<p>WHO is now saying there could be 10,000 new cases per week in Africa by December if things don’t turn around.</p>
<p>^^Anthtax white powder redux! These idiots should be fully prosecuted. </p>
<p>So much for hospitals having the highest level of PPEs ready and available rivaling the DWB protocols . . .</p>
<p><a href=“Nurses Blast Hospitals Over Ebola Safety | HuffPost Latest News”>HuffPost - Breaking News, U.S. and World News | HuffPost;
<p>LasMa re #450 yes. that. And take the whole stupidity of ‘racism’ out of a flight ban. </p>
<p>Assuming he’s really what would clarify the official response, why not?</p>
<p>You’d have to assume he’d devote his every waking hour to the Ebola crisis and not wander off into more creative epidemiology.</p>
<p>Thanks for telling us now what execs knew all along. </p>
<p>This is why private execs knew from the start this guy had never run anything for which he were truly responsible for his words and decision, i.e, if he is wrong that he would be held accountable and write big checks. He talked with assurance long before he knew what the situation actually was and like a good bureaucrat blamed everyone else. </p>
<p>I cannot imagine the money a private company would have to pay out if it made such proclamations and it turned turned out to be wrong in who was prepared to do something and and which partners were ready to implement certain actions. That company(s) would be toast. </p>
<p>But, this guy just says sorry, moves on and leaves other holding the tab and damage. What a job to have. All talk and zero real world accountability for errant decisions. Just imagine the swarm of lawyers around the company if a private company CEO was in this situation. </p>
<p>Pull Quote:</p>
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<p><a href=“Feds could have done more in Dallas Ebola case, CDC director says”>http://news.yahoo.com/feds-should-have-been-more-hands-on-with-dallas-ebola-case--cdc-director-says-214128692.html</a></p>
<p>^It’s unbelievable, really. A case of Ebola in the US and they don’t put in a ground team of EXPERTS until 2 weeks later. WTH?</p>
<p>Hospital administrations, of course, will point fingers at the CDC and scream hard that just like with the HAIs, this is all the CDC’s fault. But boots on the ground disagree with the position their leaders have taken:</p>
<p><a href=“Nurses Blast Hospitals Over Ebola Safety | HuffPost Latest News”>http://m.huffpost.com/us/entry/5986468</a></p>
<p>“Nurses had to interact with Mr. Duncan with whatever protective equipment was available at the time when he had copious amounts of diarrhea and vomiting, which produces a lot of contagious fluid,” Burger said.</p>
<p>DeMoro said her criticism was reserved for hospitals, not the government.</p>
<p>“When the director from the CDC in March said hospitals should prepare for possible pandemic of Ebola, and what’s happened in the country is the hospitals essentially ignored that,” DeMoro said."</p>
<p>If the allegations are true, it is truly outrageous that the administration chose not to stock PPEs that would be appropriate for this kind of work.</p>
<p>The nurses are talking, anonymously so they don’t lose their jobs. The Dallas hospital was in no way prepared. Full protective wear wasn’t available for three days. He sat in the ER for hours. His lab work went through the usual channels without special handling. </p>
<p><a href=“Nurses at Dallas hospital describe poor safety measures with Ebola victim”>Nurses at Dallas hospital describe poor safety measures with Ebola victim;
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<p>Using the above example, let’s assume the CDC sent all the appropriate information to Dallas hospital and other hospitals. </p>
<p>However, even with the information were sent to the hospitals, here is the stark, important difference between an institutional bureaucrat and a private exec, who has to respond directly to shareholders:</p>
<p>A bureaucrat believes (and assumes) that if he says it and sends it then it gets done, and he moves on. You can only do that is you know you will not be held accountable for major errors and outcomes, and you are comfortable your paycheck will still arrive on time. </p>
<p>In contrast, a serious private exec says it, sends it, determines that the money is there to get it done pronto, makes sure things are shipped, and then puts a procedure in place to verify all steps are done BEFORE saying they were done. And only after verification of completeness will he speak with assurances and then say we are open for business. </p>
<p>A case-in-point is one of the hospital execs I talked to yesterday - the CDC is sending out new hazmat suit directives BUT never checking if the hospitals have the budget to get and do al the stuff requested, much less the time to separate out staff to do training. Note that most training will have to be done as overtime, requiring overtime pay; another impact on hospital budgets. No proved exec would issue directives to any division without first knowing if the materials (money, shipping, staffing etc.) are in place or are readily available to be put in place to get the job done.</p>
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<p>Luck is not a strategy or effective for very long. </p>
<p>Having a bout of insomnia. I just received an alert from WFAA on my phone that a second Presby caregiver has come down with ebola. </p>
<p>Yeah, sounds like Dallas Presbyterian just had bad protocols - or no protocols. There have been no reported transmissions to health care workers in Atlanta or Nebraska, so I am suspecting that perhaps they were better prepared. I’m afraid that this is going to continue to happen to “unprepared” hospitals. I think the CDC needs to tell people “If you think you are infected, don’t go to the emergency room. Call a hotline and we will send someone round to evaluate you.” That would keep people quarantined in their own homes until proper transfer to a qualified unit can be arranged. That would keep people out of emergency rooms and unqualified hospitals. </p>
<p>I have been following this thread (and the other one) from the start but not commenting till now.</p>
<p>All the finger pointing at the CDC is remarkable to me. I find it refreshing that Dr. Frieden actually states that he wishes they’d done things differently (i.e. immediately rushed a team of experts out to Dallas to handle the patient’s care)—the guy acknowledges that things were not done the way they “should have been” and vows to correct that moving forward. Is that not what we ALL want to have happen?? </p>
<p>I think it’s completely understandable that the CDC did not rush in and take control in the first place. If they had, I can only imagine that people would have been annoyed that this government agency had usurped the authority of the local hospital, or something. The CDC had issued warnings months prior about possible Ebola cases—is the CDC responsible for going to all the hospitals to check up to be sure they are prepared?? </p>
