Wait, I thought you could only catch ebola if you came in direct contact with fluids....

[uponit7771]

.... two nurses now?

Also, that ebola wasn't HIGHLY contagious (whatever that means now) and wasn't airborne either....

I mean, even if a patient is reasonably healthy nurses don't want patients fluids or anything else on them...


Its hard to believe that these TWO nurses didn't take some kind of extra precaution with the virus


I'm far from HOF but somethin aint right...


two nurses now?


your take?

tia

[cali]

1. Of course they took precautions

but direct contact with bodily fluids can happen during removal of protective gear, for instance.

the bodily fluids of Mr. Duncan were massively loaded with the virus in his last days.

[deutsey]

5. Duncan's first few hours in the hospital were apparently a disaster

in terms of precautions and containment.

http://www.democracynow.org/2014/10/15/as_second_dallas_nurse_diagnosed_with

...allegations of the nurses on what actually happened in the days when Thomas Eric Duncan was at the Texas hospital. They talk about the fact that he came in an ambulance—this is the second time he had come to the hospital—with his family saying that they believed he had Ebola, and yet he was kept for hours in the emergency room among other patients, not isolated immediately. And even when a nurse supervisor complained and said he has to be put in isolation, that there was resistance from her supervisors to that. They talk about hospital supervisors coming in and out of the isolation unit without proper protection. They mention that the specimens for Mr. Duncan were sent through the tube system of the hospital to the labs, rather than being properly sealed and delivered, hand-delivered to the lab, which could possibly contaminate the entire tube system of the hospital. And also, what you mentioned about training, they say that the only training that was offered to them prior to this was a voluntary training, not even a required training, and it was largely just a seminar like any other seminar that they’re given at the hospital.

[uponit7771]

7. ah... this makes more sense... the hospitals awareness seemed REALLY REALLY low

[deutsey]

10. That just baffles me

Last edited Wed Oct 15, 2014, 02:53 PM - Edit history (1)

How could awareness be that low in a freaking hospital?

I can almost understand why there hasn't been a world effort to respond to and contain the outbreak in Africa (world corporations have their heads stuck up their bottom lines), but how hospital professionals could be so oblivious to the nature of this thing just has me baffled.

[SalviaBlue]

15. It depends on if the Private For Profit hospital thinks it is worth it to have high awareness...

apparently, they do not.

[deutsey]

17. Wouldn't want to cut into the CEO's $5.7 million salary, would they?

[Louisiana1976]

27. That's why we need single payer.

[Recursion]

43. Single payer doesn't end private for-profit hospitals.

Single payer has nothing to do with the delivery, just the insurance system. If you want only public hospitals you'll need a National Health System like the UK has.

[Aerows]

45. Or Canada, Australia

France, the Netherlands ...

Everyone in the world, except for people in the US, have universal health care. We donate billions to Israel and they have a far better health care system than we do. We are being crippled by our health care system and health "insurance" in the US

[Recursion]

46. And most of those do that with private providers

I'm just pointing out that those are two different questions.

[Aerows]

48. The population of the US

has a snowflake's chance in hell of being able to handle and treat an outbreak of Ebola at this time. We have 18 beds, 8 of them iffy, capable of handling a BSL-4 virus like Ebola.

[Recursion]

49. How many does Canada have? The UK? (nt)

[Aerows]

50. UK as small as it is

Has 4. Important thing to note, though, is that when you get sick in Europe you go to the doctor instead of the way it happens in the US. You put off treatment as long as you can because you might get fired for taking too many days of work off, and you WILL be bankrupted when your insurance company decides it doesn't want to pay.

There is one in Winnipeg. They have a population of 10% in the US.

[HereSince1628]

22. It's gonna a be a historic textbook case...an avalanche of of error

Mostly resulting from PRESUMPTIONS that everything was OK.

This is going to be the icon of what "blunder" means to the next generation of health science students.

[napi21]

28. I can''t recall where I read it, but the report from CDC said HC workers there had no protocall

for dealing with ebola. Their directions changes multiple times a day The first "protective gear didn't cover the neck at all, and there were no instructions on how to remove the gear after treatment was completed. It's becoming extremely clear the fault lies with the hospital and their lack of protocall directives.

[magical thyme]

66. and when they expressed concern about their exposed necks, they were told to tape them up

I still can't get over this.

