<p>Yes, these nurses had EXTENSIVE contact with Duncan while he was actively very contagious. It is wonderful that so far, none of the people who lived in the apartment with him while he was sick with ebola nor any other healthcare workers have shown symptoms or tested positive. This is very good news on how difficult it is to pass this virus from an ill person to others.</p>
<p>Here’s a handy table to sort through flu vs. enterovirus 68 vs. ebola from CDC:</p>
<p><a href=“http://www.wpxi.com/news/news/local/symptoms-flu-vs-enterovirus-vs-ebola/nhj3z/?__federated=1”>http://www.wpxi.com/news/news/local/symptoms-flu-vs-enterovirus-vs-ebola/nhj3z/?__federated=1</a></p>
<p>Forgive me if this has been reviewed, but it seems to me that the nurses, or at least the first nurse, is in relatively good condition? I thought there was no treatment really for Ebola? Yet the two medical people who were flown here earlier this year made recoveries. </p>
<p>So…is it treatable? Is it an automatic death sentence? Why was Duncan not able to be saved then? Was his treatment started too late? </p>
<p>Sorry for all the questions! </p>
<p>Well, factors are that his treatment was started later than some of the others, and because of blood type he wasn’t able to receive a transfusion from a local survivor, and of course the supplies of Zmapp had run out. He did receive some other experimental drugs, but apparently after a delay caused by some confusion regarding who amongst those considered his family could legally give consent for treatment.</p>
<p>That is my understanding, anyway. Clearly, the people at the hospital went to extremes to try to save him, to no avail.</p>
<p>It appears to be managed if it’s caught in the relatively early stages, if the patient is receiving medication (there are a couple of experimental drugs) and/or blood transfusion from an ebola survivor, if they’re hydrated and fed through IV. The virus appears to become very aggressive in the late stages. </p>
<p>It’s not an automatic death sentence in the first world, death rate is about 70%. Much higher in poor/remote/medically disadvantaged areas. </p>
<p>One of the problems with this outbreak was late recognition of ebola in West Africa. First, it’s hundreds/thousands of miles away from where the other ebola outbreaks happened in 1976 and 2000. Second, the early stages of ebola resemble many other more common tropical fevers, and it’s easy to misdiagnose. </p>
<p>Surfcity, there are no treatments for most viral diseases, but in a large number of cases, our immune system attacks and eventually clears the intruder virus. This is how we get rid of flu, colds, some HPV viruses. The stronger the person, the better the chances of survival. People with compromised immune systems are more vulnerable. People who are coinfected with other diseases are more vulnerable. People who are malnourished are more vulnerable, too. It is very likely that a healthy young individual has a better chance of surviving Ebola than an older person with latent TB. The level of care matters, too - fluids, nutrition, fever and pain management. As I said in an earlier post, Mr. Duncan was already in a bad shape when his treatment started, and I would not be surprised that his immune system was not that strong to begin with given the conditions he lived in in Liberia. </p>
<p>“It’s not an automatic death sentence in the first world, death rate is about 70%. Much higher in poor/remote/medically disadvantaged areas.”</p>
<p>katliamom, I think you meant to say that 70% is the overall death rate, which is mostly West Africa. Let’s hope we do not get any statistics on what the death rate in the first world countries is! </p>
<p>My bad, Bunsen. Thanks for the correction. (Like we need more misinformation and hysteria!)</p>
<p>There is now an official GoFundMe for Amber Vinson: Amber Joy Vinson Fund , organized by Terri Clark </p>
<p>$2195 raised</p>
<p>It says that Amber and her mother and family will use the money.</p>
<p>Nina’s has 82,615, exceeding her goal of $70000 and climbing.</p>
<p>Treatment appears to be plasma from an Ebola survivor. My understanding is that all American survivors had received plasma in addition to experimental drugs for some. But since plasma has not been studied in the rigid scientific way, I doubt the FDA can endorse it as a treatment at this time. But that appears to be the best chance for survival. Otherwise an American would face at minimum a 30% chance of survival with this strain. Granted we have access to better supportive care.</p>
<p>I’m happy for Nina but suspect folks will not think as kindly about Amber for her flights and inadvertently exposing the public, especially on planes. </p>
