Posted on 08/10/2014 12:46:23 AM PDT by Smokin' Joe
I have spent a little time compiling links to threads about the Ebola outbreak in the interest of having all the links in one thread for future reference.
Please add links to new threads and articles of interest as the situation develops.
Thank You all for you participation.
Ok, I must have run across the articles on those two out of order.
Wonder what’s the nationality of the WHO scientist...
http://allafrica.com/stories/201409040406.html?aa_source=mf-hdlns
“West Africa: Failures in the Fight Against Ebola”
Backs up the suspicion that if it gets here, EVERY SINGLE PATIENT (not just those for whom ebola is a suspicion) will have to be treated wearing full PPE.
WHO warns over Ebola in Nigeria’s Port Harcourt
http://m.news24.com/news24/Africa/News/WHO-warns-over-Ebola-in-Nigerias-Port-Harcourt-20140904
2014-09-04 13:44
Lagos - An Ebola outbreak in Nigeria’s oil producing hub of Port Harcourt could spread wider and faster than in the financial capital, Lagos, the World Health Organisation warned on Thursday.
The UN health body said the arrival of the virus in Port Harcourt, which is 435km east of Lagos, showed “multiple high-risk opportunities for transmission of the virus to others”.
The haemorrhagic fever, which has hit five countries in West Africa and caused nearly 2 000 deaths this year, first arrived in Nigeria when a Liberian finance ministry official died in Lagos on 25 July.
He was taken from the city’s airport to a private hospital by two officials from the West African regional bloc Ecowas.
One of the officials later died of the disease but the other evaded detection to travel to Port Harcourt, where he fell ill and was treated in secret at a city hotel room by medical doctor Ike Enemuo from 1-3 August.
‘Numerous contacts with the community’
The Ecowas official recovered but the WHO said Enemuo continued to treat patients at his private clinic and operated on at least two people, despite showing symptoms from 11 August of Ebola - of which he later died.
“On 13 August, his symptoms worsened; he stayed at home and was hospitalised on 16 August,” the WHO said in an emailed statement.
“Prior to hospitalisation, the physician had numerous contacts with the community, as relatives and friends visited his home to celebrate the birth of a baby.
“Once hospitalised, he again had numerous contacts with the community, as members of his church visited to perform a healing ritual said to involve the laying on of hands.”
Over the six days he spent in hospital “the majority” of healthcare staff treated him while two doctors performed an abdominal scan at an ultrasound clinic the day before his death, the statement added.
Multiple risk exposure
“Given these multiple high-risk exposure opportunities, the outbreak of Ebola virus disease in Port Harcourt has the potential to grow larger and spread faster than the one in Lagos,” it added.
A total of 255 people were currently under surveillance in Port Harcourt for signs of Ebola, Nigeria’s Health Minister Onyebuchi Chukwu said on Wednesday.
An elderly woman who was a patient at the hospital where Enemuo was treated died from the disease, taking the number of victims in Nigeria to seven out of 18 confirmed cases.
Enemuo’s wife - who is also a doctor - was in an isolation unit in Lagos, while his sister is under quarantine in Port Harcourt.
No Need for Isolation - Says U.S. Government
http://m.allafrica.com/stories/201409041117.html/?secid=10052
4 September 2014,
By Emmanuel Weedee-Conway,
Source: Heritage
The Government of the United States of America (USA) through its Ambassador accredited to Liberia, Deborah Malac, has said the US government is closely working with countries that have isolated Liberia and other countries affected with the Ebola virus to stop their isolation and restriction.
Amb. Malac said such isolation and restriction are counterproductive to the fight against the deadly virus.
The US envoy was speaking Tuesday, September 2, 2014 at a launch with some Liberian journalist in Monrovia.
“We are intervening of behalf of Liberia and others so that countries will not close their borders on them or restrict them. There is no need for such restriction or isolation against Liberia and others. There is no need to close borders, and there is no need to prevent travel from these countries. This is not a positive development in the fight of the disease,” said Amb. Malac.
