Spain and Ebola: Discuss

[transmitterdan]

Barely two weeks before the first ER visit the president had said it was very unlikely Ebola would come to the U.S. Then the CDC said any hospital is adequate to treat Ebola. Those statements surely had some effect on the outcome in this case. If the president had said there was a 1 in 4 chance like some in government believed I think the case in Dallas would have turned out much differently.

There is a debate as to whether the patient lied when he left Liberia and at the ER. The unfortunate woman he helped was pregnant. It has been argued that he did not know she was sick with Ebola. It makes no sense that if he thought he had been in close contact with an Ebola patient, came to the U.S. for treatment then he would just walk out of the ER with some Tylenol. His actions don't seem to comport with someone trying to get treated. There are some people in Liberia saying he knew but if he did he acted pretty bizarrely.

For us 20/20 hindsight experts this is a lesson in how things in the real world don't always fall into nice neat right/wrong categories. The cable news sound bytes don't always tell the whole story. We may never know about this one. Let's hope it's a wake up call for government and public health workers.

[SaltyMonkey]

Additional articles this morning:

Is 21 Days Long Enough for Ebola Quarantine? - NationalJournal.com

Visualised: how Ebola compares to other infectious diseases | News | theguardian.com

This one is more positive:
Paul Farmer · Diary: Ebola · LRB 23 October 2014

[sneuman]

Originally Posted by SaltyMonkey

I predict the Nigeria strain is dormant and will rise its ugly head again in three to four weeks.

What happens if it mutates to be able to survive in mosquitos, or warm-plants?

Scaremongering is pathogenic, that's for sure.

[BandB]

Postscript to Dallas Ebola

As of right now, even after the events of the last few days, the Dallas County Health Department protocol still wouldn't do any better on the Duncan's visit to the ER. The screening protocol didn't suggest more if he said he hadn't been in contact with an Ebola patient.

Even when Duncan returned to the hospital they didn't rush to test him. He was only tested after his nephew contacted the CDC on Monday. They then referred him to the Texas Health Department. The lady there said they couldn't do a rush test since he hadn't been in direct contact with an Ebola patient (still the story he was sticking to although that is believed to be a lie). This was Monday morning. She didn't notify her bosses until that afternoon.

Now various hospitals in the Dallas area have set up different rules. Parkland changed it's protocol on August 1 based on a CDC alert. All patients are asked at intake about travel to the Ebola-active parts of West Africa. If the answer is “yes,” that patient is isolated immediately and met with staffers wearing protective gear before any additional examination or testing, he said. That’s far above what either the county or CDC recommends. The process was developed by a committee of infectious disease experts who looked at recommendations available and came up with their own checklist. They have processed over 44,000 people using that protocol. What is interesting is that Dallas Presbyterian is a "for-profit" and highly respected hospital. Parkland is non-profit, Municipally owned and primarily medicaid and charity (but also the top trauma and burn center in the area). After Duncan’s diagnosis was made public, Parkland added another early question having to do with contact with someone with Ebola in Dallas.

Just additional information to add to the inadequacy of what was done, but also add to the total inadequacy of the protocols that were and in many places still are in place.

Here is a very telling comment: Its important to try to eliminate likelier diagnoses such as malaria first, Dr. Wendy Chung, Dallas County’s epidemiologist, said in an interview Friday. “You don’t want to waste resources.”

[Arthur Garfield]

This thread is about as ridiculous as the "guns on boats" thread.
Get an education,use self control to lose fears' reactionary grip.

Think deeply and consider.

2 people of 320 million.

Learning everyday to read less of and between lines of MSM.

[SV THIRD DAY]

Is there room in the sand for another head?
The downside is that when your head is in the sand, another body part sticks up in the air.

[transmitterdan]

What we have is a lot of chickens running around with their heads cut off. Better they had them in the sand.

[SaltyMonkey]

Haha. Foolish denial marginalizes. I laugh at your innocence. 2 million is a tremendous number of people. Do you think magically this is somehow going to fade away and we can go back to buying American Cars and eating 20 lb burgers?....*poof...ebola begone, because YOU say so? Nay, do you believe that the fairy princess will wave a magic wand and Ebola will never come again from another country, never infect these shores, never spread in large populous areas?

Bhhhhahahhahahaha!

I would like you to volunteer to sit in that airplane seat. Lets see if you all can ebola-up.

[BandB]

Originally Posted by transmitterdan

What we have is a lot of chickens running around with their heads cut off. Better they had them in the sand.

