on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
You know the way some are trying to make political hay with this Â
In the area of West Africa that all the outbreaks have come from there has been a grand total of *k cases with 4K deaths from it. Where this came from is some of the worse fucking areas in the world for medical care, personal hygiene, and a 3rd world infrastructure to be able to deal with this and YET they only have 8K cases w/ a %50 death rate.
So stop with the political agenda driven BS about this and understand that we infinitely better prepared to address any kind of outbreak here in the States.
on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
How many US citizens have died from Ebola contacted here? ZERO. So explain how they did not do their job
that the problem with quarantining Africa re: entry here is that Europe etc will follow suit and then the infected will trickle into other 3 world countries making it impossible to trace them and spreading the epidemic dramatically. I see his point.
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
concerning and this might be the worst hospital in the US. I pray that these two nurses recover but the mistakes of this joke of a hospital have put the whole country at risk.
Also, clearly the CDC and government reponse to disease that you see in movies is pure fiction. There IS no response. There IS no emergency protocol, amazing.
How can healthcare workers who dealt with an Ebola patient just up and fly so short after the first patient died? Is there no protocol? No self monitoring and at least self restriction of travel?
If this disease becomes permanent in the US we are screwed. How could any reasonable person draw any other conclusion based on how the healthcare system has response do far.
Also, the CEO and chief medical officer of this hospital should quit their jobs and apologize to this country for the epic public health failure.
on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
the whole "restricting entry" notion is amazing. How is that really supposed to work?
Astounding failure to follow fairly simple protocols Â
Whoever runs this hospital should be removed immediately. Multiple failures to carry carry out standard, easily understood protocols for infection prevention and handling of bloodborne pathogens.
This really has nothing at all to do with CDC or any national health agency. It's a matter of incompetent hospital administration. Possibly also a lack of oversight, certification, and regulation by state gov but I'm not familiar enough with Texas' health care regs to say.
this shit is hard to get how does two trained medical personel get the virus if its hard to spread? Its most likely just me but evertime that DR from the CDC gets on I feel like he is lying or holding back all the facts. they still have not explained how the camara man working for NBC contracted the sickness.
the number one national security threat to the United States. Real leaders and statesmen, which this country can not seem to produce any longer, would be thinking outside the box and taking any possible action to secure this country.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
the argument against banning flights is like the argument in favor of ''letting a team score quickly so we can prevent them from running the ball on us''
THINK people, think
each case generates 2 on average, 6.5 days incubation, 70% death rate,
10,000 new cases per WEEK in west africa per WHO by end of month
the number one national security threat to the United States. Real leaders and statesmen, which this country can not seem to produce any longer, would be thinking outside the box and taking any possible action to secure this country.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
why the fuck are they letting people - who were directly exposed to Ebola - fly before the 21 day time frame? Dumb and Dumber running things in Dallas and Washington...
The World Health Org also says we've got 60 days to get this under some kind of control, they have no plan in place for anything of that potential magnitude.
I'm of the opinion that Ebola has already mutated to Airborne Transmission, at least in some cases. Such an announcement would set off widespread panic.
This thing is starting to resemble a bad Snake Plissken Movie.
the hospital did not follow procedures or didn't know what they were:
Quote:
DALLAS (AP) — A Liberian Ebola patient was left in an open area of a Dallas emergency room for hours, and nurses treating him worked without proper protective gear and faced constantly changing protocols, according to a statement released by the nation's largest nurses' union.
Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.
Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.
Related Stories
The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.
the number one national security threat to the United States. Real leaders and statesmen, which this country can not seem to produce any longer, would be thinking outside the box and taking any possible action to secure this country.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
Just for fun, what would a "real measure" be?
I did not say I had the exact policy of the top of my head. Do you think the current policy is ok?
RE: oh, it only kills 50% of the people who get it Â
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Hey dipshit, put it into the perspective of where those cases are being handled at ...Seriously do you lack that much common sense to understand the difference between fatality rates in America, and a different area that has zero medical facilities, staff, or preventive strategies to address this?
This is why you catch so much shit on this board. It is your complete lack of common sense
the number one national security threat to the United States. Real leaders and statesmen, which this country can not seem to produce any longer, would be thinking outside the box and taking any possible action to secure this country.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
Just for fun, what would a "real measure" be?
I did not say I had the exact policy of the top of my head. Do you think the current policy is ok?
I don't really know what else we could do. But I'm also not here declaring that we're obviously doing something wrong and have no leadership either.
Well, it might help if the Senate would confirm the Surgeon General Â
It might help if the Sen Coburn would stop blocking funding for public health prevention and response to Ebola.
It might help if Congress restored funding for research of drugs for Ebola treatment and vaccinations, all of which was cut in the arbitrary Sequester.
Oh wait, Congress is still on its two-month recess because their careers are so much more important than the country's Public Health in the face of a potential pandemic/epidemic of a deadly disease. Not to mention that Flu and Enterovirus are no picnic...and potentially complicating factors.
Anyone want to talk about the huge hole in Texas' public health system, thanks to its rejection of the Medicaid expansion. You have hundreds of thousands, if not millions, of working poor people who will not get prompt medical attention for fevers because they cannot afford an emergency room visit. So they'll be delaying seeking medical help and exposing others to disease while they are symptomatic, the time when Ebola is most contagious.
So they've got that going for them....which is nice!
RE: Astounding failure to follow fairly simple protocols Â
Whoever runs this hospital should be removed immediately. Multiple failures to carry carry out standard, easily understood protocols for infection prevention and handling of bloodborne pathogens.
This really has nothing at all to do with CDC or any national health agency. It's a matter of incompetent hospital administration. Possibly also a lack of oversight, certification, and regulation by state gov but I'm not familiar enough with Texas' health care regs to say.
Where I do fault the CDC is it's failure to assess the capabilities of these facilities to handle the situation. However, they are not the ones providing incompetent hospital administration, so you raise a fair point in that regard.
I am in favor of common sense precautions. In the beginning, I was one who said it wouldn't spread here. Of course I was thinking that we had the best medical staffs, trained for this type of thing. Turns out we don't. And we lack the political will to do what is necessary (stop the voluntary quarantines). You can have all the protocols you want, but you are depending on people to carry them out. People can be stupid, lazy, careless, selfish. The NBC Doctor who was under voluntary quarantine and went to a restaurant is a great example. What are these people thinking? They are thinking they are invincible. We think the US is invincible and it can't happen here. Unfortunately we were over confident. Ebola is pretty hard to get. But imaging if it wasn't. What would we do if we had some kind of virus that was this deadly that spread more easily? We'd be fucked.
I'm of the opinion that Ebola has already mutated to Airborne Transmission, at least in some cases. Such an announcement would set off widespread panic.
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Hey dipshit, put it into the perspective of where those cases are being handled at ...Seriously do you lack that much common sense to understand the difference between fatality rates in America, and a different area that has zero medical facilities, staff, or preventive strategies to address this?
This is why you catch so much shit on this board. It is your complete lack of common sense
Yes montana, read my post above. We have medical facilities and staff and preventive strategies. How's that going so far???
As I said, Ebola will not get to the point here as it has in Africa. But it should never have gotten to this point. And what if you were a healthcare worker, or some one who comes in contact with a large amount of people each day? Do you have a right to be concerned????
we were not as prepared across the country as we might have been. Other hospitals that treated the Drs who were infected did it seamlessly with no further issues. Now everyone is ramping up education and protocols and tho we were behind the curve in some cases, we will likely catch up. The operative word being "likely."
I love that idea. Count me in. Preferably before this weekend.
Unfortunately Ebola may already mutated to airborne transmission according to some people on the internet. Personally I think Jihadist ghosts are carrying Ebola and spreading it in in the US as a terrorist revenge plot. I have nothing to back that up with but hey why not say it? Right?
we were not as prepared across the country as we might have been. Other hospitals that treated the Drs who were infected did it seamlessly with no further issues. Now everyone is ramping up education and protocols and tho we were behind the curve in some cases, we will likely catch up. The operative word being "likely."
Those patients were brought in isolation and it was known that they had Ebola. And they were in Emory, which is connected to the CDC and another pre-determined hospital that was prepared. We are not prepared to have people show up in ERs and have all the hospital workers be protected. Perhaps they need to have designated Ebola centers and once a patient is suspected of having it, transfer them there.
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Hey dipshit, put it into the perspective of where those cases are being handled at ...Seriously do you lack that much common sense to understand the difference between fatality rates in America, and a different area that has zero medical facilities, staff, or preventive strategies to address this?
This is why you catch so much shit on this board. It is your complete lack of common sense
Yes montana, read my post above. We have medical facilities and staff and preventive strategies. How's that going so far???
As I said, Ebola will not get to the point here as it has in Africa. But it should never have gotten to this point. And what if you were a healthcare worker, or some one who comes in contact with a large amount of people each day? Do you have a right to be concerned????
If you understand that then why would you be so asinine as to correlate the 50% death rate in a 3rd world area whose population is completely vulnerable to the disease, has no true medical facilities, and lacks the most basic hygienic facilities to combat this. To what can happen here in the States?
If you really understood anything, you would realize its quite amazing that the death rate is only %50 there and that there has been only 8K confirmed cases of it. But no instead, you are the only one on this thread who fails to comprehend the point that was made.
we have ONE facility with multiple Ebola cases. It's a rinky dink community hospital with apparently inept administration.
The other hospitals treating transported Ebola victims have NOT had any protocol breakdowns or transmissions.
See my post above. You can't compare facilities that took in patients that were already known to have Ebola and had procedures in place prior to those patients coming in. Also, those patients were not spewing bodily fluids as Duncan was when he entered the ER for the second time.
And the hospital is not a rinky dink community hospital. Obviously they have issue, but I doubt any average hospital in the US doesn't. And that is where these patients are going to show up.
RE: RE: RE: RE: oh, it only kills 50% of the people who get it Â
If you understand that then why would you be so asinine as to correlate the 50% death rate in a 3rd world area whose population is completely vulnerable to the disease, has no true medical facilities, and lacks the most basic hygienic facilities to combat this. To what can happen here in the States?
If you really understood anything, you would realize its quite amazing that the death rate is only %50 there and that there has been only 8K confirmed cases of it. But no instead, you are the only one on this thread who fails to comprehend the point that was made.
I understand your post perfectly. It's what you always do. Tell everyone they are stupid if they don't agree with you. Why you think saying a disease 'only' has a 50% kill rate is reassuring is beyond me. Do me a favor, you obviously don't care for my posts, just ignore me. I don't have any wish to communicate with you on any level.
RE: RE: This Is Proving to Be a Colossal Failure Â
on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
How many US citizens have died from Ebola contacted here? ZERO. So explain how they did not do their job
Not do their job? How can you even begin to defend this. 2 trained nurses have become infected. Death is not the standard, infection is.
Funding is needed to provide hospital workers with training Â
on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
the whole "restricting entry" notion is amazing. How is that really supposed to work?
Ever hear of a passport that identifies where you have been?
The World Health Org also says we've got 60 days to get this under some kind of control, they have no plan in place for anything of that potential magnitude.
I'm of the opinion that Ebola has already mutated to Airborne Transmission, at least in some cases. Such an announcement would set off widespread panic.
This thing is starting to resemble a bad Snake Plissken Movie.
There are no bad Snake Plissken movies.
It sounds like the spread is more from not following proper medical protocols than the ability of the virus to easily transmit itself from person to person. That would make us victims not so much of the virus, as our own incompetence and indolence. None of that of course would matter if it got out into the general population, as it has in West Africa, where limited medical facilities inhibit whatever precautions can be taken even by conscientious medical professionals.
If it isn't Ebola, it will be another virus. Global population is headed for 9 billion by 2050. More and more people will be living closer and closer together. A new virus will emerge, or an old virus will mutate to become more easily transmissible, and then spread quickly in close quarters. That is what happened in this country in 1918 with the Influenza epidemic. The real "crash" will be biological, not economic, at least not initially. Some kind of pandemic is inevitable.
They are transferring one of the Dallas healtcare Â
In the area of West Africa that all the outbreaks have come from there has been a grand total of *k cases with 4K deaths from it. Where this came from is some of the worse fucking areas in the world for medical care, personal hygiene, and a 3rd world infrastructure to be able to deal with this and YET they only have 8K cases w/ a %50 death rate.
So stop with the political agenda driven BS about this and understand that we infinitely better prepared to address any kind of outbreak here in the States.
The mortality rate in Western Africa is closer to 80%.
Not sure that the rate is significantly less in a developed country; is there all that much data? We can surmise that it's lower because of sanitation, culture etc but it's all supposition. And it might reflect the incidence rate more than the mortality rate.
In this latest outbreak we've had how many people become infected and cared for here? 5 or 6? Two received experimental therapy and might be outliers. Duncan died, Pham, who knows.
There's so much to be concerned about even though there's nothing to panic about. It seems that if you're not going to be a chicken little, you are an ostrich. The truth is somewhere in between.
People are exploiting this to push a political agenda. Has nothing to do with health insurance, or the sequester, or xenophobia, or God punishing us for our sins.
In the area of West Africa that all the outbreaks have come from there has been a grand total of *k cases with 4K deaths from it. Where this came from is some of the worse fucking areas in the world for medical care, personal hygiene, and a 3rd world infrastructure to be able to deal with this and YET they only have 8K cases w/ a %50 death rate.
So stop with the political agenda driven BS about this and understand that we infinitely better prepared to address any kind of outbreak here in the States.
The mortality rate in Western Africa is closer to 80%.
Not sure that the rate is significantly less in a developed country; is there all that much data? We can surmise that it's lower because of sanitation, culture etc but it's all supposition. And it might reflect the incidence rate more than the mortality rate.
In this latest outbreak we've had how many people become infected and cared for here? 5 or 6? Two received experimental therapy and might be outliers. Duncan died, Pham, who knows.
There's so much to be concerned about even though there's nothing to panic about. It seems that if you're not going to be a chicken little, you are an ostrich. The truth is somewhere in between.
From the CDC website:
Quote:
Case counts updated in conjunction with the World Health Organization updates and are based on information reported by the Ministries of Health.
workers to Emory in Atlanta. Emory is one of four hospitals with a true isolation unit. The US has a total of 11 beds in true isolation units.
And just like The Walking Dead...it all starts in Georgia.
I've got my bunker (aka my basement) set up for the oncoming apocalypse! If anyone wants, you can always come to my basement (not in the same way that Cam would invite you though, so don't get too excited).
My numbers are from reading research literature so it's coming from scientists. WHO people and science people might be working off different databases.
Survival kit contents check. In them you'll find: one forty-five caliber automatic; two boxes of ammunition; four days' concentrated emergency rations; one drug issue containing antibiotics, morphine, vitamin pills, pep pills, sleeping pills, tranquilizer pills; one miniature combination Russian phrase book and Bible; one hundred dollars in rubles; one hundred dollars in gold; nine packs of chewing gum; one issue of prophylactics; three lipsticks; three pair of nylon stockings. Shoot, a fella' could have a pretty good weekend in Vegas with all that stuff.
My numbers are from reading research literature so it's coming from scientists. WHO people and science people might be working off different databases.
