Read The Whole ThingCLUEVILLE (AP) --- The U.S. health care apparatus is so unprepared and short on resources to deal with the deadly Ebola virus that even small clusters of cases could overwhelm parts of the system, according to an Associated Press review of readiness at hospitals and other components of the emergency medical network.
TL;DR Highlights:
* Supplies, training, and funds are limited
* Health care workers may refuse to treat Ebola victims
* Smaller hospitals will be least-prepared
* Everyday demands on the emergency care system for years have been at near-crisis levels 24/7/365/forever
* As of 2008, 1/3 of hospital ERs had to divert ambulances because they were full
* 20% of normal ER visits are for Ebola-like symptoms
* Staff surveyed report 100% of their facilities unable to quarantine large numbers of possible Ebola patients
* 66% of administrators, 75% of ER docs, and 80% of infectious disease specialists say their own facilities unprepared to deal with Ebola patients
(nota bene that the greater the expertise, the greater the certainty that we can't handle this)
* "Nearly all" emergency nurses said that ER overcrowding will make dealing with Ebola well unlikely
* Less than 1% of surveyed personnel at acute care hospitals said their facility could handle even 10 Ebola patients at once, and less than 25% of major teaching hospitals thought they could
* Average hospital has 10 protective suits and PAPR respirators for staff, and only six mechanical ventilators for patients
* CDC spent $6.2B on "Strategic Supply Stockpile" which includes NO waterproof gowns, surgical hoods, full face shields, boot covers, or any of the other gear the CDC itself recommends for treating Ebola patients
* Over half of nurses have received no emergency training during the previous year;
of those who did, 44% felt poorly prepared or totally unprepared
* 1/3 of hospitals have no emergency plan for alternate care areas, staffing, beds, or equipment, morgues, or staff absences/shortages
* less than 1/3 of local health departments even had a full-scale preparedness drill
* Only 25% of teaching hospitals had such a drill
* only 4% of medium hospitals had one
* 0% of small hospitals had one
* 14% of isolation staff, 25% emergency and critical staff plan to call in sick if Ebola becomes a reality, and 17% and 50%, respectively, would refuse to work near Ebola patients
No really! They actually found that after um, you know, asking. I am not making this up!
Gosh, I almost wish I'd been saying the exact same damned thing for months and years...
Kind of puts all that nonstop crapola for the past month or two from the White House and the CDC into something like perspective.
Surprised the desertian rate is so low.
ReplyDeleteIn practice, it will be much higher.
Everyone has a plan until they get punched in the face.
Unrelated, and probably not a lot of use for the random Joe, but here is a link to the protocols that Emory has developed.
ReplyDeletehttp://www.emoryhealthcare.org/ebola-protocol/pdf/ehc-evd-protocols.pdf
Enjoy.
Very respectfully,
MM1
The military will have to build and staff temporary Ebola hospitals like they are doing in Liberia. The problem, as Aesop notes, is staying ahead of the game. If U.S. cases keep relatively low in number this might work. If we turn into Liberia it will not.
ReplyDeleteAlternatively, one hospital in the area could be sacrificed for Ebola cases. It could be the one unlucky enough to get the first Ebola case like Texas Presbyterian.
forgot to leave my name @3:17.
ReplyDeleteMaggie
One Duncan who works in a restaurant, or who infects someone who is homeless, and we are totally screwed. You'd be looking at dozens of cases 10-14 days later, and hundreds within 10-14 days after that. It would destroy our healthcare system, and could destroy our food delivery system without too much trouble. Do those things, and then you've got SERIOUS trouble even WITHOUT the Ebola.
ReplyDeleteAesop, I grabbed historical data from Wikipedia and WHO and plotted it myself. Switching to a logarithmic scale gives a bit more insight: http://bit.ly/1wdMzgG
ReplyDeleteFeel free to use and spread...
There are log scales right on the Wikipedia page.
ReplyDeleteThey are almost a perfect 45 degree incline over time, indicating a precise logarithmic increase with an R=2.
At some point it will slow down, as there are fewer uninfected close enough to become new cases.
ReplyDeleteAfrica is no where near that point yet.
And of course it is mutating, and the more people who have it the more mutations we'll see, with any change in incubation, severity, lethality, etc changing the curve.
But yeah, building 1700 beds, with an additional 700 from the brits, sometime in the next few months... not really gonna solve the problem.
nick
A friend was past head of medical staff at a local hospital group. I know the hospital doesn't want to think of itself that way -- that is, as "local" - -but that's the problem. One hopes we don't have too many of these that, through corporate pride, try to handle something they are not ready to deal with correctly.
ReplyDeleteJust another element in America's egotistical response to all this I thought to mention. At the office of the Chairman and CEO, things may not look the same as they do down here.
Note that in that AP article, when they got to discussing survey results of hospital employees, the farther a given person was from the actual patient's bedside, the more likely they were to think they knew what they were doing, and could handle this.
ReplyDeleteThen realize that the entire CDC/NIH bureaucracy is made up of people who virtually never even see a hospital, let alone an actual patient, on any regular basis.