More than 4 in 10 are worried that they or their immediate family may catch Ebola, in today's new ABC/WaPo poll. http://t.co/Uc5P3HM6kZ
— Richard Besser (@DrRichardBesser) October 14, 2014
Good news, Nina Pham, the Dallas nurse who contracted Ebola caring for a fatally ill patient, is doing well so far (as is her little dog Bentley).
Here’s an NYTimes graphic explainer on “How hospital workers are supposed to treat Ebola safely,” demonstrating all the ways things might have gone wrong. And USAToday had a good story explaining why Ebola may pose a greater risk to ICU workers:
… Nurses and others caring for Ebola patients at the end of their lives are at high risk of infection, because the virus replicates wildly as the disease becomes more advanced, says Peter Hotez, dean of the National School of Tropical Medicine in Houston and a professor at the Baylor College of Medicine…
Unlike other dangerous viruses, such as SARS (Severe Acute Respiratory Syndrome), Ebola shuts down the body’s production of a virus-fighting substance called interferon, “the body’s first defense against viruses,” Hotez says. The substance jumps into action to fight viruses even before antibodies begin to shut them down.
Ebola begins to block interferon production within four to five days after infection. Without those chemical policemen to stop it, Ebola “has the ability to just replicate and replicate and replicate,” Hotez says. “So by the time you are in the end stages of your illness, your liver and your spleen and your kidneys are just teeming with billions of viral particles.”
Because the virus attacks the liver, it interferes with the liver’s ability to make clotting factors that help stop bleeding, Hotez sais. Patients infected with Ebola can bleed profusely, both internally and externally, and vomit blood.
So Ebola patients treated in intensive care units, such as Duncan, are far more infectious than those at earlier stages of illness. “When you are working with Ebola in an ICU, there can be no margin of error,” he says…
For that reason, Hotez says, it’s not yet possible for doctors to know how Pham was infected — whether she or a co-worker committed a “breach of protocol,” as the Centers for Disease Control and Prevention initially suggested — or whether something about the nature of providing intensive care allowed her to contract the virus…
***********
My home state had its first two serious “Ebola scares” over the holiday weekend, and handled them both with the native Masshole mixture of ‘efficient’ kludging and social suspicion, per the Boston Globe. First case, a guy who’d been to Liberia showed up at a walk-in clinic:
… The man, whom officials have not identified, was taken by ambulance to Beth Israel from Braintree’s Harvard Vanguard office, where his symptoms and travel history had prompted clinic staffers to muster a hazardous materials team, alarming patients as unofficial word of an Ebola case spread. People were prevented from entering and leaving the facility for several hours…
Outside the Harvard Vanguard offices Sunday afternoon, police cruisers, fire trucks, and ambulances lined Grossman Drive, and the parking lot was cordoned off by yellow police tape. “Ebola protocol is in place,” said Joe Zanca of the Braintree Fire Department. “We don’t know if he actually has Ebola.”…
Brewster Ambulance Service said in a statement that it received a call from the Harvard Vanguard facility about 1:20 p.m. Sunday and dispatched a response team of two ambulances.
The team arrived to find the man waiting in his vehicle, as he had been instructed to do, and put him into an ambulance with its interior sealed with impermeable plastic sheeting, according to the statement. That ambulance will be decontaminated before it is returned to service, the statement said.
At about 5 p.m. a tow truck removed the man’s black Toyota 4Runner SUV, with orange biohazard warning stickers on each of its windows, from the Harvard Vanguard parking lot.
(He’s still in isolation, but according to Beth Israel “the likelihood of Ebola virus disease is extremely low”.) Then, yesterday, at the local airport:
Five passengers experiencing flu-like symptoms aboard an Emirates flight originating in Dubai were escorted off the plane Monday afternoon by a team in full hazmat suits at Logan International Airport, and other passengers were kept on board for nearly three hours while official assessed the situation…
Maimoona Shaikh was waiting with her husband for their family members, who traveled to Mecca for the Hajj and were coming back on the Emirates flight via Dubai.