The other question is is this an anomaly. When govt tells us that because protocols are set I'm place, we believe them because we assume people are not human. They don't mistake, they always follow instructions and follow them properly. They don't like the NBC crew, lie and sneak out of quarantine for a beer and a smoke.
I'd feel so much better if there was a vaccine or a drug or something that didn't involve the most flawed, but apparently central, element in the whole protection scheme...people. Because people are I her entry corrupt dumbasses. Even the good ones.
My numbers are from reading research literature so it's coming from scientists. WHO people and science people might be working off different databases.
That very well could be the case Bill
Just googling Ebola mortality rate brought up several stories with a con census 70%, so it looks like there's room for wobble in the numbers
Subways are likely not an issue. However, IMO. That's the softest part of what we are being told about Ebola. It's totally based on the fact that they haven't seen it...yet...as opposed to some tangible feature of the virus.
On another note...and Micko if you're out there, I'd appreciate your opinion...I just saw an interesting paper from 2005. They infected pigs with Ebola and housed them next to rhesus macaques, physically separated by a wire mesh fence. All of the macaques got Ebola with the primary tissue destruction site being the lungs. Conclusion is that there was airborne transmission from pigs to NHP. That's scary. However and quite interestingly, housing infected and non-infected macaques next to each but separated by fencing did not result in infection of the naive group. That suggested there wasn't airborne transmission among NHP.
IS that something that might be easily changed through mutation?
I take that back, but I've read 3 threads today from start to finish, and on two of them you called other posters idiots. You make salient points, let your arguments do the talking! ... but that's my two cents.
As for Ebola, this is scary stuff. I'm sorry to say,.
Funding for the CDC is pretty stable. There was a slight drop in FY13 due to the sequester. I'm going to go out on a limb here and suggest that the small decrease in spending in 2013 is not in any way responsible for any problems in dealing with ebola. Also, please note that the president's 2015 budget is allotting less money for the CDC as well.
US Global Health Program spending, 2001-2015:
Hey, look at that - spending rose dramatically in 2001-2010. Moving on.....According to that Kaiser report, "Pandemic Preparedness funding through the GHP account totaled $50 million". OK, so the feds spent $50m to prepare for a pandemic. Let's see what else they were spending money on:
Quote:
•Chronic disease prevention (obesity, heart disease, etc): fiscal 2014 budget approximately $1 billion, or just under 15% of the total budget.
•Birth defects: $132 million, or just about 2% of the total budget.
•Environmental health (asthma, safe water, etc): $179 million, 2.6% of total.
•Public health services (statistics, surveillance, etc): $482 million, 7% of total.
•Occupational safety (mostly research): $332 million, 5% of total.
Add all of that up and that's $2.275 billion dollars the CDC spent on things other than infectious diseases.....which is the entire reason the agency exists in the first place. $50 million for pandemic preparedness, $2.275 billion on all that other shit.
I take that back, but I've read 3 threads today from start to finish, and on two of them you called other posters idiots. You make salient points, let your arguments do the talking! ... but that's my two cents.
As for Ebola, this is scary stuff. I'm sorry to say,.
I've gotten better?
The problem is that, a lot of times the arguments put forth actually hurt us more than help us. Same with Ebola.
You thought people not getting vaccines was bad, this could rival that in terms of pretty bad side effects.
that it was skin being exposed to the bodily fluids (vomit and diarrhea) of Duncan when he first into the hospital. So unless every ER worker is going to wear full tyvek gear for all patients, I don't know how you avoid that. Hell, last time I was in the ER, I had to vomit a few times. Luckily they got me the little pan in time.
Anyone who wants to claim that a patient would be turned away because of no insurance when it was suspected they had Ebola is just crazy. We now have two healthcare workers who have contracted it from caring for this patient. And that might not be all.
RE: RE: This Is Proving to Be a Colossal Failure Â
who had been treating someone who has died from Ebola within the last week would get on to a commercial flight.
If this nurse survives, some kind of punitive action needs to be taken. I really think was negligence of the worst kind; wanton disregard.
If she was asymptomatic when she traveled, how can anyone charge her for anything beyond doing what normal people do...traveling freely in this nation?
All this talk of forcebly putting people into quarantine if they traveled to Africa against their civil rights and other nonsensical talk is scarier than the prospect of Ebola turning into some pandemic threat.
Get hold of yourselves...you're chance of catching and dying from Ebola is only 50:50...just a bit shy higher than dying from a terrorist attack, which is 1:3.
RE: RE: This Is Proving to Be a Colossal Failure Â
the whole "restricting entry" notion is amazing. How is that really supposed to work?
How does it work? The US custom looks at his/her passport, and if the person had been to West Africa recently, you say, "No, you cannot come in. Not yet at least." A forceful attempt to gain entry will be met with more greater force. He'll understand quickly.
Oh go ahead and cry "Human right violation!" or, more powerful yet, "racial discrimination!" CNN and MSNBC will cry with you.
I agree with you in principle. I don't think everybody needs to be walking around in hazmat suits...I just think for a nurse who's very recently been in close proximity to Ebola to step on to a airplane borders on criminally irresponsible.
under staffed, over worked and working in a hazardous environment. Easy to judge from where we sit. My wife is a nurse and I have heard a lot horror stories.
My wife was stuck with a dirty needle (someone else' negligence) her supervisor told her to not worry about getting tested - because the patient was low risk, yea right.
RE: RE: RE: This Is Proving to Be a Colossal Failure Â
the whole "restricting entry" notion is amazing. How is that really supposed to work?
How does it work? The US custom looks at his/her passport, and if the person had been to West Africa recently, you say, "No, you cannot come in. Not yet at least." A forceful attempt to gain entry will be met with more greater force. He'll understand quickly.
Oh go ahead and cry "Human right violation!" or, more powerful yet, "racial discrimination!" CNN and MSNBC will cry with you.
And here comes the moron from LA.
RE: RE: RE: RE: This Is Proving to Be a Colossal Failure Â
If she was asymptomatic when she traveled, how can anyone charge her for anything beyond doing what normal people do...traveling freely in this nation?
All this talk of forcebly putting people into quarantine if they traveled to Africa against their civil rights and other nonsensical talk is scarier than the prospect of Ebola turning into some pandemic threat.
Get hold of yourselves...you're chance of catching and dying from Ebola is only 50:50...just a bit shy higher than dying from a terrorist attack, which is 1:3.
I don't know about charging her, but these people were supposed to be voluntarily quarantined. We now have a doctor and a nurse breaking that quarantine. You would think that medical people would understand the need to control who has been exposed. This is the weak link in the chain.
I agree with you in principle. I don't think everybody needs to be walking around in hazmat suits...I just think for a nurse who's very recently been in close proximity to Ebola to step on to a airplane borders on criminally irresponsible.
Just my initial opinion, I could very well wrong.
But how is it criminally irresponsible when she wasn't showing any symptoms prior to her travel? She (along with everyone else in the hospital) most likely believed that they did their due diligence in safeguarding themselves. Unlike many on this thread, I doubt that these medical professionals are thinking doomsday scenarios.
It sucks that she did contract the disease, but to say that she should be punished is bordering on punitive measures for the sake of fueling hysteria.
she wasn't supposed to travel. The head of the CDC just said that. It shouldn't come down to being charged with something, but she really should have known better.
RE: RE: RE: RE: RE: This Is Proving to Be a Colossal Failure Â
Ugh...every time you post, I want to reach through my screen and punch you right in the face for not only being absolutely idiotic in almost all of your posts but for making LA look bad.
My initial post a few moments ago was probably too harsh.
But even the head of the CDC said the nurse should not have traveled on a commercial flight...I just see it as common sense.
It it unreasonable to think "Gee, I've just been in close proximity with a man who died from Ebola...perhaps it wouldn't be unwise to go on an airplane for a few weeks."
she wasn't supposed to travel. The head of the CDC just said that. It shouldn't come down to being charged with something, but she really should have known better.
Sure...everyone in any profession should know better. That isn't the issue...the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
RE: RE: RE: RE: RE: RE: This Is Proving to Be a Colossal Failure Â
Ugh...every time you post, I want to reach through my screen and punch you right in the face for not only being absolutely idiotic in almost all of your posts but for making LA look bad.
You can leave LA if my words shame you. Go ahead, leave. Who are fuck are you to represent LA, or have the authority what opinions would make LA look good or bad? Who are you, exactly? You are not an ignorant fuck?
the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
Yes, I feel my civil right was severely violated when the government that my tax money supports failed to isolate the country better from this disease. what, am I not allowed to feel that way? Is such feeling sub-human, unlawful, unmoral?
and I agree that maybe she should have practiced better judgement. However, when you have idiots like LAXin and others clamoring to start forcebly control how people travel, etc. based on their fear, any talk about criminal responsibilities, etc. become a bit much.
the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
Yes, I feel my civil right was severely violated when the government that my tax money supports failed to isolate the country better from this disease. what, am I not allowed to feel that way? Is such feeling sub-human, unlawful, unmoral?
Just stop. No one violated your rights, and I doubt you will ever be in danger of catching and dying from Ebola. So get the sand out of your gash.
maybe you should go take 5 in your fall out bunker and compose yourself
Maybe I am coming off a bit over the top, but what would be the precedent for something like this?
Where a very deadly microbe is spreading in an age of easy air travel.
Combine this with the clusterfuck that is how this case has been handled by the hospital in Dallas. This is how the "best healthcare system" in the world met dealt with Ebola for the first time.
I would grade the action and response as an F+.
To me it is not hard to believe that this will change how we view infectious disease in this country and it may have far reaching consequences that at this time we can not fully imagine.
I am not in a bunker and I am not actually panicked at all. I do think it is an unprecedented historical event for our modern age and I have no confidence with the US healthcare system, as it currently functions, to ensure that this disease does not become permanent in the US.
I also do view it as a national security issue, how could you not?
and I agree that maybe she should have practiced better judgement. However, when you have idiots like LAXin and others clamoring to start forcebly control how people travel, etc. based on their fear, any talk about criminal responsibilities, etc. become a bit much.
American really is a country that, seriously, has NOT really experienced much hardship, that's the good and bad about it.
Asked an American to describe the most difficult hardship, and he would say, "back in 1929, when we had this disaster called the Great Depression, people had to line up to get some soup. Wow, how hard that was! See, we suffered! We understand human hardship!"
Which would make most of the world laugh. Or angry.
It is such accustom to good and peaceful life that allows morons like RC02XX to ask worry things like "did we violate his civil right?" "did we hurt his feeling?" "how is travel restriction is possible to work". Those high-moral questions disappear only when dead bodies are lying on the street.
the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
Yes, I feel my civil right was severely violated when the government that my tax money supports failed to isolate the country better from this disease. what, am I not allowed to feel that way? Is such feeling sub-human, unlawful, unmoral?
Just stop. No one violated your rights, and I doubt you will ever be in danger of catching and dying from Ebola. So get the sand out of your gash.
My brother is a doctor who works out of the ER/ICU of a NYC hospital. Are YOU any closer to Ebola? How so?
Are YOU telling me what danger I am allowed to feel, and not to feel? I ask again, what are you, and based on what authority, are you telling me what to feel and what not to feel?
American really is a country that, seriously, has NOT really experienced much hardship, that's the good and bad about it.
Asked an American to describe the most difficult hardship, and he would say, "back in 1929, when we had this disaster called the Great Depression, people had to line up to get some soup. Wow, how hard that was! See, we suffered! We understand human hardship!"
Which would make most of the world laugh. Or angry.
It is such accustom to good and peaceful life that allows morons like RC02XX to ask worry things like "did we violate his civil right?" "did we hurt his feeling?" "how is travel restriction is possible to work". Those high-moral questions disappear only when dead bodies are lying on the street.
And you lived such a difficult life in LA where your civil rights were constantly violated. You came off like a buffoon and a complete bitch in your previous posts in the Ferguson related threads. And now this? Before you go into your Kim Jong Un-mode trying to violate the basic civil rights of people, maybe you should take a breath. Your hysteria and persecution complex is really blinding. And sure, tell me how you've seen and known suffering from your latte drinking life.
My brother is a doctor who works out of the ER/ICU of a NYC hospital. Are YOU any closer to Ebola? How so?
Are YOU telling me what danger I am allowed to feel, and not to feel? I ask again, what are you, and based on what authority, are you telling me what to feel and what not to feel?
No...you can fear for your life all you want. That's your prerogative. But based on reality, I doubt you will contract and die of Ebola...just saying.
between trusting people to voluntarily do the right thing and locking them up if they don't.
As Bill L said, the weak link in this whole thing is people. Sure it's a bit hysterical to think the world is ending because you can't trust a medical person to not travel and expose the world. But isn't it equally naïve to not worry when med staff are traveling after being exposed to a deadly disease?
pubic health policy for this. How could any healthcare worker who was working closely with an Ebola patient be allowed to fly?
If she had a fever on the plane is it not possible that she was contagious? Even if there is a tiny chance that is quite a roll of the dice.
If she spread Ebola on a flight that would be very serious. Obviously the CDC thinks so since NOW they will work with authorities on travel bans for those exposed to Ebola.
This is what I mean when I say that there seems to be no protocol, no plan for this. There must be some risk if the CDC is changing their actions after the fact.
Thing is with a microbe there is no after the fact. If multiple people on that flight get Ebola that is a serious problem.
between trusting people to voluntarily do the right thing and locking them up if they don't.
As Bill L said, the weak link in this whole thing is people. Sure it's a bit hysterical to think the world is ending because you can't trust a medical person to not travel and expose the world. But isn't it equally naïve to not worry when med staff are traveling after being exposed to a deadly disease?
Sure there should be a middle ground, and maybe these medical personnel should have been under long term observation with routine testing rather than just being advised not to travel. She made a terrible decision, but the protocol was just as bad in ensuring that she was better taken care of than being left to her own device in which she probably thought she was ok (which is a human nature).
Public health workers don't always do the right thing Â
Case in point, every year our local hospitals have to restrict the work nature of nurses and others because they fall for snake oil BS and refuse to get flu shots. So, they're not allowed near patients or public. Sometimes they can work with patients if they keep a mask on...hope they follow through with that. But these are people working in public health and presumably are informed. Besides being dumbasses themselves, what a horrible message to send to uninformed public.
initial phase of any crisis (whether it's isolated ebola case or a hurricane) is likely to be a snafu when bureaucracy is involved. As things progress, reaction and knowledge of how to react will improve. So, as long as you're not at ground zero for the zombie apocalypse, you should be ok.
RE: Public health workers don't always do the right thing Â
Case in point, every year our local hospitals have to restrict the work nature of nurses and others because they fall for snake oil BS and refuse to get flu shots. So, they're not allowed near patients or public. Sometimes they can work with patients if they keep a mask on...hope they follow through with that. But these are people working in public health and presumably are informed. Besides being dumbasses themselves, what a horrible message to send to uninformed public.
