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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsWhy my confidence in the CDC has shifted (downward)
Look, a guy coming from Liberia whod close physical contact with a patient who died from ebola and went to a hospital in a major U.S. city, slipped through the CDC protocols that have been issued to every hospital in this country- every one.
I'd like to think that this is a wake-up call and won't happen again, but I don't feel confident of that. This was just such a huge fuck up. purportedly the triage nurse had the information that he'd recently come from Liberia and that information didn't make it to the rest of the health team. whatever transpired, it doesn't instill confidence. Yes, I know the odds of an epidemic from ebola are vanishingly small, but this doesn't bode well.
Edited to add:
yes, it was hospital personnel who screwed up, but the CDC has been telling us for weeks that this wouldn't happen.
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Xipe Totec
(43,889 posts)SheilaT
(23,156 posts)It was the hospital staff that got it wrong.
So why in the world would something the hospital staff got wrong make you lose confidence in the CDC?
cali
(114,904 posts)magical thyme
(14,881 posts)just not with the very first positive case.
So we're living down to beyond my expectations. I predicted just last week on The Archdruid Report that while I don't expect epidemic levels here, I do anticipate small, sporadic outbreaks.
We are overworked, understaffed, have been merged and downsized the hospitals. And, as Kestrel has pointed out over and again in other threads, people lie (either outright or by omission). She saw the lying happen with rabies out in California in the 80s. I saw it with rabies here in Maine in the 90s.
Therefore, information will be withheld or skewed, mistakes will be made, and single cases will become small outbreaks.
pnwmom
(108,974 posts)And yet the first time it happens, they screw up.
leftynyc
(26,060 posts)A couple of others have been tested after being hospitalized and were found to be negative. That was the system working as it should.
ksoze
(2,068 posts)The CDC has warned hospitals - this is a Dallas hospital intake issue.
Daemonaquila
(1,712 posts)She did her job. But it's up to the rest of the staff to READ all the information she collected. She sits in an office, away from the rest of the ER staff. It's up to the others who are taking care of the guy to read her work thoroughly, not skim it, dismiss him as another routine virus, etc. That's where you'll find your breakdown.
TwilightGardener
(46,416 posts)from Liberia--a good nurse would jump into action, IF HE OR SHE was informed of what was happening in the world and of any new protocols. A good nurse would IMMEDIATELY call helpers to move this man into isolation until he could be examined--away from other patients in the waiting room, staff, etc.
840high
(17,196 posts)
Thinkingabout
(30,058 posts)I would have thought all medical facilities would be aware of the Ebola virus and questioning those
Who present themselves for medical attention but this one may have been passed over.
magical thyme
(14,881 posts)I blame the guy (who has lived in the US off and on, went to high school here) for not advising that he had direct contact with a dying patient. And I blame whoever on the care team knew he'd come here from Liberia didn't speak up when whoever made the call to send this patient home instead of isolating.
The CDC can put out all the notices they want. If people don't use their heads, it won't matter.
And the CDC has been all over it ever since they were notified of a possible Ebola patient. They had a team en route before the first test results were in on Monday.
LordGlenconner
(1,348 posts)Personal accountability has to play some role in all of this.
But hey, it must be pretty cool to know everything and have all the answers (and loads of spare time to articulate them to the masses).
bklyncowgirl
(7,960 posts)I just thought that this quote was worth highlighting. Even if the patient did not say the "E" word, and he should have, for trained doctors and nurses fever + Liberia + Ebola epidemic should have raised alarm bells.
TwilightGardener
(46,416 posts)of dealing with this effectively, whether it's those involved in airport screening and tracking of these at-risk passengers, the CDC, or the various components of our medical system (local or state public health agencies, hospitals, EMS). All it takes is one tired, uninformed, or careless person making a mistake--like the triage nurse or whoever was in the chain of error in that hospital--to cause a very urgent situation.
pinto
(106,886 posts)Yet I'd hesitate to label it a systemic issue across all medical and transportation systems.
Ruefully ironic, it's probably a gut check for all systems to ensure established protocol is understood and carried out. Even those who are already on top of procedures.
I wish the patient well and a successful recovery.