Although Shaikh’s family members were among the last ones to come off the plane, she said she was not worried about their health and that “it’s common to come back [from the Hajj] and have a little cold… “
I actually find it reassuring that we, the low-info American public, is getting exposed to a steady trickle of “oops, false alarm, sorry about the delay” incidents that only the most self-involved idiots can gin up into anything approaching Defcon 4. Despite the best efforts of alarmists and traitors…
missed this one somehow pic.twitter.com/HWP3J2hA9I
— Simon Maloy (@SimonMaloy) October 14, 2014
Warren Terra
I just want to point out: that guy who’d been to Liberia, and triggered this massive co-ordinated response: that’s a good thing, and I want to stress all the social resources and social trust involved. The guy knew he could go to a hospital, and be taken seriously, and would get help – despite these hysterical wingnuts who’d have preferred he be napalmed in the parking lot to take no chances. The emergency services could muster the resources and the cooperation to handle this fellow with an abundance of caution, while seeing to his needs.
Was there some over-reaction? Is this a situation liable to abuse by hypochondriacs and hysterics? Yeah, maybe. If this goes on for a time (and there’s no sign the outbreak in West Africa is going away), the cost in money and in medical resources could add up as this story gets replayed. But, for now, I’m very pleased that someone with plausible concerns (symptoms, recent travel to possibly infected locales) can feel safe getting help, and that the help will be available.
And it’s probably a good thing for him (and maybe for us) that he’s in Boston. If he’d been in, say, Mississippi, I don’t know if he’d have trusted the hospitals (for one thing, there’s a vastly greater chance he’d be uninsured – a phenomenon that likely contributed to the Dallas patient getting sent home), and I don’t know if he should have trusted them, whether he might have gotten a far less helpful response.
Tommy
I am not an expert on medical care nor Ebola, but from everything I know Boston has some good hospitals. Like my home town. St Louis is this or that, but get sick, we have good hospitals. It is a good town to get really sick in.
Tommy
I am a gamer. I play a lot of video games. That will not change. What I often find stunning is that about 47% of the people that play games are women. Ladies play games. I’ve been following a Twitter feed of a women at a gaming conference. OMG. The most over the top sexist shit I’ve ever seen. Fuck! Stuff should not be this way.
Botsplainer
My wife is going to Africa at the beginning of November. She has rerouted her flights to Johannesburg; instead of legging London-Dakar-Joburg, she is instead taking a flight from DFW to an overnight in Doha, and then on to Joburg. Same arrangements back. We theorized that it is less likely that potentially infected travelers would be traveling to the Middle East or Asia, and the connections through Dakar were a no-go, as so much as her typically caught November Southern Hemisphere sniffle could land her in quarantine (it ALWAYS happens, sometimes with fever).
It isn’t foolproof, but it’s better. She’s also bringing a shitload of wipes, and will be wiping down her plane seats, arm rests, seat belts, tray tables and tv buttons, and will be gloving to go to the plane head.
Calouste
If the NRA epidemic got the same amount of coverage per American victim as the Ebola epidemic, Comcast wouldn’t have enough channels to broadcast it.
LesGS
@Botsplainer: See now, that is a logical response to a real life situation.
And here in San Diego, 17 miles north of where deliberately infected ebola terrorists are presumably poised to swarm over the border, in the SoCal vernacular, we’re all, like, whatever, dude.
Where do these spazola 4 out of 10 live?
Baud
Just got an alert that a second health care worker has ebola.
Sister Rail Gun of Warm Humanitarianism
@LesGS: Florida. I’m sure a lot of them are around FayetteNam, too.
raven
Another case at the Dallas hospital just announced.
OzarkHillbilly
@LesGS: Next door to me.
OzarkHillbilly
@raven: Rick Perry needs to resign for the cause of gross incompetence.
karen
Some of the reactions and quickly infected remind me of AIDS and how in the beginning, people were unwilling to help, including hospitals. One of the differences imho is that in the beginning, it was perceived that men got AIDS as a result of homosexual contact. If Ebola was spread like that would we be focussing on it that much? I’d like to think that we’e much better today and that the answer would be yes. But I can’t bet on it.
BillinGlendaleCA
@raven: Makes me think it’s a procedural problem. In other news, Joe Scar is in panic mode. He doesn’t seem to trust doctors. “Hey Joe, when did you get your MD?”
BillinGlendaleCA
@OzarkHillbilly: Gov. Goodhair sure has been quiet, hasn’t he?
AnonPhenom
Like AIDS before it, a disease like Ebola has a way of exposing the weak links in protocols and procedures of our healthcare institutions and personel training. Everybody remember when syrings and other sharps were simply thrown out with the regular garbage? When blood soaked linens were washed and reused? Things like MRSA are way to prevalent even today, why are we suprised?
Break open a history book and read how Semmelweis managed to insult all the ‘gentlemen’ of the medical profession by suggesting that they wash their hands before trying to deliver a baby.