That's exactly my point in my response to fkap. Better protocol to take care of their own people (medical personnel) by the hospital may have prevented this nurse from thinking that she can travel. As you said, it's human nature to do what you think is best for you and not necessarily for others around you. Only way to prevent that short of locking these people up is to truly put into place something that holds these medical personnel accountable as well as making them feel like they're being taken care of beyond just some advice given to them.
initial phase of any crisis (whether it's isolated ebola case or a hurricane) is likely to be a snafu when bureaucracy is involved. As things progress, reaction and knowledge of how to react will improve. So, as long as you're not at ground zero for the zombie apocalypse, you should be ok.
to be at ground zero, you're welcome to Ronnie's basement. He'll feed you plenty of baby formula. He's located on Terminus Lane.
I did get a good chuckle out of your invite. During an apocalypse, visiting an ex marine proficient in 101 ways to kill people is low on my to do list.
The NBC news crew was specifically quarantined and ignored it. IMO, they were defined as being potential carriers and in violating the quarantine they constituted a public health threat. Then they supervisor basically shrugged it off. IMO, at the very least she should be fired and probably the rest of them dew should be as well.
to be at ground zero, you're welcome to Ronnie's basement. He'll feed you plenty of baby formula. He's located on Terminus Lane.
I did get a good chuckle out of your invite. During an apocalypse, visiting an ex marine proficient in 101 ways to kill people is low on my to do list.
Sir, there is no ex-Marine...and I will need others' help to feed my family...even if it is at the expense of their legs or arms, etc. I'm not picky...:)
RE: I'm not against punishment in some cases though Â
The NBC news crew was specifically quarantined and ignored it. IMO, they were defined as being potential carriers and in violating the quarantine they constituted a public health threat. Then they supervisor basically shrugged it off. IMO, at the very least she should be fired and probably the rest of them dew should be as well.
That's completely understandable. If you have been quarantined with just cause, then of course you should be punished for ignoring it. However, was this just an advisement or an actual quarantine? Human nature...blah blah blah.
I think it's fair to say that, while the risk for any of us as Â
individuals is very low, there is legitimate concern here as to a)how this has been handled thus far and b)the fact that ebola is, in fact, deadly. I also think that the feds have been disingenuous in their statements because they think that honesty about the situation would feed a panic, but I disagree with that. When you say things that are plainly contradictory, or illogical, in the interests of playing Chip Diller and assuring people "All is well!", it does nothing but fuel the perception that the people in charge ARE, in fact, lying about the situation. That sows the kind of distrust that really DOES fuel panic and conspiracy theories. I think the CDC and the administration would be well served to be forthright but calm about these matters rather than dismissive.
I think an important thing to consider before freaking out is that everyone (2 nurses) who has contracted Ebola in the states were basically knee deep in Ebola blood and doo-doo (regardless of how well they were protected). If any of the people on the plane get the disease by way of just being around the nurse, then it might be time to be concerned.
On the issue. I'd guess the truth of this lies a bit in between the hysteria and total discounting going on.
It is a real threat that with certain conditions prevailing could become a significant issue.
My personal guess is that after a couple of week our health care community gets it and while occasional infections are bound to occur widespread contagion will not.
That said, the problem with restrictions on air traffic are myriad. How for instance do you say to a US citizen, you cannot come back to the US if they have visited western Africa? Most will have jobs to go to and cannot simply afford staying away. A simple test of temperatures will prevent infection in transit(prior to entering a plane) and when in the states they can be advised by law to self monitor or monitor by a third party if self monitoring is impossible or considered unlikely.
We can stop boarding of planes for all people for suspected terrorism I find in unlikely we can not also stop boarding of planes by non citizens if necessary. However determining the real location of someone(where they have been), in Africa as opposed to where they leave by plane may be a insurmountable issue. Some borders are not even monitored nevertheless having passport stampings.
This second nurse infected….by my take her actions were totally irresponsible.
We really need to work at helping African nations stop this. That is the most likely solution to protect the US. It will likely never be completely eradicated, but will become manageable with proper care.
Yeah, that was an interesting study from the Kobringer lab. At the very least it shows that in the right species certain strains of Ebola can become airborne. Equally as interesting that there was no transmission among rhesus monkeys. If anything, it raises additional alarms about intra-species transmission in the US and what could happen if the virus starts popping back and forth between animals & humans.
I really don't know why everyone isn't concerned about all of this. We've had carriers walking around uncontained and flying on a plane now. These next few weeks will be interesting.
Bill, you're very much spot on with your posts. I appreciate reading them.
under staffed, over worked and working in a hazardous environment. Easy to judge from where we sit. My wife is a nurse and I have heard a lot horror stories.
My wife was stuck with a dirty needle (someone else' negligence) her supervisor told her to not worry about getting tested - because the patient was low risk, yea right.
Yup. Being understaffed and overworked is a big problem in healthcare. Seems like it's getting worse.
ebola gets into the rat population.
Since it appears dogs and such are susceptible I would guess rats as well.
Then it would become unstoppable in cities at least.
But the flip side is the chance of that happening is pretty slim I'd guess.
A case here and there is bound to occur, but untreated cases which could spread rampantly seems unlikely.
Truth is by my take nurses, docs, anyone in the field becomes complainant with infection contra over the years. They see so much in the way of infectious diseases. So with the consequence and a couple here being unfortunately infected, they will improve their procedures.
my take is that Ebola shouldn't be discounted and medical personnel treating patients should be very careful and follow protocols.
But, the hysteria over Ebola is just that - hysteria. The Media has made it sound like a huge threat to the populace and the health system, when it really isn't.
It shouldn't be discounted, but on the flip side, it shouldn't be exaggerated either.
It does lie in the middle, but unfortunately based on the media, you'd think Ebola is a serious threat and needs to be dealt with immediately.
should read complacent with infectious control. They get used to only doing so much and not as much as perhaps is required in special circumstances.
They become so used to treating patients and they tend to not think so much about getting infections from those patients.
Gloves amongst paramedics nurses docs really didn't see widespread use in starting IV's and such until the 1980's. Bugs were around back then as well but few thought to protect themselves.
I agree that the the media is scaring the hell out of some people with a low risk of the disease going widespread.
There is a branch of science dealing with risk analysis. This would probably be considered a low probability event with a very large implication if the event happens. Therefore attention must be paid with panic not necessary. An analogy could be considered nuclear power plants which are built to extremely high safety standards which some will tell you are very safe and nothing could go wrong. Except when something unexpected happens (tsunami). The analogy is the disease mutating to spread through the air. We all need to lool at this calmly but with the understanding that there is a possibility although small of things going bad.
I really don't think most people know exactly how hard it is to transmit the virus.
Unless somehow this person's bodily fluids penetrated your skin, there is no issue.
This is more fear-mongering than anything else.
Just look at this thread, you have people criticizing the person for traveling and thinking that hundreds could be exposed because of it.
I agree the risk of any individual person getting Ebola is extremely low. However, should you not do what is sensible to make the risk non-existent? I wouldn't panic and I wouldn't be blasé. I also would stay away from absolutes, and that includes statements on air travel.
I would like to see the studies showing humans are not contagious unless they are symptomatic. I will try to search for them. My gut tells me that they're basic the statement on anecdotalsmas much as anything. Even so, what exactly does it mean? They're basic the travel restriction on temperature. How does that correlate it's viremia and how long do you become contagious after hitting a certain temperature? Is a day, is it an instant....is it a few hours before? And do the studies take into account human variation? People whose bodies get fever at different rates, other infections and things going on, are they taking Tylenol for arthritis and suppressing fever?
IMO, one area where they should be putting massive efforts is developing super-rapid and convenient screening assays that could be applied to travelers without hindering traveling. Some rapid test for viremia or even for antibodies against the virus where you might get some indication of infection before a person names symptomatic. Or develop some criterion that might increase the window of assessing infection versus being infectious.
Personally, until that point I'm going to be skeptical about travel statements. So far, fellow travelers don't seem to be threatened...until they are.
who do great jobs, but the media in a general term on issues such as this…sucks.
Whatever happened to SARS and what was it before that, mass killer swine flue epidemic?
I just saw that mutation thing as a headline in one site today.
Well yeah, I guess but they failed to mention the probability of that occurring which I'd guess is no accident as by my guess, it is so low.
But flip side you know this thing can be spread in air, right now but they discount it.
If someone for instance spits when they talk, which some do, or spits when they cough and you get that in your eye you could get it. It's in bodily fluids and spit is a fluid. So in a way it is airborne transmittable.
So they go to one extreme in reporting a potential of mutation but go to the other in stating it cannot be airborne in transmission.
But it is not airborne transmittable as in a flu, where active particles can remain in air for quite a time after sneezing or coughing.
So they misreport by my take on both counts.
But it is still seemingly pretty hard to get. The guy in Dallas was throwing up all over the place(projectile vomiting), and his family was sent back to the apartment before it was decontaminated…..I mean how easy can it be to get if none of them came down with it(knock on wood).
is a bit of a unique virus. A person is only really contagious after symptomatic(fever) but the body remains highly contagious after death.
Fever I'd guess with Ebola would be the first presenting symptom. After that comes all the rest.
With a flu, you depending on type of flu and individual, may be feeling lousy have stomach problems and be contagious before you actually develop the fever.
I think that may be a bit of why it spreads so seemingly easily. It does not pattern in transmission like some other viruses we are mostly familiar with.
You die with flu the virus in you dies relatively quickly.
Viruses often have properties unique to themselves.
How can you possibly speak in absolutes like that? Scientist working in the field would never rule out the possibility of strains that could emerge with a modified transmission frequency. We simply don't know what lies ahead. Let's see how it spreads in the first world and we'll see.
Tom Frieden, head of the CDC and formerly Nanny Bloomberg's Kommissar of Salt and Soda uncorked this gem:
Quote:
Dr. Tom Frieden, director for the Center for Disease Control and Prevention (CDC), said during a telephone press briefing Wednesday that you cannot get Ebola by sitting next to someone on a bus, but that infected or exposed persons should not ride public transportation because they could transmit the disease to someone else.
...
"I think there are two different parts of that equation," he continued. "The first is, if you’re a member of the traveling public and are healthy, should you be worried that you might have gotten it by sitting next to someone? And the answer is no."
"Second, if you are sick and you may have Ebola, should you get on a bus? And the answer to that is also no. You might become ill, you might have a problem that exposes someone around you," he said.
Got that? Relax, citizen, you can't possibly develop Ebola from sitting next to someone on the bus. However, if you are sick and might have it, better stay off those city buses. We wouldn't want you spreading Ebola around!
This is, frankly, gibberish that does nothing but undermine his own credibility. Yes, I understand what he's saying here - your risk of contracting the virus in public is microscopic, but if you're actually sick you should stay away from public spaces out of caution. However, his mule headed insistence on calming us dumb panicky idiots is only giving people reasons to suspect he's full of shit. Instead of honestly saying yes, there is a risk from infected people in public places but it's extremely small, he says something stupid in a transparent attempt to play Chip Diller.
Ok my girlfriends coworkers boyfriend works for the CDC Â
The nurses who have become infected were also working on other patients in the hospital, so now the CDC going through those patients to make sure they haven't contracted the virus. How stupid is the staff at this dam hospital!
I'm not sure what they were thinking. But the CDC does too. I had read that the original ER visit by Duncan, he was sent home because he didn't pass some flow chart that the CDC sent out.
The danger if you have been exposed is that you don't know when you will get sick. So this nurse feels fine, goes to Cleveland, then she has a fever. She probably didn't spread it to anyone, but what if she got sicker on the plane and vomited? That is the real danger.
CBSDFW ✔ @CBSDFW
Follow
CBS News reporting that nurse Amber Vinson called #CDC BEFORE boarding the plane and was told she was OK to get on the plane with 99.5 temp
6:43 PM - 15 Oct 2014
Technically, "Fever" is only anything above 100.4 °F Â
and the statements here are correct on that but that does not make sense to me.
If I worked at a hospital and had this occur I would most probably be calling the nursing supervisor the hospital administration or at the very least the doc in charge of my area. Then perhaps on their direction the CDC.
Why directly call the CDC?. Would you even know who you are talking to over there and their credentials to give advice. Would they even know of your capacity and situation at the hospital, how you contacted with the patient? I'd guess they get at least a thousand calls a day on varying issues related to this ebola thing few related to actual contacts.
Not only epidemiologists work at the CDC they have all sorts of peoples in differing capacities, though only a epidemiologist or infectious control specialist could give correct advice specific to this.
And only then if they knew your exact situation or circumstance.
It just doesn't make sense, that she did this. Though again I am not doubting it was reported this way.
I thought they had established a CDC task force in Dallas subsequent to this anyway. Why, if that is true, bypass them? Not contact them, in person perhaps, instead of calling the CDC offices?
with all the hubbub subsequent to this, someone had to have given employees a actual directive on what to do if they had exposure to a ebola patient and did subsequently come down with a fever, even a low grade one as described.
Some smart people but more than anything it's a hidebound beurocracy. They are slow to react on anything and often have different people saying different things and espousing different philosophies. Nothing malicious, just big govt inefficiency and confusion. They are hugely inflexible and if they've a rule in place or a policy, then they'll follow it regardless of whether the situation calls for it. Can easily see them giving permission to travel.
that could very well happen. And as well someone answering could have assumed it is just one more hysterical person who had not really contacted a ebola patient.
But I have doubts that if she was on any sort of checklist for possible ebola exposure she should have been allowed to leave Dallas at all.
All the family members were kept in the apt initially by police force until relocated.
Why was she a possible exposure allowed to leave Dallas. You can show first symptoms up till 21 days. She was certainly within the window and as a health care worker who treated the patient, was certainly on a exposure list.
The more I think about it I think something is amiss here.
These things simply don't jive.
Predicition. In the next 72 hours you will hear: Â
depending on media reports for much of this stuff, and quite often the media is inaccurate in the details.
But what I ran a across most recently is even the blood and tissue samples of the initial patient were not kept segregated. They supposedly use some sort of tube type system to get their samples to testing within the hospital. And it is a collective system. So without segregation of samples you have the possibility for a whole new avenue of contamination and whole new groups of peoples exposed.
Hospitals have to be designed to segregate patients in isolation. A simple isolation room is not sufficient for this type of potential contaminant. Very basically isolation areas have to have entirely differing ventilation heating and waste disposal units than the rest of the hospital. If not, one patient may in theory contaminate a entire hospital depending on contagion.
Ebola is not such a contagious item, but it sounds like this hospital is not set up to handle a actual mass epidemiological event that requires segregation of patients.
There is no telling who could have been potentially exposed. Luckily for them (and us) ebola is pretty hard to get. But this could as well have been a deadly form of flu or worse.
I hope it is a wake up call.
nor the necessary stop overs. West Africa maybe a little.
Apple to name just one, has one of their major manufacturing plants in China. They are part and parcel in many ways of the American economy. Ways that are not obvious nor readily known.
To stop travel would stop parts of commerce. That especially right now with tension over the Ukraine persisting and the European economy subsequently imploding, absolutely cannot be allowed. Global recession would occur.
Monitoring of passengers temps that I expect could occur eventually. But not till or unless ebola becomes endemic in China, which is unlikely.
depending on media reports for much of this stuff, and quite often the media is inaccurate in the details.
But what I ran a across most recently is even the blood and tissue samples of the initial patient were not kept segregated. They supposedly use some sort of tube type system to get their samples to testing within the hospital. And it is a collective system. So without segregation of samples you have the possibility for a whole new avenue of contamination and whole new groups of peoples exposed.
