(click pic for source)
Posted on 10/03/2014 6:31:51 AM PDT by outinyellowdogcountry
This is an open letter to Texas public health officials: I am a software engineer, who it happens, has been working the last 10 years developing an health-care system for developing countries. In part, my goal was to stem outbreaks. Accordingly I know more about outbreaks generally, and Ebola specifically than one would expect. Engineers think differently than physicians do. I've found that difference in most cases proves beneficial, but not always. Software engineers in particular, tend to focus on the exceptions. This is how things generally work, but what are the “gotchas” that COULD happen, and then we prepare for those gotchas. This propensity seems to be particularly useful now.
With that as background, this is what I recommend for Texas officials to be thinking about, well, actually more than thinking about.
The outbreaks in Texas and Nigeria had this in common: failures within the health-care system that happened in ER settings on the initial examination of patients with Ebola. Early onset of Ebola looks like most other conditions (except trauma) that these facilities encounter. For that reason, I would suggest the following:
I would initiate state-wide a crackdown on physician compliance with the already existing regulations regarding hand-washing. Most physicians already do, but it needs to be reiterated.
I would plot the geographic locations of the Liberian, Sierra Leone, and Guinea communities within Dallas. All medical facilities in proximity should start screening all entering patients. This probably should be attended with signs and fliers saying something to the effect of: While Ebola is highly unlikely we are taking added precautions, etc... In English AND French. Patients that fit a profile (with an increased possibility of Ebola) should instead be referred to specific hospitals, not treated at the local facility.
There should be a new protocol enacted for these patients. Odds are, (hopefully) that 100% will not have Ebola. If it turns out that 99.99 don't have it, then you will be grateful for these additional safeguards. We don't want to go crazy, but separate waiting rooms, and mandatory gloves and masks would be wise (for health-care staff).
Ebola trash. Emory got caught flat-footed on this. The CDC requirements for Ebola contaminated wastes call for special certified processes. If Emory over-looked this logistical matter, odds are that the hospitals in Dallas have too. This probably needs to addressed at the state level, ASAP.
I would also recommend modifying the trash collection process at every location housing people in isolation. Hind-sight will not be kind to us. For reasons you don't want to know, the worst thing that can happen is for Ebola to infect the wild pig population.
There also needs to be Ebola waste collection gathered separately from other medical waste at the initial ER visit, even at the point where Ebola is regarded as possible, not merely likely.
If not done already, there needs to be a war room set up, equipped, budgeted, and staffed. Key contacts need to be identified now and those lines of communication should already be established. Staff should include an MPH, epidemiologist, a public health official, liaisons to the city, CDC, area hospitals, and to a group overseeing individuals living in isolation. There also needs to be a team that monitors the isolated patients, addresses their needs, and enforces compliance.
I would recommend hiring 2 young people from each of the communities (Liberia, Sierra Leone, and Guinea). They need to have been in the US for several years and have grown up within these communities. The idea is that they understand how westerners think, how their family thinks, and can anticipate and translate the differences. Liberia and Sierra Leone have English as their standard language. But its a huge mistake to assume that language is the only barrier to effective communications. Culture and cultural assumptions are huge. In fact, I would probably hire 4 teenagers out of the Guinea community because French/English are additional hurdles.
I would also initiate the planning for steps if these steps fail. Not implement, but poised. Hope for the best, be prepared for the worst. The triggers for going to step 2 needs to be established, along the plans and the budget to enact them. Time will be a factor and legislative approval will not be something we can afford to wait on. Step 2 is probably extreme enough that only the Governor can in-act. Some of the tools needed in phase 2 have to be centralized with the CDC. Presumably they are working on those now. If not, they need to be nudged.
My understanding is that there are ~100 people now in isolation. Depending on the epidemiological environment in Dallas and the general health of the individuals in that group, I would guess that there is about a 5 to 25 % chance that one or more are going to come down with a cold or the flu over the next 3 weeks. Their transport to a medical facility and the protocol for subsequent exams need to be thought through, not developed on the fly.
I hope all of this is nothing more than what is already known. It should be. If there is anything in here that surprises, I probably need to sit down and give this more thought.
My reply: “Duh”.
I’ve been stating basically the same thing, except my rant is that rather than the Gov and CDC ‘downplaying’ the incidents, they should be emphasizing general hygiene ACROSS THE ENTIRE COUNTRY.
I see people every day leave restrooms without handwashing, we read of TSA reusing gloves on repetitive travelers, we’re encouraging the rather-poor hygienic use of reusable grocery bags among a population with piss-poor hygiene habits and every time I’m in a store or mall I see at least a dozen instances of inconsiderate people coughing with no concern for those around them (the latter in my proximity only, meaning the actual rate of occurrence is much, much higher).
People are pigs. If the Gubmint can’t enforce basic protocols/practices among professionals, there’s no stopping this or any other bug.
Excellent work. Excellent analysis.
(click pic for source)
I thought all suspected ebola contaminated medical waste was incinerated on site as part of the “certification process” for those 4 special ebola treatment centers (Emory is one of them).
Just another “oops” from the “experts”.
BTW, there are wild pigs in Ga, and landfills are one of their favorite feed areas.
On top of that, we were repeatedly told there was ZERO risk to the community in bringing these ebola VIPs to this country for treatment. Just another in a string of lies.
Ideas are diminished when spelling is at the 6th grade level.
“In-act” is not a word. The proper spelling of what you were referencing is “enact”.
read later
They should have soaked the area in bleach for several hours. Then washed it away.
*click* spin *click* spin *click* spin…BANG!
Eeeee-bolllll-aaaaaa ping!
Bring Out Your Dead
We’re gonna need 
a bigger cart!
Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.
The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.
So far the false positive rate is 100%.
At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.
*sigh* Such is life, and death...
Infestation in the wild pigs would be very bad. Click link below for information on this. The link on transmission from pigs indicates it can be airborne transmission over short distances. We are talking droplets from sneezing and coughing. I truly believe the CDC is lying about airborne transmission. They are not to be trusted.
http://www.nature.com/srep/2012/121115/srep00811/full/srep00811.html
Biohazard Waste Disposal Services
Stericycle specializes in proper pickup, treatment, and disposal of biohazards, such as “red bag” medical waste and sharps containers. Our Biohazard Waste Disposal Services Protect More People
As the leading provider of medical waste disposal services, protecting people and the environment from the risks associated with biohazards is at the heart of what we do.
Tell the engineer who wrote this. Glad to have an English teacher on board.
Ebola VIOs? Ebola VIOs have been causing Ebola outbreaks, what is one, and where did they cause a problem?
I guess that finger was lazy and kept hitting O instead of P in VIPs.
Can someone explain to me, like I was a five year old, WHY transmission to the pig population would be so horrible?
I understand HOW it transmits, and I understand that the problem is transmission from pigs to primates (humans.) I live in an area without a wild pig population, so I am not fully “getting” the issue.
Can someone explain it to me (the rest of us)?
Can someone explain to me, like I was a five year old, WHY transmission to the pig population would be so horrible?
Because Muslims would be safer than the rest of us.
Great suggestions and common sense, it reminded me that modern government information releases tend to be weak on the actual work portions, or street level, or real world, nitty gritty, etc. levels of their vague and general advice that they give today.
It’s as though rather than anticipate questions and glitches that people will run into when dealing with a specific threat, that a computer program just keeps pumping out the same general memos with minor adjustments of whether earthquake or Ebola, or flu is entered.
That is exactly the reason I was expecting from FR, but I am pretty sure it is not the reason suggested.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.