Change ain’t easy.
raven
@BillinGlendaleCA:
He’s so full of shit.
Betty Cracker
The CDC chief says the organization should have been more proactive about the Dallas case:
Ya think? I had naively assumed the CDC had at least emailed a set of protocols to every hospital. Maybe they did. But if so, it looks like the hospital dropped the ball; the nurses at the Dallas hospital say there were no formal protocols in place.
OzarkHillbilly
@raven: I beg your pardon. No way am I full of sh!t. My eyes are blue, so I am at least a quart low.
Botsplainer
@LesGS:
Ocala. Dothan. Dalton. Plano. Sweetwater. Fayetteville. Fresno. Redding. Bakersfield. Spokane. Ogden. Sun City. Beaufort. Orangeburg. Ft Wayne. Florence. Edmond. Grand Junction.
You know, all the sorts of cities that worry most about them goldurn terrorists coming here and blowing up the VFW post in the name of Lenin and Allah.
bemused
@BillinGlendaleCA:
Joe is also promoting the emerging “Mitt’s the man” media promos. Go for it Joe. I’m just starting to see videos of Mitt’s worst campaign moments and there will be more to remind everyone of how awful he is.
debbie
I was just over at snopes.com trying to find out if there was any truth to the rumor that the Texas hospital sent Thomas Duncan home because he didn’t have insurance, and it turns out there’s all kinds of nonsense over there, like Ebola harboring in hair extensions:
http://search.atomz.com/search/?sp-q=ebola&x=0&y=0&sp-a=00062d45-sp00000000&sp-advanced=1&sp-p=all&sp-w-control=1&sp-w=alike&sp-date-range=-1&sp-x=any&sp-c=100&sp-m=1&sp-s=0
Of course, Obama, FEMA, and disposable coffins would pop up too.
BillinGlendaleCA
@OzarkHillbilly: I’m sure that raven was referring to our dear friend Joe.
raven
@BillinGlendaleCA: :)
OzarkHillbilly
@BillinGlendaleCA: @raven:
I’m sure I realized that. I was just twisting an inartful word into a joke on me.
BillinGlendaleCA
@OzarkHillbilly: As was I, with the phrase “dear friend”. :)
Botsplainer
@Betty Cracker:
You’d think that somebody would have watched one of those plague movies in the last 30 years or so. Or maybe read one of the dozens of works of fiction on the topic.
Botsplainer
@bemused:
Please oh please please please will they nominate that stammering entitled fuckhead again.
JPL
@Botsplainer: CBS just covered that.
If there are cases outside of Dallas, I imagine the other hospitals will follow protocol.
Baud
@Botsplainer:
Maybe they were watching all the meteor movies and figured “what’s the point.”
bemused
@Botsplainer:
It would be amusing. The guy just has no control over sticking his foot in his mouth and then there is barracuda Ann.
Botsplainer
@JPL:
The genuine protocol should also get away from the touchie-feelie “wellness center” schtick that the marketing assholes told them would work for the American public (primarily older white women). No more goddamn fabric curtains, extraneous wall decor, upholstered waiting chairs, carpeted waiting areas in surgical facilities, ERs or treatment facilities. Keep those for convalescent facilities; they’re throwing your middle-aged ass out in a day or two on your primary care anyway, and you don’t need attractive space that badly.
The revolving door between the CDC and Big Hospital on infection control is a well-known joke; your future after CDC is beyond secure if you don’t really make them make changes that would alter market share.
raven
Oh boy, Brokaw and Kissinger
bemused
I have no idea what the topic is but just hearing Brokaw use the words “gathering of wise people” makes me laugh and laugh.
Iowa Old Lady
I have to admit, if I were a health care worker, this second case would freak me out.
Botsplainer
@raven:
Why in god’s name do you inflict that on yourself? Is it some sort of “sitting cardio” routine to jack up your heartrate while not stressing the cartilage in your joints?
I can’t do it – I’d ram my fist through the TV.
GHayduke (formerly lojasmo)
@Iowa Old Lady:
I am a health care worker, and I work at one of the best hospitals in the states (If US world report, is to be believed). I can tell you that if an ebola patient came through our lab, 1/3 of my colleagues would not be alive in six months.
And yet I am not worried.
raven
@Botsplainer: Just keepin the peoples up-to-date!
eta James Baker was with them on a trip to Germany for Baker to get the Kissinger Award.