<p>It’s apparent now that they were not, in fact, prepared. It’s awful that the infection of (now) two caregivers with the virus is the result of that lack of proper preparation. But I don’t think THAT is the responsibility of the CDC—it’s on the Dallas Presbyterian folks, and it’s on the administration of all hospitals everywhere now to learn from this.</p>
<p>Agreed, churchmusicmom. The CDC provided guidelines. The individual hospitals have to follow along and provide the necessary equipment and facilities. And if the guidelines are modified based on real world experience, well, that makes sense. Adjust protocol with increased information. If a subject matter expert makes recommendations and the organizations to whom that info is directed don’t follow the recommendations, that is not the fault of the subject matter expert. If a doctor tells a patient to stop smoking and lose weight (healthcare guidelines) and the patient does not, it’s not the fault of the doctor.</p>
<p>And if there is a second Dallas healthcare worker with symptoms, that is awful.</p>
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<p>Nebraska & Atlanta have level 4 Biocontainment isolation units, with staff trained to deal with infectious diseases worse than Ebola. Theres is no comparison to the typical local hospital. They did not need or use CDC supervision.</p>
<p>I find all the defending of the CDC remarkable. Unless one does not think that controlling diseases is their job, they failed. That does not let Presby off the hook, they failed too. Now a young nurse and possibly another caregiver are paying the price.</p>
<p>FWIW I am glad that Dr Freidan admitted mistakes publicly. That’s something, at least.</p>
<p>Couple of points:</p>
<p>One of the only positive things we have learned from this situation in Dallas is that it is pretty likely that this disease is not very contagious in its early stage. We have yet to have any of Duncan’s contacts show up with the disease, even those who were around him after he became symptomatic. The fact that these nurses were monitoring their temps makes it also unlikely that any of THEIR contacts are going to get sick. Clearly once the illness takes hold and we start seeing the massive amount of fluids being secreted, this becomes a huge risk. These nurses were infected rather quickly after beginning care of the extremely ill Duncan, while Duncan’s personal contacts remain asymptomatic at day 17. Additionally, the folks who interacted with an early symptomatic Duncan in the ER also remain asymptomatic as far as we know. That is something we can be hopeful about with respect to the contacts of the health care workers. If I were a nurse who took care of Duncan and was currently asymptomatic, I would err on the safe side and self isolate. I wouldn’t be at all surprised to hear that many of them are doing exactly that.</p>
<p>About the “70 people involved in Duncan’s care” we keep hearing about: that does not mean that 70 different people actually came into contact with him. That could be the pharmacists who are mixing his drugs, the pharmacy tech who drops it off to the unit, the consulting physicians, the lab techs, etc. As usual, the people most often in direct contact with a patient are nurses. We are the ones who implement the care and I’m not believing they had 70 nurses working on this one patient.</p>
<p>That said, as soon as one nurse became infected, it was clear that she would not likely be the only one. I think that understandably, they are going to see resistance to getting other nurses to get increasingly involved, particularly if there is no confidence in the support structure and safety. </p>
<p>In order to nip this in the bud, they may have to consider transporting every nurse who cared for Duncan to one of the four specialty centers and shutting down ebola care at Presby. Now whether or not that is feasible I have no idea.</p>
<p>This is really upsetting to me personally as a working RN in Dallas. I feel for those nurses and their families. If some of the stuff I’m hearing on the internet is true, they were not given the proper tools and support to do their job safely. I am still not convinced Duncan was in the dark about his exposure to ebola in Liberia, so I still feel anger towards him. I remain angry with the ER staff who screwed up so royally, though it doesn’t appear at this time that any of the current tragedy would have been avoided even without that mistake and currently none of the people who came into contact with Duncan after his release from the ER have been infected, so in hindsight that particular mistake may not have had the consequences we had feared. </p>
<p>I know being angry doesn’t solve anything, but there it is.</p>
<p>If there was a way to make the CDC prescient so that they could have known, in advance, that the measures they had already urged all local hospitals to take if/when a case of Ebola was encountered would not be followed----THEN we’d all have good cause to be annoyed with the CDC.</p>
<p>But they are NOT prescient. They are admitting that their human hindsight (which we all know is excellent) shows them that other steps SHOULD have been taken. The local hospital did not, in fact, do as they’d suggested they should do to anticipate this. </p>
<p>So, and again I think this is remarkably refreshing, the CDC head is openly admitting that things should have been done differently and is vowing that they WILL be done differently moving forward. </p>
<p>Hindsight is a wonderful thing—we can learn a lot from it. But not if we are spending all our time pointing fingers and making accusations of ineptitude because those in charge did not enjoy the insight we now have. IMO, the CDC did what they were supposed to do. They now realize that was not enough—have admitted this—and say they will do things differently going forward. Bravo to them.</p>
<p>My prayers are for protection for all those medical personnel out there who may some day encounter this (and other highly infectious) disease(s). And, of course, for those who already have and who are now waiting….</p>
<p><a href=“http://www.cnn.com/2014/10/15/health/texas-ebola-nurses-union-claims/index.html?hpt=hp_t1”>http://www.cnn.com/2014/10/15/health/texas-ebola-nurses-union-claims/index.html?hpt=hp_t1</a></p>
<p>A nurses union is reporting that the Dallas hospital did not implement comprehensive ebola protocols and treatment staff had exposed skin in their neck region, which they were advised to cover with tape.
Also, biohazard waste materials piled up and they were not give adequate training. </p>
<p>Another person in Dallas has it??? Wow.</p>