As the Tag Says, "Whatever Doesn't Kill Me..."

 

 

Greetings, visitors and any faithful readers.
Endless apologies for the continued delay in adding fresh content. Your patience will be repaid shortly. (Anyone betting you I'd shut up on the 'net very long, take the longest odds you can get, and retire early on your winnings.)

Work is work. To be more specific, it's five nights in a row/60-hour weeks, vs. my former 3 nights/36-hour weeks. And now at a new higher pay rate. It's amazing how hard you can work when the other choice is literal poverty. The paychecks are commensurately effing awesome. The only drawback is that my enforced unemployment came rather unexpectedly, and with my cash reserves on fumes, so I have a bit more catching up to do, but that's happening at 200% of the former speed it would have otherwise.

Cool things:
I now have direct experience with another dozen medium to large ERs locally.
I have met a lot of great folks, and am constructing a short list of places I'd consider making a full-time employment home.
Several of them started pitching me to sign on FT after seeing me for about two shifts.
While trying to keep my head from swelling about that, it's nice to
a) prove that you still have the chops to do the job, esp. serially in front of strangers, and
b) a little ego-stroking after the crotch-kick of getting shoved out the door at an employer isn't a bad thing.
If this is anything like what it's like to be a pretty girl from age 16-45 or so, I can at least understand some of the attitude that goes with it. Without the PMS complications.

That doesn't mean getting pushed into a pool of career icewater wasn't an effing PITA, but the end result will be that I'll probably make enough money this year to move into a higher tax bracket, and suffer the agony of being able to reach some lifelong financial goals in short order. Poor poor me.

A few other observations:
Keep a career back-up plan: a part-time job, small-potatoes self-employment, or whatever, but have a second gig. Something. Anything. Even if it's barely paying for itself, a small cash flow beats none at all, and your car doesn't run on a tankful of canned food or ammo reserves. Ask me how I know that.
While I likes me my firearms, I've always been a more well-rounded preparer than a gun nut, but if you've never visited the local collateral loan merchant (AKA pawn shop) you should be aware that any of Gaston Glock's tactical Tupperware is readily convertible to $250 cash money in most populated precincts, and that's without things nationwide being dire. So, for instance, three or four of them "extra" that you can part with for a few months equal your monthly readies. Again, ask me how I know.
Then imagine what their barter value might be under more dire circumstances. Esp. if you had a few spare magazines and a couple boxes of ammo apiece.
The same is most definitely not true of just about anything else you might think of.
Again, go visit the local hock shop, and chat them up, to get a no-BS idea of the actual value of things you might wish to convert to cash should the need arise. As someone who would formerly never have ventured into the pseudo Arab bazaar marketplace they represent until necessity forced my hand, you'll learn a few things, not only haggling, but you'll also get an idea of what's hot and what's not (e.g., any functional pistol is cash in the bank, whereas a brand new iPhone or high-end camera is nigh on worthless. Surprise.)

Free internet when money is tight is a gift from heaven (and Starbucks/Mickie D's/the local public library). With a laptop and the time, you can do for $0 what would otherwise be a couple of hundred $$ in cell/wifi bills. And if you haven't done a job search in awhile, the entire world is now online. Walking into an office with a resume these days is tantamount to telling an employer that you can take Morse code at 30 words a minute, or type at 80 words/minute, as if that should mean something to them.
(For those of you to whom Neil Armstrong and 8-track tapes are history as remote from you as the Thirty Years' War, Google "telegraph" and "typewriter". Those of us with underwear older than you are will quietly tolerate your confusion until you bone up on such arcana.)

OTOH, showing up on time (by which I mean early) with a good attitude, being flexible, and showing up, putting your head down, and getting the job done without any drama queenery once you get the job is timeless, in every career field since Thag and Og were making stylish saber-tooth cat skin leisure attire and chiseling wheels out of stone.
I save my sarcasm for here online, by and large. Believe me when I tell you it never wins you points at work, unless you own the joint.

Lest anyone think I'm going all Pollyanna, or selling out from financial necessity, let me assure you I've already collected a few choice bucketfuls of carefully distilled snark, soon to be shared here, and even more so over at Shepherd Of The Gurneys in upcoming installments. And then some. Suffice it to say that as much fun and pleasantness as I've discovered in my expanded work universe, the depths of Stupid out there are unplumbably bottomless, and probably incapable of measurement with existing instrumentation.

As an example I'll be explaining shortly, the level of emergency preparedeness even after the recent Ebola outbreak have proven inarguably that things are now not only far worse here than I predicted 6-8 months ago, they are worse than I could have imagined then or even now without the direct experience of seeing them again and again.

Which is a short tease of explaining that, No, Ebola Hasn't Gone Away, And It's Not Going To. Better effing believe there'll be more to come on that front in short order, just for one example. In fact, 2014 wasn't the problem, or even the wake-up call, it was more likely the last whistle stop before the missing bridge ahead. Stew on that, boys and girls.

So whatever you were doing to prepare for the vagaries of life before my hiatus, keep on knocking it out. Life is not going to get more predictable or happy for anyone any time soon, by any reasonable examination of the facts. Plan accordingly, and I'll be throwing out more details in coming days.

Promise.

Okay, That Was Annoying

 

Employment has resumed.
With roughly four times the amount of grief, annoyance, and general PITA fucktardery as I experienced filling out a Top Secret/SCI special background investigation back in the day.

Jeebus crispies!

My generic advice:
Keep your resume updated.
Including all your contacts and references.
Keep 7 copies of every bit of vital certification and testing information, including DNA swabs and urine samples of the personnel administering such testing and certification. It WILL be asked for. Demanded, actually.

Working 18 days straight may give me a heart attack, but at after running around like a headless chicken for a month with no income, in the feast-or-famine sweepstakes, I choose feast.
Especially when a 20% average pay raise is involved.