Baud
I have to admit, the anger translator in me would love to see Obama get on the TV and say, “we’ve successfully contained Ebola o wingnut states that have rejected Medicaid expansion.”
Won’t happen tho.
someguy
Yeah, no reason to worry. This is blown all out of proportion. It’s not like it’s going to get out of control or spread much beyond isolated pockets. And for people who are worried due to the Texas cases, well, Texas. This is what you get in a state when you elect health care slashing Republicans for 25 years.
debbie
@Botsplainer:
Ha! I usually listen to the beginning of Glenn Beck’s show. I may not last long or I may get pretty angry, but I believe in that old expression, “Know thy enemy.”
Botsplainer
@GHayduke (formerly lojasmo):
Let me guess – spill, half assed wipe with paper towel followed by eye rubbing or nose picking? Or absentmindedly putting their snack yogurt in the sample fridge?
Botsplainer
Maybe some tax cuts and regulation slashing will fix it.
Firestone!!!1!1!!Eleventy!!1!1!!!
Seriously, I wonder what the MRSA rate is at that Dallas hospital?
Belafon
@Betty Cracker: You know the answer to that, Betty: Preparing for Ebola that might never come will cut into profit motive.
I do not blame the nurses, nor the CDC, and really, only slightly the hospital (I live in a Dallas suburb). Probably the only thing I do blame is the belief that Dallas wouldn’t be the first place to get it. The thing is, Dallas is the first place to get it here, and the first hospital was going to mess it up. As long as people are learning from their mistakes, and Rick Perry resigns, we’re still not going to have the kinds of problems that African countries are.
Elizabelle
@GHayduke (formerly lojasmo):
Your comment intrigues me. Please continue. Why would you not miss 1/3 of the lab workers?
scav
@Botsplainer: Beyond the movies, how many times have we sat around watching the latest flu scare from Asia and elsewhere? Bird, H1N1, I forget them all. But the best health care system in the world free-market free-market free-market magic!!! is full of plastic surgeons, comfy chairs, day spas, profit-centers, whatever. So indeed, let’s watch this drama of stress-testing actual basic competence work out.
For some reason, the deaths now being racked up against GM sprang to mind yesterday. Now up to twice the number they estimated, and they’re still not even providing details on how far through the list they’ve progressed. Building cars that stay functioning would seem to be an expected core competence too. easier to hide those breaches and failures evidently.
Botsplainer
Oh, this is rich. The chief clinician for the system that owns the hospital is, uh known to me. He’s a complete fucking douchebag and tort reformer to the nth degree (because that is all that is wrong in health care), spent a lot of time here as a loud advocate for insulating docs and hospitals from the consequences of their fuckups. He’s a second generation MD, entitled brat variety. Born on 2nd, thinks he hit a double.
http://www.texashealth.org/mobile.cfm?id=4769&action=detail&ref=1483
Hope he’s having long, sweaty, sleepless nights.
Betty Cracker
@Belafon: That strategy will prove penny wise and pound foolish after the infected people sue that health system into penury. But seriously, this could be a teachable moment about the benefits of a robust federal response capability. There’s little chance it will serve that purpose, which is a pity.
Botsplainer
@scav:
Had an interesting conversation in a fishing town in Mexico with a part-time expat from San Francisco. She spends enough time there to get the Mexican green card, which entitles her to participate in their national health system. She said that the service (including pharms) was top rate, but no frills – no AC or pillows (if you want one, you bring it), and no fabric beyond sheets. Lots of open windows and sunlight.
They could weather this better. Bet they have a low MRSA rate, too.
MomSense
@raven:
How are people going to understand what the heck they are saying?? Kissinger sounds like he is trying to talk with a mouthful of toothpaste and Brokaw slurs like he just guzzled a fifth of vodka.
Belafon
@Betty Cracker: The conundrum is that, in America, it would take a crisis none of us would actually want in order to affect that kind of change. It’s sort of like the collapse in 2008: The only way we would have gotten the kind of structural changes we needed after that is if it had happened a couple of years earlier, so that Bush would have had time to really screw it up.
ETA: And that’s the contradiction that is America: We’re panicked right now, but not in any constructive way.
Elizabelle
@Calouste:
This.
C.V. Danes
@Betty Cracker:
That may be true, but end-stage Ebola is also so contagious that health care workers need to be highly trained in how to use the protocols.
Back in my nuclear navy days we trained extensively in how to don and remove anti-contamination clothing to prevent the spread of radioactive contamination. This is not something you can just pick from reading a book.
