Replies

Pixie at the PFIF updated his CDC press conference text with more information from the Press Conference.

It makes for scary reading WRT the CDC.

They really are a bunch of incompetent Col Blimps.

The CDC told Texas Health Presby they needn’t put the medical contacts with Thomas Eric Duncan as “high risk contacts” if they were wearing CDC approved levels of PPE!!!

Again — Pixie comments {are in these}

“The risk is in the 48 people who are being monitored, who have been tested daily — none of them have so far developed symptoms or fever — and in any other health care workers who may have been exposed to this index patient while he was being cared for. We are still determining how many health care workers that will be. Exclamation That is an intensive investigation it takes many hours.” Question

{Again, this was not done already????}

“We’ll always cast a net wider.” {um, apparently the “low-risk” meme caused your net to land short this time}

There is no risk to people outside of that circle of the health care workers who cared for the individual patient and the individual 48 contacts who had definite or possible contact with the patient who we have already identified.

What we do to stop Ebola is to break the links of transmission, to break the chains of transmission.

{Well, your PPE guidance has allowed transmission.}

Boilerplate.

Dr. Lakey:

Appreciates support from CDC.

HCW had extensive contact with our initial patient. Had symptoms, came in to be checked. Test came back at 9:30 last night. It was positive. Amount of virus in blood less than that in index patient’s when he came in.

Refining plans. 48 original contacts continue to be monitored.

{Unbelievably, CDC took its own guidance so seriously that, because HCWs were using the recommended PPE, the folks having “extensive contact” with Duncan did not make it onto the “high-risk” monitoring list! Crikey!}

?: Why focusing on taking off of PPE?

A: Frieden: We have spoken to HCW and she doesn’t know why.

?: Will this change the way HCWs interact with this patients? Wearing more?

A: Very concerning. Need to enhance training. Protocols work. Even a single breach can result in infection.

{Nope, no way he will ever admit his half-assed PPE guidance is what is at fault}

?: Besser, ABC: One slip can be so dangerous. Consideration of moving patients to specialized units where they are trained instead of hospitals where they do not have this training?

A: We cannot let any hospital let its guard down. We do want hospitals to have the ability to rapidly consider diagnose Ebola. Anone who has been in three countries in past 21 days and has symptpoms…. “Safest way to provide that care, that’s something we’ll absolutely be looking at.”

?: CNN: Kind of extensive contact, what was the role of this person? Clarify monitoring process? She was self-monitoring?

A: Lakey: 48 individuals get onsite visit and a fever check later in the day.
“The HCWs where there was no breach in contact, we’re doing self monitoring.” {CDC hubris} “In light of this case we’re looking at the ongoing monitoring of all the HCWs and going forward having epidemiologists see them, a more active surveillance for these individuals.”

?: CNN: This woman was not in those 48 contacts, do you have a sense of how many others this extends to?

A: Frieden: “This individual was not part of the 48 and defining what that new number is, we’re working on that pretty hard right now”

{Shockingly unbelievable, even for me, that THEY DON’T EVEN HAVE A LIST OF THOSE HCWs WHO WERE TREATING DUNCAN HANDY!!! Absolutely unbelievable…Such damnable hubris!}

?: Grady, NY Times: What did you mean about limiting care to essential procedures? How do you limit procedures and not compromise care?

A: Try to keep number of HCWs that enter area to minimum. We try to limit procedures to absolute minimum. So for example a blood draw…maybe it only needs to be done once a day instead of multiple times a day.

?: Betsy MacKay WSJ: Can you comment on preparedness of hospitals that have treated other Ebola patients who have come to U.S.? What does this say about preparedness generally, is this an outlier? Or are you concerned now about possible preparedness? And an infection control person should be monitoring - is that a recommendation for all hospitals?

A: In Ebola treatment centers in Africa one of the things contributing to infection there is the lack of an onsite manager who doesn’t have any specific responsibilities other than overseeing and supervising to see that infection control is done correctly. We will ensure that that is being done in Texas at this particular hospital. Very important to distinguish physical layout from procedures and policies, training and staff work. Some special demands in place, an ante room for putting on PPE. Doesn’t spread through the air so doesn’t require some of the most intensive physical infection control procedures. “However, personnel training, supervision, followup, monitoring, it is very clear that the necessity of doing this right, 100% of the time, does require a very intensive training and monitoring process.”

