Posted on 10/13/2014 5:15:47 AM PDT by xzins
"We are deeply concerned about this new development," Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said on Sunday, after a Dallas nurse who treated a Liberian Ebola patient also tested positive for the deadly virus -- the first person-to-person transmission in the U.S.
"We now consider all of the health care workers who cared for the index patient (Thomas Eric Duncan) potentially to have been exposed, and we'll be rostering those individuals and determining which require active follow-up in addition to their self-monitoring," Frieden told CBS's "Face the Nation" with Bob Schieffer.
"We know from many years of experience that it's possible to care for patients with Ebola safely without risk to health care workers," Frieden added. "But we also know that ...even a single breach can result in contamination.
"And one of the areas that we look at closely are things like how you take off the gear that might be infected or contaminated. Another that we'll be looking at closely in-- in the investigation is the-- the interventions that were done to try desperately to keep the index patient alive. This included dialysis and intubation. These are two procedures which can result in the spread of infectious material."
The nurse who contracted Ebola after treating Duncan did wear full protective gear.
"I think the fact that we don't know of a breach in protocol is concerning because, clearly, there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients," Frieden said.
He listed for "four things" that CDC is doing now:
"First, is to make sure that that individual (the nurse) is cared for safely and effectively. Second, we're identifying that individual's contacts...Third, we now consider all of the health care workers who cared for the index patient potentially to have been exposed and we'll be rostering those individuals and determining which require active follow-up in addition to their self-monitoring. And, fourth, we'll conduct a full investigation of what happens before health workers go in, what happens when they're there, and what happens in ... taking off their protective equipment, because infections only occur when there's a breach in protocol."
Frieden said CDC is now monitoring "all individuals" (he couldn't give an exact number) who cared for Duncan in Dallas, "and we'll be determining how many of those may potentially have had contact that would have resulted in a breakdown of protocol and possible contamination."
Meanwhile, Texas Presbyterian Hospital in Dallas has shut down its emergency room until further notice, CBS reported, because of staffing limitations. Many staffers are being watched for signs of Ebola. This means ambulances will take patients to other emergency departments.
Speaking on NBC's "Meet the Press," Dr. Anthony Fauci, an infectious disease expert with the National Institutes of Health, said U.S. hospitals "need to reemphasize the importance" of the protocols involved in removing their protective gear.
Although such breaches are "very, very rare," it can happen when a health care worker is "fatigued, they've been working for a long time, and when they take it off, they do something inadvertent, like brushing their face or something like that. I don't know how it happened. The CDC's investigating it, but that's very likely what happened. An inadvertent breach."
Fauci said he's "still quite confident" that there won't be a public outbreak of Ebola in this country -- "because of our ability to reach out, do the contact tracing, and isolate people who are infected."
He also said shutting down flights from West Africa "would be counterproductive."
"We can understand how people might come to that conclusion," Fauci told NBC's Chuck Todd. "But when you look at what happens when you isolate a country, you diminish greatly their ability to handle their own epidemic. If that happens, it very likely will spread to other African countries.
"And the best way to protect Americans is to completely suppress the epidemic in West Africa. If we do that, we wouldn't be talking about this today. So to isolate them, maybe with good intentions, actually can be counterproductive and make things worse."
“He also said “
There are two ‘he’s’ in the article.
I will be quite surprised if any of them come down with it. You may note that none have to date.
Here’s the deal. As the disease progresses, more and more body fluids begin to carry the virus, and then at exponentially greater concentrations. In the last stages those body fluids are spraying all over the place. It is, after all, a hemorrhagic fever.
So in essence during the final stages the patient is a giant mass of viral contaminants, with those contaminants being actively thrown off in all directions. And, of course, invasive procedures put those performing them in direct contact with those fluids in quantity.
OTOH, before the patient becomes symptomatic he is probably not contagious at all. Thereafter he is at first only mildly infectious, with close or even intimate contact required. The degree of infectiousness increases exponentially as the disease progresses.
