http://www.zerohedge.com/...s-sidewalk-trash-can

Un-Fucking-Believable....

Actually isn't probability of nurses getting infected in Dallas closer to 1.5% not 100%? Wasn't it 70 odd nursing folks that had some interaction with the patient and only 2 have gotten sick?

So if they limit the number of medical folks working with the patient in NYC, than the odds drop to less than 1%

So far the odds outside of medical personal seem pretty close to 0%

That would explain the lack of duct tape and plastic sheeting at my local Home Depot!

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"Go yell at an M&M"

Our office manager must have bought them all up. She also posted an ebola fact sheet in the lunchroom along with the Disneyland and Knotts Berry Farm discount ticket announcements.

For crying out loud: health care workers are people. Unlike you, perhaps, people make mistakes. When a healthcare worker who is exposed to highly concentrated virus-containing fluids like vomit or feces and then makes a mistake, infections can occur. Compare that to a non-contagious person riding the subway.

Nobody said it is impossible for someone to get infected. Seriously?

That's why this physician was taken to Bellevue: it was prepared.

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"Go yell at an M&M"

Because the hospitals that specialize in this have had infections. So, no, I do not believe a "regular" hospital in NYC, or anywhere, is really capable of handling this.

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

I saw that. Unreal.

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

What's unbelievable is that anyone would be outraged that material that has no f'ing chance of containing Ebola virus was not isolated, incinerated and buried in concrete.

Why do you get your science reporting from zero hedge?

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"Go yell at an M&M"

This is just simple common sense here. I forget how many tens of millions of dollars were spent on UNMC to get it to a CDC-approved highly infectious disease center. Then, they receive millions more in government subsidies. If any hospital can handle diseases like Ebola, when why the fuck are we spending so much taxpayer money on places like UNMC???

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

That's why this physician was taken to Bellevue: it was prepared.

That may be the case, I don't know. What I DO know is that if you take in one patient and end up with twice as many infected health care workers you have a problem. That is what happened in Dallas and it's really hard to say that they were "Prepared". That also means that not every hospital is prepared. In fact I suspect that if a hospital that was supposedly "Prepared" ended up with what happened in Dallas this means there's a group that we know is not prepared and another group that we *think* is prepared when in fact they are not. Whether Bellevue is actually prepared or not we won't know until there is or is not further infection. We DO however KNOW that there are several other facilities that ARE prepared. So, again, why not send them there?

~Matt

Who said any hospital can handle Ebola? Why are you asking that? Please answer: do you think that Bellevue can handle this case of Ebola? Yes or no, please.

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"Go yell at an M&M"

a) OK - "more in line" - now that two nurses have already been infected - at least we are moving in the right direction - excellent - so we are now going to decontaminate prior to de-gowning in a way that is backed by research and/or clinical experience? (or should we just grab an antiviral wipe?) - I guess we need to wait until more nurses are infected until protocols are not "more in line" but actually "in line". Don't get me wrong. The new protocols are very good, and changing every day as we learn more (as they very well should) - but they are probably not the final iteration. Things will change as we learn more, but unfortunately, the nurses are the guinea pigs.

b) there is some wiggle room in the protocol. For example, "facilities should consider making showers available" - really? No, nurses should be removing their scrubs and showering prior to leaving the hospital if they are caring for a seriously ill ebola patient. Why would we not have them do this?

c) "nurses should consider using a respirator if there is a possibility that fluids could become aerosolized." - yes - finally. This is what I was asking for last week. Does the CDC read slowtwitch? Honestly ladies (and men) go for the respirator. Once I was caring for a terminally ill AIDS patient who bit her tongue, which started to bleed heavily- then she coughed right in my face. Blood spatter all over my face shield. Normally, I would not have been wearing a face shield to care for an AIDS patient, but since I just happened to be going in to suction her I happened to have it on. Good luck that day.

d) waste can be an issue. Again, back in the early days when I was working on a dedicated AIDS unit, it was nearly impossible to get environmental services to simply remove full (completely enclosed) sharps containers and replace them with new ones. A nurse on my unit got stuck trying to shove a needle into a full sharps box.

Caring for an ebola patient is not just about putting on and taking off protective gear. While a bunch of egg head administrators may have " thought through" protocols up in the 8th floor conference room, life is very different out on the units. There is a large body of research that shows that patients with diseases requiring specialized knowledge do better on specialized, dedicated units.



Yes. I did. That is what scares me. Right now the protocols do not call for respiratory isolation, although some hospitals are doing this. I am concerned that, at the end of life, when a patient goes into heart failure and their lungs fill with fluid - and they have labored breathing over this potentially infectious pulmonary fluid - that the disease could be airborne- at least for the nurses who are just standing inches to feet away. While I think the general public may not need to be concerned about this mode of transmission - I think it is a real concern for nurses.

