice in cases like this.

[scrub-jay]

Ebola coming to the US

I should qualify, I'm not a fan of blaming individuals in healthcare quality. I believe in systems (IHI influence) and hospitals do not have this kind of protocol in place. Emory? Nebraska? NIH? They do! They received grants to establish special units and trained people to handle these types of patients. Then they held regular drills to practice. I'd wager the majority of healthcare workers have not even put on that level of PPE, nor practiced drawing blood with it (or *insert any technique here*). So Frieden saying that "any hospital with an isolation room can handle Ebola patients"...I called BS then and unfortunately nurses had to get infected for him to realize it was BS. I suspect that's why the 2nd nurse will be treated at Emory.

[Pollyanna]

Weird. Quick Reply didn't work for me.

Frankly, there is blame to go around.

Thomas knows Frieden. His comment to me as things got started was that this was going to be a major fuck up under his management. I believe the nurse's version of events.

New treatments and vaccines? Sure, it'd be nice to hear about. In the meantime, we are dealing with an Ebola strain that appears to have a 70% mortality rate. We have two new patients, one of whom was on a flight before being isolated. This is no flu. Yes, people die from complications of the flu every year, but we do have vaccines and treatments for complications. Ebola is basically supportive care at this point. We have every right to be nervous about this and to try to figure out where things broke down so that we can manage the situation better. At this point, there is no vaccine and treatments are extremely limited.

Kris

This exactly!

[JDAZ11]

Well I am at least glad to read that she (and anyone else with contact) was at least directed not to fly commercially.

[scrub-jay]

Ebola coming to the US

Well I am at least glad to read that she (and anyone else with contact) was at least directed not to fly commercially.

I hadn't read that. Well that is a game-changer. If she broke quarantine, then that's definitely at-fault.

ETA: I just read in several places that she WASN'T in quarantine because she wasn't exhibiting symptoms and there was no restriction on her traveling. Frieden said she "shouldn't have traveled" but that doesn't mean she was on orders not to. She was in a monitored group w/daily self-administered temp checks.

[Thirteen]

Just in time for cold & flu season, as well as the masses traveling for upcoming holidays.

To be honest, how many care centers ever think "zebra"? Not many.
I feel we will see more infected as the weeks and months progress.

Petty rant(s) in the same vein: people, vaccinate against what you CAN, and stop telling the uneducated and ill-informed that essential oils can CURE Ebola.


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[scrub-jay]

You're right 13. We will see more. I've run the numbers out of West Africa and they are GRIM. Timeline, 2 months maybe. We really need a vaccine. Badly.

[WolfpackWife]

You're right 13. We will see more. I've run the numbers out of West Africa and they are GRIM. Timeline, 2 months maybe. We really need a vaccine. Badly.

Can you elaborate?

[Thirteen]

You're right 13. We will see more. I've run the numbers out of West Africa and they are GRIM. Timeline, 2 months maybe. We really need a vaccine. Badly.

The worst part is, and I've said this privately, it is only just now a pressing issue.
When Ebola was in African countries? Tragic, but very "not our problem."
Now that it's here? "Let's all panic and save the population."

I wonder how expensive it will be to administer it overseas... Will agencies and governments be able to afford it? Will the U.S. readily make and ship it at a "good price?" Sadly, everybody loses in all the scenarios I can come up with.


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[Sheherezade]

They say she had a fever when she boarded the plane. I can only guess that's from the self monitoring. It seems like that makes a mockery of all the fanfare over the "90 minutes after the healthcare worker reported the fever, they were admitted to the isolation unit" BS that happened with the first nurse. Bad judgement by nurse #2. Bad. She should have stayed put. I'm sure the CDC could have worked out something to refund her airline tickets. It's frigging EBOLA, people.

[Sheherezade]

Even more sad: The US is the only country that has committed anything to helping. We are sending over 3000 troops and lots of money. Other countries? Nothing. They are closer, too.

{{I keep thinking about playing Pandemic online though and my reaction is we need to close the ports immediately. And preferably be in Madagascar. Because only Madagascar with closed ports ever survives....}}

[scrub-jay]

Can you elaborate?

I've been following this outbreak since March. We're looking at exponential growth, not linear. I've always felt the numbers are much higher than are reported (bc of infrastructure and testing limitations) and have kept my epidemiology skills fresh by running calculations based on several assumptions. However, to simplify, this is around the same magnitude, but based on more thorough data: http://news.sky.com/story/1352857/si...-nations-warns