Saturday, November 1, 2014

So Much For "Any Hospital Can Do This Now" Happygas


(NBC News) New guidelines for the personal protective equipment that health workers should have on when treating Ebola patients make clear that what you wear counts — but even more important is how you put it on and take it off.
And the guidelines that the World Health Organization updated Friday suggest only highly trained medical professionals should be taking on the dangerous job of caring for Ebola patients, say the country’s leading doctors at the National Institutes of Health. 
Anybody could do this, but the training process is something that takes a lot of time,” Dr. Francis Collins, who heads the National Institutes of Health, told NBC News in an interview.        

Treating Ebola patients does not have to be dangerous, Collins said. “But it takes a lot of time to make it safe.”
That was obvious in a demonstration given this week at the NIH clinical center, where Dallas nurse Nina Pham was cared for until she was released earlier this month. It took a full 10 minutes to gear up Kevin Barrett, a specialist nurse who helped care for Pham.
So, it only took two different import patients, two additional hospital-acquired infections, forty false alarms, a few million dollars in direct healthcare costs, tens of millions in opportunity costs for jetliners and cruise ships pulled off-line, and several thousand people quarantined voluntarily for surveillance monitoring, to figure out that the CDC director, the NIAID director, the White House Press Secretary, The DHS national security assistant, and The President were all talking out their back ends for two or three months.

                              As Borat would say,
                                "Niiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiice!"

It's a good thing this wasn't over anything important.

Now that we know how to dress to treat it, WHAT are we doing to keep it from getting here in the first place?

Oh yeah, that would be NOTHING.

I feel so safe now!

12 comments:

Anonymous said...

Scary enough, and yes I also feel safe, but even safer when this (expletive) is still being passed around:

"Ebola isn’t as contagious as influenza, measles or even the common cold. It doesn’t float in the air or live on surfaces. To get it, people have to be in close contact with someone who is actively sick or with the person's bodily fluids, such as on a sheet covered with vomit or diarrhea. But doctors, nurses and technicians fall squarely into this risk group."

Can't live on surfaces? SINCE WHEN?

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2672.2010.04778.x/abstract

And that's older 4 year old research. For God's sakes.

Aesop said...

You have to filter out the derp to get to the nuggets.

Anonymous said...

Speaking of filtering out derp to get to the nuggets (something that's unfortunately all too normal now when reading anything), THIS Stanford ER physician deserves some credit. :) Just something brightening in all this horror (disregarding the commentary in the rest of the article about fear, blah blah blah). I'd rather this guy get the same attention as Nurse Whiny did, but that won't happen unfortunately. Still, some credit where it's due.

http://www.sacbee.com/opinion/editorials/article3503329.html

Anonymous said...

Aesop, you may find this story interesting.

"His funeral in the capital Conakry was attended by work colleagues and aid workers, as well as Cuban and Guinean officials, according to an AFP journalist at the ceremony.

"We will always remember him and we pray for the repose of his soul because he died on the soil of Cuba's friend, Guinea," government spokesman Albert Damantang Camara said.

Cuba's health ministry says Rodriguez had not been in contact with Ebola patients, but he was given two tests for Ebola, both of which were negative.

He was initially treated for diarrhoea, a symptom of both malaria and Ebola, before his health rapidly deteriorated and he suffered multiple organ failure."



Suuure....

-- Does malaria kill that fast? (Those guys just got there only a couple weeks ago.)

And: how prone is the Ebola "test" (I'm assuming they're referring to a blood test) to coming back as a false-negative (or, alternatively, easy to screw up)?

Anyway, nice, big funeral attended by all.

Aesop said...

No idea what sort of tests they use.

Percy said...

(Sorry! Had a mistake or two in my first try at this.)

From CBS and Stanford Medical School this morning, after running simulations based on foreign travel here from West Africa, including return of our own healthcare people, on what we should expect as to Ebola in America:

"I don't think there's going to be a huge outbreak here, no," said Dr. David Relman, a professor of infectious disease, microbiology and immunology at Stanford University's medical school. "However, as best we can tell right now, it is quite possible that every major city will see at least a handful of cases."

Every single major city in the U.S.? This varies from the stream of BS being fed to the citizenry by our usual authorities, the CDC, WHO and the happygas Obama Folk (I don't know what else to call them). It also seems to presuppose that the "handful of cases" expected to appear all over the place can somehow be brought under proper control, isolated, and handled in an impeccable manner by the untrained after they get here to prevent yet more people from being infected.

Chilling news.

AM said...

Percy, I actually expect that every major US city will have a handful of cases or at least a handful of scares or false positives.

Keep an eye on Europe though, how things go there is what I consider a high probability indicator of how things would go medically in America.

Yojimbo said...