JaneyVee
(19,877 posts)
JI7
(89,246 posts)but seriously i wonder if there is lack of paying attention to things like this. i hear things like this sometimes and it seems like common sense to me .
and i'm not even one of the experts in those areas.
sometimes people just seem so clueless about things they should be more aware of than even me.
AZ Progressive
(3,411 posts)Both public and private systems being dysfunctional, disasters happen.
Avalux
(35,015 posts)...or a single employee who didn't do her job, which is how all this is looking. Sure they can issue protocols, and hospitals are required to train their staff to them, but that doesn't mean every employee is going to follow them.
It's tragic and to your point - very well could happen again. I'm not sure how to prevent it. The CDC can't.
Generic Other
(28,979 posts)The responses I got were ridiculous. I was shocked. Instead of people even expressing interest in knowing more about the way this disease has progressed and the prognosis for the future, I was beaten up on by people who denied it was a serious issue, calling it media hype, a scam.
While I do not think we should panic, I do think the ostrich approach is no better. Americans act like Prince Prospero. He too believed he could hide behind his thick walls and avoid the plague ("Masque of the Red Death," Edgar Allen Poe).
cali is right. Americans either don't fully understand the dangers or are willfully pretending they are immune. There is a reason that FEMA has emergency body bags and all that stuff rightwingers think is stockpiled for them. Over the years the CDC has issued warnings about pandemics and their seriousness. Every agency has prepared emergency plans for a number of serious lifethreatening scenarios from terrorist attacks to pandemics. They are prepared for casualties. What the rest of us need to do is to make sure there are none.
kestrel91316
(51,666 posts)People who don't believe ebola exists, people who don't believe it could happen to them, people who believe it's all a government plot to kill them.
We have the exact same situation in the US.
uppityperson
(115,677 posts)From what I have read, the CDC has said large outbreaks like is happening in Africa won't happen in the USA and so far, they are correct.
ret5hd
(20,489 posts)to make sure this doesn't happen again? Surely you've got a fool-proof plan, right? Something that would guarantee with a capital g that we are all safe.
PADemD
(4,482 posts)1) World-wide suspension of all commercial flights into and out of Africa.
2) Only military flights out of Africa to a 21-day quarantine area.
3) After 21 days in quarantine, commercial travel to final destination.
Logical
(22,457 posts)kestrel91316
(51,666 posts)Really - they didn't know that coming from Liberia was any sort of RED FLAG???? Do these people live in caves?
hollowdweller
(4,229 posts)CDC did what they were supposed too do.
There's all sorts of stuff that has symptoms like Ebola why the hell would a hospital in TX think somebody had it?
In an ideal world the ER doctor would have extensively questioned him but that's not going to happen in real life.
Probably the best thing would be if we had a series of public health centers where it was known the guy came from Africa because they had seen him before, or he saw a primary care doctor before. However that's not how our health care system is set up.
Cali_Democrat
(30,439 posts)Ridiculous.
MineralMan
(146,286 posts)Perhaps you should think longer before posting. The CDC has no authority over hospitals or other providers. They can only supply information and recommendations. You do damage when you jump to judgment, mostly to your own reputation.
FSogol
(45,473 posts)The CDC stated that an major outbreak like in Africa couldn't happen here. A couple of cases is not an outbreak
Too much Monday Morning Quarterbacking, I suspect.
MineralMan
(146,286 posts)It's getting old.
NCTraveler
(30,481 posts)Although it isn't as much fun as blaming a government agency. I know many people who always blame the government first, none of them would be allowed to post at this site.
cascadiance
(19,537 posts)... only to certain "equipped" airports, where there is some advanced screening in place. Perhaps also require that airlines notify passengers that have been travelling in these areas are booked in seats next to them, so that they have the option of cancelling or getting their seats moved. Maybe make it so that these passengers have to sit along with only those travelling with them and no one else in certain seats on the plane too, to minimize the risk of "aerosol" infection.
It might be a pain for those travelling, but it would seem that we should have some ways of controlling it so that those trained to deal with this are the ones that will be constantly working with such passengers as they enter the U.S. That way, hopefully we don't have some stupid mistakes putting so many more at risk and perhaps really throwing the gates of hell open.
