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.
I could not verify the statements of this post on _Pissin' on the Roses_ using the sources provided. That's why I didn't link it when it came out a week ago.
This outbreak is clearly breaking the “Ebola rules”.
I am coming to believe that this is beyond what the “authorities” can handle; they don’t even have the medical personnel to treat all of these people. With 2-3 caregivers needed for each patient, they just don’t. Beds are nice, but they are just beds. As MSF has said, they need medical people. I fear that, ultimately, infected people are going to be housed in Ebola quarantine centers, with just the basics, separated from the community and under guard, hoping the virus burns through the people until it burns itself out. .
God help them. :^(
From PFI Forum.
Explaing just what an ETU is
Note especially the three purposes and daily consumption quantities of supply
(Original source: http://edition.cnn.com/2014/09/24/health/ebola-epidemic-liberia/index.html?)
(snip)
....For a disease whose transmission depends on the direct contact of one human being with the body fluids of another, Ebola has no better customer than nurses.
The other thing about nurses that the virus finds particularly helpful is they tend to work in shifts. Before the week was out, Bong County’s first Ebola patient had died, and seven nurses caring for her had fallen ill. Six of them would also die in the coming weeks.
The remaining clinical staff, watching their colleagues falling ill all around them, abandoned the hospital. When the patients saw what was happening, those well enough to walk out did just that.
Over the ensuing months, the epidemic rippled across Bong. Hundreds of individuals were infected, and perhaps more importantly, basic social institutions also began to collapse.
One by one, all three hospitals in the county shut down due to fear of the spread of the virus, followed by most of the primary care clinics. Women were left without midwives to deliver their babies, accident victims without emergency rooms to care with them. Next the primary schools closed, then the secondary schools, and finally Cuttington University.
Ebola is not just a disease of individuals but also one that infects society’s most basic health and social welfare structures.
As a disease that afflicts health care institutions, it is perhaps fitting that the most powerful weapon in the fight against Ebola is not a single drug or vaccine but instead a particular type of health care institution: the Ebola Treatment Unit, or ETU.
On September 15, I helped International Medical Corps open the first ETU in Bong County. I have worked in many hospitals, both rich and poor, and have set up refugee camp clinics and trauma field hospitals in poverty-stricken and war-torn countries.
But managing an ETU has been an entirely different experience.
The primary goal of a hospital or clinic is to care for patients and, if possible, to save their lives. The primary goal of an ETU is to protect the lives of its staff.
The secondary goal is to protect surrounding communities and resuscitate local health care systems by taking patients suspected of having Ebola out of their homes and hospital emergency rooms, breaking the chain of transmission.
Caring for patients comes third on the list of priorities, though still remains important. After all, why would people go to an ETU if they did not think there was at least a chance that it would help make them better?
During the week before opening our ETU, I can honestly say that I worked harder and slept less than during any other time in my life. The sheer number of details involved in the construction and management of this unique type of bhealth care facility is almost endless.
First, a site had to be chosen, which has been a significant roadblock to the opening of other ETUs. Hospitals tend to be built close to the communities they serve; most communities, however, tend to want their ETU as far away as possible.
Our ETU sits in the middle of a forest, 2 kilometers (more than a mile) down a rough dirt road, on the grounds of an old leper colony. Perhaps it is not surprising that the survivors of one of humanity’s oldest and most stigmatized diseases would be among the few to welcome a treatment facility for one of the newest stigmatized diseases.
Second, the design and infrastructure of the ETU had to be perfected, with separate spaces and wards designating different levels of risk, where staff members would know to take different kinds of precautions.
A borehole was drilled and giant tanks erected to mix up the nearly 12,000 liters of chlorine required each day to disinfect the ETU and its staff properly. A giant incinerator was built to burn the vast amounts of infected waste produced by the facility safely.
Third, supplies had to be purchased, both the normal kind present in any hospital, such as bed sheets and intravenous fluids, but also the expensive (and increasingly difficult to purchase) personal protective equipment. A single outfit of boots, gloves, suit, mask, hood, goggles and apron costs as much as $90, and at full capacity the ETU might go through 100 outfits a day.
Finally and most importantly, local staff had to be hired and trained to work in the facility. While a small team of expatriates working with International Medical Corps manages our ETU, more than 90% of the staffing remains local.
During the week before opening our facility, I helped organize an intensive training for our first 50 staff members, including physician assistants, nurses, nursing aids, hygienists, sprayers, safety monitors, waste handlers, chlorinators, laundry staff and burial team members, to ensure they knew how to protect their health and the health of their colleagues while working in the ETU.
Just 72 hours before our opening day, we had a checklist of almost 50 items, ranging from goggles to gravediggers, that we still needed to be able to begin admitting patients safely to the ETU. The pressure to open the ETU had been building for weeks as the numbers of cases of Ebola in the county began to skyrocket.
Somehow, and I’m still not sure how, we made it happen.