1. How the eff are you supposed to remove tape wound around your neck without an accidental exposure.

2. Removing the tape will leave your neck with abrasions, making it more vulnerable to any exposures.

It simply boggles my mind.

[herding cats]

19. There's more - Presbyterian workers wore no hazmat suits for two days while treating Ebola patient

Health care workers treating Thomas Eric Duncan in a hospital isolation unit didn’t wear protective hazardous-material suits for two days until tests confirmed the Liberian man had Ebola — a delay that potentially exposed perhaps dozens of hospital workers to the virus, according to medical records.

The 3-day window of Sept. 28-30 is now being targeted by investigators for the Centers for Disease Control and Prevention as the key time during which health care workers may have been exposed to the deadly virus by Duncan, who died Oct. 8 from the disease.

Duncan was suspected of having Ebola when he was admitted to a hospital isolation unit Sept. 28, and he developed projectile vomiting and explosive diarrhea later that day, according to medical records his family turned over to The Associated Press.

But workers at Texas Health Presbyterian Hospital Dallas did not abandon their gowns and scrubs for hazmat suits until tests came back positive for Ebola about 2 p.m. on Sept. 30, according to details of the records released by AP.

http://dfw.cbslocal.com/2014/10/01/cdc-confirms-patient-in-dallas-has-ebola-virus/

I'm gobsmacked at finding this out. I can't wrap my head around this new information yet.

[deutsey]

24. I'm as dumbfounded by this as you

That's just appalling.

I guess many Americans really are that uninformed.

[kestrel91316]

53. I'm not shocked at all. It's a red state that hates the federal government and

obviously prides themselves on doing the polar opposite of what those damned commiesoshalists tell them they should do.

[LannyDeVaney]

2. My take ...

Sure nurses may not want patients fluids on them. I don't want a Republican controlled Senate.

Shit happens.

[uponit7771]

8. lol... so true

[Kalidurga]

3. I read about how they "protected themselves"

it's not even close to being right. They put tape around their necks for one thing. Seriously the most dangerous part of being "protected" is when you take your gear off. That has to be thoroughly decontaminated first. The most likely time they got infected was when they removed their "gear".

[SheilaT]

4. My take is that they did come in contact with fluids.

Keep in mind that the protocols for putting on and taking off the protective gear are very strict, and it's possible it wasn't done perfectly every time. Also keep in mind that this hospital in Dallas is not a high level facility that normally deals with bio hazards. Also, these nurses were treating that man as he got sicker and sicker and then died, all the time becoming more and more highly contagious. It does not take very much Ebola virus to infect a person. Only the tiniest amount is needed.

The Diane Rehm show today covered this topic quite nicely.

[unblock]

6. not easy to get, must have contact with bodily fluids of someone showing symptoms

or from the body of someone who recently died from it.

however, it's probably rather challenging to perform nursing-type duties (handling vomit, changing clothes, cleaning etc.) without coming into contact with those bodily fluids without very diligently following careful procedures and with proper protective equipment at all times.

one slip-up can mean infection.

it's not "highly contagious" because you have to get up close and personal to be at risk; however, once you are up close and personal, it only takes about 10 individual ebola viruses to completely take over a new host.

[Autumn]

9. I have heard it said a person has to be symptomatic and have a fever to be contagious but

I have read that a fever is not a sure sighn of infection.

http://www.latimes.com/nation/la-na-1012-ebola-fever-20141012-story.html#page=1

[kestrel91316]

54. Well that would be true. On a global basis I would venture that the VAST

majority of febrile people don't have anything remotely resembling Ebola. Same for North America. Hell, same for anyplace in Africa other than Liberia, Guinea, and Sierra Leone.

[TwilightGardener]

11. Having been in their shoes, but with less-deadly circumstances, it's almost impossible

NOT to get a patient's fluids on you (well, your protective covering) if you spend enough time caring for them. I am short and had to practically climb into bed with patients to clean, assess, and care for them. Plus, nurses work 12 hour shifts. That's a lot of time to spend with a highly infectious individual.

[cherokeeprogressive]

12. Blame it on Texas. n/t

[Hekate]

13. Ebola patients are splashy, that's my take. "Bodily fluids" is a sanitized name for....

... uncontrollable vomit, diarrhea, urine, and blood being oozed out and coughed out.