Oh, and a hearty FU Very Much/ESAD to my former employer, Callous Bastard Hospital.
The last three places I've worked this month are already asking me to fill out permanent status employment apps after seeing me work as temp registry for them for a couple of shifts. It's nice to be popular.

But clearly, you have to run away from home (or be booted out the door in my case) to get any respect.

Normal posting will resume in a week or two.

Shameless Plug

Over there someplace --->>>
there should be a new addition to the blogroll:

Hogwarts' School of Grid-Down Medicine.

AKA providing medical help for you and yours, when you're all there is, or is likely going to be, for any number of reasons.

Doc Grouch, Ivymike, and myself had it suggested upon us courtesy of Concerned American over at WRSA.
We promptly all fell all over ourselves thinking what a great idea it was. Doc Grouch and Mike did just about all the work of launching it.
My input was some tinkering, and then I got a vacation, and then my return to reality, as previously noted, has been a bit...bumpy lately.
Thus any credit due to me for it so far is right about nil, so I'm not being immodest to tell you the site looks great, and there's stuff there you should read, learn, and pay attention to, if you think big shiny white hospitals and endless streams of Government Bux to pay for visits there will not last forever, in all places and times, for the rest of your life.
In other words, if you have any grasp on medical and sociological realities, let alone an awareness of the frequency of life's normal allotment of natural disasters.

Doc and Ivymike have done great things there thus far.

As my situation stabilizes, and I get back to regular posting, I'll have more of a share carrying my end of the log, along with Doc Grouch, IvyMike, and anyone else we can cobble together to keep it a going concern, and improve it.

Start at the beginning, read the posts, do the homework.

Our goal is not online medical school. (There are probably laws against that anyways.)
It is that everyone with the time and inclination be provided with the guidance, resources, and gentling prodding (of a solid boot in the ass, metaphorically) to be as prepared as they may choose to be to deal with medical emergencies anywhere, with what's in your pockets, or even better, with the prudently-stocked contents of your home version of Somewhere General Hospital. And anyplace on that spectrum between those two. Guided by what we have invested and reaped from a combined goodly number of decades each and all trudging through the corridors practicing our medical arts.

Go.
Pay attention.
Learn stuff.
Practice it.
Save Lives.

Potentially even those that mean the most to you personally, at a time when you may be their best, or only, chance.

West Point Ranger Studs - STILL not faster than a speeding locomotive

Today's Lesson: Watch Your Step

Fitness model, actor and reality TV star Greg Plitt was fatally struck by a Metrolink train in Burbank Saturday afternoon. Police say Plitt was filming on the train tracks.

People who knew Plitt and fans who wished to honor the fitness guru stopped by the train tracks Sunday to pay their respects. A bouquet of roses was left at the scene.

Plitt, 37, was a top fitness model and actor. He appeared on TV shows and movies, and was on the cover of more than 250 fitness magazines just in the last eight years.

Burbank police say Plitt was filming with two other people on the train tracks, just north of the Burbank Metrolink Station, when he was struck and killed by a Metrolink train.

Witnesses say Plitt was holding a video camera when the accident happened.

"He had on all black. The train went by. I saw him stumble over the tracks. He had a camcorder in his hand," said Metrolink passenger Victor Crowell.

Y'see, train yards are generally gravel and hardscrabble, with not just tracks, but large ties ("sleepers") sticking out, along with the anchor spikes, and all matter of other detritus afoot.
So when you stumble right in front of a moving train, that's it for you.

This is why on real productions (as opposed to someone half-assing it with a couple of buddies "on-the-cheap" with a handicam) there are whole departments of people who make sure that the person with the camera is safe from such things. Now you know what a grip does.

Tragic for Plitt and his family, and no doubt rather inconvenient for the train crew and passengers. But I daresay his DayPlanner has opened up quite a bit, and 200 other would-be fitness cover boys are shedding crocodile tears.

But even if you're rough, tough, and buff, with an Academy ring, a black-and-gold tab, a five years with the Regiment, your chances against a moving Metroliner in your gym shorts and tennis shoes are about the same as if you wore a meat suit to swim with Great White Sharks.

For Mr. Plitt, lesson learned, albeit about 5 seconds too late to deliver any helpful behavioral changes. Some stuff may look easy, and making videos is: right up until you find out the parts where it's not so much the case. Like from the undercarriage of the train.

Oh well. 

And the other shoe drops...

My vacay was lovely. As will become apparent, I should have stayed there.
(If you have the chance for two weeks on Maui, I highly recommend it. Anytime.)

Upon my return, I found out the reason they were so cheerful about letting me have time off for the holidays, was that in their ceaseless efforts to not go broke implementing ObamaCare, my facility will be "re-organizing", and wished me their best in securing another position. Just. Like. That.
The fact that I'm experienced, at the top pay tier, and recently passed the half-century milestone were all purely coincidental, they assured me. And I have a bridge for sale too, right next to some beachfront property in Kansas.

Step Two was dusting off the resume, and getting a gig with any number of nursing registry agencies hereabouts that are swamped with the need for ED nurses locally, because for some reason, there are a ton of facilities with openings for non-permanent personnel on all shifts. Everywhere.
Doubtless this is just another purely random coincidence, I'm sure.

The sweetener is that they pay on average 10-20% more than my former employer, for doing the same job, and (after a few months not there), even including my former hospital home. So they laid me off to get me a raise, and set my own days and hours forever, including no more holidays at my discretion, and all it cost them was any shred of loyalty or concern for their best interests I might have had after the last ten-plus years in their trenches.

Such a deal.
The other bummer was instantly being ripped from amongst the greatest bunch of people, doctors, nurses, and staff, I've ever worked with. $#!^ happens.

The fly in the ointment was that I needed to do all the pre-employment hoops I haven't jumped through since Clinton was president, and dig up paperwork from the late Pleistocene, as well as document my decades of competencies in everything, from scratch. (Satisfying my inner hyper-anal control freak, I have so far aced everything they've thrown at me. And thank the Flying Spaghetti Monster I can do this stuff online, at home, in my pajamas, whenever I feel the urge. Yay, 21st century technology.)

