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.
You know I can't help but remember 9/11 when our nation was under fire...heck they halted all planes! Nobody flew in or out!........Dr.s...Emts...Firemen and all, both in N.Y. and so many from other states went there to assist. Incredible turnout of manpower. So what's with the CDC and Homeland Security they can't handle this??? It makes no sense even when I consider the danger...but then there is a difference with the administration now and the one we had then....I miss adults running things instead of Hollywood wanna be's.
Thanks for all your good work and for letting me know about this thread. ( I posted an ebola related article and that’s where you mentioned it.)
That is something I have been saying all along, especially when I read comments which say 'we're so much safer because we're so modern'. But when one considers the common contact surfaces which people touch in any given day, from door handles, handrails, elevators, ATMs, countertops, etc. the greatest determinants of whether people will become infected by fomites are the locations and level of viral shedding prior to the patient being collected for treatment.
We have again come full circle, with the recognition that the virus can be transmitted by contact with bodily fluids, with droplets of bodily fluids transported in air--not always limited in range to 3 feet--possibly much greater distances, and with fomites, be the latter splatters of bodily fluids on handrails, or contaminated bedding or PPE in a clinical setting.
The CDC has not been calling for sufficient PPE for health care workers, nor the requisite team decontamination of PPE prior to removal thereof.
As a practical matter, most hospitals are not set up for that either, so the whole meme of 'it can be taken care of anywhere' is a lie. Lies get people killed.
Sure, some sort of jerry-rigged isolation setup can be made, but if the existing facilities were not purpose designed for a Level 4 pathogen--very specific design characteristics, which include specific HVAC and filtering requirements, and wastewater disposal requirements which include a kill tank with double walled piping into the tank--then the population is placed at risk, with that risk being greatest for patients and hospital and support personnel.
She had the wisdom that comes from experience. Some will learn that vicariously, others will have to learn the hard way.
The rumors I have been hearing about old times and part time HCW not showing up for work appear to be confirmed.
It appears that Texas Health Presbyterian Hospital is on “divert status” due to “personnel shortages.”
IOW, the lack of proper PPE and PPE training has caused the health care workers not to show up and Presby can’t staff its emergency room as a result.
And this is only the beginning of the West Africa outbreaks from un-quarantined airline travel from the Hot-Zone.
This is for Thud to chew upon.
I think the legal liability issues for the CDC’s inadequate PPE are going to come to a head in the next few weeks.
IMO, CDC Director Dr. Freiden has blown his credibility with the HCW community with his immediate “blame the nurse not our PPE recommendations” knee jerk accusation on “Meet The Press” and I strongly suspect that the “sick out” among Texas Health Presby Emergency room workers is a direct result.
Lack of credibility and suicidal PPE recommendations seem like legal liability paradise for the ambulance chasers...who will also have better PPE than CDC guidelines for the chasing.
CDC head criticized for blaming ‘protocol breach’ as nurse gets Ebola
BY JULIE STEENHUYSEN
CHICAGO Mon Oct 13, 2014 12:04am EDT
http://www.reuters.com/article/2014/10/13/us-health-ebola-usa-nurse-idUSKCN0I206820141013
(Reuters) - Some healthcare experts are bristling at the assertion by a top U.S. health official that a “protocol breach” caused a Dallas nurse to be infected with Ebola while caring for a dying patient, saying the case instead shows how far the nation’s hospitals are from adequately training staff to deal with the deadly virus.
Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, made the declaration on Sunday at a news conference and called for an investigation into how the unidentified nurse became infected [Why investigate? You’ve already been the judge, jury and executioner!] while caring for Liberian national Thomas Eric Duncan, the first Ebola patient diagnosed in the United States. Duncan died last week at Texas Health Presbyterian Hospital.
Healthcare and infection control experts said that hospital staff need to be coached through the stages of treating an Ebola patient, making sure they have the right safety equipment and know how to use it properly to prevent infection.
It was not immediately clear whether the Texas hospital prepared its staff with simulation drills before admitting Duncan, but a recent survey of nurses nationwide suggests few have been briefed on Ebola preparations. Officials at the hospital did not respond to requests for comment.
