I get being scared, but to refuse to treat patients with Ebola like symptoms (ie, a fever- at least that seems to be the line some are drawing) is not OK with me. What if cops and firefighters were like "nope" for 9/11? Some professions have more risk - I don't think you should be able to elect which parts of your job to do when shit gets tough. Did people act this way about aids when we thought it was more easily transmitted than we do now?
All of that being said, they deserve better training and support. I hope all hospitals make this a priority.
Yep. My mom is a nurse and worked in a hospital setting in the 80's, and told me that nurses were terrified of AIDS. Many refused to work with AIDS patients, and she knew many nurses who left hospital work for something like a job at a doctor's office just to avoid being around AIDS.
Remember when there were people calling for deportation and quarantine (in the Molokai leper colony style) of HIV+ people? It's really crazy to think back to just how panicked everyone was. Reminds me a little bit of the "shut down all travel in and out of Africa" business.
The Reston strain in DC was here 25 years ago. It turned out to be non-lethal but we didn't know that at the time.
That's what pisses me off. We've had (at minimum) 25 years to better prep our healthcare folks for this, and now according to even the nurses on this board, we're all as a country acting brand new to this and not giving anyone better tools to protect ourselves.
Okay, I'm not understanding HOW precisely the nurses (or anyone, really) are contracting this. I know a little something about blood borne pathogens (I had to teach an OSHA class a few times) and the pathogen needs an entry point - as you mentioned. One of the points we went over in class was OSHA reporting, and if you get blood/shit/vomit on your unbroken skin, you don't have to report it.
So even if the nurses had exposed skin, as long as it was unbroken, they should be okay, right? It's not absorbed through the skin like LSD, is it? Why aren't "standard" blood borne pathogen protocols good enough?
Okay, I'm not understanding HOW precisely the nurses (or anyone, really) are contracting this. I know a little something about blood borne pathogens (I had to teach an OSHA class a few times) and the pathogen needs an entry point - as you mentioned. One of the points we went over in class was OSHA reporting, and if you get blood/shit/vomit on your unbroken skin, you don't have to report it.
So even if the nurses had exposed skin, as long as it was unbroken, they should be okay, right? It's not absorbed through the skin like LSD, is it? Why aren't "standard" blood borne pathogen protocols good enough?
I think (and I could be totally wrong) that one of the issues is the sheer volumes of fluids involved. It's much messier than most illnesses - which means that many more chances for it to end up on your skin either because it's exposed, or when you remove your gear incorrectly, and then later you touch an entry point (like rub your face)
Okay, I'm not understanding HOW precisely the nurses (or anyone, really) are contracting this. I know a little something about blood borne pathogens (I had to teach an OSHA class a few times) and the pathogen needs an entry point - as you mentioned. One of the points we went over in class was OSHA reporting, and if you get blood/shit/vomit on your unbroken skin, you don't have to report it.
So even if the nurses had exposed skin, as long as it was unbroken, they should be okay, right? It's not absorbed through the skin like LSD, is it? Why aren't "standard" blood borne pathogen protocols good enough?
I think (and I could be totally wrong) that one of the issues is the sheer volumes of fluids involved. It's much messier than most illnesses - which means that many more chances for it to end up on your skin either because it's exposed, or when you remove your gear incorrectly, and then later you touch an entry point (like rub your face)
It seems the CDC said the 2nd nurse knew she wasn't supposed to fly and did anyway. Awesome
I read that too.
Look, this shit absolutely will NOT be contained until people can actually listen to and follow the most basic guidelines for quarantine if they have been exposed.
I assume that Duncan's family has been cleared by now?
I think (and I could be totally wrong) that one of the issues is the sheer volumes of fluids involved. It's much messier than most illnesses - which means that many more chances for it to end up on your skin either because it's exposed, or when you remove your gear incorrectly, and then later you touch an entry point (like rub your face)
Well, they should wash their fucking hands!
full circle.
Seriously, though, they ARE supposed to wash their hands after removing their gear. Always.
Okay, I'm not understanding HOW precisely the nurses (or anyone, really) are contracting this. I know a little something about blood borne pathogens (I had to teach an OSHA class a few times) and the pathogen needs an entry point - as you mentioned. One of the points we went over in class was OSHA reporting, and if you get blood/shit/vomit on your unbroken skin, you don't have to report it.
So even if the nurses had exposed skin, as long as it was unbroken, they should be okay, right? It's not absorbed through the skin like LSD, is it? Why aren't "standard" blood borne pathogen protocols good enough?
Unlike strictly bloodborne pathogens like AIDS or Hepatitis, Ebola can be transmitted through vomit, poop, saliva, maybe sweat (they aren't sure) and can enter the body through nasal passages, mucus membranes, eyes, etc. My understanding is that AIDS needs a pretty direct path to the bloodstream (needle stick, etc) while Ebola can be contracted by touching your eyes, nose, or mouth. I think it also has a pretty low viral load needed for transmission, so all you need is one or two lone germ cells somewhere on your skin, then you touch that part of your skin and rub your eyes, or touch your lips, and you get sick. So if these nurses were wading around in bodily fluids, which sounds likely based on the reports of 30 liters of contaminated stuff being disposed of daily, then it would have been pretty easy to have some germs left on their skin after they disrobed. All it took then was for one of those germs to get on their hands and eventually to their mouth, eyes, nose, etc. This is why in other locations the doctors are wearing multiple layers of suits, and being sprayed down with disinfectants after removing each layer.
I read something about how they suspect this strain may be more virulent (that's probably not the right term) and require fewer germs to transmit the disease than they've seen in the past.