Hospitals have to be designed to segregate patients in isolation. A simple isolation room is not sufficient for this type of potential contaminant. Very basically isolation areas have to have entirely differing ventilation heating and waste disposal units than the rest of the hospital. If not, one patient may in theory contaminate a entire hospital depending on contagion.
Ebola is not such a contagious item, but it sounds like this hospital is not set up to handle a actual mass epidemiological event that requires segregation of patients.
There is no telling who could have been potentially exposed. Luckily for them (and us) ebola is pretty hard to get. But this could as well have been a deadly form of flu or worse.
I hope it is a wake up call.
I've mentioned this before but it sort of goes tho this point and my comment about cdc in general.
If the hospital is relying on cdc I wouldn't be too harsh on them. At our place we are set up or are setting up to test samples for Ebola in case the need arises. Cdc is very unclear on their guidelines on how to handle potentially infected specimens. For some things they're saying you have to work in BSL 3 which is a lot of PPE and safety precautions and for other things or at other times they say it's okay to use bsl2 which is almost, but not quite bench top. They're confused and I think it's because they're cobbling together stuff based on other pathogens. We've opted to treat all potential Ebola as bsl3 at very step but not all places are equipped to do so
I'm not reasonably doing anything and I'm not a virologist or someone working in testing labs. But I've sat in on a couple meetings to observe. So "we" doesn't mean me.
But to draw a bit of a parallel, though it is not a exact. On handling Hazardous Materials there exists a federal agency with which a responder to a incident may contact to find the necessary precautions and necessary actions to take to remediate the situation. This agency is available 24/7 by phone and internet.
And they are much used. However any manager of a incident may not depend upon the federal agency to do the mitigation of the incident for them. The proposals for handling such things are right and true but textbook answers to textbook scenarios. Management of such a incident must utilize various resources and this may be a primary resource but in no manner is the manager exempt from their responsibility of handling the incident due to a federal protocol being available.
Similarly the CDC is a resource. It's easy to think they may provide a protocol and have it followed as if it is a textbook but really this is not their functional responsibility. They are only a resource and cannot fill the hole that must be filled by responsible hospital management.
As the management of a hospital is responsible perhaps to see to it their employees may get flu shots to protect their patients. The CDC can reinforce the necessity by guidelines and such but really it is to the hospital to manage the requirement.
So to my view this is largely a individual hospital deficit. Why is the employe calling the CDC? This is the question I have. In a proper relationship management calls talks to and develops the proper response concurrent with CDC input and guidelines and then advises the employee of the outcome, the steps it must implement and hence the employee must implement to mitigate the circumstance of infectious disease containment.
Clearly this did not happen. The employe upon finding a fever does not even call the hospital but instead calls the CDC. And the hospital apparently did not make clear the requirement of the employe to remain in state and to monitor their vitals. Like a flu shot this is part and parcel of the employment. The employer can legally require these things and have the force of the law to back them. Once unemployed if the nurse chooses instead to quit as result then the state and federal agencies can step in. As they did with the family of the victim. If one of the passengers on the plane gets ebola by some rare event, the hospital is the responsible party for not implementing containment, not the CDC for not implementing as the employe is the hospitals charge not the CDC's.
So the CDC is as it is as you clearly display and I do not dispute.This however does not absolve the hospital from its charge on the employee. In this specific the extension to others is clearly to those employed by the hospital. If it was the general public I would say the CDC would bear more responsibility and liability.
Fatman
Micko : 10/15/2014 7:22 pm : link : reply
How can you possibly speak in absolutes like that? Scientist working in the field would never rule out the possibility of strains that could emerge with a modified transmission frequency. We simply don't know what lies ahead. Let's see how it spreads in the first world and we'll see.
What I've said is that the situation today is one of minimal risk. You know who is talking about the strains modifying? The Media and the talking heads they bring on to discuss Ebola.
They always are telling us the "What If's" and not the present situation. That's why I call it a fear mongering of sorts.
Every virus that arises, we constantly are told that it could mutate. Someday a serious one will, but is it really worth starting a panic over right now?
I'd rather hear in realities, and frankly that should be how the Media reports.
years and years ago, I was part of a state medical working group tasked to address the problems of containment of radiological waste spillage and contamination of personnel, subsequent to the movement of low level radioactive waste through NM. The Wipp project.
These very same issues of isolation and containment in relation to radioactive particles I find now presenting in the ebola outbreak.
We had to basically reengineer a level one trauma hospital, the only one in NM at that time(not me likewise as you mention I just sat in the meetings) for purposes of absolute isolation. This assisted largely by federal funds as Wipp was a federal issue.
Radioactive contaminant, terrorist agent such as a risen agent or ebola really the requirements for isolation are not very different.
All hospitals should be prepared to handle all of them and not depend upon the CDC to do it for them.
The CDC sucks but really that is not the reason to not allow them to be the final determinate of hospital action or inaction, liability and responsibility to the community they serve is.
if the virus did mutate almost undoubtably it would do so in a place where there are thousands upon thousands of those afflicted not in a place where the numbers are in the singles.
It is fear mongering, nothing more nor less, to sell viewership and thus as in all things in America adds and the buying of things.
Been around for hundreds of years that.
A mutation here is almost a impossibility considering the numbers of those infected. And keep in mind viruses may mutate to less harmful forms as well.
The swine flu in Mexico a couple of years back is one example of that.
There is a real threat here and it can as I mention be spread by coughing by saliva and such things coughed out and then found into a persons eye, and some other ways not yet mentioned in the media.
So there is really no reason to make up impossibles to sell the threat.
It exists but really is not the end of all. Think of it,…. it appears Nigeria of all places eradicated it in this latest manifestation.
His uncle wasn't cautious. He had direct contact with Ebola patients, he carried one to the hospital. If he hadn't entered the US there would be no cases of Ebola here. He didn't have a high enough fever when he went to the ER the first time, according to the CDC guidelines, that is why he was sent home. Not because he didn't have insurance. He also didn't have insurance the second time, and wasn't turned away then.
When you go into the ER, their goal is to stabilize you and send you home. Many people get released by the ER and then wind up back there a few hours or a day later. I did, and I have insurance. Even if you have insurance, there are rules for being admitted that the hospital and insurance companies agree to.
Shepard Smith tells it like it is... say what you want about this guy Â
Some speculate that this was a failure of the internal communications systems. Others have speculated that antibiotics and Tylenol are the standard protocol for a patient without insurance.
The hospital is not talking. Until then, we are all left to wonder. What we do know is that their error affects all of society. Their bad judgment or misjudgment sent my uncle back into the community for days with a highly contagious case of Ebola.
He's not blaming lack of insurance or even implying that.
Did you read the article before deciding he was looking for a payday?
yeah emergency rooms don't treat patients without insurance any differently
especially in a state like texas that has the most uninsured in the nation 22%
yeah emergency rooms don't treat patients without insurance any differently
especially in a state like texas that has the most uninsured in the nation 22%
please google the term
GOMER
Do you honestly think that if the hospital thought he had ebola they would have just sent him home? Do you know how many people show up at the ER with a fever, stomach pain etc? Do you want them all to be admitted?
His uncle wasn't cautious. He had direct contact with Ebola patients, he carried one to the hospital.
You know this how?
The nephew claims the dead guy says that was all a fabrication.
Ok, then how did he get Ebola?
Obviously he came in contact with someone. Does that automatically mean he was carrying a bleeding, shitting, vomiting woman to the hospital and licking his hands afterwards? Of course not.
A freaking nurse caught it. Someone that deals with contagions daily and has access to better PPE. But this guy was obviously careless? Hell, for all we really know, he caught it standing in line to board his plane when somebody sneezed on him.
The idea that you come from a country that has an epidemic Â
and you don't think you can get it is absurd. Blaming the hospital is absurd. He would have had no chance if he stayed in Liberia. To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
RE: The idea that you come from a country that has an epidemic Â
and you don't think you can get it is absurd. Blaming the hospital is absurd. He would have had no chance if he stayed in Liberia. To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
Where are they blaming the hospital for him having ebola?
They're blaming the hospital for sending him home knowing he was in West Africa and that he had a fever of 103- which is their fault, no?
the hospital says his fever wasn't that high and they were following CDC guidelines. Obviously that was wrong, but it's not the hospitals fault and it didn't have anything to do with insurance.
Please post back if you get any further info on transmission/contagion relative to symptoms. I'm very curious about the current threshhold of fever (100.4 apparently lowered now from 103!) as the point of risk to take treatment or quarantine actions.
To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
The only mention of any of that in what the nephew wrote is the insurance thing I quoted above- in which he just accuses them of fucking up and says we don't know why or how exactly.
Please post back if you get any further info on transmission/contagion relative to symptoms. I'm very curious about the current threshhold of fever (100.4 apparently lowered now from 103!) as the point of risk to take treatment or quarantine actions.
Thanks!
I can't find info on that and the people that i've asked don't have a good answer.
However, there is a very good article in today's NEJM that talks about the epidemic and discusses mortality rates etc. It actually addresses the rates question that montana and I mentioned yesterday. Their estimate is 71% mortality. One interesting finding was that there is an average of 5 days between when a person becomes symptomatic and when they're admitted to the hospital. That's pretty scary IMO. Of course, it's in Africa and not the US but they also found that the number was the same for regular people and health care workers. Since health care workers should be the more informed and culturally modern, that might (or might not) say something about how people would act here.
To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
The only mention of any of that in what the nephew wrote is the insurance thing I quoted above- in which he just accuses them of fucking up and says we don't know why or how exactly.
There have been a few reports of Jesse Jackson and John Wiley Price (a crazy Dallas councilman) claiming that Duncan died in large part due to neglect or non-use of experimental therapeutics completely due to his race.
I think the reason for the confusion on the fever is the CDC itself(no surprise there).
Reading through their literature today they list for medical health care professionals a fever of 101.5 symptomatic of ebola. However in the section on airline travel, in the general section(I did not peruse all potential documentation related to this) they state fever only. They then go about describing symptoms of a fever.
So it appears in general terms for airline travel any fever is a reason for a airline to deny the ability of a person to fly(accompanied with flu like symptoms and travel history). However in ER treatment Ebola is not suspected unless the symptoms are accompanied by a fever of 101.5.
A note on fever, some peoples normally have differing temperatures. It is rare but quite possible for someone to have a normal of 99.6 or 97.6. 98.6 is normal for about 6 billion of us but then we may have still millions that have normals which differ.Statistically it is very rare but it happens and environmental circumstances may in fact very greatly affect body temp. When cold we may drop a degree or 2 when hot up a degree or 2 as in when exercising .
Did insurance status have anything to do with the first patients medical ER treatment……. I would say absolutely not. Most admitting in hospitals ER's have separate personal doing the paperwork and they rarely if ever communicate with the medical staff. The nurses and docs don't have a clue if who they are treating is insured or not. Later on when admitted it is then that insurance comes into play.
There is some dispute on the temperature of the first patient in the ER. I have heard 103. If that is true he was released back to the community considering his history of travel inappropriately.
If that is true the hospital screwed up big time. As they did with their infection protocols when treating the patients allowing 2 nurses to get ebola.
I suspect it is true, this hospital is worse than the CDC, they seemingly really suck. the CDC as displayed by their contradictory statements on temperature which confuses and causes concern unnecessarily, just plain suck.
No offense to the docs and nurses working at the hospital nor the scientists and such at the CDC, this is most certainly a administrative issue.
They do advise health care peoples to call the CDC with questions on diagnosis of ebola but do not make any statements on their advise or protocols being mandatory or binding. To my read that establishes them as a resource but not a director of treatment in a professional health care context(rightly so I would say).
years and years ago the federal government found in necessary to establish a right to care for patients. Basically they enacted legislation that forced hospitals to care for all patients in a emergency context.
Subsequent to that hospitals found the necessity for care but no funds to pay for this care. A situation whereby they would lose cash on a daily basis and soon go out of business.
Varying solutions some based solely on the federal medicaid model some based upon state initiatives arose.
These solutions allowed hospitals to be paid back by state or local governments for no retrievable health care costs subsequent to the federal mandate for care.
The solutions by state vary greatly, in how the hospitals are paid. But ER visits are compensated for in all states by some manner by public funding of some sort. NM uses part of a land tax delegated to this
When admitted this no longer applies and degree of care is greatly affected by insurance coverage or lack of. In the ER I would say never.
some may be familiar with them and some not so much.
This is not like FEMA, boots on the ground, hands on people, who have done the job and are drawn from the real world.
Largely to my experience they are academics drawn from that type of environment. Great teachers, scientists epidemiologists, perhaps but these peoples are not ones you would choose to handle emergency situations.
This is not how their organization is set up nor functions as a emergency response unit.
These are peoples who you go to on advise on how to textbook, handle things. The real world as Bill mentions with his exception on tylenol and arthritics, is not textbook.
So they guide but can not manage.To expect them to do so causes problems, some of which we are seeing.
The local health care communities must handle this crisis by developing responses guided by CDC instruction, but not depending upon them to each and every extent.
If our most recent experiences in the ER is an indicator Â
sometimes not having insurance benefits you. Often times the mode of transport is by ambulance and people arriving in ambulances get bumped to the head of the line, no matter the underlying reason for coming to the ER in the first place.
but most ambulance/rescue crews will advise their patients if they need to go to the hospital by ambulance or not. One can absolutely refuse to go on their own to go by taxi or some other means and go by ambulance, but that is rare. Most places no longer provide bill free transport, regardless if the transport is by public entity or not.
Typically they are told up front, this ride costs money and you can save a bill by not going by ambulance(if they don't need to). Ambulances in most places are set up as separate entities from hospitals in a legal sense and bill separately.
But absolutely right, ambulance patients receive first treatment. It is assumed their conditions are worse then walkers in.
To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
The only mention of any of that in what the nephew wrote is the insurance thing I quoted above- in which he just accuses them of fucking up and says we don't know why or how exactly.
Cam, this is in the article
'But he was a man of color with no health insurance and no means to pay for treatment, so within hours, he was released with some antibiotics and Tylenol.'.
So which is it? They fucked up or they are racist and didn't want to treat him because he had no insurance?
Your patient just shows up from Africa with a fever a no insurance. Its low grade he's otherwise well. Suspecting a tropical disease and admitting him will cost the hospital big $$$, and lead to reviews about necessary or unnecessary admissions by ER attendings (especially if you're wrong).
What do think is a likely outcome?
If your same patient had insurance and admitting him and testing would be profitable to the hospital (wether your hunch was right or wrong) what do you think would happen?
In practice the ER staff is never critiqued on admissions unless there is a overt problem, like lots of peoples being admitted erroneously or potentially lots of people being not admitted.
The hospitals(some of them) have stats on how many patients percentage should result in admissions. Fall above or below that and they may study the issue to determine why. But that is a crew or shift study not a individual.
So docs have little fear of seeing their admissions being considered inappropriate by the rational of fee retrieval. A floor or speciality doc has no more pull nor weight in hospital administration than a ER doc. In fact the opposite is usually true as the ER docs position is very much harder to fill. And it is the docs who determine who is admitted and who is not. The nurses advise.