During which, it turns out that between eating like a teenager, no small amount of it grazing on craft service, and the very same two decades of dealing with nightshift ED work and the lovely people deposited on my gurneys, my blood pressure seems to have decided to translate into flight data from a space launch liftoff, after being textbook normal up to at least six months ago.

Oh goody. After a quarter-century in healthcare, I always wondered what it'd be like to be the patient. (Not.)

I have consequently been just a wee bit pre-occupied with securing gainful employment, and not having my head explode, while finding a regular physician for the first time since I was a teenager, managing new meds, and embarking on a new quest to burn off at least a decade of crap daily diet and not enough cross training. With my former health insurance a distant memory.

So the 20 extra pounds around my gut are my fault, and the ED is the ED, but a hearty "Fuck You" to president for-life? HopeyDopey, and his ceaseless efforts to destroy the 17% of the American economy that has been my career, by mucking up the revenue stream for all hospitals. The only silver linings are that having discovered my new health situation, I won't be stroking out from his upcoming State Of The Union, 'cuz I've got meds to fix that now, and because of totally screwing the pooch for the medical industry, there are suddenly no shortage of doctors happy to see me for cash-for-service, indefinitely.

Regular blogging will resume when the recent roller coaster comes in for a landing.

The fivefold teaching moments are thus:

The government is not here to help you. Ever.
Neither is your employer. Loyalty is for dogs. Their end of the contract comes when the paycheck clears. Anything else is icing on the cake, but don't count on it.
Keep your resume current and updated.
More veggies, less pizza.
More PT, sergeant, more PT. Because I miss the Daily Seven like BUDS candidates miss getting wet and sandy in January.

And if you thought I was a non-cheery cranky caustic SOB before all this needless personal drama,

GET OFF MY LAWN.

 

 

Back regularly as soon as I can. The medical chances of me shutting up on the internet are about 8 billion to 1, against.

Paradise, Bitchez

For the first time in two decades, I got the holidays off for personal vacation. (Seniority, or the gods of random fortune, thank you).

Consequently, by the time this goes up, I'm sitting on a beach much like this one.
Just because.

Happy Holidays, &c.

Back after New Year's.

@$$Clown Of The Ides: Chuck U Very Much, Senator...

The real motivation for all that Ebola preparedness comes out:

(PORKVILLE) - Senator Chuck Schumer on Monday called on U.S. secretary of health and human services Sylvia Mathews Burwell to recognize the enormous amount New York hospitals have spent preparing for and treating the Ebola virus, and use some of the money she was given by Congress to reimburse hospitals for their expenses.
Burwell has 30 days to come up with a spending plan for the $733 million her agency received from the latest continuing resolution, a $1.1 trillion spending package that allotted a total of $5.4 billion to combat Ebola.
Most of that money is headed to West Africa, where the epidemic continues to claim thousands of lives, but some can be used domestically.
Schumer said he would like New York hospitals to receive roughly $50 million
         “I am urging secretary Burwell to make sure all of New York's institutions are completely reimbursed for their funding,” Schumer said at a press conference today outside Bellevue Hospital. “That was the purpose of the fund when we push for it and created it.”
Mayor Bill de Blasio has already reimbursed Bellevue, a part of the city's Health and Hospitals Corporation, $20 million for the expenses it incurred when treating Dr. Craig Spencer, the physician who contracted Ebola while working with Doctors Without Borders in West Africa.
But other hospitals have spent tens of millions of dollars preparing for the virus, Schumer said.
Montefiore has spent approximately $7.5 million building a biocontainment unit and training staff, Mount Sinai has spent between $7 and $8 million, and New York Presbyterian has spent roughly $3.3 million, according to Schumer's office.
Ken Raske, president of the Greater New York Hospital Association, estimated the ten Ebola-designated hospitals in New York have collectively spent between $50 million and $75 million on capital construction, the purchase of protective gear and training.

Try and look surprised at the prospect of a Democrat senator trying to shove both arms armpit deep into the taxpayers' pockets and keep everything he can get his hands on.

Webster's Dictionary could save space by consolidating the entry for Chuck and the entry for chutzpah. Or at least using the same picture.

Like Getting Ebola Wasn't Bad Enough

Kenema, Sierra Leone (Al Jazeera )- Massah Kamara sat patiently with her brother Momoh, her haunted eyes focused somewhere in the middle distance beyond the walls of the post-Ebola clinic.
Three months earlier, doctors gave her the good news - after weeks of fighting the disease, she had finally beaten Ebola. She would live.

Back in her home neighbourhood of Nyandeyama, a quiet suburb of sandy streets and mango trees, she found out 22 members of her family were dead, including her parents. She had no money, so was unable to go back to her tailoring business, and many of her possessions had been burned by terrified neighbours.

Then, just when she thought things couldn't get worse, she began to lose her eyesight.

"My eyes are dark," she said sadly. "Even when the sun is shining, my eyes are dark." Kamara said she was happy to have survived Ebola, but fear and misery were etched onto her face.
Kamara is one of 40 percent of Ebola survivors to have gone on to develop eye problems, according to a recent study carried out by the World Health Organisation and Kenema's District Health Management Team. It has been more than a month since the district saw it's last case of Ebola, and attention is turning to the plight of survivors.
The results of the survey, a copy of which was seen by Al Jazeera, outline a raft of physical, social and psychological problems the survivors are experiencing.
Seventy-nine percent, for example, now suffer from joint pain; 42 percent have problems sleeping, while more than one-third of those surveyed experienced peeling of the skin. Many others reported problems with their reproductive system.
Post-survival effects 
"There is so little written about post-Ebola problems," said Maggie Nanyonga, a WHO consultant working with Ebola survivors in Kenema district. "We don't know if it's the drugs that are causing it, or the disease, or just stress."
In a small room at the government hospital in Kenema, now known simply as "Psychosocial", volunteers busily transcribed forms with survivors' complaints. "Serious backbone pain. Difficulty breathing. Properties burned but not replaced," reads one.

