Ebola part 3: FOR THE LOVE OF GOD DON'T PANIC!

[daskool]

What, so all large public events across the continent should be cancelled indefinitely? Do you think maybe that's a bit of an overreaction?

There might be hundreds of thousands infected by then, or the virus may have run it's course. It's probably a bit premature but it will be more than Morocco considering banning all travel to and from these countries.

[Grand Moff Mithrandir]

What, so all large public events across the continent should be cancelled indefinitely? Do you think maybe that's a bit of an overreaction?

Not all, just the ones that aren't essential. Look, you also have to look at the continent and the situation at hand. If the WHO's predictions are even slightly accurate then the consequences, of hosting a tournament of this magnitude in a country that is in the region that's been hardest hit, could be dire.

[Summah]

Morocco is really not that close to the countries hit by Ebola, unless you're speaking of entire continents I wouldn't say Morocco and Liberia are in the same region, there is a whole desert in between West Africa and North Africa. Certainly travel restrictions could be reasonable if the outbreak is still ongoing. But Morocco already pulled out, so that doesn't matter for them.

[Grand Moff Mithrandir]

Morocco is really not that close to the countries hit by Ebola, unless you're speaking of entire continents I wouldn't say Morocco and Liberia are in the same region, there is a whole desert in between West Africa and North Africa. Certainly travel restrictions could be reasonable if the outbreak is still ongoing. But Morocco already pulled out, so that doesn't matter for them.

You are correct. However, I was referring to Ghana. Apparently CAF is trying to get Ghana to agree to host the tournament now.

[ants]

...

What has been stated is that because protocols can be wrong, they can't be accepted on blind faith and need to be critically reviewed, and that you can't expect untrained people to follow a complex protocol, so it makes sense to get highly trained people to perform these protocols. Since it's hard to criticize these positions, people are left with their tired panic and fearmonger routines. Keep it up guys.

I think the problem is that you're putting too much risk aversion around the impacts. Is Ebola bad and needs to be stopped? Obviously. At all costs? No. Because although deadly at the individual level and for people treating, it's not really a widespread risk.

The main things that can make it a widespread risk are not following the government's advice and panic. And questioning the first repeatedly and in an unbalanced way can lead to the second and a lower level of confidence in the first. Why is Ebola spreading like mad in W. Africa? Because the people spent months not trusting the government and hiding the sick people and preferring tradition and suspicion over safeguards. Given the historical performance of the West, their own governments, and Pharma over the years they have some justification. However, the simple fact is that this outbreak would be significantly better or even stopped if they had trusted their government.

Yes, the CDC and Texas health officials have had some stuff ups. The consequence? A small group of extra people are at risk. In the grand scheme of things this is nothing. Should the differing officials all be questioned and reviews done at the end? Yes. But in the mean time, the best thing that can be done is recognise that following these guidelines is the best way forward.

You may not like that idea of simply "putting trust" into the government, but right now that is the smartest route. The likelihood of Ebola killing even hundreds of Americans is incredibly low. Let alone having a major outbreak. People not panicking is the smartest move, and questioning every little decision by the CDC doesn't help. Sure, someone with a temperature below 38c might have Ebola and be transmitting. So? The likelihood is so low (given no other symptoms) that making up the rules on that basis is a poor risk decision.

I swear, half the problem is that its EBOLA!, and yet people aren't taking flu shots or wearing their safety belts...

[TerraPrime]

I swear, half the problem is that its EBOLA!, and yet people aren't taking flu shots or wearing their safety belts...

Yes.

[Slick Mongoose]

Good news:

http://www.bbc.co.uk/news/world-europe-29683616

Teresa Romero seems to be recovering.

[Mudguard]

I think the problem is that you're putting too much risk aversion around the impacts. Is Ebola bad and needs to be stopped? Obviously. At all costs? No. Because although deadly at the individual level and for people treating, it's not really a widespread risk.

The main things that can make it a widespread risk are not following the government's advice and panic. And questioning the first repeatedly and in an unbalanced way can lead to the second and a lower level of confidence in the first. Why is Ebola spreading like mad in W. Africa? Because the people spent months not trusting the government and hiding the sick people and preferring tradition and suspicion over safeguards. Given the historical performance of the West, their own governments, and Pharma over the years they have some justification. However, the simple fact is that this outbreak would be significantly better or even stopped if they had trusted their government.

Yes, the CDC and Texas health officials have had some stuff ups. The consequence? A small group of extra people are at risk. In the grand scheme of things this is nothing. Should the differing officials all be questioned and reviews done at the end? Yes. But in the mean time, the best thing that can be done is recognise that following these guidelines is the best way forward.