The billing is kept separate from the ER docs knowledge.
Docs have personal bias, and may for instance see a obvious homeless person being treated and refer him to a publicly run hospital in some places, but this is a personal bias and not a system bias.
Could that have happened to this guy…I'd say no probably not.The doc would not know by looking or talking with him if he was insured or not and has no reason to ask him. ASking him would in fact be inappropriate, by other than admitting or paperwork oriented staff. A medical professional person in a ER should never ask insurance status, it is simply not their job.So they don't do so. Other staff do so. They basically don't care.
When admitted…the whole story changes. Further treatment is absolutely determined by ability to pay and potential retrievability of monies.
In the ER no it is not that way. Never say never but 99.9% sure.
In one scenario, the aide workers who had ebola are admitted to Emory under the CDC's oversight - no problems, everyone gets better, and certainly none of the treating staff become infected.
In the other scenario, a guy with ebola walks into this hospital in Texas, but is discharged. Then he is readmitted, and not only does he die, but two of the nurses who treated him are infected, and a whole host of stories about the hospital's lack of preparedness seem to be trickling out.
It seems to me the hospital was just unprepared for this high risk/low frequency event.
hospitals largely have no economic interest in preparing for low frequency but high risk events.
Why redo your whole facility to provide for real isolation. Why train and certify peoples to perform in epidemic or potential epidemic situations that require isolation?
In NM with Wipp there was a economic benefit as Wipp related monies provided incentive. Remodel and establish protocols and you got fed funds, it was that simple. And Radiation directly translates to ebola and other things that require isolation.
Hospitals are largely for profit. Even if not publicly so they internally are devoted to cost containment.
This is one of the problems with a for profit insurance based health care system model in America.
The s hits the fan and there are going to be significant problems. This crisis is way way hyped and overblown ebola is just not that contagious.
What will happen when a real crisis like in 1918 deadly flu type thing occurs?
This is a wake up call, but it is to no avail.
As the ER eval is ongoing and pt says "I just came back from Africa" every ER doc knows to put tropical diseases at the top of their differential. Maybe not Ebola, but the thought had to have been there. Simple stuff. Once that possibility is raised, admission has to be considered. But the thought process doesn't end there. The ER has to find someone to admit him. So he will ask the patient "Do you have a primary?" At that point he will essentially know the guy is uninsured, and will consider admitting to house staff. He may think house staff is 1) overworked 2) incompetent 3) a financial burden or a combination of the above. Thinking along those lines he may back up a little and say its unlikely a disease of significance, just go home.
Sounds very plausible to me, and the lack of insurance was a contributing element.
But most commonly to my experience the ER doc will make the decision to admit or not, and then after that decide where to admit the patient, here, where his primary works out of, and all the rest.
Decide whether to admit depending on the patient having a primary or not….I'd say not.
Of course all docs will get a med history on making their decisions but really there presence of a primary or not is pretty insignificant medically in a case like this.
Some conditions mandate interaction with a primary such as past heart problems perhaps but the ER is basically making a pretty simple decision, where to put this guy.
Then the floor doc can interact with the primary. Could they ship this guy to another hospital where his primary works out of certainly…it happens all the time(by ambulance)
To decide not to admit….I'd say no it generally does not happen that way.
Possible I say again never say never but highly improbable.
One of the decisions hospitals make, as they largely assist with malpractice insurance, (it is generally part of the compensation package) is how many situations of litigation does any doc engage in yearly.
Quite a few litigations and they may decide not to renew, as the insurance becomes prohibitive a red flag is raised.
Again not all hospitals but many. Some areas such as pediatrics and obstetrics are known for having high rates of litigation. A ER doc not so much at all.
That way of thinking would lead straight to litigation, and the doc would potentially not have a contract renewal as result.
So the hospital and the doc would personally suffer, far more then if they denied admission Even in Texas.
So largely ER docs don't do things that way.
but hey, good spin doctors and all very PC
which is really what's most important. Glad you guys are getting on board with this.
but hey, good spin doctors and all very PC
How about.....alligatorpie?
In the area of West Africa that all the outbreaks have come from there has been a grand total of *k cases with 4K deaths from it. Where this came from is some of the worse fucking areas in the world for medical care, personal hygiene, and a 3rd world infrastructure to be able to deal with this and YET they only have 8K cases w/ a %50 death rate.
So stop with the political agenda driven BS about this and understand that we infinitely better prepared to address any kind of outbreak here in the States.
How many US citizens have died from Ebola contacted here? ZERO. So explain how they did not do their job
each case generates 2 new ones on average, 6 day average incubation rate.
do the math
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Also, clearly the CDC and government reponse to disease that you see in movies is pure fiction. There IS no response. There IS no emergency protocol, amazing.
How can healthcare workers who dealt with an Ebola patient just up and fly so short after the first patient died? Is there no protocol? No self monitoring and at least self restriction of travel?
If this disease becomes permanent in the US we are screwed. How could any reasonable person draw any other conclusion based on how the healthcare system has response do far.
Also, the CEO and chief medical officer of this hospital should quit their jobs and apologize to this country for the epic public health failure.
the whole "restricting entry" notion is amazing. How is that really supposed to work?
This really has nothing at all to do with CDC or any national health agency. It's a matter of incompetent hospital administration. Possibly also a lack of oversight, certification, and regulation by state gov but I'm not familiar enough with Texas' health care regs to say.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
Restricting entry would cause people to follow circuitous routes to the U.S., making it potentially much harder to track their progression.
But, hey, when you're on the side of buford, you must be correct...
THINK people, think
each case generates 2 on average, 6.5 days incubation, 70% death rate,
10,000 new cases per WEEK in west africa per WHO by end of month
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
Just for fun, what would a "real measure" be?
This is is a unique situation that requires new thinking and policy.
This is a public health crisis that is a national security risk to the United States. It should be viewed as such by those in power.
I'm of the opinion that Ebola has already mutated to Airborne Transmission, at least in some cases. Such an announcement would set off widespread panic.
This thing is starting to resemble a bad Snake Plissken Movie.
Among those nurses was Nina Pham, 26, who has been hospitalized since Friday after catching Ebola while caring for Thomas Eric Duncan, the first person diagnosed with the virus in the U.S. He died last week.
Public-health authorities announced Wednesday that a second Texas Health Presbyterian Hospital health care worker had tested positive for Ebola, raising more questions about whether American hospitals and their staffs are adequately prepared to contain the virus.
Related Stories
The CDC has said some breach of protocol probably sickened Pham, but National Nurses United contends the protocols were either non-existent or changed constantly after Duncan arrived in the emergency room by ambulance on Sept. 28.
Link - ( New Window )
Quote:
the number one national security threat to the United States. Real leaders and statesmen, which this country can not seem to produce any longer, would be thinking outside the box and taking any possible action to secure this country.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
Just for fun, what would a "real measure" be?
I did not say I had the exact policy of the top of my head. Do you think the current policy is ok?
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Hey dipshit, put it into the perspective of where those cases are being handled at ...Seriously do you lack that much common sense to understand the difference between fatality rates in America, and a different area that has zero medical facilities, staff, or preventive strategies to address this?
This is why you catch so much shit on this board. It is your complete lack of common sense
Quote:
In comment 11921596 rocco8112 said:
Quote:
the number one national security threat to the United States. Real leaders and statesmen, which this country can not seem to produce any longer, would be thinking outside the box and taking any possible action to secure this country.
This is not happening at all. Any measure needed to secure the borders of the US and to ensure that real public health becomes a priority should be taken.
Problem is there is no leadership.
When this germ spreads to other cities around this country it will be game over. Basically everyone posting on this site has lived in a world where we have no reason to fear infectious disease, that world will no longer exist.
To me the repercussions of that fact have yet to be seen and I doubt anyone is qualified to even predict them.
One saving grace would have been that the US had a real response planned for this and a real push towards true public health. Based on this joke of a hospital and the CDC's actions so far that hope is fleeting.
Just for fun, what would a "real measure" be?
I did not say I had the exact policy of the top of my head. Do you think the current policy is ok?
I don't really know what else we could do. But I'm also not here declaring that we're obviously doing something wrong and have no leadership either.
It might help if the Sen Coburn would stop blocking funding for public health prevention and response to Ebola.
It might help if Congress restored funding for research of drugs for Ebola treatment and vaccinations, all of which was cut in the arbitrary Sequester.
Oh wait, Congress is still on its two-month recess because their careers are so much more important than the country's Public Health in the face of a potential pandemic/epidemic of a deadly disease. Not to mention that Flu and Enterovirus are no picnic...and potentially complicating factors.
Anyone want to talk about the huge hole in Texas' public health system, thanks to its rejection of the Medicaid expansion. You have hundreds of thousands, if not millions, of working poor people who will not get prompt medical attention for fevers because they cannot afford an emergency room visit. So they'll be delaying seeking medical help and exposing others to disease while they are symptomatic, the time when Ebola is most contagious.
So they've got that going for them....which is nice!
This really has nothing at all to do with CDC or any national health agency. It's a matter of incompetent hospital administration. Possibly also a lack of oversight, certification, and regulation by state gov but I'm not familiar enough with Texas' health care regs to say.
Where I do fault the CDC is it's failure to assess the capabilities of these facilities to handle the situation. However, they are not the ones providing incompetent hospital administration, so you raise a fair point in that regard.
I am in favor of common sense precautions. In the beginning, I was one who said it wouldn't spread here. Of course I was thinking that we had the best medical staffs, trained for this type of thing. Turns out we don't. And we lack the political will to do what is necessary (stop the voluntary quarantines). You can have all the protocols you want, but you are depending on people to carry them out. People can be stupid, lazy, careless, selfish. The NBC Doctor who was under voluntary quarantine and went to a restaurant is a great example. What are these people thinking? They are thinking they are invincible. We think the US is invincible and it can't happen here. Unfortunately we were over confident. Ebola is pretty hard to get. But imaging if it wasn't. What would we do if we had some kind of virus that was this deadly that spread more easily? We'd be fucked.
Yeah, ok.
1. Infect easily (purely airborne transmission).
2. Kill large swaths of the population.
3. Don't confer a natural immunity after you have survived it
are unsuccessful viruses.
Quote:
I feel much better now....
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Hey dipshit, put it into the perspective of where those cases are being handled at ...Seriously do you lack that much common sense to understand the difference between fatality rates in America, and a different area that has zero medical facilities, staff, or preventive strategies to address this?
This is why you catch so much shit on this board. It is your complete lack of common sense
Yes montana, read my post above. We have medical facilities and staff and preventive strategies. How's that going so far???
As I said, Ebola will not get to the point here as it has in Africa. But it should never have gotten to this point. And what if you were a healthcare worker, or some one who comes in contact with a large amount of people each day? Do you have a right to be concerned????
Ironic
J Stew suggested last nite that we go ahead and build that fence down south, we just move it a little extra northward lol
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The other hospitals treating transported Ebola victims have NOT had any protocol breakdowns or transmissions.
I love that idea. Count me in. Preferably before this weekend.
Unfortunately Ebola may already mutated to airborne transmission according to some people on the internet. Personally I think Jihadist ghosts are carrying Ebola and spreading it in in the US as a terrorist revenge plot. I have nothing to back that up with but hey why not say it? Right?
Day Cases
1 1
2 2
3 4
4 8
5 16
6 32
7 64
8 128
9 256
10 512
11 1,024
12 2,048
13 4,096
14 8,192
15 16,384
16 32,768
17 65,536
18 131,072
19 262,144
20 524,288
21 1,048,576
22 2,097,152
23 4,194,304
24 8,388,608
25 16,777,216
26 33,554,432
27 67,108,864
28 134,217,728
29 268,435,456
30 536,870,912
Those patients were brought in isolation and it was known that they had Ebola. And they were in Emory, which is connected to the CDC and another pre-determined hospital that was prepared. We are not prepared to have people show up in ERs and have all the hospital workers be protected. Perhaps they need to have designated Ebola centers and once a patient is suspected of having it, transfer them there.
1 Ebola Begets 2 Ebolas
Day -- Cases
1 -- 1
2 -- 2
3 -- 4
4 -- 8
5 -- 16
6 -- 32
7 -- 64
8 -- 128
9 -- 256
10 -- 512
11 -- 1,024
12 -- 2,048
13 -- 4,096
14 -- 8,192
15 -- 16,384
16 -- 32,768
17 -- 65,536
18 -- 131,072
19 -- 262,144
20 -- 524,288
21 -- 1,048,576
22 -- 2,097,152
23 -- 4,194,304
24 -- 8,388,608
25 -- 16,777,216
26 -- 33,554,432
27 -- 67,108,864
28 -- 134,217,728
29 -- 268,435,456
30 -- 536,870,912
Quote:
In comment 11921579 buford said:
Quote:
I feel much better now....
Face it, we are NOT prepared for this. And if the concern is for the people in W Africa will get to other 3rd world countries then shouldn't something to be done to prevent that?
It's not just this guy getting on a plane. All healthcare workers are at risk. Doctors without borders has has several get Ebola and die, and they were following strict protocol. Maybe the protocol isn't good enough anymore.
Hey dipshit, put it into the perspective of where those cases are being handled at ...Seriously do you lack that much common sense to understand the difference between fatality rates in America, and a different area that has zero medical facilities, staff, or preventive strategies to address this?
This is why you catch so much shit on this board. It is your complete lack of common sense
Yes montana, read my post above. We have medical facilities and staff and preventive strategies. How's that going so far???
As I said, Ebola will not get to the point here as it has in Africa. But it should never have gotten to this point. And what if you were a healthcare worker, or some one who comes in contact with a large amount of people each day? Do you have a right to be concerned????
If you understand that then why would you be so asinine as to correlate the 50% death rate in a 3rd world area whose population is completely vulnerable to the disease, has no true medical facilities, and lacks the most basic hygienic facilities to combat this. To what can happen here in the States?
If you really understood anything, you would realize its quite amazing that the death rate is only %50 there and that there has been only 8K confirmed cases of it. But no instead, you are the only one on this thread who fails to comprehend the point that was made.
The other hospitals treating transported Ebola victims have NOT had any protocol breakdowns or transmissions.
See my post above. You can't compare facilities that took in patients that were already known to have Ebola and had procedures in place prior to those patients coming in. Also, those patients were not spewing bodily fluids as Duncan was when he entered the ER for the second time.
And the hospital is not a rinky dink community hospital. Obviously they have issue, but I doubt any average hospital in the US doesn't. And that is where these patients are going to show up.
If you understand that then why would you be so asinine as to correlate the 50% death rate in a 3rd world area whose population is completely vulnerable to the disease, has no true medical facilities, and lacks the most basic hygienic facilities to combat this. To what can happen here in the States?
If you really understood anything, you would realize its quite amazing that the death rate is only %50 there and that there has been only 8K confirmed cases of it. But no instead, you are the only one on this thread who fails to comprehend the point that was made.
I understand your post perfectly. It's what you always do. Tell everyone they are stupid if they don't agree with you. Why you think saying a disease 'only' has a 50% kill rate is reassuring is beyond me. Do me a favor, you obviously don't care for my posts, just ignore me. I don't have any wish to communicate with you on any level.