C.V. Danes
@Botsplainer:
Also, you know, the places with the worst health care systems in place.
jonas
@Betty Cracker: Shorter head of the CDC: “We kinda assumed that a big hospital like Dallas Presbyterian would have its shit together, but apparently we were mistaken. Our bad.”
Belafon
@C.V. Danes: I was a nuke electrician, and we didn’t have to help the mechanics take water samples every day, but we were occasionally required to so that we could keep in practice in case they really needed us. I hated donning all that gear, and it was minimal compared to what they need for this.
mtiffany
This suspected “breach of protocol” must obviously not include defective protective equipment, because not one of the spewing mouths on the teevee has bothered to mention that (un)possibility; as we all know corporations and their products are perfect in every way.
scav
@Belafon: Rem, no one seemed to expect the well-honed technique of terrorism to show up here either — despite it being used in how many other developed nations prior and how many smaller exemplars had even we experienced? Reality, in its less bountiful form, deigns to visit even these blessed shores once in a while. Shocking. And now they’ve misplaced the welcome matt, let alone the guest towels. back to the unconstructive panic again.
d58826
It is with morbid ‘humor’ that I watch the events as they unfold in Texas. This is the heartland of profits before people. A state that prides itself on little regulation and what does exist is sold to the highest bidder for them to make a private profit. It is the poster child for cut government spending and every man for himself and the devil take the hindmost.
It represents the GOP plan to reduce government to the fit in a bath tub and then drown it. The agencies charged with confronmting this type of outbreak have seen their budgets cut by 50% over the past decade. Almost 50k government puiblic heath workers have lost their jobs as a result of budget cuts. The GOP game plan in action.
The final ‘laugh’ comes from the GOP’s call for an Ebola czar to be named when they will not confirm Obama’s chice for Surgeon General.
And after all this the GOP will probably pick up seats in the House and the lastest NYT estimate is they have a 68% chance of gaining control of the Senate. Since this is still a democracy (sort of) its the peoples choice. And if they chose ignorance, stupidity and indiffernce to the needs of their neighbors, then that is what the will get. Juist to bad everyone else has to go along for the ride
C.V. Danes
@Belafon:
Yup. But you still had to do it to keep in practice, even if you never had to go into the RC.
Botsplainer
@mtiffany:
Saw one interesting thread somewhere – somebody had gotten a Chinese manufactured box of gloves where they worked and each was riddled with holes. When they put the defective ones on over a pink set, they saw lots of pink, usually in the same place.
C.V. Danes
@d58826:
There does seem to be some karmic retribution going on here but, as you said, they will still come out on top because freedum.
skerry
Remember, this is Texas. The nurses’ aide in El Paso with known positive TB test was allowed to expose over 500 infants and her co-workers because there was no regulation against it. I am not surprised they had no protocol for ebola, or if they had one, were compelled to follow it.
debbie
@d58826:
Was there ever any truth to the report that the hospital sent Duncan home because he didn’t have insurance, or was it because they didn’t recognize the symptoms?
Belafon
@skerry: According to the news reports here, the “training” was an optional webinar.
Belafon
@debbie: They didn’t really put 2 and 2 together. He came in with flu-like symptoms, and told a nurse that he was from Liberia. And the nurse noted it. But it was never raised as a flag. So he was sent home. You rarely keep people in the hospital for the flu.
Southern Beale
Apparently the people panicking about ebola are the people who absolutely should NOT be in a panic, while the ones who should be taking action are sorta like no biggie. You had one job, Texas.
Botsplainer
@d58826:
Yet the sodbusters will continue voting for it because someday they might become rich enough to fuck over everybody for sport, too, all despite the fact that mountains of data show declining economic and class mobility in places like that.
beth
@debbie: I don’t think we’ll ever know the truth about that. It struck me as strange because just a few months ago, my kid had what I thought was a bad cold. When I took her temp that night, it was 103 and I made her go to the hospital because even as a non-medical person, I knew that was bad. The doctor there did all sorts of tests because he knew something was wrong to cause that high a fever. It turned out she had double pneumonia. They weren’t going to let her leave until they knew what was up. Of course, I have great insurance.
d58826
@debbie: There has been some speculation that he didnot get first line treatment because he did not have insurance. Given how events have played out I suspect it was they didn’t recognize ther symptoms.
There were also questions asked about why he didn’t get a transfusion like others have or why he didn’t get the experimental medicine. In the case of the former it was incompitable blood.serum type and the later there were no doses available.