You may not like that idea of simply "putting trust" into the government, but right now that is the smartest route. The likelihood of Ebola killing even hundreds of Americans is incredibly low. Let alone having a major outbreak. People not panicking is the smartest move, and questioning every little decision by the CDC doesn't help. Sure, someone with a temperature below 38c might have Ebola and be transmitting. So? The likelihood is so low (given no other symptoms) that making up the rules on that basis is a poor risk decision.

I swear, half the problem is that its EBOLA!, and yet people aren't taking flu shots or wearing their safety belts...

While I disagree with some of your points, I appreciate the thoughtful response. As for ebola being a widespread risk, I've always said that it's really going to come down to controlling the outbreak in West Africa.

The US is more than capable of handling a random case of ebola popping up here and there if we take it seriously and have the right procedures in place with the right people performing the procedures. I think we pretty much have things in place now, but that wasn't the case initially. Much of the criticism leveled at the CDC and others was well deserved, led to close scrutiny of the previous protocols, and ultimately led to an improved set of procedures and protocols. I think the criticism was much more helpful than just assuming they knew what they were doing, especially after it becomes clear that mistakes were made.

As for the reasons why things have gotten out of control in West Africa, it's way, way too early to try and claim that the major reason is that because the people didn't trust their government. While fear of government may have played a role, there are many other potential reasons that could have played at least as big a role. For example, the latest reports have suggested that the WHO may not have taken the risk posed by this outbreak seriously until much too late.

Dr. Peter Piot, the co-discoverer of the Ebola virus, agreed in an interview Friday that WHO acted far too slowly, largely because of its Africa office.

"It's the regional office in Africa that's the front line," he said at his office in London. "And they didn't do anything. That office is really not competent."

WHO's other regional directors — the Americas, Southeast Asia, Europe, Eastern Mediterranean and the Western Pacific — are also not accountable to Geneva and are all elected by their regions.

Piot, director of the London School of Hygiene and Tropical Medicine, also questioned why it took WHO five months and 1,000 deaths before the agency declared Ebola an international health emergency in August.

...

When Doctors Without Borders began warning in April that the Ebola outbreak was out of control, a dispute on social media broke out between the charity and a WHO spokesman who insisted the outbreak was under control.

At a meeting of WHO's network of outbreak experts in June, Dr. Bruce Aylward, normally in charge of polio eradication, alerted Chan about the serious concerns being raised about WHO's leadership in West Africa. He wrote an email that some of the agency's partners — including national health agencies and charities — believed the U.N. agency was "compromising rather than aiding" the response to Ebola and that "none of the news about WHO's performance is good."

View gallery

Five days later, Chan received a six-page letter from the agency's network of experts, spelling out what they saw as severe shortcomings in WHO's response to the deadly virus.

"This (was) the first news of this sort to reach her," WHO said in the draft document. "She is shocked." In the following weeks, the WHO country office heads in Guinea, Liberia and Sierra Leone were all replaced.

I'm sure a lot of people had a blind trust in the WHO too, but it looks like that was misplaced.

[Fragile Bird]

So I had dinner tonight with a friend who is a senior executive in a hospital here. She said next week is going to be all Ebola since the province has handed down a set of instructions with regard to preparedness.

She told us about the training medical staff go through with regard to haz-mat suits (we've had SARs and the H1N1 scare to thank for that) and it's very careful, step-by-step training. Practice sessions putting them on and taking them off was done in front of the trainers. And the senior trainer saw videos from the US and was shocked at the way they put on and took off the suits. She said the order wasn't right.

In addition, everyone in the hospital (and I assume this happens across the province) gets measured annually for the correct size of face mask pieces, to ensure properly fitting masks. My friend said the size is marked on the back of her hospital ID card, so in case of emergency she can obtain the correct size of mask from their supplies. Do the nurses here on the board also do this as well?

[Er Rn]

In addition, everyone in the hospital (and I assume this happens across the province) gets measured annually for the correct size of face mask pieces, to ensure properly fitting masks. My friend said the size is marked on the back of her hospital ID card, so in case of emergency she can obtain the correct size of mask from their supplies. Do the nurses here on the board also do this as well?

I'm assuming she's talking about an N95 mask. If so, every RN job I had required you to go through a fitting procedure once when you're hired. I can't remember ever having to repeat it.

[Fragile Bird]

I'm assuming she's talking about an N95 mask. If so, every RN job I had required you to go through a fitting procedure once when you're hired. I can't remember ever having to repeat it.

I'll ask. It might not be, since the measurement is updated annually.

[Michael Seswatha Jordan]

http://fox13now.com/2014/10/16/news-anchor-the-ebola-message-everyone-needs-to-hear/ I'm not partial to any news channel, wich I think their all bias....I'll stay on topic though. This video is what everyone needs to listen to and be reasonable. Quit listening to everything you hear on the internet and what the fear mongers want you to believe. Its not Armageddon people, relax!

