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@littlebug: so scary...
When the first patient recovered, I thought, "okay, we can handle this in US--it's not going to get out of control" and then the man who came over from Liberia died and less than a week later, the nurse who cared for him, gets on a plane with a fever???? Now I'm starting to get more concerned.
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@Adira: my friend who is an ER nurse in Mass posted a pic on FB of her in her 'ebola' suit... it's definitely not the hazmat-type suit with a respirator, etc... more like a painter's suit with a plastic face shield. Her neck is totally exposed. I'd be worried if I were her, but at least she's not in Boston (she's in a suburb) so the chances of getting an Ebola patient at this point are probably lower.
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@Adira: Try not to worry, seriously. All states are having meetings like this - it's precautionary.
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Someone in healthcare in the US might want to weigh in on this, but a friend who is a nurse in Europe said that they take an oath and part of that oath is taking care of whichever patient they are given, no matter what their condition/illness is. Refusing a patient would end up in losing their nursing license. Not sure if this is true in the US, but it could be something to consider with all of this craziness right now.
Apparently the CDC is saying that they did not give her permission to fly, but didn't tell her not to. Stupid on their part but I also think the nurse is just as much to blame. She is a professional healthcare worker who knew exactly what risk she was running by possibly infecting other people.
All hospitals NEED to have hazmat suits to deal with this. Why is it that MSF doctors in Africa has them yet nurses in Texas don't?! Makes no sense.
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@HLK208: The thing about the guy who died, though, is he was sent home after he was already sick. So he didn't get treatment as soon as he could (and should) have. So far the seven other people who have been treated here have survived, so that's definitely a comfort!
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@alohaorchid: I think it's because Ebola is (relatively) common in Africa. Hazmat suits really only get broken out here for bioterrorism-like events...I work in healthcare and I'm not sure I've ever seen one!
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I feel like the CDC has been reading too many of the bloggers that said Ebola . . . Meh. . . And then applied the meh, no biggie even to people who have had direct contact. That's amazingly incompetent for them to have given her the go ahead to get on the flight. They've had months to prepare there's really no excuse for their response.
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@MrsSCB: very true
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Stepping my toe (very carefully) into this discussion - is anyone else surprised that no one from the first man's family or any non-healthcare workers got Ebola? Did the two nurses that got Ebola treat him early in the process before he was diagnosed or when he was presumably very sick - mean lots of bodily fluids (blood, vomit) etc that needed cleaning?
It makes me feel better that no one that had contact with the patient outside of the healthcare setting has contracted it. At least not yet.
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@TemperanceBrennan: I was just thinking about that last night. I wonder when their quarantine ends?
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@TemperanceBrennan: @FliegepilzHut: Their quarantine is up this weekend I believe. I read on another board that there's a lot of people thinking that they contracted the virus and the city is trying to keep hysteria levels low. I'm not sure I believe that though, I'm pretty sure when public health is at risk they would have to report on something like that.
However, there was an article posted a few days ago that the fiance said they are all ok and healthy. Maybe they just got lucky?! Or he wasn't as contagious when he was staying with them.
@FliegepilzHut: That's scary that you have never seen one! I live close to a new hospital and they said that they have some for situations like this. So does the Children's hospital in this city.
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@TemperanceBrennan: My guess would be that as the disease progressed, he got more and more contagious. It just makes sense, given that you're not contagious at all until you exhibit symptoms. Plus caring for a very ill person entails being exposed to a LOT of bodily fluids.
@alohaorchid: I seriously doubt the city would keep that from people. I work for a large group of hospitals and people are being completely ridiculous. They'll call the PR people and literally say, "We know you have an ebola patient there, why don't you just admit it?!" We're like, "Umm, no, we really don't..." We would never hide it. We've already talked about how we'd communicate it to the public if we were to actually get a patient. So there's no way a city like Dallas wouldn't tell people if his family members had it.
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@TemperanceBrennan: I heard at least one HCW was a dialysis nurse, which is very bloody. The other was covered in vomit and diarrhea while caring for him.
Also, reading this - really interesting about why she got on the plane:
http://www.newyorker.com/news/amy-davidson/amber-vinson-ebola -
@alohaorchid: Are you in a major metro area? I'm sure all of the big teaching hospitals have a few suits...but probably not enough (to deal with one or more Ebola patients)...
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@Shutterbug: if your friend's initials are AL, please wall me!