“To those countries that have already closed their borders and sanctioned Liberia, we will work to get these lifted. That isolation has to end. This is not the right way to resolve the problem,” she said.
Among other things, the US envoy added that her government will bring a mobile testing center, which will be sent to Lofa County.
Liberia: Ebola Casualties Reach 1,015 - Government Announces
http://m.allafrica.com/stories/201409041327.html/?secid=10052
4 September 2014
The Liberian Government has announced that confirmed, probable and suspected Ebola casualties in the country reach 1,015.
A Ministry of Health and Social Welfare statistics on the current Ebola death cases, says from March to September 1, 2014,
34 death cases were reported in Bomi,
41 in Bong, 12 in Grand Bassa,
8 in Grand Cape Mount,
2 in Grand Gedeh,
332 in Montserrado,
109 in Margibi,
409 in Montserrado,
72 in Nimba,
5 in Rivergee and
1 in Rivercess Counties.
The report mentioned that there are 238 probable deaths and 396 confirmed cases with
19 in Bomi,
11 in Bong,
6 in Grand Bassa,
4 in Grand Cape Mount,
147 in Lofa and
155 in Montserrado Counties.
The statistics revealed that cumulative cases among health workers are 150 and out of the number,
5 cases were confirmed in Bomi,
26, in cases in Bong,
3 in Grand Bassa,
3 in Grand Cape Mount,
22 in Lofa,
32 in Margibi and
57 in Mountserrado Counties.
The Health and Social Welfare Ministry indicated that 1,771 confirmed, probable and suspected cases are reported from March to September 1, 2014.
The record indicates that 63 cases were confirmed in Bomi,
141 in Bong,
1 Gbarpolu,
40 in Grand Bassa,
10 in Grand Cape Mount,
3 in Grand Gedeh,
624 in Lofa,
233, in Margibi, and
541 cases in Mountserrado Counties.
The report maintained that 512 cases are confirmed with 1 suspected case
1 in Bomi,
81 in Bong,
1 in Gbarpolu,
18 in Grand Bassa,
2 in Grand Cape Mount,
3 in Grand Gedeh,
63 in Lofa,
119 in Margibi,
201 in Mountserrado,
17 in Nimba and
1 in Sinoe Counties.
The report highlighted that of 847 probable cases, 512 are suspected cases and are 412 confirmed Ebola cases.
West Africa: Ebola ‘Racing Ahead’ of Response - Obama to Raise at NATO
http://m.allafrica.com/stories/201409031656.html/
(Excerpt)
Dr Keiji Fukuda, WHO Assistant Director-General for Health Security, said there is a shortage of everything needed to contain the virus – treatment centres, beds, ambulances and personal protective equipment for health care workers – the most vulnerable population. He said an estimated 200-250 workers, from clinicians to people who clean and disinfect facilities, are necessary to care for every 80 Ebola patients.
______________________________________
Make note:
“...an estimated 200-250 workers, from clinicians to people who clean and disinfect facilities, are necessary to care for every 80 Ebola patients.”
And there are those here who believe that our health system would not be quickly overwhelmed by an out break here. Logistics quickly raise its head in such situations.
Just consider this one item:
If the appropriate level PPE’s are employed as per safety directives and can only be worn for 30-45 minutes at a time, how many PPE’s is that per day, where are they stored, how are they disposed? What happens to suspected contacts and probable cases? Where are the quarantined?
Movement of ebola patients at admitting, they sure as hell aren’t going through regular entries or ER entries.
Travel paths, corridors and stairs, wouldn’t they need to be isolated from regular hopsital circulation? Where are contaminated supplies and linens staged before removal for incineration. How about increased security 24/7?
The list goes on and on.
My local hospital in one of the richest counties in the USA would be quickly overwhelmed in a matter of days.
Joe,
See this —
http://virologydownunder.blogspot.com.au/2014/08/ebola-virus-may-be-spread-by-droplets.html
For a useful pictography of “droplet” versus “airborne” spread of Ebola.
If we were to have an Ebola outbreak here during flu season, then Katie bar the door.
This would be an absolute nightmare. Being that flu season is right around the corner, and so is Ebola in the US, the imaginable could be at the door.
