Friday, October 24, 2014

Ebola a few weeks later

Last week there was the issue of Ebola spreading through the Dallas area. I can remember going to lunch in my non hospital environment co-workers were wanting to put on masks to deal with customers out of fear of getting ebola. I would turn on the radio and hear people discussing how President Obama was not on the job for not closing down airports and sending a CDC SWAT team to Dallas.  In the aftermath it seems easier to look at the situation and say what we should have done to make the situation better.

I have been trying to understand how things have come the way they are. I do know that with the advent of technology such as the EMR or electronic health record was supposed to help with preventing a patient as such to have gone through the process that occurred. The patient claimed to go to the hospital after being in the country facing a viral outbreak. Instead of being admitted to the hospital, the patient was turned away with the possibility of  infecting others as well as eventually dying.

The problem is that this infection is very similar to having the flu. The emergency room staff are not always able to discern the effects of foreign illnesses from standard illnesses. Finally after three days the patient is admitted to the hospital.  

The thing that I don't understand is how the CDC was not able to enact any type of security measures to prevent  further spread of the illness. A few weeks ago I found some of the CDC guidelines about dealing with the virus in Africa. The thing was the manual was about 200 pages which half devoted to the appropriate wear and removal of the PPE.

The line from the Executive office is that they do not want to close the borders due to destabilizing emerging countries.
"Everything will be okay... we have the best health system in place"

I can understand why the guy wasn't diagnosed at the beginning 

Why weren't the people that had primary contact with the Ebola patient quarantined?

Days later after patient zero had been admitted to the hospital two nurses involved in patient care tested positive for the Ebola virus. 

As usual the government has been slow to react. I find this troubling considering that the virus is not quite as contagious as some and didn't end up in a city that is densely populated.

Monday, October 13, 2014

Protocols for containment of Ebola

Monday Moring Quarterbacking

It is very easy to look at a situation after things happen and place blame. That is not my intent of understanding what is going on.  I do believe in looking at things from a rather simplistic point of view. Ebola virus disease (EVD) according to the World Health Organization is formerly known as Ebola Hemorrhagic fever.
·         The Virus is transmitted to people from wild animals and spreads in the human population in human to human transmission.
·         The average EVD case fatality is around 50%  Case Fatality rates have varied from 25% to 90% in past outbreaks.
·         There are currently no licensed Ebola vaccines but two(2) potential candidates are undergoing evaluation.
Ebola gets its name from a 1976 outbreak in a village near the Ebola River in the Democratic Republic of Congo.
According to the WHO the Ebola virus is difficult to distinguish from other infectious diseases such as  malaria, typhoid fever and meningitis.  
While I was driving the children this morning I heard Peter Brock radio talk host say that the CDC has issued a statement regarding about the new infection of a nurse.  According to the CDC “There was a break in protocol.”   According to Fox News there are trainings and standards that must be adhered to.  Well According to the CDC there is a document that explains how to control those virus infections.
Infection Control for Viral Haemorrhagic Fevers In the African Health Care Setting. Developed and written by Ethleen Llyod M.S. Helen Perry, M.A. Liliien Yang, M.S. written in 1998.
So now my question is which procedures were broken and did the Nurse test positive for the virus? Was the hospital following the CDC/WHO guidelines?