Ebola outbreak - general thread #5

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Wow ATL. A virologist? Fascinating. I would love to hear how labs deal with highly contagious viruses!

I would also be totally interested in hearing about the early days of HIV research, as well as other viruses! Wonder if atthelake would be interested in a q&a thread in another forum? :)


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Up thread, there was discourse regarding hemodialysis for acute renal failure. IIRC, Another advantage of doing hemodialysis with Ebola in the hemorrhagic phase is to help combat DIC (dessiminated intravascular coagulation).

I am going back to my ICU days, so if anyone else can weigh in on this, I would appreciate it.

Also, it's been mentioned that hemodialysis adds to the "danger of infection factor for personnel". What about peritoneal dialysis if nothing else? Any possible benefit there?
 
Well, we don't know for sure what effect this will have. But I'm very very hopeful for this dedicated young lady that this will help her beat this illness.

I know a lot of the ICU nurses at this hospital and I'm feeling constantly sick inside worrying for them.

Remember people, when you bash this "hospital," that the "hospital" is so much more than the administrators. It is TEEMING with smart, dedicated professionals, doctors, nurses, CNAs, respiratory techs, lab techs, etc., who had nothing to do with the fiasco and who have always given and continue to give excellent care to their patients.

With these cases in the united states, including the exposure of her dog that will not be put down... there is going to be exponential learning of this strain of virus amongst the community of scientists.:moo:

For those that like to read... I would strongly recommend the book "The band played on " . It talks about the HIV virus ... It is a sad and tragic story about politics and profit and disease and a viral epidemic. It is based on fact it is not fiction. I lived it and breathed it ..and it is amazing what went on. It reads like fiction and it is 100 percent a background for anybody who is very interested in this out break. For anyone interested please please please get a book from the library and read it.

we're already seen this happen with stock prices at certain companies go up so much because they offer items which may be available to people who are panicking. Also we are seeing public relations mechanisms go into overdrive speed for companies that can possibly offer a viral test or a vaccine.

I just hope that many people realise that these companies are perhaps exclaiming they have the next quick test or vaccine so that their stock price can increase.

:moo:

Take everything you read from now forward with a grain of salt for medical companies giving information to the media .
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Not sure if this has been addessed but.....

Read somewhere today that most hospitals do not even HAVE rooms to accommodate spraying/disinfecting the suits before removal. They can't spray themselves down unlike the CDC folks because typically there is nothing set up for that (i.e. can't step out into the hall and do it, or run down the hall to user another room's shower etc... without tracking germs everywhere).

Then someone else was saying they work in construction and some jobs (i.e. asbestos removal) require full PPE suites with respirators etc....and the workers ARE decontaminated and sprayed down in a special temporary "shower rooms" before removing their gear. Construction companies bring in PORTABLE showers and use tons of plastic to create temporary and secure shower rooms in whatever building they happen to be working in.

Yet the hospitals can't or won't do this??? Another note if you read the CDC guidelines (that do NOT specify suit disinfection probably because it isn't happening in most hospitals) the instructions DO say to keep disinfecting your gloves every step of the way (i.e. remove first set of gloves, disinfect hands, remove outer suit, disinfect hands, remove mask and disinfect hands, etc....) which is not at all what we saw on the EMT instruction video yesterday.

Here is the link to the CDC guidelines for healthcare workers:

http://www.cdc.gov/vhf/ebola/pdf/ppe-poster.pdf

There is no mention of disinfecting gloves every step of the way, and there is only one pair of gloves. It says remove gloves and if you think your hands got contaminated at any part of the process, immediately wash them and then wash again when finished removing PPE.
 
I'm also concerned that we are already seeing a stigma towards anyone who is from anywhere in Africa (despite the enormous size of the continent - US folks are in general pretty poor at world geography and it shows), or has been to/come from anywhere in Africa.