"Ear and joint pains. Poor health with red eyes," reads another. 

 "Tired legs and weakness. Cannot see clearly," reads a third.Health education officer Michael Vandi said the eye problems are of particular concern. "We just weren't expecting this. A lot of them are experiencing it, often combined with headaches," he said.The head of the hospital's eye department, Ernest Challey, said he believes he has found the cause - a condition called Uveitis that occurs when the innermost coating of the eye becomes inflamed.
It is triggered by problems with the immune system, a viral infection, and sometimes trauma, he explained. It leaves patients with dim and blurred vision, and pain when they're in bright light. If left untreated, said Challey, it can lead to blindness.

But the physical symptoms are just a part of the immense challenge many Ebola survivors face. "Sometimes I cry when they tell me their stories," said one nurse after writing down Kamara's details in the post-Ebola clinic, the first of its kind.

And it gets worse, according to the rest of the story: the locals treat survivors like pariahs, having burned their few belongings, and shun them afterwards, so they're left with no place to live and no job, as all the health problems pile on.

There's never been a post-Ebola clinic, because historically, the Ebola Survivors Clubs have usually been able to meet in a phone booth.

But with a few thousand survivors this time out of at least 20,000 victims, medical science is getting a new chapter in Ebola treatment: follow-up prognosis for survivors. And it isn't pretty.

Not least of which because what little assistance is going there is aimed at trying to curb the actual outbreak, not deal with the aftermath.

We never had to do much of that before...

Some People Don't Know When The Music Is Over

"Can I just get five more seconds in the spotlight? How about four? Okay then...three...?

Speaking of Slow Learners, today's NPR blast of woulda-coulda-shoulda:

Speed. That's key to ending the Ebola epidemic, says the director of the U.S. Centers for Disease Control and Prevention.
Dr. Thomas Frieden is visiting West Africa this week to figure out how to reduce the time it takes to find new Ebola cases and isolate them.
Otherwise, Ebola could become a permanent disease in West Africa.
               "That's exactly the risk we face now. That Ebola will simmer along, become endemic and be a problem for Africa and the world, for years to come," Frieden tells NPR. "That is what I fear most."
Frieden plans to spend several days in each country where the virus is still out of control — Guinea, Liberia and Sierra Leone.
The biggest challenge right now is in Sierra Leone, he says, where the epidemic shows no signs of slowing down. New cases continue to rise exponentially. Last week, the country reported nearly 400 cases, or more than three times the number of cases reported by Guinea and Liberia combined.
Since February, there have been nearly 18,000 reported Ebola cases globally, the World Health Organization says, with more than 6,000 deaths.
               But Frieden is still confident that the three countries can eventually reach zero new cases and end the epidemic.
Why?
Because the world has stopped every Ebola outbreak before, Frieden says. "Even in this epidemic, we are stopping individual outbreaks. The challenge is doing it at a scale and with a speed that we've never done before."
When Frieden visited West Africa last time, in August and September, the disease was "raging out of control in Monrovia," he says.
Since then, the epidemic has slowed down in Liberia. "But we haven't been able to get it under control," he says.
               "As the weeks have gone by, we have been able to intervene faster [in Liberia]," Frieden says. "We've found that we can stop outbreaks in weeks instead of months."
So a hot spot in one town or county ends up having only a handful of cases instead of hundreds, he says.
Now the CDC and international aid groups need to figure out how to do that in Sierra Leone.
But even then, the response may not be fast enough. All it takes is one sick person to travel to a vulnerable town and ignite a new hot spot. That's been happening in Guinea for months.
"It's not like a forest fire, so much," Frieden says, "as a country full of bush fires in different places."

Tom, check your spam filter: President Obola sh*t-canned you back in October, when he appointed Flounder to be the new Invisible Disinformation On Ebola Czar. The memo you missed is probably in there.
So, a few pointers:

* If you've noticed a lot of space on your Day Planner lately, it's because you're officially dead in D.C.
* The first hurdle to tracking Ebola contacts in West Africa, is getting the countries involved to admit that they have them. When everybody admits that there's a "fudge factor" of between 2 and 200 to multiply official reports by, going back to, oh...forever in this outbreak, that's how many cases you'll never track, times the 10-100 contacts they create.
* The second hurdle would be teaching 20,000,000 people there how to count. If the illiteracy rate there was the growth rate of GDP, they'd all be driving Beemers and flying in Gulfstreams. As it is, they wear sandals in case they have to make change for a quarter.
* Ain't nothing happening there on a Western "right now" time frame. They make "island time" look like a FedEx Distribution Hub. "Just in time" in West Africa means "order three years in advance, double the needed amount, and keep a slush fund handy for last minute bribes, and there's a 60% chance we'll have this no later than a month after you need it."
Seriously, dude, try talking to any of your own people there about this.
* Once you tackle those paltry problems, you only have to get past two or three other minor details:
The cultural hurdles of a grabby/touchy/feely society
The religious hurdles of inshallah and the associated local burial rites and customs
The scientific hurdles of taking a country to accepting scientific germ theory accepted here since Pasteur, in one where this month 50-75% of the peoples there are more likely to believe that what's killing people is curses and witchcraft than "Ebola".

If you look closely Tommy, you might notice how curiously similar all that sounds to the phrase "nation-building". Something Britain and France couldn't do there in centuries. Maybe there's no TV in your lab or office, or you're more of a theatres-and-symphony kind of guy, but that phrase doesn't have quite the cachet now that it might have had in, say, 2003.

So why don't you respond to one of the 47 e-mails that career recruiter has been sending you for the last 8-10 weeks, and see about updating your resume.

You've "solved" quite enough geo-political epidemics for one lifetime, I think, and maybe you should get a new hobby to fill your golden years.

