<p>I am reading Hot Zone now and the first thing that is obvious to me is that it must take a great deal of training, practice, repetition, along with a buddy system to ensure that suits are being worn and removed properly. There is just no way that one can expect to show a health care worker how to suit up during a half hour training session and think that disease will be prevented. Shouldn’t the CDC know that? i think they should have. Just freakin’ common sense.</p>
<p>Well in my area it is the public hospital that has stepped up and said that they are supplied, trained and ready to accept an Ebola patient should one materialize in the region. They also have the level 1 trauma center, burn center, psych beds etc and consider their mission to treat everyone. They are not a relatively plush boutique hospital that competes for maternity patients and elective surgeries. You go there because you have to and they are excellent at what they do. Some here might argue that this is despite their status as a public facility rather than because of it (myself not included). But they are one data point that does not support the “private does it better” idea.</p>
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<p>There is. Extreme mearsures are needed to be fully prepared to take on an Ebola patient. The kind Atlanta/Nebraska has. Doctors without borders go through 6 week training. I don’t know how CDC didn’t expect general hospitals don’t have that kind of resources. If they didn’t, they shouldn’t be the position issuing protocols since protocols should be something an average can follow. Not only general hospitals lack the resources, it would also be a tremendous waste to train a team at every hospital in the country to take care of Ebola patients. They should either designate a few hospitals around the country and train them thoroughly or plan to deploy a team to affected area. All this should have been done when they were claiming they were fully prepared.</p>
<p>I lean on the side of defending the CDC. They issued protocols, and hospitals should’ve taken this seriously. Instead, as usual, they didn’t, because Ebola was way on the other side of the world, and the chance of them having an ebola patient was slim to none. Adminstrators ultimately care about the bottom line, and of course they dont want to spend money on hazmat suits, training, etc that they think will never be used, which is sad…</p>
<p>The same folks in Texas that are railing against the CDC are some of the same folks that are always screaming get the govt out of our lives. They are also some of the same folks willing to cut things like NIH and CDC, as they are deemed not important. I can only imagine some of the outrage, if the CDC had immediately sent a team down to take over. </p>
<p>Having said that, I hope that this proves that there is a role for some government agencies, and it would help if we could all have civil discourse and** work together**, to make things better for everyone.</p>
<p>As I mentioned in a previous post, all Ebola patients should be transferred to one of the four facilities that are clearly able to deal with the illness. I just dont think many hospitals are prepared. With the confirmation of a second nurse, you are going to be hard pressed to get a lot of nurses to care for a patient, and I cant say I blame them, considering their bosses are not equipping them properly, with training and equipment.</p>
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How long before the general public realizes how few beds there are in qualified units (didn’t someone here write there are 23 nationwide?)? We all have the image of people being turned away in Liberia. How many people would really believe that they would ever get someone sent round to check them out and then have them transferred to one of those very few beds? People would ignore that directive and just go to the ER. The hospital couldn’t then turn them away. I think “the greater good” would not be a consideration for people who suspect they might have ebola. </p>
<p>CDC presscon. The second patient is a “she.”</p>
<p>23 beds may be enough.</p>
<p><a href=“U.S. lacks a single standard for Ebola response”>http://www.usatoday.com/story/news/nation/2014/10/12/examining-the-nations-ebola-response/17059283/</a></p>
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For the umpteenth time, igloo, the CDC cannot mandate that any state or county facility do anything. They can offer guidelines, but cannot enforce them. If a hospital wants to play financial roulette and hold off on acquiring the necessary equipment or provide the necessary training, its is not the fault of the CDC.</p>
<p>If you watch the video CNN did of Dr Gupta demonstrating the CDC protocol I posted a few pages back, it shows exposed head, exposed neck, PAPER gown. Gupta even exceeded CDC protocol by double-gloving. Even if the hospital followed that exactly, that was inadequate for something as virulent as Ebola.</p>
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<p>This is a little like giving a gun and instructions to a kid and expect them to know to shoot at the target safely. You don’t just issue protocols. First, the protocol has to meet the requirement. It didn’t. It didn’t meet the requirements laid out by WHO. Second, it should be realistic to implement. If hospitals are as stretched out they say, there’s no way they could’ve done the training that’s needed. If CDC had any trace of thinking mind, it should’ve been clear that to do what’s practically possible they needed a different approach like what they are discussing now.</p>
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<p>Not surprising really. It took them 4 days to clean up Duncan’s vomit from public area. That’s because CDC classified Ebola virus something special and DOT couldn’t issue a permit to transport.</p>
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<p>Indeed! </p>
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<p>Amen. It has to be a partnership.</p>
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<p>And doctors including NIH head are saying you need to double up the gear and a self contained respiratory system to take care of Ebloa patients in late stage. Do hospitals normally stock these items?</p>
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<p>The approach should be something you can control, namely tell them to isolate and stabilise patient and that you 'll take it from there. You can’t just sit there and say, Well I don’t have a control over hospitals not meeting the requirement to train their satff for 6 weeks to be ready for an Ebola patient when they can’t even spare one week. You make it possible for hospital to comply.</p>
<p>“It has to be a partnership.”</p>
<p>It’s designed to be a partnership. </p>
<p>Q&A article on CDC role and state & local health dept role. </p>
<p><a href=“http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2014/10/15/q-a-what-are-states-doing-to-prepare-for-an-ebola-outbreak”>http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2014/10/15/q-a-what-are-states-doing-to-prepare-for-an-ebola-outbreak</a> </p>
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It is certainly easier and more efficient to be prepared for something that you know is coming, when it’s coming and how it’s coming, as opposed to having SOMETHING show up on your doorstep, figure out what it is, THEN deal with it. I think it will always be harder to contain cases if any more spewing victims (God forbid) show up at an emergency room out of the blue, particularly if it happens in a place where most people wouldn’t expect it.</p>
<p>It’s hardly a partnership if CDC issues directives that are hard for hospitals to follow and blame hospitals for their mistakes/negligence. Hospitals can’t even refuse the patient whether they are ready or not. That’s more like a dictatorship.</p>
<p>BTW if anyone wants to watch the video of Dr Gupta demonstrating, it is in scholame’s post #381.</p>
<p>There is also the painful question of what to do when the risk to healthcare workers exceeds the possible benefit to an end-stage Ebola patient. It has been stated clearly that the viral load is so huge at the end, when the organs are liquifying, that the risk of transmission is enormous during medical interventions and there is little likelihood of survival for the patient. Should those interventions be undertaken or is there a point at which the safety of healthcare workers should take precedence? </p>