So now they have quarantined the doctors two friends and are "reaching out" to those who used the bowling alley, the Uber car, the subway and "anyone else he may have come in contact with". In New York City!

Yeah, that's better than just isolating one doctor who just got back from his African Ebola tour.

Btw, I don't think is MUCH risk in allowing this guy to walk around, but look at what is happening (despite the oft told lack of risk). Like I said, giant clusterfuck instead of just isolating this guy for a couple weeks.

Help me out here. Why is what is being done better?

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Civilize the mind, but make savage the body.

- Chinese proverb

I never said it was better. All this quarantining and searching is due to the requisite "out of an overabundance of caution." You can bet that there are a number of epidemiological experts rolling their eyes about this. But, if the opinions on this thread are any indication, they are trying to forestall mass hysteria. In this particular case, it is security theater.

If you enact your three week quarantine on everyone who goes to West Africa to help with the Ebola epidemic, you'll just make things worse: fewer people will be able to volunteer, the epidemic will get worse, and it'll get here more potently than otherwise.

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"Go yell at an M&M"

I guess we are about to find out. Sounds like a fun experiment for the people of NYC.

" Contact with bodily fluids includes unprotected sexual contact with patients up to three months after they have recovered" from link

and the plot thickens now, no?

You did. This is what you said:



My response was:

jsa wrote:

Because the hospitals that specialize in this have had infections. So, no, I do not believe a "regular" hospital in NYC, or anywhere, is really capable of handling this.

So, if you want to change your own statement, change it and we can move forward from there.

In anticipation of you "clarifying" (i.e., changing) your statement, Bellevue is NYC's marquee trauma center. There have a division for infectious diseases, but, do not specialize in it. HHC tagged Bellevue as the primary Ebola treatment facility in NYC b/c of its size, location, and facilities; because, there is no CDC-certified facility in NYC. But, it is not a CDC-certified infectious disease center. IF Bellevue was perfectly capable of handling diseases like Ebola, why the fuck is the government pouring millions into places like UNMC???

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

English is a great language. However, saying "NYC hospitals aren't run by newbie healthcare providers" does not mean "any hospital can handle Ebola."

And "You really believe that there isn't a hospital in NYC" means "You don't believe that there is a single hospital," not "You believe that all hospitals…"

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"Go yell at an M&M"

Yeah, that one got me as well. The costs associated with making sure providers have on a proper mask (not just a surgical mask, but one fitted to them personally that filters aerosolized particles) is not going to go unnoticed by administration either, so I wonder how much of that played into what happened in Dallas (typically most facilities have a small # of negative pressure isolation rooms to care for patients like this and only providers trained to work in that are fitted).

I can also recall taking care of patients in isolation and while the PPE is helpful, you still stomp around the unit in scrubs and shoes that are worn out in public and have God knows what on them. Hospitals don't furnish scrubs anymore and launder them like they used to, but would that also cut down on public exposure to disease? I know the ORs might still do this, but the units and general med/surg floors do not. Is there even enough viral load that will live on the surfaces to cause concern?

Interesting thread. I wish people would get up in arms about influenza and Measles like the do Ebola.

do you think that Bellevue can handle this case of Ebola? Yes or no, please.

Again "Can they" is not the question. Obviously "They can" as could the hospital at Dallas. The question is whether or not someone else can do a better job handling the case and the answer is a resounding yes.

~Matt

If you enact your three week quarantine on everyone who goes to West Africa to help with the Ebola epidemic, you'll just make things worse: fewer people will be able to volunteer, the epidemic will get worse, and it'll get here more potently than otherwise.

While there have been actual studies on the subject of whether a travel ban is effective or not I'd be curious as to what you have to back up the above claim. Any "Volunteer" going to help with this epidemic is going to be able to deal with a three week quarantine as well. "Less volunteers", sure maybe but I would say that's a good thing by weeding out those that aren't taking the issue seriously enough to understand that in order to protect everyone you need to make sure you're not infected before heading back out into the general public.

You go spend a month or a week or a year working with Ebola patients, plan on spending three weeks when you get back in quarantine.

~Matt

and the plot thickens now, no?

I heard that a while back. Not looked at the link yet but heard the virus can live up to 90 days post being declared "Virus free" in sperm.

~Matt

I got that from an interview with an administrator of a major hospital in Mass. who indicated that the extra time would make them reconsider their policy of supporting people who wished to volunteer.

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"Go yell at an M&M"

Don't blame me for your poor writing skills. Of course, I didn't go to no fancy private grade school ...

More importantly, you completely dodged the real issue.

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

Did they develop an Ebola vaccine when I wasn't looking???

FWIW, the wifie works in a long term care facility and they quarantine suspected flu infected patients and will actually fire a staff member who refuses to get a flu shot and/or shows up to work with the flu.

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR