It is unforgivable that two healthcare workers are infected with Ebola (with more likely)

[morningfog]

When the CDC director said there was a breach in protocol in Dallas that led to Pham's infection, he also said there would likely be more infected from the same breach. As is clear now, he was not blaming the nurse. He never said "the nurse breached protocol." The hospital was ill-prepared and perhaps ill-advised by the CDC.

It is unacceptable to send workers into conditions without the proper protections. This was avoidable and negligent behavior.

Currently, two of 76 people who cared for Duncan while in isolation are infected. How many of the remaining 74 will show symptoms is not yet known. The next few days are when they most likely would, if they were infected.

These infections are unforgivable and hope there is a recovery by the two and that there are no new cases.

The ray of hope is that it has been 17 days since Duncan was isolated and 7 days since his death. He was most infectious in the final days of his life. Hopefully, his exposure was to fewer people at that time. We don't know yet, but I think it is safe to assume at least some of the workers were treating him early, but not later. I wonder how many of the 76 had contact with him and his bodily fluids in the last 3 or 4 days of his life. Those are the people most at risk. We know Pham was in his room the day before he died, for example.

The other ray of hope is that this is still confined to the hospital. No one pre-isolation has shown any symptoms, they are on day 17.

[hollysmom]

1. not to mention how it feeds into the public panic

[justiceischeap]

2. But the other question we need to ask is this

of the people who came into contact with him in the last 3-4 days of his life, how many other patients did THEY come into contact with? Since it's being reported that happened, I would hope they're keeping an eye on those patients too because I would think they're at greater risk (but that could be my lack of science knowledge showing through).

[Ilsa]

7. From what has been observed,

any person carrying the virus only becomes contagious after showing symptoms. I think that is why they aren't worried about that generation of contact.

[Yo_Mama]

3. A number of hospitals are expressing severe concern over CDC's new recommendations.

Which cover not only PPE, but more about the protocol for removing it, etc.

We were not at all prepared. Most hospitals don't have enough of the equipment probably necessary (especially fluid impermeable gowns and leg coverings), much less the isolation necessary, to deal with a very sick Ebola patient. They tend to go on for a while and then suddenly get very ill.
http://www.nbcnews.com/watch/nightly-news/health-care-workers-show-concern-over-ebola-preparedness-341021251542

So there are shockwaves running through the system right now. Also capacity concerns - in many hospitals, properly executing CDC's and ECDC's new advice would mean temporarily shutting down most or all of the ICU to treat one gravely ill suspected Ebola case, much less a real one.

People who have low levels of live virus in their bodies really aren't that infectious, unless they have other conditions as well. So it is unlikely that the casual day-to-day exposures from the early ill are going to result in new infections. Unless one of them happens to get in a medical crisis.

When you start getting a pool of potentials of 100 or so, the very small probabilities start accumulating. So I think CDC is going to have to rethink what it's doing here again, with more isolation of potentials.

[In_The_Wind]

4. At this point we are still learning about Ebola.

[morningfog]

5. The CDC, WHO, and MSF have long known about it,

and what works.

The local hospital either wasn't properly informed or didn't properly learn.

[In_The_Wind]

6. It looks like the hospital was totally unprepared to treat Ebola.

[randome]

8. I would think most hospitals are unprepared for a one-in-million chance of every infectious disease.

Should they have a leprosy ward just in case? A smallpox ward? It takes one wake-up call like this to put the others on notice, though.
[hr][font color="blue"][center]“If you're not committed to anything, you're just taking up space.”
Gregory Peck, Mirage (1965)[/center][/font][hr]

[In_The_Wind]

9. Now, they've decided that the 21 day observation period be extended to 42 days.

We don't know enough about Ebola yet.

[cwydro]

12. I hadn't heard that yet.

So will they extend those almost out of quarantine?

I can't imagine being essentially locked up for that long.

[In_The_Wind]

13. I don't know the answer to your question.

But I agree with you that living locked up, under observation, would be devastating.

[HereSince1628]

15. They said to incorporate 98% of prepatent infections rather than 95%,

the distribution stretched out 42 days.

The distribution of the symptomless time isn't the usual bell-shape people think about, when they think of statistics....but rather, the distribution has a very long tail going off to the right.

I'm not sure that they've actually changed the recommendations for the monitoring period, yet. But they probably will be.

95% confidence is a common decision making point, but decisions can't be made just based on commonly used standards. The consequences of being wrong vary with the problem.

This isn't a question about being right about something as benign as getting the time it takes for latex paint to dry on a wall. The consequences of being wrong with a pathogen like ebola are obviously very significant.

[LisaL]

11. Do they know what works?

Why wasn't Mr. Duncan transferred into one of the hospitals where people actually know what they are doing and can protect themselves?

[morningfog]

17. Yes. They know what works. They are learning that at the local level, that information

has not been integrated.

[LisaL]

18. Their protocols are clearly inadequate.

I don't know what else to say on the matter.
Sending in people to treat an Ebola patient in a gown, face mask, goggles, and gloves, with exposed skin is ludicrous.
That's not what personnel were in Emory or Nebraska.

[HereSince1628]

10. Yes, but we are ALSO learning about ebola -in- American HOSPITALS

Think about that good old epidemiological triad ... agent, host, environment

the virus is only part of the story. What we're finding out is many presumptions about quality of infection control in American hospitals isn't completely true.

I don't say that to condemn, but rather, the learning that takes place about -that- is going to result in very important changes/corrections of policy and activity in hospitals and in directives of health policy

[In_The_Wind]

14. We'll have a better chance of dealing with it as the hospital gathered information is compiled.

[HereSince1628]

16. Yes it is. And learning the shortcomings and mistakes at the hospital in Texas

is very important.

I hope the CYA operation being shown to the public isn't paralleled with obstruction to inquiries being made by national and state medical and pubic health officials.