Okay, I'm not understanding HOW precisely the nurses (or anyone, really) are contracting this. I know a little something about blood borne pathogens (I had to teach an OSHA class a few times) and the pathogen needs an entry point - as you mentioned. One of the points we went over in class was OSHA reporting, and if you get blood/shit/vomit on your unbroken skin, you don't have to report it.
So even if the nurses had exposed skin, as long as it was unbroken, they should be okay, right? It's not absorbed through the skin like LSD, is it? Why aren't "standard" blood borne pathogen protocols good enough?
Unlike strictly bloodborne pathogens like AIDS or Hepatitis, Ebola can be transmitted through vomit, poop, saliva, maybe sweat (they aren't sure) and can enter the body through nasal passages, mucus membranes, eyes, etc. My understanding is that AIDS needs a pretty direct path to the bloodstream (needle stick, etc) while Ebola can be contracted by touching your eyes, nose, or mouth. I think it also has a pretty low viral load needed for transmission, so all you need is one or two lone germ cells somewhere on your skin, then you touch that part of your skin and rub your eyes, or touch your lips, and you get sick. So if these nurses were wading around in bodily fluids, which sounds likely based on the reports of 30 liters of contaminated stuff being disposed of daily, then it would have been pretty easy to have some germs left on their skin after they disrobed. All it took then was for one of those germs to get on their hands and eventually to their mouth, eyes, nose, etc. This is why in other locations the doctors are wearing multiple layers of suits, and being sprayed down with disinfectants after removing each layer.
I know the *biggest* concern is hepatitis, which is also transmitted the same way and is highly infectious. So everyone should be very familiar with basic protocols, regardless of the pathogen they're dealing with.
I suppose I'm having difficulty with the amount of fluids they must be dealing with. I don't think I have enough imagination - lol.
Post by cattledogkisses on Oct 15, 2014 12:39:06 GMT -5
Who was it who said in one of the other threads that stupidity is going to kill us all? Good lord people, if you are told not to fly, or to stay in quarantine, then DO IT. OMG.
It seems the CDC said the 2nd nurse knew she wasn't supposed to fly and did anyway. Awesome
Ummmm what? Why did she know she wasn't supposed to fly? Also shit if I think I have Ebola I am flying to Atlanta!!
This part is what makes me see red. We can control this thing, if people would quit being so deliberately fucking stupid. Taking your exposure to another state when you are on watch for symptoms? This and Dr. ijustneededasandwich really anger me.
I think a lot of hospitals THINK they are prepared because they have policies outlining protocols for contact and droplet isolation. But until they run drills they will not understand their vulnerabilities. If you aren't doing it repeatedly people forget the protocols, especially when stressed. When the parasympathetic nervous system kicks in people need to rely on muscle memory and practice. Any hospital that is not already conducting drills to test their vulnerabilities is negligent, IMO.
I am exhausted and hungry. I've been working on communications all morning regarding guidance for employees traveling to/from affected areas, having members of their household traveling to/from affected areas, addressing the statements by NNU about the Dallas situation, making sure employees who are pregnant or have compromised immune systems know what options they have under the ADA with regard to treating Ebola patients, etc. Big meeting at 1p and then I can grab a bite to eat!
Who was it who said in one of the other threads that stupidity is going to kill us all? Good lord people, if you are told not to fly, or to stay in quarantine, then DO IT. OMG.
I know I mentioned it once but others have as well. It was in that thread where a Sheriff's Deputy showed up in urgent care with symptoms even though he knew he had direct contact with Duncan's family earlier.
ttt, Even though the nurse scheduled this flight before she knew the first one had Ebola, she should still have been on hyper alert considering she was caring for Duncan. I am glad one of the nurses is being transferred to Emory but I am wondering why not the other. Did they say which nurse is going? I wonder if they are sending the one who is not doing as well, meaning maybe the 1st nurse?
The nurse being transferred is Amber Vinson, the one most recently diagnosed.
Thanks kapoentje. I wonder why her and not the other. Like iammalcolmx said, if I get sick I'm heading straight to Emory.
Maybe they seem to be okay with the first one and/or her symptoms are improving. But they don't want to risk more exposure, if possible, since it seems like Vinson will be contagious longer? And/or they will have to dedicate more staff to her.
“Ebola got a head start on us,” Anthony Banbury, head of UNMEER, told the members of the UN Security Council Tuesday. “It is far ahead of us, it is running faster than us, and it is winning the race.”
In order to turn the tide, Banbury identified four targets that must be met: identifying and tracing contacts, managing cases, ensuring safe burials, and providing people with information they can use to better protect themselves. He also set a 60-day deadline to ensure that 70% of infected people are in care facilities, and 70% of burials are done without causing further infection.
Ebola is spread through direct contact with the bodily fluids of a person who is symptomatic – a transmission process that makes people caring for the sick or the deceased particularly vulnerable.
“If we fail at any of these, we fail entirely,” said Banbury of the stated objectives. “With each passing day as more people are infected, the number of people infected grows exponentially.”
Soooooo...she had a low grade fever when she boarded the plane. I am allowing myself to be a little mad at her now.
She was below the threshold to be considered symptomatic.
"The nurse, who has been identified by family as Amber Joy Vinson, had a low-grade fever of 99 degrees while on a Frontier flight from Dallas to Cleveland on Oct. 13th, which is below the threshold of 100.5 degrees which may indicate that a patient is contagious or becoming ill with Ebola, Friedan said."
Also, if I'm either of these nurses, I'm pissed that my name is public.