Dear Lord, have mercy.
WHO spokeswoman Fadela Chaib identified the patient as a man from Senegal infected while working for the agency as a consultant.
http://www.postbulletin.com/life/health/un-doctor-with-ebola-in-germany-for-treatment/article_ada75e38-9e3b-51cb-9904-f88442aebfd1.html
imaginable s/b unimaginable.
I have been working almost nonstop on a plan and workflow to deal with one “rule out Ebola” patient (never mind 2 or more), and I have concluded that, after 3-4 days, any normal hospital system would grind to a halt, for all the reasons you so cogently describe.
The obvious thing is not to permit air departures from Freetown, Conakry, and Monrovia, and to quarantine arrivals from Nigeria, Senegal, and DRC. I am becoming concerned that there has been no CDC update sine August 28 - it’s reasonable to infer that the news is bad.
“FG monitoring 400 contacts of doctor who died of Ebola”
I agree that the lack of published info is a grim glimmer into the real facts.
Sept 3 2014 at teleconference in Washington, DC, WHO director Dr Chan remarked:
“...As of this week, we are reporting 3500 cases confirmed. More than 1900 deaths.”
There has been no published information since the Aug 28 2014 WHO Ebola update;
“As of 26 August 2014, the cumulative number of cases attributed to EVD in the four countries stands at 3,069, including 1,552 deaths.”
That’s an increase of 450-500 deaths in about 8 days.
And yet Dr Chan and Frieden of CDC are still adamant about not creating an international cordon sanitaire in West Africa. The only hope is that more air carriers will refuse to fly there, but holes will remain and runners will flee.
In addition it appears that at the onset of symptoms the afflicted are not markedly incapacitated as witness by Sawyer and others and were able travel for days before external sypmtoms became evident.
Baffles me.
I came to my conclusions about our hospitals becoming overwhelmed in a matter of days by working it out much in the same manner as you. We could handle a local massive trauma event by routing, triage, etc. But that’s pretty much a finite event which resolution is determined by staff size and bed space. No extraordinary measures are necessary.
http://abcnews.go.com/Health/wireStory/officials-monitor-200-ebola-nigeria-25246736?singlePage=true
“On Ebola Ward, Liberian Nurses Must Improvise Gear”
This is outrageous!
http://who.int/csr/don/2014_09_04_ebola/en/
“As of 31 August 2014, 3685 (probable, confirmed and suspected) cases and 1841 deaths have been reported in the current outbreak of Ebola virus disease by the Ministries of Health of Guinea, Liberia and Sierra Leone.”
Chart at link
...and since Ebola presents initially the same as flu....
see also Jim Noble's post http://www.freerepublic.com/focus/chat/3191066/posts?page=1612#1612
>>If the appropriate level PPE’s are employed as per
>>safety directives and can only be worn for 30-45
>>minutes at a time, how many PPE’s is that per day,
This applies to PPE worn in un-air conditioned 100 Degree F medical facilities.
Presumably that 30-45 minute number would be on the order of a couple of hours in the West.
The problem is the triage of patients into Ebola versus non-Ebola cases.
There just isn’t a way to do that, given LD50 for 10 viral particles, a one to ‘several’ day fomite active period in human droplets/particles and any sort of asymptomatic period of Ebola infection.
Shelayne just posted WHO numbers.
( Just published this afternoon)
http://who.int/csr/don/2014_09_04_ebola/en/
“As of 31 August 2014, 3685 (probable, confirmed and suspected) cases and 1841 deaths have been reported in the current outbreak of Ebola virus disease by the Ministries of Health of Guinea, Liberia and Sierra Leone.”
Chart at link
And yet, on Sept 3 2014 at teleconference in Washington, DC, WHO director Dr Chan remarked:
“...As of this week, we are reporting 3500 cases confirmed. More than 1900 deaths.”
Wonder what the actual numbers are.
Won’t quibble on more suited time in A/C space, still it’s not one suit per day or shift.
BTW, I’m ignorant as to LD50 term. Has it to do with viral loading?
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.