Oh, and nota bene, careful readers, that NPR and Frieden himself are still describing this outbreak as "out-of-control" in no uncertain terms, in all three countries.

Slow Learners Pay The Price

GENEVA (Reuters) - The failure of Sierra Leone's strategy for fighting Ebola may be down to a missing ingredient: a big shock that could change people's behaviour and finally prevent further infection.
Bruce Aylward, the head of Ebola response at the World Health Organisation, said Sierra Leone was well placed to contain the disease -- its worst outbreak on record -- with infrastructure, organisation and aid. The problem is that its people have yet to be shocked out of behaviour that is helping the disease to spread, still keeping infected loved ones close and touching the bodies of the dead. "Every new place that gets infected goes through that same terrible learning curve where a lot of people have to die ... before those behaviours start to change," Aylward told Reuters.The WHO's death toll from outbreak has climbed to 6,583 but the actual figure is likely to be far higher due to under-reporting of cases. The flare-up in Sierra Leone's capital Freetown and the country's more heavily populated western areas resemble the massive infections suffered in August by Liberia's capital Monrovia. "In Monrovia you had bodies on the streets, you had a riot, you had someone shot - awareness went through the roof in a very, very short time as a result," said Aylward.             "You don’t want to see that kind of thing drive public awareness but it has an impact very, very fast. People changed behaviours in Monrovia - bang! Like that." Mali also learned through a shock. Just as it seemed nobody had been infected by its first Ebola patient in October, another cluster of deaths sprang up the following month. Aylward said he told Malian officials that the only way to stop the outbreak was to trace anyone who may be at risk. "That’s when the contact tracing... took a jump from around 60-70 percent completion to 98 percent," he said.Denial and ignorance are part of the problem but a weak healthcare system and logistics also play a part. Officials in Kono - where an explosion of infections was discovered this week - said the eastern district of 350,000 inhabitants had only one ambulance and no Ebola treatment centre."The forest area of these three countries has got some really special and concerning practices, where they share meals with the corpse, where they sleep with the corpse," he said.Some areas of eastern Sierra Leone that were hit hardest early in the epidemic -- around the towns of Kenema and Kailahun -- have seen a massive reduction in case numbers as people change behaviour. "The areas that are now doing badly are the areas that were affected last. They are still on the learning curve."

Amazing to hear the UN official in charge of the entire WHO response wistfully longing for the more resposible parties to shoot few stupid people to get their attention, but there it is, and in print.

And short of that or massive die-offs, currently in progress, about the only thing likely to wake them up.

And as noted by commentor geoffb, the lesson fades from view overnight:

ABUJA Nigeria (Leadership) -The declaration of Nigeria as an Ebola-free country by the World Health Organisation (WHO) in October has prompted many Nigerians to discontinue the practice of maintaining a good level of hygiene as a measure of containing the Ebola Virus Disease.
From schools to banks and other public places, the strict measures of screening for signs of the disease put in place while the outbreak lasted between July and October, have fizzled out in most places. Most Nigerians are now living a care-free life because, according to them, Nigeria has been certified Ebola-free by the WHO, which means there is no cause for alarm.

Hopefully Ebola got the same memo, or the remedial course is going to be a bitch there.

Another Ebola Round-Up

Given the all but predictable info-dumps on the weekends, the latest:


(Reuters) Liberia's elections have gone from on to off and back to on, currently for Dec. 20th.

(WaPo) Johns Hopkins has designed a vastly-improved next-gen moonsuit for Ebola caregivers to wear.
Takeaways: it's months from production and distribution (if that even occurs), so currently it's total vaporware this side of next summer. Or perhaps ever.
It's also exactly the isolation spacesuit all the naysayers said we didn't need to use to keep health care workers from getting infected. It's amazing what a dose - or 20,000 of them - of reality does to all those cheery "We can handle this stuff" bull$#!^ assertions. Remarkably, you can't find those people opening their yaps about things now. How curious.

(CTV) Sierra Leone reports the 12th doctor there now infected with Ebola. At this rate, they won't have any doctors left at all in a couple more months, other than outsiders come to help. They've gone 1 for 11, with the other 10 dead, on previous MDs infected. Interns have gone on prolonged and repeated strikes demanding actual protective gear, and almost all the doctors who have been infected had it happen while treating patients in other non-Ebola areas, indicating the Ebola-infected are going to other (non-screened) treatment areas, and cross-infection has already or will soon wipe out the entire minimal health system in the country unless everyone everywhere is treated as an Ebola patient 24/7/365.


And the best of the bunch, from (NPR) : What Happens When You Let Illiterate Retards Run  A Crisis (quoted in its entirety, as it was just too good to chop up)

As part of Sierra Leone's broader effort to contain the deadly Ebola virus, the country opened a new ambulance dispatch center in September in the capital, Freetown. Along with a new Ebola hotline, the center is considered an important step forward in the war on Ebola.
But on the center's second day of operation, a series of errors put the life of an apparently healthy 14-year-old boy at risk.
The dispatch center is situated in a meeting room at the Cline Town hospital just north of downtown Freetown. Inside the room, a group of men and women are huddled around a table full of laptops. Safa Koruma, a technician, points at a message on a screen. It describes a possible Ebola patient, reported through the hotline, with the words "vomiting and very pale."
Koruma forwards this message — along with hundreds of others — to the nearest health official. A community health worker is then supposed to evaluate the patient and assess the likelihood of Ebola.
"Probable" Ebola cases end up on a large whiteboard on the other side of the meeting room. It's the master list for ambulance pickups.
Victoria Parkinson, of the Tony Blair African Governance Initiative, is one of the directors of the center. She points at a name on the board with the number five written next to it, indicating the number of cohabiting family members.

