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.
Insurance companies won't insure aeromedical evacuation companies against Ebola risks, so those companies have told international public health authorities “no insurance, no ride.”
Ebola Tests Insurers’ Medical Evacuation Services As Airlines Cut Flights
By Carolyn Cohn | October 13, 2014
http://www.insurancejournal.com/news/international/2014/10/13/343322.htm?
Leading companies offering medical evacuation services are drawing a line at flying Ebola patients out of West Africa for treatment abroad as the cost and the complexities of the deadly epidemic grow.
Several airlines have cut flights to the region and there are reports of countries not allowing air ambulances to make refueling stops, further complicating the so-called medevac option many companies provide for staffers in risky regions.
The world’s worst Ebola epidemic since the disease was identified in 1976 has killed nearly 4,000 people, mainly in West Africa. The virus, spread by contact with bodily fluids, causes fevers and potentially fatal bleeding.
Several foreign health workers have been repatriated for treatment after contracting Ebola in West Africa.
Two leading companies in the field – medical assistance company International SOS and insurance firm Allianz Worldwide Care – have recently said they will not provide medevac services for patients with Ebola symptoms.
“International evacuation should not be considered as feasible for patients with active clinical symptoms of Ebola,” International SOS said in a statement on its website last updated on Thursday.
“International evacuation of patients with Ebola or other viral haemorrhagic fevers is highly complex, and may not be achievable,” said the statement, which a spokesman said had first been issued some weeks ago.
The medical insurance firm Allianz Worldwide Care also ruled out such services in an online statement updated on Wednesday, saying: “Our air ambulance partners are currently not evacuating patients with suspected or confirmed Ebola infection out of affected regions due to the highly complex nature of evacuations when Ebola or other viral haemorrhagic fevers are involved.
“In the case of suspected or confirmed Ebola cases, we would liaise closely with our clients and brokers to see whether there is any possibility of military medical evacuation via support from the patient’s local embassy and home government.”
MEDEVAC AND EPIDEMICS
An Allianz spokeswoman said no insurers or air ambulances were able to evacuate people with symptoms of Ebola.
Other insurance and assistance firms contacted by Reuters declined to comment, did not respond to requests for comment or said they had not dealt with Ebola cases.
Insurance companies often provide medical evacuation as a routine part of international health insurance policies, but the evacuation option may not apply in the case of an epidemic.
Reductions in the cover provided by insurance or assistance companies may make the job of non-governmental organizations harder, as they battle to fight the virus.
Save the Children will be managing an Ebola treatment center in Sierra Leone, which will involve employing “scores of people” in the country, a Save the Children spokesman said.
He said the charity’s workers were covered by medical insurance. “What we cannot say is that we can absolutely cover evacuation, I do not think anybody possibly can, because of availability of aircraft,” he said.
“All options of evacuation would be assessed on a case by case basis,” he added.
Insurance specialists estimate medical evacuation from West Africa could cost at least 45-65,000 pounds ($72-104,000) per person.
International SOS provides services such as clinics and emergency assistance for member companies around the world.
Evacuation only makes up 2-3 percent of its work, the spokesman said, including the evacuation of healthy workers who can travel on regular or specially chartered flights.
The cost of medical evacuation, however, would be met by the member companies themselves or by their insurance companies, he added.
Another complication is that Ebola patients may simply not be well enough to be moved. Those symptoms would involve the secretion of bodily fluids, the International SOS spokesman said.
(1 US dollar = 0.6238 British pound)
(Reporting by Carolyn Cohn; Editing by Tom Heneghan)
Usually two full incubation periods are considered the minimum before declaring an outbreak over...42 days--so this may be premature.
I hope and pray for the sake of Spain and all there that they have contained and eliminated the outbreak there.
Emory and Nebraska have BSL-4 facilities. The average hospital falls well short of that mark.
CDC head criticized for blaming nurse’s Ebola infection on ‘protocol breach’
http://www.freerepublic.com/focus/f-news/3214475/posts
Some healthcare experts have criticized the head of the Centers for Disease Control and Prevention for saying that a “protocol breach” was responsible for the infection of a Dallas nurse with the Ebola virus, claming that the description scapegoats the nurse in a case that shows how unprepared nursing staffs are for dealing with a potential outbreak.
