"Here's How You Get Ebola"

[Oerets]

Today IIRC is the 21st day for the family of the Dallas patient who infected the nurses. So far they have not contracted the disease AFAIK, it would be all over CNN if they had.








Barney

[donquixote99]

I won't throw a party for them quite yet, but this is unexpectedly fortunate news.

[Oerets]

Originally Posted by donquixote99

I won't throw a party for them quite yet, but this is unexpectedly fortunate news.

I'm more worried of some of the ""stupid virus"" infecting me from my Tea Party friends. Then this Ebola hype.




Barney

[Ike Bana]

Originally Posted by icenine

It is ok.....I think people are under the assumption that our hospitals would be able to handle an outbreak like the one in Africa.....logistically I do not think they are. You have to remember American facilities are not used to diseases like dengue fever and Ebola.....this is a disease that needs spe************************t centers like in Atlanta.

The reason this disease scares me is that two professional ER nurses got it....
and they were using the normal universal precautions they do with all patients. So to me this thing is very dangerous. In other words they were using rubber gloves and still got it. Which is kind of scary to me.

I think in a month we will know. I just hope there is no outbreak in Ohio.
And if the ones who catch it here (vice Africa) and live that will be a good sign.

I believe there will never be nor would never have been an outbreak here as severe as there has been in Africa. Mostly because they were blindsided by it there and we have significant advanced warnings regarding who may be carriers and what to do if there are symptoms in a family member or friend. Also...at the beginning, and perhaps even now, the health care workers in Africa were not properly provided the precautions gear, and if they were, not properly trained in the use of the gear. More importantly not properly trained in the handling and disposal of gear that has been exposed to patient fluids. Right from the beginning there were reports of workers overwhelmed by wearing the gear the heat of the non-A/C wards an stripping the masks and other gear off after 15 or 20 minutes and just tossing it into a corner somewhere. The issue isn't wearing surgical gloves, the issue is what to do with used surgical gloves. The general public in these African countries was constantly in contact with dying and dead family members and friends. It was a nightmare waiting to happen in Africa.

There are also indications that effective vaccines are close.

http://www.bbc.com/news/health-29076371

[donquixote99]

It does appear that the danger of contagion really ramps up at the end-stage of the disease, when the afflicted are leaking virus-laden substance by the quart.

Better protective gear training:

1. Heath care provider suits-up.
2. In a way that they cannot observe, contaminate them randomly with a test substance that's invisible under room light, but fluoresces under UV.
3. Have them remove gear using recommended protocols. Then check with UV for contamination on their person or on surroundings.
4. Repeat until protocols and worker skills are sufficient to avoid dangerous contamination.

[donquixote99]

Just thought of an additional measure. Spray with the UV indicatior before every patient care session. Check for fluorescence afterwards. If any found, suspect contamination and take immediate countermeasures.

[sheltiedave]

Don, we do this at government rad sites, and no one can make it through totally clean. Tyvek suits are not made to be 100% wet barrier effective - they are moisture resistant for about 45 minutes. They are permeable, they also degrade and they abrade.

I would be going in to a room in outer Level B with supplied air and a climatized blower, and underwear with Tyvek coveralls underneath. All interfaces would be double taped.

Coming out of the hot room, I would step into an enclosed zippered positive pressured automated three level headed shower, with a 50% bleach and tepid water wash for two minutes.

The next zippered enclosure would need to be a negative pressure HEPA unit, where you would cut yourself out of the suit with a helper. The next garbage can would catch the Tyvek and underwear.
The next stop would be the antiseptic shower, and then into hospital tyvek for the rest of the work day. NOTHING going in with the nurse would go home with the nurse...no jewelry, shoes, glasses, NOTHING.

All of this is moot, because like all hospitals, infection control is placed into effect by doctors, and accomplished by the lowest paid people in the hospital staff, janitors. Hospitals are not staffed, nor are they equipped with the infection control apparatus and training needed to throttle all vectors for transmission.

I have worked in radiation hot cells where contaminants will end your career in one accidental breach of PPE, and end your life from cancer in twenty years or so. Defense in depth means you have three distinct engineering controls working at all times, and each of those three controls has yet another backup.

The hospital in Texas foolishly thought a few Tyvek changes, waste segregation, and simple Hudson spray applications, would take care of transmission vectors. They were grossly wrong, and at least two nurses, friends, family, folks who flew on the plane, workers at the various fliers jobs, and school children now are at risk. And this is just two people!

[donquixote99]

Originally Posted by sheltiedave

Don, we do this at government rad sites, and no one can make it through totally clean. Tyvek suits are not made to be 100% wet barrier effective - they are moisture resistant for about 45 minutes. They are permeable, they also degrade and they abrade.

I would be going in to a room in outer Level B with supplied air and a climatized blower, and underwear with Tyvek coveralls underneath. All interfaces would be double taped.

Coming out of the hot room, I would step into an enclosed zippered positive pressured automated three level headed shower, with a 50% bleach and tepid water wash for two minutes.

The next zippered enclosure would need to be a negative pressure HEPA unit, where you would cut yourself out of the suit with a helper. The next garbage can would catch the Tyvek and underwear.
The next stop would be the antiseptic shower, and then into hospital tyvek for the rest of the work day. NOTHING going in with the nurse would go home with the nurse...no jewelry, shoes, glasses, NOTHING.

All of this is moot, because like all hospitals, infection control is placed into effect by doctors, and accomplished by the lowest paid people in the hospital staff, janitors. Hospitals are not staffed, nor are they equipped with the infection control apparatus and training needed to throttle all vectors for transmission.

I have worked in radiation hot cells where contaminants will end your career in one accidental breach of PPE, and end your life from cancer in twenty years or so. Defense in depth means you have three distinct engineering controls working at all times, and each of those three controls has yet another backup.

The hospital in Texas foolishly thought a few Tyvek changes, waste segregation, and simple Hudson spray applications, would take care of transmission vectors. They were grossly wrong, and at least two nurses, friends, family, folks who flew on the plane, workers at the various fliers jobs, and school children now are at risk. And this is just two people!

Well, there's definitely been competent engineering work done on this, in the nuke world at least, which is good. But your observation that doctors are in charge of this at hospitals is bad. Just try to tell a doctor anything....

[icenine]

I think the most likely outbreak would be among the poor or those uninsured who do not present to a hospital until the last minute. You have to remember that the nurses in Texas are getting the cadillac treatment. Not so sure if that would be the case if there was an outbreak among the disenfranchised in say a state like Texas, which because of the idiot governor's refusal to expand medicare has the lowest health insurance coverage in the nation. That is what scares me.

Remember Duncan was an uninsured man when he showed up at the hospital. If he had had some decent insurance they might have admitted him the first time he presented.

[donquixote99]

Originally Posted by icenine

I think the most likely outbreak would be among the poor or those uninsured who do not present to a hospital until the last minute. You have to remember that the nurses in Texas are getting the cadillac treatment. Not so sure if that would be the case if there was an outbreak among the disenfranchised in say a state like Texas, which because of the idiot governor's refusal to expand medicare has the lowest health insurance coverage in the nation. That is what scares me.

Remember Duncan was an uninsured man when he showed up at the hospital. If he had had some decent insurance they might have admitted him the first time he presented.

Republicans kill.