I don't think getting a grasp of the facts is running around with one's head cut off. I'm not personally doing anything differently. But here is just a bit of what had my attention:

From the WHO:

There have been more cases and deaths in this outbreak than all others combined. It has also spread between countries starting in Guinea then spreading across land borders to Sierra Leone and Liberia, by air (1 traveller only) to Nigeria, and by land (1 traveller) to Senegal.

Note that in each country it has been spread by one traveler. That's how it came to the US. In countries like , Guinea, Liberia and Sierra Leone it has become a serious epidemic.

Now WHO continues by saying most of those countries have very weak health systems. So, the assumption that one might then make is that we would control it effectively due to a better health system. Adding to that hope has been Nigeria's ability to limit it.

So really the exposure is if our system lets us down. That's why Dallas is important as the system hasn't worked as needed with the first cases. The proper protocols to protect health care workers were not in place. Then the proper controls to limit their travel.

The talk of it being difficult to transmit is overstated in my opinion, it just doesn't seem to transmit through air, requiring touch. But it has been transmitted a great deal to health care workers. It can also be transmitted through animals as carriers. That's why so much attention to the nurse's dog. Even burial ceremonies which is why cremation is encouraged. Discarding one's possibly contaminated belongings is a challenge. Even determining when it's safe to be around someone who does survive the disease is difficult.

It's not a reason for panic. But it is a reason for education. First, for health care professionals from WHO to the CDC to the ER triage persons. Second, for us as individuals. It's easy to not be concerned if you don't know or live close to someone exposed. But how would you feel if you were sitting beside the nurse on the plane, knowing you could have been exposed and only because the system failed? What about the families of currently watched health care workers knowing your spouse did not wear Hazmat gear the first three days?

I do believe we have the capability to minimize the risk and the number of fatalities in this country. I don't believe we showed that capability in Dallas. At Presbyterian hospital it wasn't 2 in 320 million, it was 2 in 78 and may be more. There is a new patient in isolation there now, transferred from another hospital. It came to Dallas as it's traveled before through one patient. People in Ohio and on planes were exposed, although no one has been reported to get it, by one patient.

I would think, although I don't know, that hospitals in Dallas are taking great precautions now and going far beyond the weak County protocol. Hope hospitals in other areas are better prepared. To my knowledge our protocol on travel still depends on whether one says they've been exposed or not. Should all people entering from the high risk countries be quarantined? We do know some who were "voluntarily quarantined" but decided they needed take out food. Subsequently the state of New Jersey made the quarantine mandatory.

There are lessons to be learned from Dallas and hopefully they turn out to be that have the systems in place to limit the spread of Ebola.

[JPA Cate]

B&B wrote, "A diagnosis of Ebola was made but instead of going into hazmat mode and treating it like an Ebola patient, they waited until they had confirmation back from the lab results that it was Ebola."

Waiting until you know what you're treating does make some sense. Hospitals are unlikely to admit patients till they know what's wrong. For me, this led to a 3 AM phone call to come in and get admitted RIGHT NOW. Third visit to the ER in one day. Three days in ICU and 4 or 5 in isolation. I would have been better off had I been admitted when I first presented, and probably released a day or two sooner.

The point of this is that for suspected Ebola, both victims of it and health care workers will need to be pro-active. And more mindful of normal hygiene practices.

Ann

[DeepFrz]

A friend, artist and writer has come up with a new word and a painting to go along with it.

Funambulist - The Funambulist (who remains steady over the steaming cauldron of ridiculousness that we are encouraged to fear: economic deleveraging, ISIS, Ebola, genetic engineering, sins of the flesh, stagflation, the Chinese housing market, Elvis impersonators, falling bond yields, Hollandaise sauce).

Although the painting isn't on the Daily Painter's site yet I'm sure it will be soon.
David Roberts- Gallery of Paintings by Manitoba, Canada artist David Roberts on DailyPainters.com, Page 3

[hpeer]

I don't see myself as in panic mode, but I do think this thing bears close watching.

Dark clouds are gathering, it may be a distant squall. It may be much more. How does the air feel? Time to run through the preps once again. And watch.

[Wotname]

Originally Posted by hpeer

I don't see myself as in panic mode, but I do think this thing bears close watching.

Dark clouds are gathering, it may be a distant squall. It may be much more. How does the air feel? Time to run through the preps once again. And watch.

Good point and to continue the analogy here, when should the US (and others) health system reef down?

When do you reef?

[hpeer]

When you first think about it?

[s/v Beth]

I'm reefed because the fog is too thick. Even though there may be nothing out there, it's twilight and may be the start of a long night. Many people are suffering right now. It could just as easily been me.