 

"We want to get that [person] quickly, because there's many people in the home that could be infected by," she says.
One of Parkinson's colleagues, Ama Deepkabos, writes down an address and hands it to an ambulance driver. "It's 7 Hannah Street, 555 Junction. Do you understand?" she says, imitating the local Krio accent. "Go directly to the patient. No other stops!"
The driver nods and hustles out to the dirt parking lot, along with a nurse. I attempt to speak with the driver and nurse, but neither speaks good English. They step into a white Toyota SUV with the word "Ambulance" in large red letters, and pull out of the parking lot.
Sierra Leone is in the midst of a three-day national lockdown, intended to slow the spread of Ebola, so the roads are clear. The ambulance speeds across town and is waved through multiple police checkpoints.
After two wrong turns and several stops for directions, it eventually bounces down a long dirt road in Waterloo, a rural suburb 15 miles southeast of Freetown.
The driver and nurse spot the person they believe to be the patient: a 14-year-old boy in a blue T-shirt slouched on a white lawn chair.
They get out and put on glimmering white protective suits, surgical masks and rubber gloves. They walk over and escort the boy, who is able to walk on his own, into the back of the ambulance without touching him. They kick the door closed behind him.
The boy's guardian, Suleiman Espangura, is the principal of a nearby high school. He recently took the boy, Ngaima, into his custody because his family was moving to a rural part of Sierra Leone, and Ngaima wanted to stay at his current high school near Freetown.
"He likes to play football," Espangura says of the boy. "And he's very clever. We [teachers] like children who are clever."
Espangura says he's unclear why Ngaima is being taken away in an Ebola ambulance. He says the boy doesn't have any signs of Ebola — no fever, no vomiting, no diarrhea. He just has a headache and a slight loss of appetite.
But because Espangura had heard multiple public service announcements encouraging people to report any signs of illness, he contacted a health official and was told a community health worker would come to evaluate Ngaima. Instead, an Ebola ambulance showed up.
Espangura says the ambulance driver and nurse asked him if Ngaima was "the patient." Espangura said yes, thinking the men were here to evaluate him. Instead, they ushered the boy into the ambulance and whisked him away.
The ambulance rushes across town to a military hospital with an Ebola isolation unit set up outside — a series of white plastic tents with a blue tarp stretched around the perimeter.
The hospital guards, in military fatigues, tell the ambulance driver and nurse that Ngaima is not on their list of expected patients. A heated argument ensues. The driver insists that he is merely following instructions, and that this is the correct patient.
One of the guards eventually calls the head of the hospital, who consents to admitting Ngaima. The driver and nurse spray the back of the ambulance with chlorine and open the door to let him out. Ngaima steps out of the vehicle and disappears behind the blue tarp fence, into the Ebola ward.
A few minutes later, another Ebola ambulance arrives. The military guards are expecting this patient. But they say the beds beds are now completely full — Ngaima has taken the last one. The new patient is admitted anyway.
It's not clear exactly what went wrong here. But now, a 14-year-old boy with a headache is sitting inside an Ebola isolation center.

It's really heartwarming that Sierra Leone's Ebola response is being administered with the same tenderness and regard for common sense and patient outcomes as our own Veteran's Administration, by people that put the Keystone Kops' sketches to shame. And don't worry, if little Ngaima didn't have Ebola when he arrived in the treatment center, he soon will. 

And As A Reminder

Here's the YouTubed home vid of a doc coming out of PPE isolation in W. Africa (in this case, for his last time). Note the process, and the fact that despite doing this one or more times a day while working there, the second safety monitor catches him a couple of times; also note the numerous times where he washes and re-washes and re-washes his gloved hands before touching the next item(s). The apron, goggles, and boots are re-used; everything else is toast after a single use, including both pairs of gloves, suit, and hood.

This is TIME's Person Of The Year, #30014. Now you have a taste for why.

Stupid Is As Stupid Does

Surprise! Surprise!
Shortly after re-opening their border with Guinea(?!), closed since mid-August, the nation of Guinea Bissau let someone through with a high fever. Someone of surpassing intellect amongst the assorted rent-seekers belatedly realized that was a bad thing, and they subsequently located and pulled the next potential Index patient (and 8 others in close contact) off of a bus preparing to head from their border straight to the regional teeming capitol. (Stop me if you're heard this one.) He was several miles away from the border when finally located.The nine individuals are all now in isolation pending test results on Mister Potential Ebola.

Kudos to whatever semi-literate suddenly had an attack of intelligence; he probably saved his country joining the Ebola tally in 2-21 days.

And whatever Customs and Immigration @$$hole (or whatever passes for it in Guinea Bissau) decided opening their border to an endemically-infected Ebola nation was a good idea should be the next recipient of the "Up Against The Wall!" African Retirement Ceremony usually reserved for deposed dictators.

(French-language link in the local press)

This is why Ebola isn't going away in the retarded part of the world anytime in the foreseeable future, sports fans. This was one IQ point away from becoming next week's newest outbreak, and 5-50 more cases. And remember, according to our government, we aren't safe here until they wipe it out over there.

When Hyperbole Isn't Enough

In past, I have rhetorically used the phrase "cancel Christmas" to describe things when/if the Ebola situation gets bad. Now, Sierra Leone has done exactly that:

(AU News) SIERRA LEONE is banning public Christmas celebrations as the spiralling caseload of Ebola infections continues to spread alarm. Soldiers are to be deployed throughout the festive period to force people venturing onto the streets back indoors, the government’s Ebola response unit announced on Friday.
Palo Conteh, head of the department, told reporters in the capital Freetown there would be “no Christmas and New Year celebrations this year”.