Texas and CDC officials say that the nurse was wearing the recommended personal protective gear for handling an Ebola patient, including a gown, gloves, mask, and eye shield. However, one expert told Reuters that gear only offers a minimum amount of protection, especially when the disease enters its final phases.
Sean Kaufman, president of an Atlanta-based firm that helps train hospital staff said that caregivers may need to add more layers of protection in the patient’s final days, such as double gloves, a respirator, or even a full bodysuit.
That depends on the gear, but there is also a decontamination and gear removal sequence which helps keep the health care worker from getting infected by their own gear as they remove it.
Among other things, that includes washing the gear off with disinfectant (usually bleach) before removing it, and disinfecting footwear by standing in a footbath of bleach. The removal sequence is specific, and people do this in pairs on a 'buddy system' to help keep each other form contaminating themselves.
Most hospitals just aren't set up for that.
A good description of the nuts and bolts of a BSL-4 lab can be found here: Biosafety Level 4 Labs Up Close and Personal
The CDC requirements are to be found here, with a summary of the criteria on page 30 in Table 2.
That the CDC would so undercut its own lab protocols for patient care and healthcare workers is something I cannot fathom.
Good article, however, past actual construction costs within the last 5 years indicate BSL-4 facilities run closer to $15,000/SF vice the $700-$1200/SF cost quoted in the article.
Their commissioning and staffing costs comprise probably half of that amount. They also tend to be 3-7 year processes, vice 2-5 year complex construction schedules.
Video links.
As far as the buddy system for post patient care bleaching of the protective gear prior to its removal, if MSF can handle that in the bush in the 3rd world, it’s scandalous we pretend we can’t here in CONUS in a real live hospital.
MSF protects its workers better in the third world than we do in CONUS. That’s reprehensible.
I’ve said from the beginning that the lawyers would help sort out the ‘unwise’ things that were going on with the first few cases.
Potential irreversible contamination of a multimillion dollar plane is probably why the military is already saying any infected troop will have to stay in Africa.
Agree 100%. Asking HCWs to care for Ebola-infected patients in Level 2 garb, with little to no training in PPE donning and doffing to begin with, borders on criminal.
>I watched a video early on with this virus...and even the ‘least’ protected medical workers in Africa, when just taking off their gloves were very careful to take them off in such a way they were inside out...<
Taking gloves off so that you touch the side next to your skin and they’re inside out is part of basic sterile procedure. I’m willing to bet all medical staff in this country would do so with a contagious patient.
So much for being so well prepared to “stop ebola in its tracks”.
CDC appears to be so politicized that all of their publications appear to be written by the zampolits of the administration. Posters and flyers. What, no giant Obama portraits?
More important though is the lack of preparation drills at “any modern US hospital”. Given the lethality of Ebola prudent care demands rehearsals of these decon and safety procedures. It’s the only safe way to find deficiencies and slop and find fixes for these..
Ebola triage drills, anybody heard of these? In my area they’ve had metro wide massive trauma drills which IIRC involved antrax like scenarios. But the potential stack up of ER patients during current flu season presents a serious problem in distinguishing and separation.
At what point does the health facility establish first triage contact without mixing flu and Ebola patients? It’s not a trivial problem. Dense urban areas make any exterior first check point and contained waiting and triage examination stations near impossible. I can imagine a suburban hospital with larger grounds making this marginally possible. But has CDC even considered this much less having established safe procedures and protocols?
And given CDC tattered reputation who would trust such?
I hear the sound of lawyers salivating and licking their chops.
...And that’s with only two “roamers”. What happens with subsequent ones?
There’s going to have to be social pressure applied for anyone with flu-like symptoms to stay home, period. There’s little to be done medically unless a secondary infection or very high fever occurs, so some means of contact and monitoring self-quarantined flu sufferers needs to be implemented and tested before the first wave hits. Some of these may be Ebola, the vast majority will not be. I don’t know that our people in general possess the self-control across the board to make this work, but even making it work among half the population will greatly lessen the mayhem and lessen the spread of both flu and Ebola.
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