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@FliegepilzHut: @alohaorchid: @MrsSCB: @JoJoGirl: Thanks everyone!
So it seems to me that most people have very low risk of contracting it. There is too much conflicting and sensationalized reporting. The focus should be on getting the most amount of training and adequate equipment to the healthcare workers providing care. In my mind, it would seem worth the expense to transfer each new Ebola patient to the hospitals with the best facilities and training.
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@rachiecakes: LOL... just walled you!
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@TemperanceBrennan: Agreed. The media is going COMPLETELY OVERBOARD.
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Been following this thread closely, but haven't been sure what to say. It's interesting to me that the media talks a lot about protective gear and number of cases, but little about what actually happens to a person who contracts Ebola. I feel like everything is being downplayed by the media, and I'll be honest, I'm very very nervous about the whole situation. It just doesn't seem like it's as hard to contract as they're making it out to be.
Someone posted this on FB today - can someone weigh in on her thoughts? http://dtolar.wordpress.com/2014/10/01/ebola-a-nurses-perspective/
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@TemperanceBrennan: @JoJoGirl: Totally agreed. I'm so frustrated with the way the media is handling this. And I say that as a former member of the media, haha. I know how focused things are on getting the most clicks and the most eyes on your work, but now it's coming at the expense of public sanity. I think this is an awesome info graphic from the CDC that should be shared more:
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@FliegepilzHut: It's a major Canadian city and the two hospitals are fairly new, one is about 2 years old and the Children's one is less than 10 years old. The city said they have approx. 1000 hazmat suits for the hospitals and emergency responders.
@MrsSCB: I agree completely, I dont' think it would ever be hidden. I just think the lack of reporting on the family is making people paranoid. I read another article that was interviewing parents pulling their kids out of school in Dallas to homeschool them because of Ebola fear. Nuts.
@TemperanceBrennan: Education and training is #1 in all of this I think.
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@alohaorchid: Oh totally, people are really quick to become paranoid. Especially when it comes to scary, mysterious diseases. My guess about why we haven't heard much more about the family is it's out of respect for their privacy. They're grieving a loss and they're waiting around to see if any of them contracted the same scary disease. I feel really bad for them
Semi-related -- I thought this was a great article on the whole freakout happening right now: "We Americans do panic really well. We could use a few pointers on prudence." http://www.nytimes.com/2014/10/15/opinion/frank-bruni-scarier-than-ebola.html?_r=0
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@MrsSCB: The fear-mongering and outright lies by the media are driving me crazy. I work in an immunology research lab and read non-fiction books about virology, infectious diseases, and public health for fun. The hysteria over this is so unfounded and is becoming down-right ridiculous, IMO.
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@Mrs. High Heels: Disclaimer: I stopped reading about 2/3 of the way in...but I'm not sure how helpful her commentary is (this from a fellow HC worker). YES...Ebola, the disease, is terrifying. It's scary for a number of reasons that she pointed out-- it's exotic; it's transmitted differently than most viruses; it's miserable (if you contract it); and it has an extraordinarily high mortality rate (treated supportively, in Africa...there are very few "orphan" drugs with any known efficacy against Ebola and they are in very short supply). However, to become infected with Ebola...you have to be in DIRECT CONTACT with either an Ebola patient or their bodily fluids. Until recently, this just meant avoiding travel to regions suffering Ebola outbreaks...but now that we've had cases in the US (all connected with a single index case from Africa), it all boils down to infection control (meaning appropriately limiting contact with infected patients through PPE and other protocols) to halt the spread of infection. And because the transmission of Ebola is a little different, that burden primarily falls on healthcare workers, who should be operating with a high index of suspicion for all potential contacts of an Ebola patient. I think my problem with her blog was that really, no one wants/needs to hear the blow-by-blow of any disease...I feel that it is unduly alarmist and fear-mongering.
Just my 2cents, though.ETA: It sounded like her argument was: no, REALLY-- here's why you should panic! And, really, panic is very rarely a helpful response.
@TemperanceBrennan: I think it makes a lot of sense at this point, to get all of these patients, upon identification, to tertiary centers with rigid protocols in place and years of prior bioterrorism/disaster training!
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@Mrs. High Heels: That article starts out decently but then turns into total fear-mongering.
For instance, only ~18% of people with Ebola experience the bleeding/oozing/hemorrhaging that this nurse talks about so no, Ebola patients aren't just walking around with blood in all of their bodily secretions. And for those 18% of patients who do experience bleeding, it doesn't come until the very latest stages of disease (about 24-48 hours before death).
