Second Ebola patient

<p>^Big deal. Easy to amend that practice and start stamping. Not a good reason to refuse banning the flight.</p>

<h1>177, Wasn’t that how the spanish nurse got infected? If so, it’s the second case of making the same mistake. As I said before, a protocol that is hard to follow in practice is not much of a protocol. The protocol should have included a measure that would prevent common mistakes; hose it down before removing, institute a buddy system, or install someone specializing in the removal of the gear.</h1>

<p>If taking care of Ebola patients takes that much training, we are not prepared at all to deal with Ebola patients. Until then, we should ban flights from the area. Or airlift them to a handful hospitals that are trained to take care of them. You can’t force any ER to deal with it and point fingers at them when they fail. </p>

<p>Two interesting aspects about this situation re current policy dealing why Ebola: 1) a lack of an executive looking-forward approach and thus misses what things actually cost, and 2) the definition of harm being used is so limited, as to be missing the larger picture. And it is that larger picture that will eventually determine how people deal with this issue.</p>

<p>Someone pointed out what’s the big deal in that only 2 people got infected out of the 7 - 8 million in the Dallas area. No big problem there and the policy to take care of Ebola patients is effective in preventing spreading of the infection.</p>

<p>My take is a bit different, as I find the Dallas situation a pyrrhic victory at best. </p>

<p>Specifically, the cost of only having 2 infections out of about 7+ million people is millions of dollars (>$10M) when one adds up the all economic costs, as someone has to pay for the following:</p>

<ol>
<li>Entire hospital floor / wing shut down to one patient, reducing services to numerous others who need said wing</li>
<li>The quarantining of about 100 people in the Duncan case alone</li>
<li>The quarantining of a new set of people (unknown number) for this in infected nurse</li>
<li>The economic loss of the quarantined people being unable to go to work and do their jobs</li>
<li> The overall reduction in services by the hospital to serve just these two patients</li>
<li>The taxing of emergency services to address one apartment building and neighborhood</li>
<li>There reduction in value of the apartment owner’s property, not to mention surrounding property</li>
<li>The damage to healthcare workers state of mind for fear of contracting the disease, leading to less attentive care in other areas</li>
<li>The damage to Dallas area where people out of fear go out less, spend less, visit less, and may change plans, which takes support away from poor communities due to reduced tax base (I know of two conferences already cancelled)</li>
<li>A possible rise in muni bonds rates, which cost cities more to raise money for development - a serious long-term cost that lasts for a decade or more</li>
</ol>

<p>Such astronomical costs to ensure just 2 infected illustrate that the current process and policy of dealing with this disease is totally, 100% unsustainable. And while it is a victory of sorts that only 2 people are infected, as stated above, it is a pyrrhic victory given the larger damage to the infrastructure. </p>

<p>As a country, we also got lucky that Duncan was in a place, such as Dallas, as it is rich town and will absorb the costs, even as it takes a huge loss. However, medium-sized cities and smaller towns do not have such resources and literally will be pushed towards bankruptcy and unable to handle such cases. This would mean shipping their issues elsewhere for other cities to pick up the tab, and those other cities are going to start saying no way once they start realizing the true costs. </p>

<p>People, on a personal level, are also now starting to calculate the costs of this policy to them. This is already starting here in the US where certain personnel would rather quit than expose their families and their neighborhoods to this potential. </p>

<p>And this is just the beginning. Only a bureaucrat or someone who does not calculate overall long-term costs on a community could remotely think this is smart policy. This is one case where prevention is worth a pound of cure seems rather apt. And ironically, we are not even curing anything, as 60 - 90% will die. But worse, we are not even trying to prevent it from occurring in our backyard. That is a lose-lose situation if there ever were one.</p>

<p>Add to that the cost of all the false alarms that seem to occur daily. </p>

<p><a href=“2nd Ebola Case in U.S. Stokes Fears of Health Care Workers - The New York Times”>2nd Ebola Case in U.S. Stokes Fears of Health Care Workers - The New York Times;

<p>Read the last paragraph: The hospital has closed its emergency room due to ‘staff limitations’. </p>

<p>I would like to know what that means. Have hospital staff refused to work the ER? Are they quitting? </p>

<p>Another cost of just two Ebola patients. Dallas loses one of its emergency rooms.</p>