Would they make ones big enough to handle several gallons of waste materials per batch though?
Nope, those are for sterilizing equipment like surgical tools and such.
‘Waste materials’ are burned on the premises in the MSF hospitals. Probably violating any number of US regulations to do so including smoke and use of fuels to do that. In a pinch I’m sure that sort of thing would happen here too, possibly even defiantly.
Your post is very helpful. Thank you.
Eye-opening. Thanks.
It also brings to mind when the Emory doctors who treated Dr. Brantly and Nancy Writebol were asked by Matt Lauer in the “Saving Dr. Brantly” NBC special, if they just flushed the human waste, “ripe with Ebola virus” down the toilet. Dr. Ribner replied “we can’t flush it straight down the toilet, because our sewage treatment plant would not be very happy with us.” He explained how every time the toilet was used, they would treat it with a sterilizing solution and let it sit for 5-10 minutes before “we can safely flush it down the toilet.” Yet, here on CDC’s site it says it is fine to flush Ebola-infected human waste down the toilet.
http://www.cdc.gov/vhf/ebola/hcp/environmental-infection-control-in-hospitals.html
So, is it or isn’t it safe to do so? They might want to get on the same page with that one as well.
IF/when EVD gets here in any numbers, our preparedness will really be tested while essentially flying by the seat of “our” pants. That is not very comforting when dealing with a Level 4 pathogen.
... along with fabric furniture and drapes and carpeting...
EPA would have a total meltdown.
Are our morgues and morticians and undertakers ready?
http://news.sciencemag.org/africa/2014/09/who-cdc-publish-grim-new-ebola-projections?
Note the quote from our “favorite” Caribbean Medical School graduate in this excerpt:
Government officials also continue to stress that there’s little chance of a mass Ebola outbreak in the United States, a point that the NIH’s Anthony Fauci reiterated to Congress last week. And even if a few Ebola patients arrive in the U.S., the nation’s hospitals would be well-equipped to handle them.
“Controlling Ebola is not a very sophisticated task,” Dr. Amesh Adalja, a biosecurity specialist at the University of Pittsburgh Medical Center, told The Hill last week. “Ebola outbreaks are stopped in their tracks when basic public health measures are in place … and the United States would not be a hospitable environment for something that spreads exclusively through blood and body fluids.”
And apparently ipods, iphones and taxis along with anything else that they’ll burn if you’re found to be infected...
The primary goal of a hospital or clinic is to care for patients and, if possible, to save their lives. The primary goal of an ETU is to protect the lives of its staff.
The secondary goal is to protect surrounding communities and resuscitate local health care systems by taking patients suspected of having Ebola out of their homes and hospital emergency rooms, breaking the chain of transmission.
Caring for patients comes third on the list of priorities, though still remains important. After all, why would people go to an ETU if they did not think there was at least a chance that it would help make them better?
__________
Well, that pretty much spells it out. I read somewhere that when looking back on this, Africans will refer to these ETUs as “concentration camps”.
Will they burn homes to the ground, do you think, or will they try to “disinfect” them? Maybe seal them off for a few months? Something else to think about. Imagine an apartment complex...
I wish there were an “edit” feature, because I would add this to my last post—
Ultra violet lights?
http://www.aabb.org/tm/eid/Documents/72s.pdf
Or unleash the robots? (Again using UV)
With a mortality of 80+% and an infective dose of as little as one viron I’m not sure I’d feel safe with those either.
Just one crack or crevice hidden under a nut or bolt on the bedframe.
If they could set the thermostat in the hospital room to 150F for a day or so I might feel safer...
"Only one laboratory study, which was done under environmental conditions that favor virus persistence, has been reported. This study found that under these ideal conditions Ebola virus could remain active for up to six days.1 In a follow up study, Ebola virus was found, relative to other enveloped viruses, to be quite sensitive to inactivation by ultraviolet light and drying; yet sub-populations did persist in organic debris.2In the only study to assess contamination of the patient care environment during an outbreak, conducted in an African hospital under "real world conditions", virus was not detected by either nucleic acid amplification or culture in any of 33 samples collected from sites that were not visibly bloody. Virus was detected on a blood-stained glove and bloody intravenous insertion site by nucleic acid amplification, which may detect non-viable virus, but not by culture for live, infectious virus.3 Based upon these data and what is known regarding the environmental infection control of other enveloped RNA viruses, the expectation is with consistent daily cleaning and disinfection practices in U.S. hospitals that the persistence of Ebola virus in the patient care environment would be short – with 24 hours considered a cautious upper limit."
BTW, flushing of toilets, even when the lid is closed, tends to aerosolize and spread most any infective agent in the human waste being flushed. I assume this is true for Ebola.
#2431 is my original question. I was referring to someone coming up with a quick solution to needing sterilization of liquid and solid wastes from ebola patients BEFORE releasing to the sewers.
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