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on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
How many US citizens have died from Ebola contacted here? ZERO. So explain how they did not do their job
Not do their job? How can you even begin to defend this. 2 trained nurses have become infected. Death is not the standard, infection is.
You can't burn down Dallas. I fucking love Dallas.
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on so many fronts. The CDC saying "in hindsight..." Really? Really? You are the idiots who were so arrogant in proclaiming the ability to control this should it get into this country. Yet on the first opportunity, we now have 2 people who have contracted the virus by caring for 1 victim. I'm sorry, but how the Government did not do its job and restrict entry into the U.S. by anyone who had been in any of the hot zones is infuriating. Another failure by the institution whose first and most important job is to protect its citizens.
the whole "restricting entry" notion is amazing. How is that really supposed to work?
Ever hear of a passport that identifies where you have been?
I'm of the opinion that Ebola has already mutated to Airborne Transmission, at least in some cases. Such an announcement would set off widespread panic.
This thing is starting to resemble a bad Snake Plissken Movie.
There are no bad Snake Plissken movies.
It sounds like the spread is more from not following proper medical protocols than the ability of the virus to easily transmit itself from person to person. That would make us victims not so much of the virus, as our own incompetence and indolence. None of that of course would matter if it got out into the general population, as it has in West Africa, where limited medical facilities inhibit whatever precautions can be taken even by conscientious medical professionals.
If it isn't Ebola, it will be another virus. Global population is headed for 9 billion by 2050. More and more people will be living closer and closer together. A new virus will emerge, or an old virus will mutate to become more easily transmissible, and then spread quickly in close quarters. That is what happened in this country in 1918 with the Influenza epidemic. The real "crash" will be biological, not economic, at least not initially. Some kind of pandemic is inevitable.
Day Cases
1 1
2 2
3 4
4 8
5 16
6 32
7 64
8 128
9 256
10 512
11 1,024
12 2,048
13 4,096
14 8,192
15 16,384
16 32,768
17 65,536
18 131,072
19 262,144
20 524,288
21 1,048,576
22 2,097,152
23 4,194,304
24 8,388,608
25 16,777,216
26 33,554,432
27 67,108,864
28 134,217,728
29 268,435,456
30 536,870,912
and this is how hospitals treat uninsured patients
he went to the hospital the first time they saw he did not have health insurance and they gave him some antibiotics and sent him home
the second time he waited in the emergency room unattended
only when they realized he had ebola did they give him the medical attention he required
You can't burn down Dallas. I fucking love Dallas.
We'll wait until you're not there. Life is full of little disappointments. Hope you are well.
Can one of you statisticions please confirm my math; it may be longer than 180 days.
I need to get my affairs in order and whether I have 30, 180 or more days is relevant.
In the area of West Africa that all the outbreaks have come from there has been a grand total of *k cases with 4K deaths from it. Where this came from is some of the worse fucking areas in the world for medical care, personal hygiene, and a 3rd world infrastructure to be able to deal with this and YET they only have 8K cases w/ a %50 death rate.
So stop with the political agenda driven BS about this and understand that we infinitely better prepared to address any kind of outbreak here in the States.
The mortality rate in Western Africa is closer to 80%.
Not sure that the rate is significantly less in a developed country; is there all that much data? We can surmise that it's lower because of sanitation, culture etc but it's all supposition. And it might reflect the incidence rate more than the mortality rate.
In this latest outbreak we've had how many people become infected and cared for here? 5 or 6? Two received experimental therapy and might be outliers. Duncan died, Pham, who knows.
There's so much to be concerned about even though there's nothing to panic about. It seems that if you're not going to be a chicken little, you are an ostrich. The truth is somewhere in between.
Because it fits a political driven agenda argument. This thread is a litmus test for the dunderheads
People are exploiting this to push a political agenda. Has nothing to do with health insurance, or the sequester, or xenophobia, or God punishing us for our sins.
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Is laughable.
In the area of West Africa that all the outbreaks have come from there has been a grand total of *k cases with 4K deaths from it. Where this came from is some of the worse fucking areas in the world for medical care, personal hygiene, and a 3rd world infrastructure to be able to deal with this and YET they only have 8K cases w/ a %50 death rate.
So stop with the political agenda driven BS about this and understand that we infinitely better prepared to address any kind of outbreak here in the States.
The mortality rate in Western Africa is closer to 80%.
Not sure that the rate is significantly less in a developed country; is there all that much data? We can surmise that it's lower because of sanitation, culture etc but it's all supposition. And it might reflect the incidence rate more than the mortality rate.
In this latest outbreak we've had how many people become infected and cared for here? 5 or 6? Two received experimental therapy and might be outliers. Duncan died, Pham, who knows.
There's so much to be concerned about even though there's nothing to panic about. It seems that if you're not going to be a chicken little, you are an ostrich. The truth is somewhere in between.
From the CDC website:
As of October 8, 2014
(Updated October 10, 2014)
Total Cases: 8400
Laboratory-Confirmed Cases: 4656
Total Deaths: 4033
link - ( New Window )
And just like The Walking Dead...it all starts in Georgia.
I've got my bunker (aka my basement) set up for the oncoming apocalypse! If anyone wants, you can always come to my basement (not in the same way that Cam would invite you though, so don't get too excited).
Airborne Ebola - ( New Window )
As I have a family member working there (not in administration) I can confirm it's not a rinky dink community hospital.
Likely, though not certain.
That very well could be the case Bill
The other question is is this an anomaly. When govt tells us that because protocols are set I'm place, we believe them because we assume people are not human. They don't mistake, they always follow instructions and follow them properly. They don't like the NBC crew, lie and sneak out of quarantine for a beer and a smoke.
I'd feel so much better if there was a vaccine or a drug or something that didn't involve the most flawed, but apparently central, element in the whole protection scheme...people. Because people are I her entry corrupt dumbasses. Even the good ones.
Repo Man - ( New Window )
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My numbers are from reading research literature so it's coming from scientists. WHO people and science people might be working off different databases.
That very well could be the case Bill
Just googling Ebola mortality rate brought up several stories with a con census 70%, so it looks like there's room for wobble in the numbers
One thing we don't know about is how mass hysteria and panic will play into this.
Just wait until the infected hit the subway systems of a crowded city. All bets are off at that point.
On another note...and Micko if you're out there, I'd appreciate your opinion...I just saw an interesting paper from 2005. They infected pigs with Ebola and housed them next to rhesus macaques, physically separated by a wire mesh fence. All of the macaques got Ebola with the primary tissue destruction site being the lungs. Conclusion is that there was airborne transmission from pigs to NHP. That's scary. However and quite interestingly, housing infected and non-infected macaques next to each but separated by fencing did not result in infection of the naive group. That suggested there wasn't airborne transmission among NHP.
IS that something that might be easily changed through mutation?
And I appreciate your concern.
You can place it alongside the others.
As for Ebola, this is scary stuff. I'm sorry to say,.
Funding for the CDC is pretty stable. There was a slight drop in FY13 due to the sequester. I'm going to go out on a limb here and suggest that the small decrease in spending in 2013 is not in any way responsible for any problems in dealing with ebola. Also, please note that the president's 2015 budget is allotting less money for the CDC as well.
US Global Health Program spending, 2001-2015:
Hey, look at that - spending rose dramatically in 2001-2010. Moving on.....According to that Kaiser report, "Pandemic Preparedness funding through the GHP account totaled $50 million". OK, so the feds spent $50m to prepare for a pandemic. Let's see what else they were spending money on:
•Chronic disease prevention (obesity, heart disease, etc): fiscal 2014 budget approximately $1 billion, or just under 15% of the total budget.
•Birth defects: $132 million, or just about 2% of the total budget.
•Environmental health (asthma, safe water, etc): $179 million, 2.6% of total.
•Injury prevention (domestic violence, brain injury, etc): $150 million, 2.2% of total.
•Public health services (statistics, surveillance, etc): $482 million, 7% of total.
•Occupational safety (mostly research): $332 million, 5% of total.
Add all of that up and that's $2.275 billion dollars the CDC spent on things other than infectious diseases.....which is the entire reason the agency exists in the first place. $50 million for pandemic preparedness, $2.275 billion on all that other shit.
As for Ebola, this is scary stuff. I'm sorry to say,.
I've gotten better?
The problem is that, a lot of times the arguments put forth actually hurt us more than help us. Same with Ebola.
You thought people not getting vaccines was bad, this could rival that in terms of pretty bad side effects.
Anyone who wants to claim that a patient would be turned away because of no insurance when it was suspected they had Ebola is just crazy. We now have two healthcare workers who have contracted it from caring for this patient. And that might not be all.
If this nurse survives, some kind of punitive action needs to be taken. I really think was negligence of the worst kind; wanton disregard.
She had no evidence of infection, and probably was at no greater risk than the other hundred or so that cared for the pt.
If this nurse survives, some kind of punitive action needs to be taken. I really think was negligence of the worst kind; wanton disregard.
If she was asymptomatic when she traveled, how can anyone charge her for anything beyond doing what normal people do...traveling freely in this nation?
All this talk of forcebly putting people into quarantine if they traveled to Africa against their civil rights and other nonsensical talk is scarier than the prospect of Ebola turning into some pandemic threat.
Get hold of yourselves...you're chance of catching and dying from Ebola is only 50:50...just a bit shy higher than dying from a terrorist attack, which is 1:3.
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the whole "restricting entry" notion is amazing. How is that really supposed to work?
How does it work? The US custom looks at his/her passport, and if the person had been to West Africa recently, you say, "No, you cannot come in. Not yet at least." A forceful attempt to gain entry will be met with more greater force. He'll understand quickly.
Oh go ahead and cry "Human right violation!" or, more powerful yet, "racial discrimination!" CNN and MSNBC will cry with you.
Just my initial opinion, I could very well wrong.
My wife was stuck with a dirty needle (someone else' negligence) her supervisor told her to not worry about getting tested - because the patient was low risk, yea right.
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In comment 11921553 Bernie said:
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the whole "restricting entry" notion is amazing. How is that really supposed to work?
How does it work? The US custom looks at his/her passport, and if the person had been to West Africa recently, you say, "No, you cannot come in. Not yet at least." A forceful attempt to gain entry will be met with more greater force. He'll understand quickly.
Oh go ahead and cry "Human right violation!" or, more powerful yet, "racial discrimination!" CNN and MSNBC will cry with you.
And here comes the moron from LA.
And here comes the moron from LA.
And you are ignorant idiot.
If she was asymptomatic when she traveled, how can anyone charge her for anything beyond doing what normal people do...traveling freely in this nation?
All this talk of forcebly putting people into quarantine if they traveled to Africa against their civil rights and other nonsensical talk is scarier than the prospect of Ebola turning into some pandemic threat.
Get hold of yourselves...you're chance of catching and dying from Ebola is only 50:50...just a bit shy higher than dying from a terrorist attack, which is 1:3.
I don't know about charging her, but these people were supposed to be voluntarily quarantined. We now have a doctor and a nurse breaking that quarantine. You would think that medical people would understand the need to control who has been exposed. This is the weak link in the chain.
Just my initial opinion, I could very well wrong.
But how is it criminally irresponsible when she wasn't showing any symptoms prior to her travel? She (along with everyone else in the hospital) most likely believed that they did their due diligence in safeguarding themselves. Unlike many on this thread, I doubt that these medical professionals are thinking doomsday scenarios.
It sucks that she did contract the disease, but to say that she should be punished is bordering on punitive measures for the sake of fueling hysteria.
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In comment 11921865 LAXin said:
And here comes the moron from LA.
And you are ignorant idiot.
Ugh...every time you post, I want to reach through my screen and punch you right in the face for not only being absolutely idiotic in almost all of your posts but for making LA look bad.
But even the head of the CDC said the nurse should not have traveled on a commercial flight...I just see it as common sense.
It it unreasonable to think "Gee, I've just been in close proximity with a man who died from Ebola...perhaps it wouldn't be unwise to go on an airplane for a few weeks."
Just my opinion- perhaps I'm wrong.
Sure...everyone in any profession should know better. That isn't the issue...the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
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In comment 11921874 RC02XX said:
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In comment 11921865 LAXin said:
And here comes the moron from LA.
And you are ignorant idiot.
Ugh...every time you post, I want to reach through my screen and punch you right in the face for not only being absolutely idiotic in almost all of your posts but for making LA look bad.
You can leave LA if my words shame you. Go ahead, leave. Who are fuck are you to represent LA, or have the authority what opinions would make LA look good or bad? Who are you, exactly? You are not an ignorant fuck?
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the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
Yes, I feel my civil right was severely violated when the government that my tax money supports failed to isolate the country better from this disease. what, am I not allowed to feel that way? Is such feeling sub-human, unlawful, unmoral?
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In comment 11921894 buford said:
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the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
Yes, I feel my civil right was severely violated when the government that my tax money supports failed to isolate the country better from this disease. what, am I not allowed to feel that way? Is such feeling sub-human, unlawful, unmoral?
Just stop. No one violated your rights, and I doubt you will ever be in danger of catching and dying from Ebola. So get the sand out of your gash.
Maybe I am coming off a bit over the top, but what would be the precedent for something like this?
Where a very deadly microbe is spreading in an age of easy air travel.
Combine this with the clusterfuck that is how this case has been handled by the hospital in Dallas. This is how the "best healthcare system" in the world met dealt with Ebola for the first time.
I would grade the action and response as an F+.
To me it is not hard to believe that this will change how we view infectious disease in this country and it may have far reaching consequences that at this time we can not fully imagine.
I am not in a bunker and I am not actually panicked at all. I do think it is an unprecedented historical event for our modern age and I have no confidence with the US healthcare system, as it currently functions, to ensure that this disease does not become permanent in the US.
I also do view it as a national security issue, how could you not?
American really is a country that, seriously, has NOT really experienced much hardship, that's the good and bad about it.
Asked an American to describe the most difficult hardship, and he would say, "back in 1929, when we had this disaster called the Great Depression, people had to line up to get some soup. Wow, how hard that was! See, we suffered! We understand human hardship!"
Which would make most of the world laugh. Or angry.
It is such accustom to good and peaceful life that allows morons like RC02XX to ask worry things like "did we violate his civil right?" "did we hurt his feeling?" "how is travel restriction is possible to work". Those high-moral questions disappear only when dead bodies are lying on the street.
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In comment 11921900 RC02XX said:
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In comment 11921894 buford said:
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the issue is people going high and to the right with regards to wanting to punish people or violate their civil rights because they have been bitten by the hysteria bug is a bit much, no?
Yes, I feel my civil right was severely violated when the government that my tax money supports failed to isolate the country better from this disease. what, am I not allowed to feel that way? Is such feeling sub-human, unlawful, unmoral?
Just stop. No one violated your rights, and I doubt you will ever be in danger of catching and dying from Ebola. So get the sand out of your gash.
My brother is a doctor who works out of the ER/ICU of a NYC hospital. Are YOU any closer to Ebola? How so?
Are YOU telling me what danger I am allowed to feel, and not to feel? I ask again, what are you, and based on what authority, are you telling me what to feel and what not to feel?