If folks wanted to prevent stigmatizing immigrants from West Africa in the U.S. then stop unnecessarily travel from infected countries so the people here won't HAVE to worry about the West African immigrants.

If there are two or three more cases that break out due to West Africans visiting the U.S. (and exposing many of their West African friends/relatives who end up on the watch lists) that WILL make folks nervous and more cautious.
 
Also, it's been mentioned that hemodialysis adds to the "danger of infection factor for personnel". What about peritoneal dialysis if nothing else? Any possible benefit there?
The patient wouldn't tolerate it. The only kind of dialysis that would be used in a severely ill patient would be CRRT. Hemodialysis and peritoneal would cause too quick a shift in blood pressure.
 
With these cases in the united states, including the exposure of her dog that will not be put down... there is going to be exponential learning of this strain of virus amongst the community of scientists.:moo:

For those that like to read... I would strongly recommend the book "The band played on " . It talks about the HIV virus ... It is a sad and tragic story about politics and profit and disease and a viral epidemic. we're already seen this happen with stock prices at certain companies go up so much because they offer items which may be available to people who are panicking. Also we are seeing public relations mechanisms go into overdrive speed for companies that can possibly offer a viral test or a vaccine.

I just hope that many people realise that these companies are perhaps exclaiming they have the next quick test or vaccine so that their stock price can increase.

:moo:

Take everything you read from now forward with a grain of salt for medical companies giving information to the media .
.
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You are referencing the book by Shilts? If so, I completely agree - Excellent read.


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Also, it's been mentioned that hemodialysis adds to the "danger of infection factor for personnel". What about peritoneal dialysis if nothing else? Any possible benefit there?

Good question. In PD, you still have to access the PD catheter and if there is internal bleeding from major organs, the dialysate might increase it? I am thinking on that one. Not every patient is a candidate for PD. I am going use one of my lifelines to phone a friend :) She is a dialysis RN.
 
2 hour special with anderson cooper is just starting on cnn re Ebola

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If folks wanted to prevent stigmatizing immigrants from West Africa in the U.S. then stop unnecessarily travel from infected countries so the people here won't HAVE to worry about the West African immigrants.

If there are two or three more cases that break out due to West Africans visiting the U.S. (and exposing many of their West African friends/relatives who end up on the watch lists) that WILL make folks nervous and more cautious.

But Sonya not everyone who flies in from W Africa is immigrating. Some come to visit relatives, or come on vacation. They will visit and leave.

And it's not just people from affected areas who are stigmatized. Because Americans are not so good with African geography and politics, they are becoming fearful of people who come in from areas that are thousands of miles away from the three most affected nations.

Later this week I have an appointment with my Nigerian (Western Africa) doctor. Tomorrow I will probably see a priest at the parish school who is from Gambon when I drop off the girl I babysit for. both of these men, I know, visit family in their home countries regularly. I am not afraid to interact with either. But already there have been people on thread saying they are afraid/afraid for their family members to associate with people "from Africa". Regardless of the fact that "from Africa" could mean thousands of miles away from any Ebola case!

We cannot let disease dehumanize people. Even if you (general "you", not you personally) don't care on compassionate grounds, maybe "you" care in economic grounds? We cannot allow life to grind to a halt because of unwarranted fear.


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This will definitely help .......

http://news.yahoo.com/ebola-families-bodies-bribes-153423993.html

''The family says the person is not an Ebola patient, and [the retrieval team] pull them away from the other people," Vincent Chounse, a community outreach worker on the outskirts of Monrovia, told the paper. "Then they say, ‘We can give you a certificate from the Ministry of Health that it wasn’t Ebola.'''''
 
Ugh, I can't edit my posts for some reason - sorry for typos and autocorrect errors! Blame my fat fingers on my tiny mobile!


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I have a question for RNs or MDs. Does it make sense to you to take off gloves then remove the rest of the PPE? Per CDC, then just wash hands well if they become contaminated. I don't understand why a fresh pair of gloves wouldn't be used to remove the rest of the gear. Thanks.
 