Once again, Rachel Maddow's program last night was intelligent and well-informed. She used the story of experienced pilots learning to take off and fly a complicated new aircraft, the B-17. Finally, after too many crashes, they developed a rigorous written check-off list. The crashes stopped and the B-17 went on to become an invaluable tool in (as she colorfully put it) "kicking the snot out of the Nazis."

Or take the case of the hospital that had too many central line infections in its ICU patients and too many deaths from same. They did a controlled study using a check-list that began with "Wash Hands for X-amount of Time" and went on from there in excruciating detail. It worked.

Rachel's point is well-taken: Hospitals everywhere are going to have to do this with those haz-mat suits their personnel have to put on and take off. The nurses who got sick are experienced professionals, but something went wrong, some small detail.

Personally, I'm still awaiting word on the cleaning crew that pressure-hosed the vomit outside the initial patient's apartment, wearing T-shirts and sandals while a woman in a sari walked past the runoff.

[arthritisR_US]

21. Wow, I didn't know about this. Now THAT is cause

for concern. I think of animals sniffing or licking it (which dogs do with everything) and then they go home to their masters and lick their hands or face

[kestrel91316]

55. And we already know that dogs can become ASYMPTOMATICALLY

infected. What we don't know at all is whether or not they shed virus at any stage of that game.

My Spidey Sense says yes, they do. And that's another really ominous, disturbing development if true.

[arthritisR_US]

64. My understanding is tha the virus can't live very long

when exposed to air so I don't think the shedding is a problem.

[kestrel91316]

56. They have no clue how Patient Zero in the West African outbreak

got Ebola. He was a TWO YEAR OLD BOY. I am thinking maybe a dog or three in his village found and ate a dead, infected wild animal. Got it. Shed it in poop. Kid put poopy hands or poop itself in mouth.

We'll never know.

I REALLY hope they are looking for virus every single freaking day in that poor King Charles spaniel's poop to start building some sort of database on this.

[arthritisR_US]

65. Studying her pets feces makes sense. I would think local primates would be

a more likely source

[ctaylors6]

41. OMG they had that video looping on local news

during press conferences that day. I keep screaming at the guy with the power washer to stop. I almost drove over there and told him to stop but was afraid to get too close. I searched news reports of that and no one actually ever reported (that I could find locally or nationally) that he was cleaning off vomit as opposed to just cleaning the sidewalk there. Fingers crossed, he's one of the many I'll stop wondering about after another few days.

[lonestarnot]

47. Whut? The guy I saw spraying wasn't in sandals, maybe I have it mixed up with the first nurse.

What in the fuck is the stupid going on in Texas?

[Daemonaquila]

14. My take is that they came into contact with fluids.

Have you read about the nursing staff's complaints about how protocols were changing and how at least initially the equipment was inadequate? About how his samples were being sent to the lab via the hospital's regular pneumatic system? How the nurses were having to use some makeshift gear and tape up? How there had been the most minimal training? How many people came into contact with him before he was put into isolation? How there was lots of explosive diarrhea, projectile vomiting, etc., etc., etc.?

This is absolutely par for the course. This is why so many health care workers in Africa have caught the disease whether or not they have good equipment. It's really hard to do it 100% right, every time, over and over. Even gowned up, one unconscious slip in either failing to cover something, or in ungowning, is all it takes.

[seveneyes]

16. I heard right here you had to go out of your way to catch Ebola

And allowing non-citizens to come here as tourists from hot zones is better than waiting until this burns itself out.

[apples and oranges]

18. It saddens me to see this because you were strongly in the CDC's corner

But it proves what I've been saying, the CDC is burning through it's credibility even with people who accepted their assurances from Day 1. Now Obama has had to cancel his plans to clean up Friedman's mess. Friedman should have never left THP to their own devices.

[hedgehog]

23. The CDC made the mistake of assuming that when it announced

that there were certain procedures to prevent spreading Ebola, and described those procedures, responsible adults would at least attempt to follow those procedures rather than business as usual.

[SidDithers]

30. Nailed it...nt

Sid

[hedgehog]

31. Engineers have a saying "You can't make anything idiot proof,

because idiots are so ingenious". Not exactly what happened here, but close.

[MattBaggins]

52. Yet when I worked in biotech

"Find an engineering solution" was always pushed for if possible.

People forgot to shut off a valve at the right pressure.. automate it.