IOW, in the final stages the patient is orders of magnitude more infectious than in the early stages. I thought, along with most others who work regularly with
PPE, that American-level sanitation and gear would completely prevent transmission.
Obviously we were all wrong, and this automatic blaming of the nurse is CYA BS. All procedures need to be re-examined.
Inadvertent breach of protocol - this is a lie
Stopping travel from west Africa to US is counterproductive - this is a lie
They had the nurse on video surveillance throughout
the whole course of her contact. They know she didn’t breach
protocol - but they will make something up - this is true.
They are JUST NOW evaluating the dialysis and intubation
procedures - this may be true, but is unbelievable.
A protocol which is easily breached, and where one mistake can be disastrous, is a lousy protocol. A good protocol allows occasional single mistakes, and requires multiple failures to happen before disaster occurs.
In Africa, they practice using multiple layers of protective gear. We should do that here too. Coming out of the patient setting, you get sprayed with chlorine bleach, take off the outer layer, get sprayed with chlorine all over, then take off the inner layer.
What?
You mean allowing Ebola patients to hop on a plane and come here to spread it around and infect other people who in turn spread it around and infect even more, isn’t the best way to stop it?
BUT! BUT! BUT!
The experts say it is.
I’m so confused.
Do I listed to my common sense or do I listen to an expert that can’t find their butt with both hands?
I guess they didn't know about this beforehand???
Second, we're identifying that individual's contacts...
And what about their contacts' contacts... such as a certain democrat county judge looking for headlines?
This is a very dangerous statement because it claims absolute knowledge of transmission.
Basically, he's saying, "If you do it my way, there's no chance of error" when he should be saying, "We need to find out if there things about our protocols that don't work."
This one press statement should be enough to scare anyone. It is a medical scientist unwilling to accept the self-scrutiny of the scientific method.
We are now clealy trying to treat disease with a political poultice.
The facts and assumptions need to be re-examined.
We're being told that somehow they broke 'protocol'.
Another view is that the real facts make their protocol incomplete.
So what happens to the healthcare system when nurses refuse to take the risk of being infected with a deadly and gruesome disease? Because in the two cases (Spain and Dallas) it was nurses who took the hit, not WHO operatives or CDC officials.
Geometrically...... the disease is being spread geometrically.
Protocols used by 9 do not spare # 10 that in turn infects 20.
Good point thank you.
Frieden, then Fauci. Fauci said we need to keep open flights from the effected countries.
Not Frieden. Thanks for clarifying.
Each county should dedicate one hospital or clinic to Ebola treatments only. That’s where EVERYONE goes with symptoms, arrival by ambulance only. Stop the spread and contamination in its tracks.
See #28. It is agrees 100% with your excellent post.
Of course it isn’t their fault! They work for the FedGov.
There are a lot of healthcare workers who will not assist anymore. And we are sending the 101st airborne to play with Ebola. What can go wrong?
Duncan was puking all over the apartment, sidewalk and ambulance.
You’re not concerned about the family or ambulance crew? Really?
Nurses make hospitals effective. Without them there is no healing. And I agree with you. Nurses will begin to refuse to be involved because the protocol is obviously faulty.
Great humility would require authorities to say, “we really don’t know an awful lot...our previous posturing as if we did was wrong. We need to approach this as largely unknown.”
The irony of this statement would be humorous if it weren't so serious. To explain: Shut down the emergency room, but don't shut down the source of the infection by limiting flights from the source?????
Would not a better plan be to create a single Ebola treatment center at the Dallas Presbyterian Hospital where infections have already occurred, for potential additional patients, than to take them elsewhere and risk exposure at other hospitals, and thus the risk of further spreading of this highly contagious disease?
This is our government at work, people!!!
1 breach for 1 infected patient, sorry your point doesn't hold up.
So the “experts” have a new tune now?
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