Some experts also question the CDC’s assertion that any U.S. hospital should be prepared to treat an Ebola patient as the outbreak ravaging West Africa begins to spread globally. Given the level of training required to do the job safely, U.S. health authorities should consider designating a hospital in each region as the go-to facility for Ebola, they said.
“You don’t scapegoat and blame when you have a disease outbreak,” said Bonnie Castillo, a registered nurse and a disaster relief expert at National Nurses United, which serves as both a union and a professional association for U.S. nurses. “We have a system failure. That is what we have to correct.”
[snip]
In recent months, the CDC has published detailed guidelines on how to handle various aspects of Ebola, from lab specimens and infectious waste to the proper use of protective equipment.
How that information gets communicated to frontline workers, however, varies widely, Castillo said.
In many cases, hospitals “post something on a bulletin board referring workers and nurses to the CDC guidelines. That is not how you drill and practice and become expert,” she said.
CDC spokesman Tom Skinner said the agency is still investigating the case of the Dallas nurse, but stressed that “meticulous adherence to protocols” is critical in handling Ebola. “One slight slip can result in someone becoming infected.”
Skinner said the CDC is going to step up its education and training efforts on how to triage and handle patients, and may consider designating specific hospitals in each region as an Ebola treatment facility.
“We’ve been doing a lot over the past few months, but clearly there is more to do,” he said. “The notion of possibly transporting patients diagnosed with Ebola to these hospitals is not something that is out of the question and is something we may look into.”
LEGAL RECOURSE
Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, also disagreed with the talk of a breach of protocol, saying it just puts the onus on the nurse.
“I think that is just wrong,” said Macgregor-Skinner, who helped the Nigerian government train healthcare workers when a traveler from Liberia touched off an outbreak of Ebola this past summer.
“We haven’t provided them with a national training program. We haven’t provided them with the necessary experts that have actually worked in hospitals with Ebola,” he added in reference to U.S. hospital staff.
Legal experts said the Dallas nurse may be entitled to compensation if the hospital carries workers’ compensation insurance. If it doesn’t, she would have the right to sue the hospital for damages under Texas law, said Jay Harvey, a lawyer in Austin, Texas.
Her ability to show that the hospital was negligent by, for example, not providing proper training, would be key to winning such a suit, Harvey said.
Sean Kaufman, president of Behavioral-Based Improvement Solutions in Atlanta, helped train healthcare staff at a special isolation unit at Atlanta’s Emory University which treated U.S. aid workers Dr. Kent Brantly and Nancy Writebol, the first two Ebola patients to be treated on U.S. soil.
He would observe the nurses and doctors as they cared for patients and keep detailed notes when someone would accidentally touch their sleeve or mask with an infected glove.
He then helped coach them through the process of carefully removing their infected gear. Facilities caring for Ebola patients are encouraged to use a buddy system so that colleagues are watching each other to make sure they don’t take risks.
“Doctors and nurses get lost in patient care. They do things that put themselves at risk because their lens is patient-driven,” Kaufman said. In Dallas, “I suspect no one was watching to make sure the people who were taking care of the patients were taking care of themselves,” he said.
CDC and Texas health officials said the nurse who became infected had been wearing the recommended personal protective gear for Ebola, which consists of gloves, a gown, a mask, and a shield to protect the eyes from possible splatters from the patient.
According to experts, that gear offers the minimum level of protection. When an Ebola patient enters the latter stages of the disease, as Duncan did, they become so-called fluid producers, Kaufman said.
“Towards of end of the illness, the virus is trying to live and thrive. It’s trying to get out of the person’s body. It’s producing massive amounts of fluid,” he said.
At that point, caregivers need to add more layers of protective gear, such as double gloves and a respirator or a full bodysuit. Those kinds of decisions need to be made by managers who are constantly assessing the risk to healthcare workers, Kaufman said.
Macgregor-Skinner said all U.S. hospitals must be ready to identify and isolate an Ebola patient, but should also be able to turn to a regional facility that is better prepared to receive them.
“Every hospital can then prevent the spread of Ebola, but not every hospital in the U.S. can admit a patient in the hospital for long-term care,” he said.
(Reporting by Julie Steenhuysen; Additional reporting by David Ingram in New York; Editing by Michele Gershberg and Martin Howell)
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