Now for the conspiracy minded these may all be CYA b/s but they do seem reasonable explainations.
Botsplainer
@Belafon:
Most hospitals do a shit job on initial reports with fever and aches.
It’s all cookie cutter, and gets people killed.
debbie
@Belafon:
Thanks. I went to snopes.com for an answer, but it was filled with rumors like Ebola hiding in hair extensions and Obama secretly ordering 1 billion disposable coffins. Sigh.
raven
And in Georgia this fucking genius governor says:
Svensker
@GHayduke (formerly lojasmo):
Why would they be dead?
Frankensteinbeck
@Botsplainer:
I think they mainly enjoy the spiteful thrill of people being fucked over, no matter who’s doing it. These are the people who cheered about veteran deaths during the 2012 debates. With a black man as president, they are even more filled with an anger they can’t put a name on, and dish it out everywhere – but it was already there in smaller form. The GOP has been the party of asshole policies at least since Reagan.
chopper
so, without knowing precisely what the danger is, would you say it’s time for our viewers to crack each other’s heads open and feast on the goo inside?
d58826
@raven: I guess ‘stupid’ is a mathamaticly infinite number:-)
chopper
@raven:
oh for fuck’s sake.
beth
@chopper: So just give the victims a shower?
Botsplainer
@chopper:
Slow down, bubba – there’ll be enough time for that later.
Wonder if my zombie self will know how to find the neighborhoods of the fat wealthy?
Keith G
If you haven’t been listening to Mike Pesca’s podcast The Gist, you really should treat yourself to that program. it is available each weekday between 500 and 600 Eastern Time. he was on fire last night with episodes on Obama’s popularity versus gas prices and the FBI vs the tech industry.
Belafon
@d58826: Probably equal to the size of the power set of the set of all power sets. (I’m trying to teach myself some abstract algebra and set theory, and the infinite set stuff is kicking my butt.)
boatboy_srq
@LesGS: If it’s any indicator, the best response to this I have seen was a FB posting.
Not exactly scientific, but it would explain the 4 in 10 number pretty well.
scav
This poor Frieden and the CDC, apparently he really was so naive as to expect ‘mercan hospitals to at least be as competent as Nigerian or Senagalese ones, who seem to have managed to halt their national outbreaks so far (in about a week, here’s hoping). Score a few more for those “uneducated people in developing countries” and their reactions.
bemused
@raven:
OMG
Face
I predicted this over-the-top response weeks ago. And as Official Flu Season kicks in, expect schools to be sending home students and teachers IN DROVES. Gunna be the most effed up winter ever, as this hysteria turns the corner and guns its engine.
Corner Stone
The hospital where my ex now works got an alert in August. The whole hospital was notified about what the issue was, what to look for, what to ask, and how to respond. They had meetings with this on the agenda.
There is simply no way Texas Presby should have missed this.
Corner Stone
@Betty Cracker:
And also something about the competing interests of profit vs care.
Having keystone institutions at the mercy of greedy CEOs seeking short term profits for the benefit of shareholders and their own pocketbook makes no sense. It never has, and it’s too bad that even something as easy to fearmonger as ebola will not wake people up to this.
Botsplainer
@Corner Stone:
When the Chief Clinical Officer is overly focused on markets and profit, they couldn’t NOT miss it.
The guy is a fucking toad with a black hole in his soul.
Gin & Tonic
@Belafon: Loved set theory, but realized it was hard to make a living at it. Large cardinals are large, though.
Corner Stone
@debbie:
I don’t have any proof, but just IMO, they sent away an uninsured individual. How could they see he had a fever, and was presenting with a viral infection and give him antibiotics?
Gin & Tonic
@Botsplainer: This is true. I presented last year with a complicated and unusual infectious disease which also looks flu-like at its outset, and even though I have great insurance, know what I’m talking about, and clearly described something that should have been a red flag, I was sent home. Took another two visits for a correct diagnosis. If you’re out at the small end of a normal distribution, good luck.
Corner Stone
@Tommy:
Indeed they do. Indeed.
Botsplainer
@Corner Stone:
The system’s chief clinical officer makes a statement on taking the job in 2012:
Corporate gobbledygook, and too big a brief.
Belafon
@Gin & Tonic: I’m ultimately heading toward category theory, which 1) looks interesting, and 2) looks like an interesting way to think of software. But the road there is tough, especially on my own.
kc
@Betty Cracker:
Best healthcare system in the world!
Botsplainer
@Corner Stone:
Happens all the time.