[ants]

While I disagree with some of your points, I appreciate the thoughtful response. As for ebola being a widespread risk, I've always said that it's really going to come down to controlling the outbreak in West Africa.

The US is more than capable of handling a random case of ebola popping up here and there if we take it seriously and have the right procedures in place with the right people performing the procedures. I think we pretty much have things in place now, but that wasn't the case initially. Much of the criticism leveled at the CDC and others was well deserved, led to close scrutiny of the previous protocols, and ultimately led to an improved set of procedures and protocols. I think the criticism was much more helpful than just assuming they knew what they were doing, especially after it becomes clear that mistakes were made.

As for the reasons why things have gotten out of control in West Africa, it's way, way too early to try and claim that the major reason is that because the people didn't trust their government. While fear of government may have played a role, there are many other potential reasons that could have played at least as big a role. For example, the latest reports have suggested that the WHO may not have taken the risk posed by this outbreak seriously until much too late.

I'm sure a lot of people had a blind trust in the WHO too, but it looks like that was misplaced.

Although the WHO definitely stuffed up, I think you have failed to read the Vanity Fair article which has been linked multiple times. It talks of how in Guinea the incidences of Ebola dropped to near zero in May. They thought they had controlled it successfully. But instead it had been kept quiet a nobody was reporting it and were caring for each other in their communities. When that got revealed (because there were too many ill to hide) the numbers exploded. Although there were certainly stuff ups, in Guinea the major influencer was the lack of following government guidance.

Now, certainly in the other countries the larger contributor may have been government/international stuff ups. I don't know.

And I would disagree a lot of the criticism targeting the CDC was well deserved. There have been posts after posts in these threads - which are pretty moderate compared to other sites - questioning virtually every action of the CDC, parsing the statements of senior government/CDC officials for words that can become "gotchas", and a general suspicion of everything they have done. Some has been accurate and fair. But a lot of it has been wrong. For all the "stuff ups", two medical carers have it who might not have otherwise. Tragic for them, hardly for the country.

The level of suspicion and criticism has significantly out-weighed the errors, and in an environment where almost the only major disaster is to panic, has not helped give the public the level of confidence they should have.

[Ice Queen]

I think the problem is that you're putting too much risk aversion around the impacts. Is Ebola bad and needs to be stopped? Obviously. At all costs? No. Because although deadly at the individual level and for people treating, it's not really a widespread risk.

The main things that can make it a widespread risk are not following the government's advice and panic. And questioning the first repeatedly and in an unbalanced way can lead to the second and a lower level of confidence in the first. Why is Ebola spreading like mad in W. Africa? Because the people spent months not trusting the government and hiding the sick people and preferring tradition and suspicion over safeguards. Given the historical performance of the West, their own governments, and Pharma over the years they have some justification. However, the simple fact is that this outbreak would be significantly better or even stopped if they had trusted their government.

Yes, the CDC and Texas health officials have had some stuff ups. The consequence? A small group of extra people are at risk. In the grand scheme of things this is nothing. Should the differing officials all be questioned and reviews done at the end? Yes. But in the mean time, the best thing that can be done is recognise that following these guidelines is the best way forward.

You may not like that idea of simply "putting trust" into the government, but right now that is the smartest route. The likelihood of Ebola killing even hundreds of Americans is incredibly low. Let alone having a major outbreak. People not panicking is the smartest move, and questioning every little decision by the CDC doesn't help. Sure, someone with a temperature below 38c might have Ebola and be transmitting. So? The likelihood is so low (given no other symptoms) that making up the rules on that basis is a poor risk decision.

I swear, half the problem is that its EBOLA!, and yet people aren't taking flu shots or wearing their safety belts...

Or using condoms. Or vaccinating their kids.

[Suttree]

Little news round up.

Texas Officials Clear 43 People After Ebola Monitoring

Breathing a sigh of relief, Texas officials said Monday that 43 people who may have had contact with a man who died of Ebola, Thomas Eric Duncan, were cleared of twice-daily monitoring, and they urged residents to accept those people back into the community.

At a news conference, Judge Clay Jenkins, Dallas County’s top elected official, said that the 43 were part of an initial 48 people who were being monitored because they had contact with Mr. Duncan before he was admitted to the hospital on Sept. 28. The group included Mr. Duncan’s fiancée, Louise Troh, who nursed him in their cramped apartment, along with her 13-year-old son, Timothy, and the two young men who shared the apartment with her and Mr. Duncan.

Nigeria and Senegal have contained the disease.

How did Nigeria do it?

What can we learn from this African country's success quashing an Ebola outbreak?

Authors of a paper published October 9 in Eurosurveillance attribute Nigeria's success in "avoiding a far worse scenario" to its "quick and forceful" response. The authors point to three key elements in the country's attack:

• Fast and thorough tracing of all potential contacts
  
• Ongoing monitoring of all of these contacts
  
• Rapid isolation of potentially infectious contacts
  

No risk of Ebola on the Carnival cruise ship.