And this talk of people treating the patients wearing "space suits" isn't typically accurate either. I've not seen inside the isolation units in Atlanta and Nebraska but I do know that most of the healthcare workers in Africa are not wearing "space suits". They are wearing barrier coverall suits (ex. Tyvek), double gloves, goggles, rubber boots, and face masks.
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@Mrs.KMM: Exactly. Ridiculous and possibly dangerous. I'm honestly concerned this might stir up xenophobia in this country (or more than we already have...) particularly aimed at Africans. I've read articles with quotes from Liberian communities in the U.S. saying they're afraid of how they will be treated, and I don't think that fear is unfounded, unfortunately.
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Glad I don't have a TV to watch the hype. But there has been a lack of appropriate handling by both the CDC and the Texas Hospital which is only feeding the hype. Any teaching hospital should have some laboratory safety expert who could have easily set up and over saw people to make sure they were dressing and undressing appropriately using clean and dirty hallways and scrubbing afterwards. It seems that this strain of ebola doesn't cause as much hemorrhaging as other strains and most of the infections seem to occur after the disease has significantly progressed. However it would have been wise for the CDC to be more cautious instead of banking on probably.
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@FliegepilzHut: @Mrs.KMM: thank you both for weighing in and clarifying!
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I have to say, I'm really disgusted at the response to Ebola. Originally, I said, you don't have to worry about it. This is a first-world country with the infrastructure and people and procedures to handle it. There will not be many cases. But I think I looked at my knowledge on Ebola (I've been involved in Ebola research) and forgot that what I would consider "common sense" might not be common sense to lay people. And I'm wondering if a similar thing happened when these protocols were given to the hospitals. Did the CDC assume that hospitals (who have never seen Ebola or any other level 4 pathogen) would know that masks, gown, gloves and face sheild aren't enough? I would expect tyvek suits, tyvek hoods, disposible boots, double-gloved, the seam between gloves and boots to the suit be taped, mask, face sheild. Minimum. I would expect trained people arriving to teach staff how to take that gear off without contaminating themselves. I would expect protocols for how to deal with highly infectious waste. I would expect people to arrive at that hospital giving them hands-on help and assistance and training. My gosh, I have more protective gear in a level 2 lab (which is used for bacteria that is pathogenic, but has treatment) than these people seemed to have in the hospital. I expected better.
... and don't get me started on the nurse who thought it was appropriate to break quarentine and get on a plane.
Rant over. ...maybe.
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@Grace: I feel the same way. The nurses didn't even wear booties and they were dealing with the bodily fluids...everywhere.
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@littlebug: I hear you about the CDC worker, but really I'm just over the passing the blame game to be honest. She's a nurse, she should have known better! Fever or not, it's common sense when you're in that close of contact with a highly infectious patient you don't go gallivanting around in public during self monitoring.
I'm also over the mass hysteria and now people in my state freaking out that a patient may be coming here (to NIH). We are ALL safer if these patients are dealt with in the FOUR facilities that are equipped to handle them properly. No good comes of keeping these patients in regular hospitals that have no idea what they're doing when it comes to this kind of thing (not that it's their fault, it just is what it is!) Having the right protective gear and teaching someone how to put it on/take it off properly is not the whole equation. You need to be experienced and have practice with using the equipment and robing/disrobing properly.
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@Grace: YES.
There still haven't been any community-acquired cases, so I'm still not "worried", but am rather disappointed/infuriated/horrified at what has already happened in Dallas.
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@catomd00: I grew up walking distance from you
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@alohaorchid: I'd risk losing my job and license to not treat that patient, especially if I knew I was not adequately trained to care for them or had access to the proper equipment.
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@JoJoGirl: well don't come back to visit any time soon, we've got ebola heading this way!
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@catomd00: LOL! I'll be sure to warn my parents...
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@FliegepilzHut: I too thought it was adding to the hysteria and fear-mongering!
@MrsSCB: Couldn't not agree with you more on the xenophobia issue. -
@catomd00: Sure. They flew people over from Africa to be treated at Emory. No reason they can't do that for domestic cases. They do still have to implement the protocols and have training in them for the time between diagnosis and transport though.
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@Grace: @catomd00: Yes to all of this!
@Mrs.KMM: I'm sorry if "moon suit" is not technically correct. Full-body coverage (like MSF uses) was what I had in mind.
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