Ruckus
@debbie:
Aren’t all coffins “disposable”? Otherwise what’s the point?
Snarki, child of Loki
@Baud:
.”..soon, the wave of Zombie Ebola Suicide Bombers will arrive, and we will seal the border. At the Mason-Dixon line. Good luck, you’re gonna need it, suckas”
Belafon
@Corner Stone: I’m sure you know, being a Texas resident yourself, but the DFW area has a lot of money, so much that we eat out way too often. Not too long after I moved here, I started hearing about doctors giving antibiotics to kids for the flu, because it kept the parents from throwing a fit, you know, “Do something, Doctor.” It floored me. Why spend the money on something that doesn’t work, and that’s not even taking into account the issues of antibiotic abuse. I made it a point of explicitly telling the doctor not to give my kids anything that wouldn’t help them.
Corner Stone
@someguy:
I’ll agree to some extent. But the truth is that no matter where this happened there were inevitably going to be some breakdowns.
So far we’re seeing two individuals with direct exposure, most likely due to protocol breakdowns. That there are no tertiary cases as yet should be a pretty good sign, IMO.
I’m still wondering how Duncan’s close family and fiancee are not positive. When he returned home from the hospital he had to be quite sick before the ambulance ride.
kc
@Botsplainer:
What a load of crap.
Botsplainer
Danny, Danny, Danny – the company Christmas party is going to be…awkward. It was supposed to be all big paycheck, stock options, a few meetings, the occasional PowerPoint while things more or less ran themselves in free market bliss.
Corporate officering can be hard when things are fucked up.
http://thescoopblog.dallasnews.com/2014/10/second-health-care-worker-tests-positive-for-ebola-in-dallas.html/
Punchy
You noobs weren’t really expecting such an efficient and successful profit center such as a hospital to actually know how to ID, report, and treat sick people, were you? How the fuck does successfully ID’ing Ebolites and their ilk actually enhance the flow of sawbucks? If you cant CT and PET scan these losers, there’s no fiscal reason to keep them around, trying to drain their insurance’s pockets with $50 bandaids and $200 ice packs.
Corner Stone
@Botsplainer:
It’s not all gobbledygook. The part quoted here is clearly stating that a bean counter will be riding herd on all care providers to make sure they don’t spend too much of the margin taking care of patients and sick people.
The consistent connection is going to be a taser applied anytime you even think about spending a penny more of my…er, the hospital’s money.
raven
@Ruckus: Not it you have a condo made of stonea!
scav
@Ruckus: I think I’ve heard of a reusable coffin once, which are likely to be the scarier ones. Emergency / Rescue archaeology site in Bordeaux: I was digging in one of the interior lined pits, which they said was for pauper / poorer-sort burials (well-off enough to have the nuns handle the event at least). Get a brief service, little coffin face time all the while, shoved into a hole in the wall and then once mourners left, the coffin bottom was pulled out, you’d tumble to the bottom and the coffin went off for the next Elvis burial service. Small babies were to be found outside the covent walls (SOP unbaptized) and no one could come up with a reason for the beef shanks in the nave.
Corner Stone
@scav:
Why were there beef shanks in the nave?
Botsplainer
@Corner Stone:
Years ago (over 15 of them) I was involved with a weird case. Part of the discovery involved getting the HMO network contracts with docs. There were definite penalties in the contracts for hospital admissions.
It was fucking sick.
scav
@Corner Stone: Hungry Hungry Nuns?
Corner Stone
Can someone tell me why really rich people are donating millions to the CDC?
khead
I remember the good ol’ days when any action taken by a public health department to monitor the population was part of a liberal conspiracy to control all our lives.
And by “good ol’ days” I mean 2 weeks ago.
Booger
@Botsplainer: Wow. You just ruined my day, fer sher. That’s a lot to consider.
Booger
@Ruckus: zing!
Cermet
@C.V. Danes: But these are hospitals that are RUN by DOCTORS which is often (by them) mis-spelled as all-knowing and faultless ones. They can do no wrong when performing any task even for the first time. Hence, your training requirements by experienced people are neither necessary nor cost effective. Thank Gof (sic to protect the highly nutcase … I mean religious) for lawyers and our only real recourse for correction – the law suit.
PsiFighter37
At work – saw across the wire that 6 people at Barcelona airport have tested positive for Ebola.