Asked an American to describe the most difficult hardship, and he would say, "back in 1929, when we had this disaster called the Great Depression, people had to line up to get some soup. Wow, how hard that was! See, we suffered! We understand human hardship!"
Which would make most of the world laugh. Or angry.
It is such accustom to good and peaceful life that allows morons like RC02XX to ask worry things like "did we violate his civil right?" "did we hurt his feeling?" "how is travel restriction is possible to work". Those high-moral questions disappear only when dead bodies are lying on the street.
And you lived such a difficult life in LA where your civil rights were constantly violated. You came off like a buffoon and a complete bitch in your previous posts in the Ferguson related threads. And now this? Before you go into your Kim Jong Un-mode trying to violate the basic civil rights of people, maybe you should take a breath. Your hysteria and persecution complex is really blinding. And sure, tell me how you've seen and known suffering from your latte drinking life.
Are YOU telling me what danger I am allowed to feel, and not to feel? I ask again, what are you, and based on what authority, are you telling me what to feel and what not to feel?
No...you can fear for your life all you want. That's your prerogative. But based on reality, I doubt you will contract and die of Ebola...just saying.
As Bill L said, the weak link in this whole thing is people. Sure it's a bit hysterical to think the world is ending because you can't trust a medical person to not travel and expose the world. But isn't it equally naïve to not worry when med staff are traveling after being exposed to a deadly disease?
If she had a fever on the plane is it not possible that she was contagious? Even if there is a tiny chance that is quite a roll of the dice.
If she spread Ebola on a flight that would be very serious. Obviously the CDC thinks so since NOW they will work with authorities on travel bans for those exposed to Ebola.
This is what I mean when I say that there seems to be no protocol, no plan for this. There must be some risk if the CDC is changing their actions after the fact.
Thing is with a microbe there is no after the fact. If multiple people on that flight get Ebola that is a serious problem.
As Bill L said, the weak link in this whole thing is people. Sure it's a bit hysterical to think the world is ending because you can't trust a medical person to not travel and expose the world. But isn't it equally naïve to not worry when med staff are traveling after being exposed to a deadly disease?
Sure there should be a middle ground, and maybe these medical personnel should have been under long term observation with routine testing rather than just being advised not to travel. She made a terrible decision, but the protocol was just as bad in ensuring that she was better taken care of than being left to her own device in which she probably thought she was ok (which is a human nature).
That's exactly my point in my response to fkap. Better protocol to take care of their own people (medical personnel) by the hospital may have prevented this nurse from thinking that she can travel. As you said, it's human nature to do what you think is best for you and not necessarily for others around you. Only way to prevent that short of locking these people up is to truly put into place something that holds these medical personnel accountable as well as making them feel like they're being taken care of beyond just some advice given to them.
+100000000
I did get a good chuckle out of your invite. During an apocalypse, visiting an ex marine proficient in 101 ways to kill people is low on my to do list.
I did get a good chuckle out of your invite. During an apocalypse, visiting an ex marine proficient in 101 ways to kill people is low on my to do list.
Sir, there is no ex-Marine...and I will need others' help to feed my family...even if it is at the expense of their legs or arms, etc. I'm not picky...:)
That's completely understandable. If you have been quarantined with just cause, then of course you should be punished for ignoring it. However, was this just an advisement or an actual quarantine? Human nature...blah blah blah.
So it was voluntary but they had already agreed to it.
Yes, lets not infringe on civil rights at the expense of causing an outbreak of a virus we know little about.
I love the blurred lines between theory and reality.
Won't come to us.
Won't die from it.
No one will get infected here.
Now it's no one else will get it.
That is reason alone to bet this is the next apocalypse.
It is a real threat that with certain conditions prevailing could become a significant issue.
My personal guess is that after a couple of week our health care community gets it and while occasional infections are bound to occur widespread contagion will not.
That said, the problem with restrictions on air traffic are myriad. How for instance do you say to a US citizen, you cannot come back to the US if they have visited western Africa? Most will have jobs to go to and cannot simply afford staying away. A simple test of temperatures will prevent infection in transit(prior to entering a plane) and when in the states they can be advised by law to self monitor or monitor by a third party if self monitoring is impossible or considered unlikely.
We can stop boarding of planes for all people for suspected terrorism I find in unlikely we can not also stop boarding of planes by non citizens if necessary. However determining the real location of someone(where they have been), in Africa as opposed to where they leave by plane may be a insurmountable issue. Some borders are not even monitored nevertheless having passport stampings.
This second nurse infected….by my take her actions were totally irresponsible.
We really need to work at helping African nations stop this. That is the most likely solution to protect the US. It will likely never be completely eradicated, but will become manageable with proper care.
I really don't know why everyone isn't concerned about all of this. We've had carriers walking around uncontained and flying on a plane now. These next few weeks will be interesting.
Bill, you're very much spot on with your posts. I appreciate reading them.
My wife was stuck with a dirty needle (someone else' negligence) her supervisor told her to not worry about getting tested - because the patient was low risk, yea right.
Yup. Being understaffed and overworked is a big problem in healthcare. Seems like it's getting worse.
Since it appears dogs and such are susceptible I would guess rats as well.
Then it would become unstoppable in cities at least.
But the flip side is the chance of that happening is pretty slim I'd guess.
A case here and there is bound to occur, but untreated cases which could spread rampantly seems unlikely.
Truth is by my take nurses, docs, anyone in the field becomes complainant with infection contra over the years. They see so much in the way of infectious diseases. So with the consequence and a couple here being unfortunately infected, they will improve their procedures.
Unless somehow this person's bodily fluids penetrated your skin, there is no issue.
This is more fear-mongering than anything else.
Just look at this thread, you have people criticizing the person for traveling and thinking that hundreds could be exposed because of it.
But, the hysteria over Ebola is just that - hysteria. The Media has made it sound like a huge threat to the populace and the health system, when it really isn't.
It shouldn't be discounted, but on the flip side, it shouldn't be exaggerated either.
It does lie in the middle, but unfortunately based on the media, you'd think Ebola is a serious threat and needs to be dealt with immediately.
They become so used to treating patients and they tend to not think so much about getting infections from those patients.
Gloves amongst paramedics nurses docs really didn't see widespread use in starting IV's and such until the 1980's. Bugs were around back then as well but few thought to protect themselves.
So they will get better at this is my guess.
There is a branch of science dealing with risk analysis. This would probably be considered a low probability event with a very large implication if the event happens. Therefore attention must be paid with panic not necessary. An analogy could be considered nuclear power plants which are built to extremely high safety standards which some will tell you are very safe and nothing could go wrong. Except when something unexpected happens (tsunami). The analogy is the disease mutating to spread through the air. We all need to lool at this calmly but with the understanding that there is a possibility although small of things going bad.
Unless somehow this person's bodily fluids penetrated your skin, there is no issue.
This is more fear-mongering than anything else.
Just look at this thread, you have people criticizing the person for traveling and thinking that hundreds could be exposed because of it.
I agree the risk of any individual person getting Ebola is extremely low. However, should you not do what is sensible to make the risk non-existent? I wouldn't panic and I wouldn't be blasé. I also would stay away from absolutes, and that includes statements on air travel.
I would like to see the studies showing humans are not contagious unless they are symptomatic. I will try to search for them. My gut tells me that they're basic the statement on anecdotalsmas much as anything. Even so, what exactly does it mean? They're basic the travel restriction on temperature. How does that correlate it's viremia and how long do you become contagious after hitting a certain temperature? Is a day, is it an instant....is it a few hours before? And do the studies take into account human variation? People whose bodies get fever at different rates, other infections and things going on, are they taking Tylenol for arthritis and suppressing fever?
IMO, one area where they should be putting massive efforts is developing super-rapid and convenient screening assays that could be applied to travelers without hindering traveling. Some rapid test for viremia or even for antibodies against the virus where you might get some indication of infection before a person names symptomatic. Or develop some criterion that might increase the window of assessing infection versus being infectious.
Personally, until that point I'm going to be skeptical about travel statements. So far, fellow travelers don't seem to be threatened...until they are.
Whatever happened to SARS and what was it before that, mass killer swine flue epidemic?
I just saw that mutation thing as a headline in one site today.
Well yeah, I guess but they failed to mention the probability of that occurring which I'd guess is no accident as by my guess, it is so low.
But flip side you know this thing can be spread in air, right now but they discount it.
If someone for instance spits when they talk, which some do, or spits when they cough and you get that in your eye you could get it. It's in bodily fluids and spit is a fluid. So in a way it is airborne transmittable.
So they go to one extreme in reporting a potential of mutation but go to the other in stating it cannot be airborne in transmission.
But it is not airborne transmittable as in a flu, where active particles can remain in air for quite a time after sneezing or coughing.
So they misreport by my take on both counts.
But it is still seemingly pretty hard to get. The guy in Dallas was throwing up all over the place(projectile vomiting), and his family was sent back to the apartment before it was decontaminated…..I mean how easy can it be to get if none of them came down with it(knock on wood).
Fever I'd guess with Ebola would be the first presenting symptom. After that comes all the rest.
With a flu, you depending on type of flu and individual, may be feeling lousy have stomach problems and be contagious before you actually develop the fever.
I think that may be a bit of why it spreads so seemingly easily. It does not pattern in transmission like some other viruses we are mostly familiar with.
You die with flu the virus in you dies relatively quickly.
Viruses often have properties unique to themselves.
Where did you hear that she called the CDC?
...
"I think there are two different parts of that equation," he continued. "The first is, if you’re a member of the traveling public and are healthy, should you be worried that you might have gotten it by sitting next to someone? And the answer is no."
"Second, if you are sick and you may have Ebola, should you get on a bus? And the answer to that is also no. You might become ill, you might have a problem that exposes someone around you," he said.
Got that? Relax, citizen, you can't possibly develop Ebola from sitting next to someone on the bus. However, if you are sick and might have it, better stay off those city buses. We wouldn't want you spreading Ebola around!
This is, frankly, gibberish that does nothing but undermine his own credibility. Yes, I understand what he's saying here - your risk of contracting the virus in public is microscopic, but if you're actually sick you should stay away from public spaces out of caution. However, his mule headed insistence on calming us dumb panicky idiots is only giving people reasons to suspect he's full of shit. Instead of honestly saying yes, there is a risk from infected people in public places but it's extremely small, he says something stupid in a transparent attempt to play Chip Diller.
The nurses who have become infected were also working on other patients in the hospital, so now the CDC going through those patients to make sure they haven't contracted the virus. How stupid is the staff at this dam hospital!
The danger if you have been exposed is that you don't know when you will get sick. So this nurse feels fine, goes to Cleveland, then she has a fever. She probably didn't spread it to anyone, but what if she got sicker on the plane and vomited? That is the real danger.
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CBS News reporting that nurse Amber Vinson called #CDC BEFORE boarding the plane and was told she was OK to get on the plane with 99.5 temp
6:43 PM - 15 Oct 2014
If I worked at a hospital and had this occur I would most probably be calling the nursing supervisor the hospital administration or at the very least the doc in charge of my area. Then perhaps on their direction the CDC.
Why directly call the CDC?. Would you even know who you are talking to over there and their credentials to give advice. Would they even know of your capacity and situation at the hospital, how you contacted with the patient? I'd guess they get at least a thousand calls a day on varying issues related to this ebola thing few related to actual contacts.
Not only epidemiologists work at the CDC they have all sorts of peoples in differing capacities, though only a epidemiologist or infectious control specialist could give correct advice specific to this.
And only then if they knew your exact situation or circumstance.
It just doesn't make sense, that she did this. Though again I am not doubting it was reported this way.
I thought they had established a CDC task force in Dallas subsequent to this anyway. Why, if that is true, bypass them? Not contact them, in person perhaps, instead of calling the CDC offices?
Doesn't make sense as it is reported.
I find it very hard to believe this was not done.
But I have doubts that if she was on any sort of checklist for possible ebola exposure she should have been allowed to leave Dallas at all.
All the family members were kept in the apt initially by police force until relocated.
Why was she a possible exposure allowed to leave Dallas. You can show first symptoms up till 21 days. She was certainly within the window and as a health care worker who treated the patient, was certainly on a exposure list.
The more I think about it I think something is amiss here.
These things simply don't jive.
2) Healthcare workers will walk off the job.
3) The area will declare a state of emergency.
Not necessarily in that order.
But what I ran a across most recently is even the blood and tissue samples of the initial patient were not kept segregated. They supposedly use some sort of tube type system to get their samples to testing within the hospital. And it is a collective system. So without segregation of samples you have the possibility for a whole new avenue of contamination and whole new groups of peoples exposed.
Hospitals have to be designed to segregate patients in isolation. A simple isolation room is not sufficient for this type of potential contaminant. Very basically isolation areas have to have entirely differing ventilation heating and waste disposal units than the rest of the hospital. If not, one patient may in theory contaminate a entire hospital depending on contagion.
Ebola is not such a contagious item, but it sounds like this hospital is not set up to handle a actual mass epidemiological event that requires segregation of patients.
There is no telling who could have been potentially exposed. Luckily for them (and us) ebola is pretty hard to get. But this could as well have been a deadly form of flu or worse.
I hope it is a wake up call.
http://www.ustream.tv/recorded/53942765/highlight/563746
Apple to name just one, has one of their major manufacturing plants in China. They are part and parcel in many ways of the American economy. Ways that are not obvious nor readily known.
To stop travel would stop parts of commerce. That especially right now with tension over the Ukraine persisting and the European economy subsequently imploding, absolutely cannot be allowed. Global recession would occur.
Monitoring of passengers temps that I expect could occur eventually. But not till or unless ebola becomes endemic in China, which is unlikely.
But what I ran a across most recently is even the blood and tissue samples of the initial patient were not kept segregated. They supposedly use some sort of tube type system to get their samples to testing within the hospital. And it is a collective system. So without segregation of samples you have the possibility for a whole new avenue of contamination and whole new groups of peoples exposed.
Hospitals have to be designed to segregate patients in isolation. A simple isolation room is not sufficient for this type of potential contaminant. Very basically isolation areas have to have entirely differing ventilation heating and waste disposal units than the rest of the hospital. If not, one patient may in theory contaminate a entire hospital depending on contagion.
Ebola is not such a contagious item, but it sounds like this hospital is not set up to handle a actual mass epidemiological event that requires segregation of patients.
There is no telling who could have been potentially exposed. Luckily for them (and us) ebola is pretty hard to get. But this could as well have been a deadly form of flu or worse.
I hope it is a wake up call.
If the hospital is relying on cdc I wouldn't be too harsh on them. At our place we are set up or are setting up to test samples for Ebola in case the need arises. Cdc is very unclear on their guidelines on how to handle potentially infected specimens. For some things they're saying you have to work in BSL 3 which is a lot of PPE and safety precautions and for other things or at other times they say it's okay to use bsl2 which is almost, but not quite bench top. They're confused and I think it's because they're cobbling together stuff based on other pathogens. We've opted to treat all potential Ebola as bsl3 at very step but not all places are equipped to do so
But to draw a bit of a parallel, though it is not a exact. On handling Hazardous Materials there exists a federal agency with which a responder to a incident may contact to find the necessary precautions and necessary actions to take to remediate the situation. This agency is available 24/7 by phone and internet.