I have a question for RNs or MDs. Does it make sense to you to take off gloves then remove the rest of the PPE? Per CDC, then just wash hands well if they become contaminated. I don't understand why a fresh pair of gloves wouldn't be used to remove the rest of the gear. Thanks.
Double gloves. First pair off, then gear.
 
The Dangers of Overreacting

The health care system’s mixed messages about Ebola.

"The overutilization of medical resources in response to widespread panic, and not to genuine medical needs."


"As the CDC has stated, medical providers need sturdy blue gowns, gloves, and a mask with a face shield to take care of suspected Ebola patients. They do not need to wear hazmat suits. Suspected patients should be kept 3 meters away from other patients and given masks of their own. They do not require negative-pressure airborne isolation. Private rooms are nice, but not necessary. "

However, the CDC’s behavior has consistently exceeded its own reasonable guidelines.

The perspective of an Emergency Medicine Resident Physician at Mt. Sinai in New York.....

http://www.slate.com/articles/healt...zmat_suits_and_negative_air_pressure_are.html
 
But Sonya not everyone who flies in from W Africa is immigrating. Some come to visit relatives, or come on vacation. They will visit and leave.

And it's not just people from affected areas who are stigmatized. Because Americans are not so good with African geography and politics, they are becoming fearful of people who come in from areas that are thousands of miles away from the three most affected nations.

Later this week I have an appointment with my Nigerian (Western Africa) doctor. Tomorrow I will probably see a priest at the parish school who is from Gambon when I drop off the girl I babysit for. both of these men, I know, visit family in their home countries regularly. I am not afraid to interact with either. But already there have been people on thread saying they are afraid/afraid for their family members to associate with people "from Africa". Regardless of the fact that "from Africa" could mean thousands of miles away from any Ebola case!

We cannot let disease dehumanize people. Even if you (general "you", not you personally) don't care on compassionate grounds, maybe "you" care in economic grounds? We cannot allow life to grind to a halt because of unwarranted fear.


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<modsnip>
Why not close our borders to people flying in from the affected areas until this thing is under control? Why do they need to schedule a vacation here now??? We can still fly medical personnel and supplies to West Africa via military transport. Proposing this is not mass hysteria. Other countries are doing the exact same thing.
 
If folks wanted to prevent stigmatizing immigrants from West Africa in the U.S. then stop unnecessarily travel from infected countries so the people here won't HAVE to worry about the West African immigrants.

If there are two or three more cases that break out due to West Africans visiting the U.S. (and exposing many of their West African friends/relatives who end up on the watch lists) that WILL make folks nervous and more cautious.

Also - just remember what stigma/fear did for HIV/aids: it kept people from testing, it kept people in denial. People would think, "Oh, he's not gay, so Im safe". Stigmatizing puts people in danger. We have to look clearly at things, because acting out of fear results in denial and risky behavior.


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Anderson Cooper is reporting that he is going to have an interview with Louise's pastor who has been visiting with her. I assume the visiting is via phone.
 
BBM. Duncan was here on the pretext of "visiting", even though he only had a one-way ticket. He hadn't applied for the Fiance Visa.
Why not close our borders to people flying in from the affected areas until this thing is under control? Why do they need to schedule a vacation here now??? We can still fly medical personnel and supplies to West Africa via military transport. Proposing this is not mass hysteria. Other countries are doing the exact same thing.

As I said I am mixed on a commercial ban from the three heavily hit nations.

But keep in mind - even from an affected nation like Liberia, not everyone has or carries Ebola! Liberia has approx 4 million citizens. Go conservative and say 10k are affected. Of the 150 or so that fly in, what are the chances you will be infected by one?

It is scary, but we need to be realistic. Not everyone from the three heavily affected nations is contagious. Of those who are, how many can afford to make it here? How many hold dual citizenship? How many come on business or to see family? Duncan is but one man out of millions!


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