Number Crunching Reported Cases

Courtesy of Reddit and user c0mputar, here are the 4-day daily case totals of reported Ebola cases going back to late August:

Dec 4th-7th: 102/day

Nov 30th-3rd: 128/day

Nov 26th-29th: 129/day

Nov 22nd-25th: 129/day

Nov 18th-21st: 120/day

Nov 14th-17th: 122/day

Nov 10th-13th: 165/day

Nov 6th-9th: 185/day

Nov 2nd-5th: 115/day

Oct 29th-1st: 115/day

Oct 25th-28th: 146/day

Oct 21st-24th: 107/day

Oct 17th-20th: 168/day

Oct 13th-16th: 127/day

Oct 9th-12th: 130/day

Oct 5th-8th: 132/day

Oct 1st-4th: 124/day

Sept 27th-30th: 138/day

Sept 23rd-26th: 129/day

Sept 19th-22nd: 137/day

Sept 15th-18th: 130/day

Sept 11th-14th: 124/day

Sept 7th-10th: 127/day

Sept 3rd-6th: 105/day

Aug 30th-2nd: 104/day

Aug 26th-29th: 101/day

Aug 22nd-25th: 101/day

With all the caveats regarding "official" reported numbers vs. actual cases, and noting that this includes periods where nations added - and subtracted - thousand-plus numbers into short periods, what's notable is that since late August, this outbreak hasn't been below 100/new cases day. It's also never gotten as high as 200 cases/day.

IMHO, that points to this range being the maximum number of tests that can be run in one day, and/or the maximum number of people who come forward for testing, versus any approximation of the actual number of people infected in any place or period.

Which explains everything else about supposed flattening of the growth curve.
The fact that it isn't going anywhere, up or down, is proof that there are always (for the last nearly 4 months) at least 100 people so sick with Ebola that they'll finally drag themselves to an ETU - or collapse in the street - for isolation and testing. (It's more than that, but a notable number of them die before testing, which opts them out of the process with some finality, while simultaneously letting those nations elect to not count them in the death stats, since the cause of death is thus "unknown". How convenient. Shovel, shut up, and keep the news cheerful. QED)

So what this tells us is more like a tachometer than a speedometer of the infection: it tells us how fast the labs are cycling tests.
It doesn't tell us what gear the infection is in, if you will.

It might be fair to think things were winding down, except for recent note that burials are humming along everywhere, while stacks of unburied bodies are being discovered all over Sierra Leone, while in Guinea, the spread of the disease simply refuses to taper off. Liberia seems mainly to have mastered the use of pencil erasers to solve their statistical problems.

And Now, The Serious Lying Starts

(Reuters) - An American nurse who was exposed to Ebola while volunteering in an Ebola treatment unit in Sierra Leone will be admitted to the National Institutes of Health's Clinical Center in Maryland on Thursday, NIH announced.NIH did not release any further information on the nurse, including when he or she might have been exposed to the virus, current medical condition or affiliation.

It is thus apparent that we're not meant to know where she's arriving from, whether and how many people she may have already exposed here or anywhere else, or anything further about the case.

And she's being taken to the one facility (out of four) completely under the control and purview of the U.S. government, from top to bottom. Make of that what you will.

If you aren't continuing to get your personal quarantine ducks in a row, you aren't paying attention.

UPDATE: NBC local affiliate is reporting that the nurse has tested negative for Ebola. So whether she's actually infected is an open question, and/or will accidentally leak out the truism that a negative initial Ebola test doesn't mean you're not infected.
Disinformation Czar Klain will not be pleased.

Lid Blows Off WHO's Operation Happygas

Breaking:

WHO notices horses are gone, Sierra Leone rushes to lock barn:

(AP/ABC) Health workers sent to Sierra Leone to investigate an alarming spike in deaths from Ebola have uncovered a grim scene: piles of bodies, overwhelmed medical personnel and exhausted burial teams.

The World Health Organization says the health workers from several local and international agencies are racing to the latest Ebola hotspot, a diamond-mining area that Sierra Leone put on "lockdown" Wednesday.

"In 11 days, two teams buried 87 bodies, including a nurse, an ambulance driver, and a janitor who had been drafted into removing bodies piled up at the only area hospital," the WHO said in a statement Wednesday night.

"Our team met heroic doctors and nurses at their wits end, exhausted burial teams and lab techs, all doing the best they could, but they simply ran out of resources and were overrun with gravely ill people," said Dr. Olu Olushayo, an official in WHO's response Ebola team.

In the five days before its members arrived, 25 people had died in a makeshift, cordoned-off section of the hospital in Sierra Leone's eastern Kono district. The Ebola virus carries its heaviest load right after death, with bodies being a frightening source of contagion.

Sierra Leone authorities said they ordered a two-week "lockdown" there until Dec. 23, in hope of containing transmission of the virus, which was confirmed in seven people Tuesday.

People will be able to move within the district, but no one will be allowed to enter or leave, said Emmanuel Lebbie, a local official of the Independent Media Commission.

 Oopsie. Guess the celebrations were still a bit premature...

Lying With Statistics

US Airports Screened 2000 Travelers For Ebola, But Found No Cases  

Nearly 2,000 travelers from West Africa who arrived at five U.S. airports over a recent one-month period were screened for Ebola, but the screenings did not reveal any of these people to actually have the disease, according to a new report. The report from the Centers for Disease Control and Prevention is the first to look at how the heightened airport screening of all travelers arriving from Guinea, Sierra Leone and Liberia has proceeded since it began, in October.
One traveler included in the report was health care worker Dr. Craig Spencer, who developed symptoms of Ebola later, and was diagnosed with the disease six days after he arrived in the U.S. (Spencer has since recovered from the disease and has been released from the hospital.)
Under the heightened screening procedures, travelers from the three Ebola-affected countries have their temperatures checked, and are asked questions aimed at determining if they have Ebola symptoms or were exposed to the disease. Between Oct. 11 and Nov. 10, there were 1,993 travelers screened, according to the report. Of these, 86 people — all health care workers — were referred to the CDC for more evaluation.
Seven of these travelers required a medical evaluation because they had some symptoms, but these evaluations revealed that none had Ebola.
The most common final destinations for travelers arriving in the U.S. from Ebola-stricken countries were New York (19 percent), Maryland (12 percent), Pennsylvania (11 percent), Georgia (9 percent) and Virginia (7 percent), the report found.
The airport screenings allowed the public health departments to get contact information from travelers so they could be monitored, "and provided an added layer of protection for the U.S. public," the report said.
The U.S. began this screening after the first person to be diagnosed with Ebola in the United States, Thomas Eric Duncan, traveled from Liberia to Dallas in September, and developed symptoms of Ebola after arriving in the U.S. Duncan died of the disease on Oct. 8.
Airports in Guinea, Liberia and Sierra Leone have been screening departing passengers with temperature checks since August. Between August and October, about 80,000 people traveled by plane out of those countries, including 12,000 on their way to the United States, the report said.
None of these passengers on international flights developed symptoms of Ebola while they were traveling, the report said.