[kestrel91316]

59. This saying finds perfect application in this situation.

Idiots are indeed ingenious.

[uponit7771]

36. This sounds like the most likely answer

[kestrel91316]

58. Yep. I've been told I'm a terrible person for saying as much.

[uponit7771]

39. I still am, I don't reflexively dislike gov agencies... I don't think the CDC is doing a good job...

... right now..

The nurse called the CDC multiple times before going on the plane and the CDC cleared her for flight according to CBS

[apples and oranges]

40. I actually had a great deal of respect and trust in the CDC, but that was

lost after the mishandling of Duncan's family, the lack of information given to neighbors, waste disposal, clean up, the list goes on and on. We saw all of it unfolding live on TV at the same time that Frieden was bragging about how quickly the problem would be resolved.

[arthritisR_US]

20. They could have contracted it when they were

taking off their gear. It is not airborne and relies on direct contact with bodily fluids. Take a deep breath and quit being the reactionary alarmist of which the media is the greatest culprit of that right now.

[Rex]

25. Entropy.

You always have to take into account the unfactorable.

[morningfog]

26. No one wore protective gear for days, until Ebola was confirmed.

It was really stupid and doesn't change the fact that direct contact with bodily fluids is how the infection is spread.

[Louisiana1976]

29. Exactly. They should've started wearing protective gear when they suspected Ebola.

[uppityperson]

32. Indeed. Bodily fluids is how you spread it. They weren't protected for too long. Appalling.

[Puzzledtraveller]

34. it is particularly present in the lungs

the smallest droplet sprayed from a cough or sneeze could be all it takes and you have probably seen those videos showing how far the droplets travel and how much you can ingest even being several feet away.

[LisaL]

42. That's not true. They did wear protective gear.

What they didn't wear are the hazmat suits. Which CDC doesn't call for anyway.

[Puzzledtraveller]

33. It could be the f*ck up of the new millenium

There needs to be some leadership on this now. I hold everyone involved and responsible accountable. That ebola is even in the US, wtf!!!!!

[kestrel91316]

35. Wet fluids, teh patient himself, or contaminated objects collectively as fomites.

Ebola has never shown the transmission pattern of an aerosol-spread virus like flu or colds. Not even now.

Get over your science-denying panic already. And stop listening to freaking Alex Jones.

[rustydog]

37. The nurses cared for the patient, they TOUCHED the patient

They came in contact with the fluids if they touched the patient. The common denominator is the two cared for the patient who DIED from Ebola....stop the panic please.

[uponit7771]

38. There's no proof that they "touched" the patient with bare hands and we should question what doesn't

... jive with what's been told.

In this case it looks like CDC didn't make sure the hospitals in this country were adequality prepared for hazardous diseases

[kestrel91316]

60. It's not CDC's job to prepare hospitals. It is their job to provide them with

guidance so they can prepare themselves, should they think it important.

THP did not think it important, as is apparently their prerogative in Texass.

[Recursion]

44. Critial Ebola patients bleed out of their eyes, mouth, nose, and anus

While nearly constantly vomiting and passing diarrhea (which towards the end is mostly just blood).

That's why in Africa it spreads so quickly in hospitals and clinics, and particularly to health care workers: the fluids are everywhere.

[Justice]

62. On Rachel's show last night, doctor said bleeding occurs only 18% of time

[Recursion]

63. Most ebola cases do not become "critical". We still don't know why

That would be a very good thing to learn.

[Jamastiene]

51. That is where I am too.

I started out freaked out, but calmed down. Now, I'm slightly concerned. I'm not sure why they both got it if they knew Duncan could even *possibly* be infected with Ebola. I would think that would put them in a more alert state of mind to be cautious. The CDC downplayed the risks at the expense of their health.

[uponit7771]

61. BINGO! CDC Downplayed the risk, Then just sent "protocol" to hospitals, then didn't make sure

... to at LEAST communicate EXACTLY what people who've come into contact with Duncan should do.

[Aerows]

57. This has been mishandled from the beginning

Texas Presbyterian is not equipped to handle BSL-4 cases. Only 4 hospitals in the US are, and one is iffy.

Emory in Atlanta and Omaha in Nebraska are the only places equipped to deal with BSL-4.

The CDC has repeatedly dropped the ball. At least they came to their senses and flew the latest patient to Emory where they know the protocol.