And they are much used. However any manager of a incident may not depend upon the federal agency to do the mitigation of the incident for them. The proposals for handling such things are right and true but textbook answers to textbook scenarios. Management of such a incident must utilize various resources and this may be a primary resource but in no manner is the manager exempt from their responsibility of handling the incident due to a federal protocol being available.
Similarly the CDC is a resource. It's easy to think they may provide a protocol and have it followed as if it is a textbook but really this is not their functional responsibility. They are only a resource and cannot fill the hole that must be filled by responsible hospital management.
As the management of a hospital is responsible perhaps to see to it their employees may get flu shots to protect their patients. The CDC can reinforce the necessity by guidelines and such but really it is to the hospital to manage the requirement.
So to my view this is largely a individual hospital deficit. Why is the employe calling the CDC? This is the question I have. In a proper relationship management calls talks to and develops the proper response concurrent with CDC input and guidelines and then advises the employee of the outcome, the steps it must implement and hence the employee must implement to mitigate the circumstance of infectious disease containment.
Clearly this did not happen. The employe upon finding a fever does not even call the hospital but instead calls the CDC. And the hospital apparently did not make clear the requirement of the employe to remain in state and to monitor their vitals. Like a flu shot this is part and parcel of the employment. The employer can legally require these things and have the force of the law to back them. Once unemployed if the nurse chooses instead to quit as result then the state and federal agencies can step in. As they did with the family of the victim. If one of the passengers on the plane gets ebola by some rare event, the hospital is the responsible party for not implementing containment, not the CDC for not implementing as the employe is the hospitals charge not the CDC's.
So the CDC is as it is as you clearly display and I do not dispute.This however does not absolve the hospital from its charge on the employee. In this specific the extension to others is clearly to those employed by the hospital. If it was the general public I would say the CDC would bear more responsibility and liability.
Micko : 10/15/2014 7:22 pm : link : reply
How can you possibly speak in absolutes like that? Scientist working in the field would never rule out the possibility of strains that could emerge with a modified transmission frequency. We simply don't know what lies ahead. Let's see how it spreads in the first world and we'll see.
What I've said is that the situation today is one of minimal risk. You know who is talking about the strains modifying? The Media and the talking heads they bring on to discuss Ebola.
They always are telling us the "What If's" and not the present situation. That's why I call it a fear mongering of sorts.
Every virus that arises, we constantly are told that it could mutate. Someday a serious one will, but is it really worth starting a panic over right now?
I'd rather hear in realities, and frankly that should be how the Media reports.
These very same issues of isolation and containment in relation to radioactive particles I find now presenting in the ebola outbreak.
We had to basically reengineer a level one trauma hospital, the only one in NM at that time(not me likewise as you mention I just sat in the meetings) for purposes of absolute isolation. This assisted largely by federal funds as Wipp was a federal issue.
Radioactive contaminant, terrorist agent such as a risen agent or ebola really the requirements for isolation are not very different.
All hospitals should be prepared to handle all of them and not depend upon the CDC to do it for them.
The CDC sucks but really that is not the reason to not allow them to be the final determinate of hospital action or inaction, liability and responsibility to the community they serve is.
It is fear mongering, nothing more nor less, to sell viewership and thus as in all things in America adds and the buying of things.
Been around for hundreds of years that.
A mutation here is almost a impossibility considering the numbers of those infected. And keep in mind viruses may mutate to less harmful forms as well.
The swine flu in Mexico a couple of years back is one example of that.
There is a real threat here and it can as I mention be spread by coughing by saliva and such things coughed out and then found into a persons eye, and some other ways not yet mentioned in the media.
So there is really no reason to make up impossibles to sell the threat.
It exists but really is not the end of all. Think of it,…. it appears Nigeria of all places eradicated it in this latest manifestation.
Have we sunken so low we cannot outdo Nigeria?
his only medication was a saline drip.
the family only heard about his death thru the news
and as i said previously... uninsured so he was sent home
Ebola victim’s nephew speaks out and criticizes hospital system - ( New Window )
When you go into the ER, their goal is to stabilize you and send you home. Many people get released by the ER and then wind up back there a few hours or a day later. I did, and I have insurance. Even if you have insurance, there are rules for being admitted that the hospital and insurance companies agree to.
story - ( New Window )
You know this how?
The nephew claims the dead guy says that was all a fabrication.
The hospital is not talking. Until then, we are all left to wonder. What we do know is that their error affects all of society. Their bad judgment or misjudgment sent my uncle back into the community for days with a highly contagious case of Ebola.
He's not blaming lack of insurance or even implying that.
Did you read the article before deciding he was looking for a payday?
especially in a state like texas that has the most uninsured in the nation 22%
please google the term
GOMER
Quote:
His uncle wasn't cautious. He had direct contact with Ebola patients, he carried one to the hospital.
You know this how?
The nephew claims the dead guy says that was all a fabrication.
Ok, then how did he get Ebola?
especially in a state like texas that has the most uninsured in the nation 22%
please google the term
GOMER
Do you honestly think that if the hospital thought he had ebola they would have just sent him home? Do you know how many people show up at the ER with a fever, stomach pain etc? Do you want them all to be admitted?
LOL. So HOT!
lol
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In comment 11922736 buford said:
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His uncle wasn't cautious. He had direct contact with Ebola patients, he carried one to the hospital.
You know this how?
The nephew claims the dead guy says that was all a fabrication.
Ok, then how did he get Ebola?
Obviously he came in contact with someone. Does that automatically mean he was carrying a bleeding, shitting, vomiting woman to the hospital and licking his hands afterwards? Of course not.
A freaking nurse caught it. Someone that deals with contagions daily and has access to better PPE. But this guy was obviously careless? Hell, for all we really know, he caught it standing in line to board his plane when somebody sneezed on him.
Where are they blaming the hospital for him having ebola?
They're blaming the hospital for sending him home knowing he was in West Africa and that he had a fever of 103- which is their fault, no?
Thanks!
The only mention of any of that in what the nephew wrote is the insurance thing I quoted above- in which he just accuses them of fucking up and says we don't know why or how exactly.
Thanks!
I can't find info on that and the people that i've asked don't have a good answer.
However, there is a very good article in today's NEJM that talks about the epidemic and discusses mortality rates etc. It actually addresses the rates question that montana and I mentioned yesterday. Their estimate is 71% mortality. One interesting finding was that there is an average of 5 days between when a person becomes symptomatic and when they're admitted to the hospital. That's pretty scary IMO. Of course, it's in Africa and not the US but they also found that the number was the same for regular people and health care workers. Since health care workers should be the more informed and culturally modern, that might (or might not) say something about how people would act here.
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To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
The only mention of any of that in what the nephew wrote is the insurance thing I quoted above- in which he just accuses them of fucking up and says we don't know why or how exactly.
There have been a few reports of Jesse Jackson and John Wiley Price (a crazy Dallas councilman) claiming that Duncan died in large part due to neglect or non-use of experimental therapeutics completely due to his race.
Reading through their literature today they list for medical health care professionals a fever of 101.5 symptomatic of ebola. However in the section on airline travel, in the general section(I did not peruse all potential documentation related to this) they state fever only. They then go about describing symptoms of a fever.
So it appears in general terms for airline travel any fever is a reason for a airline to deny the ability of a person to fly(accompanied with flu like symptoms and travel history). However in ER treatment Ebola is not suspected unless the symptoms are accompanied by a fever of 101.5.
A note on fever, some peoples normally have differing temperatures. It is rare but quite possible for someone to have a normal of 99.6 or 97.6. 98.6 is normal for about 6 billion of us but then we may have still millions that have normals which differ.Statistically it is very rare but it happens and environmental circumstances may in fact very greatly affect body temp. When cold we may drop a degree or 2 when hot up a degree or 2 as in when exercising .
Did insurance status have anything to do with the first patients medical ER treatment……. I would say absolutely not. Most admitting in hospitals ER's have separate personal doing the paperwork and they rarely if ever communicate with the medical staff. The nurses and docs don't have a clue if who they are treating is insured or not. Later on when admitted it is then that insurance comes into play.
There is some dispute on the temperature of the first patient in the ER. I have heard 103. If that is true he was released back to the community considering his history of travel inappropriately.
If that is true the hospital screwed up big time. As they did with their infection protocols when treating the patients allowing 2 nurses to get ebola.
I suspect it is true, this hospital is worse than the CDC, they seemingly really suck. the CDC as displayed by their contradictory statements on temperature which confuses and causes concern unnecessarily, just plain suck.
No offense to the docs and nurses working at the hospital nor the scientists and such at the CDC, this is most certainly a administrative issue.
They do advise health care peoples to call the CDC with questions on diagnosis of ebola but do not make any statements on their advise or protocols being mandatory or binding. To my read that establishes them as a resource but not a director of treatment in a professional health care context(rightly so I would say).
Subsequent to that hospitals found the necessity for care but no funds to pay for this care. A situation whereby they would lose cash on a daily basis and soon go out of business.
Varying solutions some based solely on the federal medicaid model some based upon state initiatives arose.
These solutions allowed hospitals to be paid back by state or local governments for no retrievable health care costs subsequent to the federal mandate for care.
The solutions by state vary greatly, in how the hospitals are paid. But ER visits are compensated for in all states by some manner by public funding of some sort. NM uses part of a land tax delegated to this
When admitted this no longer applies and degree of care is greatly affected by insurance coverage or lack of. In the ER I would say never.
This is not like FEMA, boots on the ground, hands on people, who have done the job and are drawn from the real world.
Largely to my experience they are academics drawn from that type of environment. Great teachers, scientists epidemiologists, perhaps but these peoples are not ones you would choose to handle emergency situations.
This is not how their organization is set up nor functions as a emergency response unit.
These are peoples who you go to on advise on how to textbook, handle things. The real world as Bill mentions with his exception on tylenol and arthritics, is not textbook.
So they guide but can not manage.To expect them to do so causes problems, some of which we are seeing.
The local health care communities must handle this crisis by developing responses guided by CDC instruction, but not depending upon them to each and every extent.
Typically they are told up front, this ride costs money and you can save a bill by not going by ambulance(if they don't need to). Ambulances in most places are set up as separate entities from hospitals in a legal sense and bill separately.
But absolutely right, ambulance patients receive first treatment. It is assumed their conditions are worse then walkers in.
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To blame it on the hospital or no insurance or racism or whatever they come with next is absurd.
The only mention of any of that in what the nephew wrote is the insurance thing I quoted above- in which he just accuses them of fucking up and says we don't know why or how exactly.
Cam, this is in the article
'But he was a man of color with no health insurance and no means to pay for treatment, so within hours, he was released with some antibiotics and Tylenol.'.
So which is it? They fucked up or they are racist and didn't want to treat him because he had no insurance?
What do think is a likely outcome?
If your same patient had insurance and admitting him and testing would be profitable to the hospital (wether your hunch was right or wrong) what do you think would happen?
In practice the ER staff is never critiqued on admissions unless there is a overt problem, like lots of peoples being admitted erroneously or potentially lots of people being not admitted.
The hospitals(some of them) have stats on how many patients percentage should result in admissions. Fall above or below that and they may study the issue to determine why. But that is a crew or shift study not a individual.
So docs have little fear of seeing their admissions being considered inappropriate by the rational of fee retrieval. A floor or speciality doc has no more pull nor weight in hospital administration than a ER doc. In fact the opposite is usually true as the ER docs position is very much harder to fill. And it is the docs who determine who is admitted and who is not. The nurses advise.
The billing is kept separate from the ER docs knowledge.
Docs have personal bias, and may for instance see a obvious homeless person being treated and refer him to a publicly run hospital in some places, but this is a personal bias and not a system bias.
Could that have happened to this guy…I'd say no probably not.The doc would not know by looking or talking with him if he was insured or not and has no reason to ask him. ASking him would in fact be inappropriate, by other than admitting or paperwork oriented staff. A medical professional person in a ER should never ask insurance status, it is simply not their job.So they don't do so. Other staff do so. They basically don't care.
When admitted…the whole story changes. Further treatment is absolutely determined by ability to pay and potential retrievability of monies.
In the ER no it is not that way. Never say never but 99.9% sure.
In the other scenario, a guy with ebola walks into this hospital in Texas, but is discharged. Then he is readmitted, and not only does he die, but two of the nurses who treated him are infected, and a whole host of stories about the hospital's lack of preparedness seem to be trickling out.
It seems to me the hospital was just unprepared for this high risk/low frequency event.
Why redo your whole facility to provide for real isolation. Why train and certify peoples to perform in epidemic or potential epidemic situations that require isolation?
In NM with Wipp there was a economic benefit as Wipp related monies provided incentive. Remodel and establish protocols and you got fed funds, it was that simple. And Radiation directly translates to ebola and other things that require isolation.
Hospitals are largely for profit. Even if not publicly so they internally are devoted to cost containment.
This is one of the problems with a for profit insurance based health care system model in America.
The s hits the fan and there are going to be significant problems. This crisis is way way hyped and overblown ebola is just not that contagious.
What will happen when a real crisis like in 1918 deadly flu type thing occurs?
This is a wake up call, but it is to no avail.
As the ER eval is ongoing and pt says "I just came back from Africa" every ER doc knows to put tropical diseases at the top of their differential. Maybe not Ebola, but the thought had to have been there. Simple stuff. Once that possibility is raised, admission has to be considered. But the thought process doesn't end there. The ER has to find someone to admit him. So he will ask the patient "Do you have a primary?" At that point he will essentially know the guy is uninsured, and will consider admitting to house staff. He may think house staff is 1) overworked 2) incompetent 3) a financial burden or a combination of the above. Thinking along those lines he may back up a little and say its unlikely a disease of significance, just go home.
Sounds very plausible to me, and the lack of insurance was a contributing element.
But most commonly to my experience the ER doc will make the decision to admit or not, and then after that decide where to admit the patient, here, where his primary works out of, and all the rest.
Decide whether to admit depending on the patient having a primary or not….I'd say not.
Of course all docs will get a med history on making their decisions but really there presence of a primary or not is pretty insignificant medically in a case like this.
Some conditions mandate interaction with a primary such as past heart problems perhaps but the ER is basically making a pretty simple decision, where to put this guy.
Then the floor doc can interact with the primary. Could they ship this guy to another hospital where his primary works out of certainly…it happens all the time(by ambulance)
To decide not to admit….I'd say no it generally does not happen that way.
Possible I say again never say never but highly improbable.
One of the decisions hospitals make, as they largely assist with malpractice insurance, (it is generally part of the compensation package) is how many situations of litigation does any doc engage in yearly.
Quite a few litigations and they may decide not to renew, as the insurance becomes prohibitive a red flag is raised.
Again not all hospitals but many. Some areas such as pediatrics and obstetrics are known for having high rates of litigation. A ER doc not so much at all.
That way of thinking would lead straight to litigation, and the doc would potentially not have a contract renewal as result.
So the hospital and the doc would personally suffer, far more then if they denied admission Even in Texas.
So largely ER docs don't do things that way.
So what you say could happen.
But the system actually works against, not for that happening.
So I cannot rule it out.