PADemD
(4,482 posts)
riverwalker
(8,694 posts)We have not had ANY instructions, or additional preparation for Ebola patients. Our admission check list of over 100 questions, does not include even ONE about recent travel. Our hospital is in an area that has a high population of Liberian immigrants, which makes it even more astonishing.
Lars39
(26,109 posts)I've been asked about foreign travel etc recently.
And to look on the bright side, I bet a lot more hospitals and personnel will be pushing the correct protocols now.
pnwmom
(108,974 posts)of the massive amounts of waste that must be burned or securely buried.
MineralMan
(146,286 posts)the hospital is negligent. Information about foreign travel should be included in every history taken from a patient. There are many diseases that are endemic in some places, but not in the US. Any diagnosis that doesn't reflect recent travel is suspect, and not just because of Ebola. Perhaps you should suggest that your hospital move into the 21st Century with its patient history forms.
Sheesh!
NCTraveler
(30,481 posts)They know it is a problem area. Yet they have to be told to ask the question instead of doing it themselves.
pnwmom
(108,974 posts)that this guy slipped through, because he had no symptoms when he got on their plane.
It IS a failure for their protocols to allow someone to fly who SHOULD be on a 21 day watch, since he was known to have been exposed to Ebola.
Barack_America
(28,876 posts)What kind of jurisdiction do you think they have in Liberia?
pnwmom
(108,974 posts)Or airport workers failed to abide by them.
http://www.nytimes.com/2014/10/02/us/man-in-us-with-ebola-had-been-screened-to-fly-but-system-is-spotty.html
In early August, the C.D.C. sent medical workers to the region to train local government officials and airport workers in Ebola screening, according to Dr. Nicole Cohen, an infectious disease specialist with the agency’s Division of Migration and Quarantine. As part of that process, the agency advises that airport workers ask travelers if they have been exposed to Ebola in the last 21 days, have had a fever, and have had any symptoms including severe headache, muscle ache, abdominal pain, unusual bruising or bleeding, vomiting and diarrhea. The screener is expected to use a hand-held non-contact temperature monitor, a few inches from the travelers’ forehead, to check for fever.
But the system has its limits, relying on the traveler to reveal whether he or she has been exposed. And it leaves it to local officials to conduct the screening as they see fit, Dr. Cohen said. It is unclear how consistently or effectively those screenings are conducted across West Africa, and Dr. Cohen said she did not know how many potential travelers had been caught by screeners — if any.
“Our expectation is that people who are sick or people who are exposed should be getting the message they shouldn’t be traveling.”
Airlines have not taken any specific steps to deal with Ebola, representatives from several carriers said. They follow general guidelines issues by the C.D.C. and the World Health Organization. They have also informed their flight attendants about the hazards of Ebola, its symptoms and how the disease is spread. Delta has increased the supplies of gloves and sanitizers on board. But beyond taking simple precautions, airlines said they were not responsible for screening passengers.
Logical
(22,457 posts)cali
(114,904 posts)that would ensure that if someone came in who had recently been in an Ebola impacted area, with symptoms that could be ebola, they would be immediately put in isolation.
Logical
(22,457 posts)locks
(2,012 posts)a true model of what a government agency can do if it hires people who are committed, trained, funded well and haven't been corrupted. They work in 60 countries and in every state. The whole world looks to the CDC for research, protocols, innovation, teaching, solid information, and they coordinate their work with government agencies as well as NGOs in every area of public health. They can send a trained team anywhere when needed. They have professionals in every large airport to contain epidemics like ebola and help many countries to build working health systems like we have here.
We know what often happens when work like the CDC does is privatized, when the mission of the agency or the hospital is to make money for executives and shareholders. We are fortunate to have many great NGOs like Doctors without Borders but they can never do what government can do if we support and regulate our workers and do not allow government and elected officials to be bought by corporations.
Puzzledtraveller
(5,937 posts)
marlakay
(11,448 posts)Its all about money, I bet they have been screaming to each other on the phone, with hospital admin screaming WHO is paying for this?