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<p>I also wondered the same a few pages ago. As I mentioned earlier, the national nurse message forum I read is full of postings by nurses saying they would absolutely refuse to take a patient with ebola. Now that a nurse at that facility has been infected, it wouldn’t surprise me if their staffing problems are related to resignations. I DO NOT KNOW that and have no inside sources to confirm it; that is just my own question.</p>

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What would you do? Would you care for an abola patient?</p>

<p>Which makes me appreciate even more the humanitarian efforts of frugaldoctor and the other members of doctors without borders and mission groups as well, whose generosity, dedication and commitment is invaluable. Wonder if in an emergency situation like this, if the hospital is understaffed and they cannot get enough fulltime or temporary support/nursing staff, could members of the DWB team volunteer their services in a domestic situation? Surely they could get temporary staff privileges. Those with experience or training in dealing with Ebola might be able to manage the protective gear with minimal errors.</p>

<p>Didn’t they say 50 caretakers were caring for Duncan? Could that have exhausted the staff even if no one resigned? If the hospital is as stretched as someone mentioned upthread under normal conditions, I can imagine how diverting resources to one patient would disrupt the operation. That means we are simply not ready to take on an Ebola patient.</p>

<p>The patients handled in the dedicated isolation facilities didnt strain the staffing needs., That said, there are other costs in transporting them/caring for them elsewhere. And not to mention the idiots who called in death threats to the agencies transporting and guarding the transport of the patients.</p>

<p>I don’t know how much it costs to airlift but if you consider infecting others in inexperienced hospitals, it may be cheaper to airlift.</p>

<p>What happened to the Boston case? Is it confirmed yet, one way or other?</p>

<p>I have not read this entire thread. I am surprised that there is not a cooperative effort between the CDC and the military medical corps in training medical staff around the country in the use of PPE, (there are many types of gear and it does not appear to be standardized across the nation). I was an Army reserve nurse and we trained extensively in this area, decontamination and also practiced working in the gear. I also think that regional mobile military hospitals could handle Ebola cases and act as a housing unit for quarantined patients. Let the experts take care of the patients. This would probably need an Executive order and cause mass hysteria but I think it would stop the spread of the virus. I believe that these units should be mobilized to the countries in Africa that are effected. </p>

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<p>But, you need somewhere to airlift them and that somewhere must be willing to absorb the costs of a wholly imported problem. So, all that would be done is the costs are shifted to some other community. </p>

<p>And that is going to be the tough argument to keep convincing people about - that they have some overriding financial and personal exposure risk responsibility for a problem we are importing because of a specific policy, i.e., a problem that we did not have.</p>

<p>Britain denies Gambia Bird Airlines direct access to Britain from Sierra Leone. Air France and British Airways no longer fly to or from the hot zone. Only Brussels Airlines flies to Europe from the affected countries. When Doctors Without Borders said that the decision would make it more difficult to fly in humanitarian aid the British Department of Transportation said that it’s first duty ‘was to protect the British public’. What a concept.</p>

<p><a href=“Ebola: UK cancels resumption of direct flights to Sierra Leone | Ebola | The Guardian”>http://www.theguardian.com/world/2014/oct/13/ebola-uk-cancels-resumption-direct-flights-sierra-leone-gambia-bird&lt;/a&gt;&lt;/p&gt;

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<p>Agreed. And I cannot imagine the sacrifice that their families are making, as well. </p>

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<p>True but as it is now local hospitals are forced to bear the burden straining their infrastructure and inconveniecing local populations. </p>

<p>Either way, they would still have to be admitted to the local hospital before being transported somewhere else.</p>

<p>This inconveniencing humanitarian efforts comes up again and again. That has an easy solution. There are only about 290 DWB in Africa. I don’t see much difficulty to move them around as needed. It sounds like sending people who want to ban flights to guilt trip.</p>

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<p>True but that’s minor compared to keeping the patients and treating them with inexperienced staff. I doubt anyone has resources/manpower to train their staff to the needed standard. Did I read somewhere DWB goes through training for 6 weeks? I think I should ban the flights. Until then, we need other measures to minimize the spread.</p>

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<p>An executive order cannot do it, as the above violates the Posse Comitatus Act. Therefore, it would require an act of Congress.</p>

<p>But even then, look at the financial problem. All the above costs money for something that we are importing. Before Congress approves such an act, I suspect they will ask the CDC to curtail its importing the disease policy. And that is going to be the front and center problem that all levels of the bureaucracy is going to have to answer for - why have a policy that openly and directly increases our risk and increases our taxpayers costs?</p>