In the end, there was never any risk of the Ebola virus aboard what became known as the Ebola Cruise.

Last week, the announcement that a passenger on the Carnival Magic was a Dallas lab supervisor who had handled an Ebola patient’s blood samples transformed a weeklong Caribbean jaunt into a high-seas drama showcasing anxieties over the spread of the virus. Passengers used hand sanitizer, avoided touching railings and offered elbow taps instead of handshakes.

And as we have seen in this thread, the line between vigilance and hysteria can be blurry.

A crowd of parents last week pulled their children out of a Mississippi middle school after learning that its principal had traveled to Zambia, an African nation untouched by the disease.

On the eve of midterm elections with control of the United States Senate at stake, politicians from both parties are calling for the end of commercial air traffic between the United States and some African countries, even though most public health experts and the Centers for Disease Control and Prevention said a shutdown would compound rather than alleviate the risks...

In his work on panic in various disasters, Anthony Mawson, a visiting professor in the School of Health Sciences at Jackson State University in Mississippi, found that while physical danger is presumed to lead to mass panic, in actual physical emergencies “expressions of mutual aid are common and often predominate.” But the threat of an illness that has infected only two people in the United States appears to have had the opposite effect, inciting a widespread desire to hide and shut things down.

“Obviously there’s fear,” said Dr. Anthony Fauci, the Director of the National Institute of Allergy and Infectious Diseases, in an interview Sunday on ABC. He said fear of the disease is dramatically outstripping current risks. “We always get caught when we say zero,” he said. “Nothing is zero. It’s extraordinarily low, much less than the risk of many other things which happens to them in their lives.”

[daskool]

So I had dinner tonight with a friend who is a senior executive in a hospital here. She said next week is going to be all Ebola since the province has handed down a set of instructions with regard to preparedness.

She told us about the training medical staff go through with regard to haz-mat suits (we've had SARs and the H1N1 scare to thank for that) and it's very careful, step-by-step training. Practice sessions putting them on and taking them off was done in front of the trainers. And the senior trainer saw videos from the US and was shocked at the way they put on and took off the suits. She said the order wasn't right.

In addition, everyone in the hospital (and I assume this happens across the province) gets measured annually for the correct size of face mask pieces, to ensure properly fitting masks. My friend said the size is marked on the back of her hospital ID card, so in case of emergency she can obtain the correct size of mask from their supplies. Do the nurses here on the board also do this as well?

You'll have to define what you mean when you say haz mat suit? What the CDC recommends to protect health workers are essentially droplet isolation precautions. Non permeable surgical gown, N95 face mask, face vizor/goggle, surgical hat, OR booties, double gloves with the outside gloves taped to the gown. Even with this there are parts of the body left exposed, notably the neck and back of the head. In the close confines of an ICU room were the patient might be explosively vomiting or shitting I'd personally want to be completely covered with a onesie coverall plus hood. The good thing about this is the decontamination routine is less involved and complex than removing various bits of protective gear with the associated risk of fucking up if you're not careful when taking them off.

As for being measured for a face mask, never heard of it.

[The Iceman of the North]

Two Ebola patients in Europe have been declared Ebola free today, leaving the two US nurses the only patients under treatment in the West. So far three patients have died outside Africa, two old Spanish missionaries and the Liberian in Dallas, out of IIRC 14 cases. This would indicate that given proper, and early treatment, the mortality rate of this strain isn't particularly high.

[Aemon Stark]

N95 masks have to be fit tested, and the "fit" has to be renewed every 20-24 months depending on the institution.

My N95 size is 1870M for 3M masks, which I remember because they're not very abundant.

[Suttree]

Even with this there are parts of the body left exposed, notably the neck and back of the head. In the close confines of an ICU room were the patient might be explosively vomiting or shitting I'd personally want to be completely covered with a onesie coverall plus hood.

That has apparently been revised:

Health officials had previously allowed hospitals some flexibility to use available covering when dealing with suspected Ebola patients. The new guidelines are expected to set a firmer standard: calling for full-body suits and hoods that protect worker's necks, setting rigorous rules for removal of equipment and disinfection of hands, and calling for a "site manager" to supervise the putting on and taking off of equipment.

[The Iceman of the North]

Two Ebola patients in Europe have been declared Ebola free today, leaving the two US nurses the only patients under treatment in the West. So far three patients have died outside Africa, two old Spanish missionaries and the Liberian in Dallas, out of IIRC 14 cases. This would indicate that given proper, and early treatment, the mortality rate of this strain isn't particularly high.

The correct should be 4 out of 17 dead, with 5 still in treatment. I wasn't quite updated on the situation in Germany, and I thought all of those diagnosed in the US in early September had been cleared, but apparently two is still under treatment.