I’m not a freak-out kind of person…but if true…uh oh.
d58826
@Belafon: When I was a little one our family GP still made house calls. He always reminded me of Doc. Admas from ther TV show Gunsmoke. He always had a supply of little pink pills to give to me and my sister – sugar pills no doubt – but it made us feel MUCH better.
Mike in NC
Good news is that dead Andy Breitbart has nothing to worry about regarding Ebola.
Sister Rail Gun of Warm Humanitarianism
Another data point for “cost containment” playing a role in Dallas:
Sister Rail Gun of Warm Humanitarianism
Uh-oh. Lots of protocol breakdowns at Texas Health Presbyterian Hospital reported.
JR in WV
@Elizabelle:
That’s not what she said, Elizabelle, she said she wouldn’t be surprised, and isn’t scared.
Completely diff from what you asked.
Cermet
@Belafon: Never did get that one – the others seem more understandable but that one, still leaves my head spinning!
Comrade Mary
@PsiFighter37: Not true, thankfully.
catclub
@LesGS:
I really want to bet them they will not get ebola! I would also take the under on their bets of how many cases we will see in the US over the next 6 months.
catclub
@PsiFighter37: You mean this?
http://www.benzinga.com/news/14/10/4924492/barcelona-airport-spokesperson-confirms-no-passengers-tested-positive-for-ebola-n
Elie
A couple of things ocurr to me:
1) Lord willing this continues, but so far, none of the original folks who had contact with Mr Duncan when he was first infectious have gotten sick, and they are close to the 21 day marker.
2) The complexity of care in an ICU may be equally at fault as the PPE protocols. Nurses (who are the main care givers in the ICU), do a lot of invasive, liquid producing tasks in caring for patients. These need to be examined for necessity and maybe improved or simplified, reducing the scatter of fluids.
Also, my guess (no data yet) is that its not the PPE (personal protective equipment) per se, but problems when taking it off that may be the biggest issue. THAT technique needs to be rehearsed and rehearsed and every person caring for the patient needs a protocol buddy watching and guiding them after they emerge.
3) I bet staffing also played a role. All these hospitals are marginally staffed, even in the ICU… they probably had no backups nor worked in teams like they did with Medicins sans frontieres, one of the team watching the other’s technique entering and emerging from isolation.
Just my thoughts
Elie
I also think that we need to be careful with the “AHA”, this is because of corporate medicine..
No system is without flaws and constant rehearsal and testing confirms that we know that about most medical care and services. We practice CPR, codes and all sorts of things over and over because we know that in the middle of care, you have to be able to function quickly with tried and true approaches. In all fairness, even with AIDS, we did not have an infectious agent this virulent when much of the techniques for appropriate avoidance of contamination were “storyboarded” in most hospitals. This of course, is different now and I am happy that we have a change to review and improve our protocols.
Americans have a habit of chiding the experts, but please realize that managing many infectious and biological conditions require learning and adapting on the fly, and that “error term” has to be built into every developed care process. Experts and care givers need to remember to be confident but also humble enough to examine themselves and their practice without whining and pointing fingers. Not only is that unprofessional, but it doesnt help us at all to focus on our practice and correct and improve what we do. It should be done without emotion.
Elizabelle
— Andy Borowitz
rikyrah
@Tommy:
Boston is racist as phuck, but if you get sick, no better place. Have so many prime medical centers there.
rk
I’m a bit shocked at the hysteria. As a joke I asked my daughter if the kids at her school are taking about Ebola. Apparently they are, quite a bit, everyone with a sniffle or cough is suspected of having Ebola: one teacher was absent for 3 days, rumors started, so another teacher came in and told them that no Mr so and so did not have Ebola. One girl has an anti Ebola ritual involving obsessive hand washing and disinfecting her surroundings. Right now it’s sounds like a bit of joking around with a dash of teen hysteria. But the media is not helping. I’m hoping though with all this sudden interest in cleanliness the kids escape the enterovirus.
Elie
@rk:
You are right on about the enterovirus which is a much bigger risk.
I am not surprised by the media hysteria which is the way they sell clicks. I am unfortunately surprised by the tone of some of the “professionals” in leadership positions – esp the nurses (I am one) from who I expect much more cool and dispassionate attitudes and less finger pointing. I am disappointed and expect more from them. Hope that they can “tighten it up” soon.. they have influence with the public and they need to respect that and mind themselves better.
mclaren
40% of Americans are worried about their immediate family contracting ebola?
Seriously?
Americans are really this stupid and ignorant?
Boy, I missed my profession. Should’ve become a snake oil salesman.