Dear AESOP,

I try to point as many people as I can to your site to get them to wake up to the potential disaster of Ebola.

Half of them are woken up and the site serves as a bucket of cold water thrown in their face.

But the other half say that the site is simply fear-mongering, and they compare it to the over-hyping of SARS, and bird flu, and swine flu, and HIV.

I counter that the clear difference is that the government and media over-hyped those other flues and viruses, whereas with Ebola they are clearly suppressing the facts and dampening the legitimate concern over this possible pandemic.

How would you answer them? Could you do a post about whether Ebola is being "fear-mongered"?

Unless we wake the sleeping giant of America, we have no chance of our Republic surviving an outbreak of Ebola here.

Thanks.

Anonymous said...

Percy, I found the link to what you're referring to:

http://www.wsaw.com/home/headlines/281175452.html

That jibes with what this spokesperson from the CDC said in the AP article yesterday:

"The Centers for Disease Control and Prevention prefers not to focus on a particular number. But spokeswoman Barbara Reynolds said Ebola will not be a widespread threat as some outside the agency have warned.

"We're talking about clusters in some places but not outbreaks," she said."

http://hosted.ap.org/dynamic/stories/U/US_EBOLA_HOW_BAD_CAN_IT_GET?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2014-11-01-10-25-24

Because now "clusters" and "handfuls of cases in every major city" are now just PERFECTLY acceptable.

If they came out with this even a month ago, store shelves would be emptying. Why aren't they? Creeping normality, or the boiled frog. People should be angry and a little scared right now, angrier than I'm reading anyhow. This is Ebola we're talking about here, and all of the constant references to the flu or AIDS don't negate the fact that this is Ebola. People may have vague ideas about Ebola, so to go to Yojimbo's point..

I've referred a lot of people here via link for sure. But I think Aesop will best make his point at this point by describing, in excruciating detail, what HAPPENS when a person gets Ebola maybe. Because everyone's been set on simmer so now we're supposed to be hunky dory with Ebola being in all of our major cities, it may be time to pull out the big guns that aren't for squeamish and wake people the hell up. If they aren't finally woken up by that AND another great post by Aesop about how infectious this thing ACTUALLY is, then they're never gonna wake up, at which point you discount them a lost cause and virus fodder. At least the way I figure it.

Aesop said...

It's just another example of what the late Sen. Daniel Patrick Moynihan described as "Defining Deviancy Downward".
IOW, "bad" becomes the new "normal".

Ultimately, it won't work. We have but 23 dedicated BL4 isolation ward beds, but staffing for only 8-11, and 2-3 of them are permanently reserved (in the Montana facility) for their intended purpose, i.e. treating BL4 research lab workers infected inadvertently.
So if we have single-case import patient outbreaks which fill the other 5-8 beds, there will be no overflow, and local hospitals will be impacted. (As if we have so much extra capacity we can afford that.)

THP-Dallas lost both its ER and ICU for weeks from just Duncan. A city that gets a cluster of patients will be crippled, and the normal toll of shootings, stabbings, car accidents, heart attacks, strokes, etc., will suffer and die from lack of alternative care, esp. in smaller cities with only a few hospitals. or worse, only one.

Part of the reason for THP-D's long-term problem was staff quarantines, and threatened and actual staff walkouts, which is the same problem observed in West Africa.

Which will, in short order, occasion the same results. Welcome to Liberia USA at that point.

Once US casualties start inching upwards, esp. among health workers, and Ebola infection approaches more like the expected 70-90% likelihood of death, enthusiasm for "remain calm" will wane, and the interstates outbound will fill up.

Anybody in charge who doesn't think about that, or is trying to suppress talking about it, is on the future dinner menu for the mob at the point that a cluster or three breaks out.

Anonymous said...

I'm a bit underwhelmed by the so-called difficulty of teaching so-called 'trained medical professionals' how to put on and take off PPE. Any surgeon who has had experience with suiting up with helmets with positive pressure ventilation, as has been done for total knee / total hip procedures would find this a slam dunk.
I teach nursing students and have taken them on medical missions as scrub and circulating nurses to assist me in operations. Despite being told that they can't wipe their noses with gloved hands, I frequently find that they screw up, because sterile technique has not become habit, only head knowledge.
So there's a difference between 'medical professionals' and 'medical professionals experienced in sterile technique'.
Only a bureaucrat or some hospital admin puke would assign a floor nurse rather than an experienced OR nurse to suit up and take care of the Duncans of this world.
And once you truly have both knowledge and experience in sterile technique, the addition of NOT TOUCHING any outward surfaces of PPE should already be ingrained.
Bill K.

"Greg" said...

Hey Aesop,
when you quoted Borat, I thought you were going to go with "GREAT SUCCESS!"