The factual way to look at that is that screening confirmed that 1992 travelers who didn't have Ebola were screened, but that screening procedures failed in 100% of the infected cases to actually point them out or prevent them from arriving here, which is the whole point of doing a screening.

(Other than that, Mrs. Lincoln, how was the play?)

And that only pure happenstance and luck prevented that one infected lying jackass from infecting any one of hundreds of people while he was gallivanting around Manhattan and Brooklyn symptomatic for three days and in full denial about his condition, and only secondary investigation of his credit cards and subway pass led authorities to conclude he was absolutely lying about his wanderings while infectious.

IOW, airport security theatre screenings are as effective as putting signs up in Central Park forbidding elephants to nest in the trees. Or posting a sign in Vegas telling people they aren't allowed to win at blackjack.

The only thing the study documents accurately is that we've had nearly 12000 tosses of the dice since August, and only hit snake eyes two times (which were both epic fusterclucks).

Thanks for nothing, CDC geniuses.

Sierra Leone: Caught You, You Lying Mofos!

 

(click to embiggen)

FREETOWN (UK Guardian) - They send in surveillance officers to investigate homes where there have been deaths. They don’t get too close. “They do a clinical assessment from afar,” says Parkinson. It’s all run with military precision by the Sierra Leonean army. Grim scorecards on whiteboards are positioned around the room – the cases, the treatment beds available and the bodies.

Burials of Ebola victims recorded week-by-week. Photograph: Sarah Boseley

“For the last five weeks we have buried every body reported to us the same day,” says Parkinson. “But yesterday we left 43 bodies because the burial teams had not been paid.”

 

It keeps happening. Sometimes it’s the burial teams, sometimes the nurses and sometimes the ambulance workers. All are supposed to get extra danger money. Nobody seems to know whether the government can’t pay, won’t pay or is just bureaucratically bogged down. Whichever, it causes deadly delays. Two weeks ago, burial teams dumped highly infectious bodies – local people claimed as many as 15 – in the street outside a hospital gate in Kenema in the east of the country to make their point.

Nota bene that from Oct 24 - present, Sierra Leone has reported less than 600 Ebola victim deaths to WHO, as reflected in their stats column on the bottom of this Wikipedia page .
But as this snapshot from Sarah Boseley, author of the diary linked here recorded, Sierra Leone's Ebola crisis center recorded over 2600 burials by their own burial team members during this exact same time frame.
And, the story goes on to note, people are reportedly wandering off into the jungle to die, which persons aren't reflected in the burial numbers anywhere.

"People are afraid to report their numbers to the government. They are afraid to call the helpline. They are afraid they will be taken away to treatment centres and never see their families again. There are reports of people disappearing into the forest because they’d rather die with their family than be taken into a treatment site.”“It is a puzzle. We don’t know what it is. It is not a low death rate. It is probably the labs aren’t able to get swabs for all the dead bodies,” he says. That means they can’t be sure Ebola was the cause of death.
And there are many hidden deaths. “We have evidence that less than two-thirds of burials are being reported,” he said.

So they don't test the dead bodies, they simply cart them away post haste and shovel them under, same day.

Liberia is "solving" their crisis with a pencil eraser.
Sierra Leone is "solving" theirs with shovels.

Neither approach will do anything about Ebola, except insure it continues to spread in wider and wider circles.

So those 600-odd deaths? We have photographic evidence that the number of reported burials are 5-6X that many, and half as many again aren't being reported at all.

If we change Sierra Leone's death report numbers in accordance with that knowledge, we get an additional 4000 dead people, which brings their numbers much closer to reality as observed elsewhere. Then factor in the number of people who just wander out and die in the jungle (which ensures that the virus reservoir in the wild will be well-stocked for decades once various critters tear into the corpses).

And the lying m******f*****s sitting in those centers, their Western accomplices, and the morons in the media stand right in front of the tally boards they know to be lies, and just stare at them like deer in headlights, and can't seem to figure out what's going on.

Yeah, it's a real poser, you jackholes.

UN's Newest Fabulism

GENEVA ( Reuters) - Ebola is still spreading quickly in western Sierra Leone and deep in Guinea’s forested region, a senior UN official said on Tuesday.
“We know the outbreak is still flaming strongly in western Sierra Leone and some parts of the interior of Guinea. We can't rest, we still have to push on,” Nabarro told a news briefing in Geneva.
More foreign health workers are needed to combat the epidemic, especially in Sierra Leone where treatment centres are still opening and need expert staff, said David Nabarro, the UN Secretary General’s special envoy for Ebola.

So to recap from last Monday:
: the WHO hit all their targets for containing the outbreak
: except they didn't, because the numbers are ca-ca
: so the war is over, but they need more soldiers.

Got that?
And the minute our troops leave Liberia, they lose rapid lab turnaround, and even the official infection rate there skyrockets, and they still haven't figured out, in either Sierra Leone or Liberia, how to lure people into the ETUs now that everyone knows they're simply death houses (except for the 11% who survive despite zero medical intervention, just as they would at home). The only thing the ETUs stop is further spread by the infected, and the governments there are so mistrusted, the people would rather take their chances with Ebola than with what passes for government help there.

Word.