Posted on 10/16/2014 5:51:17 AM PDT by shortstop
We have screwed the pooch.
With this ebola thing, it is hard to imagine how we could have been more incompetent.
Our stupidity has killed one patient and infected two nurses, and left a nation suddenly unsure of the reliability of its health care system.
For all the cocky assurances and arrogant assertions, it turns out that primitives with dust masks are better at caring for ebola patients than we are with our isolations units and high-tech doo-dads.
In the treatment of one patient, the American hospital system has infected more health care workers than would be infected by the treatment of hundreds of Africans.
It is almost inconceivable.
Let’s review the chain of calamity.
A man who self-diagnosed as having ebola, and who informed a nurse that he had recently traveled to the United States from Liberia, was misdiagnosed and sent home to allow his disease to fester and potentially spread to dozens.
When an ambulance brought him back two days later, we now learn that he lay in an open emergency department essentially unattended and spreading his contagion for hours.
And that somehow through the course of his treatment – until his death to the disease – two nurses operating under strict contagious-disease guidelines became infected with ebola.
How does that happen?
How do we, with our moon suits and boy-in-the-bubble technology, catch this deadly disease when doctors and nurses in Africa, working with far fewer assets and much less technology, largely avoid it?
What went wrong?
And why are we worrying about the fate of a nurse’s dog when what the UN is calling potentially the worst epidemic of the modern era is knocking at our door?
About that. Though the UN isn’t staffed by the smartest kids in class, and warnings do tend to be alarmist, it is worrisome that health officials at the United Nations think this ebola outbreak has the potential to rival AIDS and the Spanish flu of 1918.
Only time will tell about predictions. And only time will tell if the incompetence at the CDC and Texas Health Presbyterian are representative of the rest of the American health care system.
Ebola is controlled by diagnosis and isolation. You diagnose patients and those exposed, and you isolate them from the rest of the population.
We failed to do that in Dallas.
And then we got dumber.
The second nurse to be announced as sick with ebola, concerned about her temperature and an approaching trip to Ohio, called the CDC, informed the person she spoke of her work with an ebola patient and her own fever, and asked if she should fly on a commercial airliner or not.
Think that through.
You’ve been around an ebola guy. Coincidentally, a co-worker of yours has just been in the news for coming down with ebola, and you’ve got a fever, and you want to know if you should fly commercial.
That’s the question laid before a CDC official.
That’s a question almost everyone in America would have gotten right.
But a question which the CDC got wrong.
It told the nurse that, though her temperature was bad, it wasn’t bad enough. So she was free to fly.
And she did, from Ohio to Texas, while arguably contagious for ebola.
That’s the kind of stupidity that gets people killed. That’s the kind of leadership the CDC is giving us. That’s the kind of direction our nation is getting in the fight against ebola.
And it raises a question.
If a state-of-the-art hospital in one of America’s largest cities can so fail in its handling of an ebola patient, then what about the hospital in your town? Do you live in Magicville, where mistakes are never made? Are all your doctors and nurses just smarter?
And what about the CDC?
When a federal agency clears a likely ebola sufferer to fly on a commercial jetliner, you have to wonder how engaged it is, and how it will avoid such stupidity in the future.
Finally, there is the issue of the president’s order to send some 3,000 American soldiers and Marines into western Africa to help fight ebola.
If we can’t protect our health care workers in isolation units in America, how are we going to protect GIs operating in the open air in Liberia?
If you send 3,000 Americans into the cauldron of contagion, don’t you expect that some of them are going to come home sick?
And what are you going to do with GIs who catch ebola? Do they get treated where they are? Are they shipped off to military hospitals in Germany? Do they come back home for treatment?
And if they do come back home for treatment, how will we keep the nurses from catching it?
It seems like sending troops to fight ebola is a pretty good way to bring that virus into the heart of our population.
Seems like if we wanted to keep this contagion out of our society we would tell folks coming from affected areas that they have to sit out an incubation period over there before they can come over here.
But we’re not doing that.
We’re screwing around taking temperatures at airports and pretending that this will be a piece of cake.
We’re pretending that ebola is nothing.
That’s what our words say.
Though, thus far, our actions say something else completely.
Our actions say we’re in trouble.
“Not one person will support that.”
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I guarantee you are wrong on that, some idiot will support anything you can possibly imagine. There is nothing so ridiculous that some fool somewhere will not support it.
That wouldn’t be a coup, it would be doing what should be done.
>>> Duncan’s deceptiveness & lack of judgement placed everyone in harm’s way.
While you are 100% correct about Duncan, any national preparedness plan that relies on all people doing the right thing at the right time is a fatally flawed plan. Our evident lack of preparedness goes right back to the CDC, which has had 7 months to spin up all sorts of defenses (vaccine work, stockpiling supplies, building facilities, training HCW, etc.), but has failed on all counts.
Glaxo offered the CDC to spin up their vaccine work in May, if I recall, but was told it was not needed...until the CDC changed their mind in August. Criminal negligence!
jjsheridan is exactly right. If you calculate HCW infected per patients treated, the US currently stands at 2.0, whereas west Africa is maybe 0.05. No comparison at all. African HCW are much better at controlling the spread in the HCW workforce.
Now admittedly, I’d prefer to be in the US as a patient, but that may change too. I understand they did things like intubate Duncan, which may be the sort of thing that new protocols will forbid, to limit disease spread.
Post to me or FReep mail to be on/off the Bring Out Your Dead ping list.
The purpose of the “Bring Out Your Dead” ping list (formerly the “Ebola” ping list) is very early warning of emerging pandemics, as such it has a high false positive rate.
So far the false positive rate is 100%.
At some point we may well have a high mortality pandemic, and likely as not the “Bring Out Your Dead” threads will miss the beginning entirely.
*sigh* Such is life, and death...
The "Doctors without Borders" group - which has treated Ebola in Africa before - and has much better protocols than the CDC... had quite a few of their people DIE from this strain of Ebola in Africa.
bump
Obviously the US has failed on keeping it contained, and hopefully the protocols will tighten up. But not sure the doctors to victims ratio is the way to look at it. Duncan probably had contact with numerous HCW (4? 8? 20?) I imagine that a single HCW in Liberia would see numerous patients. In one article about an Ebola ward in Liberia, of the 27 HCW it has had since it started this summer, something like 24 had died.
And of course, many of the victims in Liberia are turned away from the clinics and sent home to die.
True, but maybe you are drawing the wrong conclusion from that.
I will make a prognostication that one of the strategies that will evolve will precisely be to minimize the number of HCWs in the hot zone of the hospital. The notion of having 20 HCWs attend one ebola patient will, I think, prove in the long run counterproductive.
The latter is the case. Some have difficulty accepting this
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