{So…logic then dictates that Ebola patients should be transferred to highly specialized units located in hospitals which have been specially prepared for this level of caution and care.}

?: “How frustrating is this for you after saying we are going to stop Ebola in its tracks to know that a breach of protocol was what caused this.” {wow!} Is it shaking your faith in hospitals around the country to adequately…and prepare their staff?

A: It’s deeply concerning that this infection occurred. Thoughts are with HCW who became infected in the process of that care. “That doesn’t change the bottom line — we know how to break the chains of transmission. We need to ramp up the infection and control for any patients suspected as having or confirmed of having Ebola. And we need to do what we’ve been doing with contact tracing and monitoring.” She identified symptoms. She was isolated immediately. “It doesn’t change the bottom line. We know how Ebola spreads. We know how to stop it from spreading.”

But it does reemphasize how meticulous we have to be in every single aspect of the control measures.”

{Yes, more blood just shot out of my eyes…He did the little “meticulous” hand gesture while he was saying this.}

A: Lakey: We have to be very careful, we need to closely look at the infection control practices as they are occurring in the hospital, to be meticulous {omg he’s Borg!} to make sure there are no breaches. Is it frustrating or disappointing? Of course it is. Our hearts go out… “The HCW who is infected, she’s going to have a rough time.”

?: When will screening begin at additional airports?

A: Frieden: Began at JFK yesterday. Anticipate it starting on Thursday.

?: How a HCW using high precautions caught ebola while people in apartment for several days did not. Do you have plans to transfer patient to Nebraska?

A: Patients with Ebola become progressively more infectious the sicker they become because the amount of virus in their body and in their secretions increases. The people who had contact with indue patient in Dallas are not yet out of their 21 day exposure period. We’re not out of the woods yet with potential additional cases among contacts who are in isolation. But medical procedures… dealing with things that may have large quantities of virus. And that’s why the PPE and the protocols are so important.

?: Clarify this HCW was not in initial group of 48. Varga said there were 19 hospital employees they were tracking. Is this person part of the 19? The hospital by its own track record has not provided the best information, they’ve had to do a lot of walk backs. The hospital this morning said there was low grade fever. Are there any other symptoms? Is there any other information we need to parse further given the hospital’s track record in not providing accurate information initially?

A: The 48 contacts were individuals who had contact with patient up to Sept. 28 when he was isolated. From the 28th to October 8th, that’s a period of 10/11 days when there may have been additional contact given that this individual was clearly exposed then. Now we’re doing a new investigation given the diagnosis of anyone else who may have been exposed.

Clinical information on patient showing only mild symptoms and low grade fever.

?: Why was she not, you’ve kind of gone around this, initially included in the 48 who were monitored?

{The media doesn’t understand that CDC in its hubris has believed that any HCW using proper PPE while caring for an Ebola patient is at *NO* risk. They just need to read the CDC risk of exposure chart for clarification on that.}

?: When you were in Africa did you take special precautions that you normally wouldn’t have in putting on the protective equipment?

A: We monitored all the contacts of the patient up to Sept. 28. We will now monitor all contacts who may have had exposure during the hospital stay.

“In terms of precautions in Africa, yes they are very specific for personal protective equipment in terms of taking off and putting it on and what happens there.”

A: Lakey: “The HCWs who were in full PPE during their involvement in the care of the initial individual were specified at minimal risk and those individuals had guidance to do self-monitoring but were not in that 48.”

?: How common is it for people to be on dialysis or to be intubated during an Ebola infection? Is that something you’ve seen in other patients being treated in other Western countries? How often have HCWs had to deal with that?

A: Frieden: I don’t know the details of the patients cared for in other parts of the world but “I am not familiar with any other patient who has undergone either intubation or dialysis.”

Of the 48 -— that does include health care workers who had contact with the patient before he was isolated on the 28th, but doesn’t include anyone after Sept. 28th.

{Because they were, according to your own CDC charts, at NO risk. This idiocy needs to change, and Frieden needs to resign.}

Frieden now saying they will investigate how this happened, but he’s already come to his own verdict and he has voiced it.

“Anxiety producing time.”

{No, it’s you who is “anxiety producing,” Dr. Frieden, by undertaking a giant in vivo experiment in Dallas which has so far seen the death of your first patient and the infection of a health care worker.}
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