<p>I really hope both nurses make a full and prompt recovery. I’m sure it helps that they were young and healthy, as well as they started supportive therapy promptly. </p>
<p>Our neighbor to the north is nearly doubling its Ebola aid:</p>
<p>
</p>
<p>And: </p>
<p>
</p>
<p><a href=“http://online.wsj.com/articles/canada-pledges-to-almost-double-contribution-to-fight-against-ebola-1413579410”>http://online.wsj.com/articles/canada-pledges-to-almost-double-contribution-to-fight-against-ebola-1413579410</a></p>
<p>Good job, Canada.</p>
<p>The doctor who treated Mr: Duncan called the accusations of prejudice “remarkably insulting”':</p>
<p><a href=“http://www.king5.com/story/news/health/2014/10/18/texas-ebola-doctor-gary-weinstein-interview/17486307/”>http://www.king5.com/story/news/health/2014/10/18/texas-ebola-doctor-gary-weinstein-interview/17486307/</a></p>
<p>He does not appear to be the doctor who sent him home the first time. He also seems to be genuinely distraught.</p>
<p>I think that the CT scans and so on that Duncan was given when he went to the hospital the first time are ample evidence that his ability to pay was not on their minds. It was a simple, straightforward mistake to not take into account the triage nurse’s notes in the diagnosis. </p>
<p>At least that’s what it seems like to me.</p>
<p>
</p>
<p>Gary Weinstein was not present in the ER when Duncan first presented and had nothing to do with the first interface between Duncan and PHD. He is a pulmonary specialist who works the ICUs at PHD, and as he clearly states in that interview, wasn’t even involved at all with Mr. Duncan until he rotated to the unit one particular day. By this time, Mr. Duncan was already intubated and on the ventilator.</p>
<p>I want to say that I have worked professionally with Dr. Weinstein. He is a brilliant pulmonary specialist, as are his partners. He is very intelligent, dedicated, etc. I would trust my children’s lives to this guy, and he treated my husband during a very scary incident. If you watch the interview closely, you get a sense of his calm and thoughtfulness. That was what I observed in my DAILY interactions with him. TOP NOTCH, so I believe every word that he said in that interview. He has no agenda, he’s not doing PR, he’s speaking from the heart. I was riveted watching that interview. It just reaffirms my suspicions that there is so much more to this incident than has been revealed in news reports, and unfortunately so often medical professionals cannot legally respond to the vitriol lobbed at them due to HIPAA, and I’m sure it is so frustrating. Most of people hurling insults at the PHD team just have zero clue of what actually transpired. I doubt they care, because the truth is often not nearly as exciting as fiction.</p>
<p>He sounds like a doc I would completely trust - completely down to Earth. What a nightmare for him and his team! </p>
<p>Indeed. At the same time, I wish the hospital itself were more forthcoming about exactly what happened at the first ER visit, and about the now-evident breakdowns in worker safety. No names, no blame. But it is important that other hospitals know what worked and what pitfalls to avoid. </p>
<p>On travel bans, this is a good statement of the problem:</p>
<p>
</p>
<p><a href=“http://www.sfgate.com/news/medical/article/Effectiveness-of-Ebola-travel-ban-questioned-5831314.php”>http://www.sfgate.com/news/medical/article/Effectiveness-of-Ebola-travel-ban-questioned-5831314.php</a></p>
<p>The doc is very credible and likeable–it must to so stressful, insulting and painful for him and his team to risk their lives, work so hard and be critized and accused of not doing their best and trying to save ALL their patients. As he says, they all worked “their tails off,” and I think it’s totally irresponsible for Jesse Jackson and others to try to incite the family to find fault with the hospital, other than mistakes they admit they made. </p>
<p>It’s not clear that even if Duncan had been properly diagnosed initially that his life could have been saved. None of us know his other health conditions and his health at the time he was first seen. Since his body has been disposed of for public health and safety reasons, there is no way to know other conditions he had at the time he acquired the ebola infection.</p>
<p>I hope (but sadly am not holding my breath) that all the talk of lawsuits goes away and that we can just have lessons learned so that everyone can keep healthcare workers safer from infectious diseases like ebola and other conditions that can be contagious. In spite of the mistakes made, I doubt the jury would be very sympathetic to Duncan, who lied at several points, including to exit Liberia and enter the US. More importantly, it would be tough to prove that he would have survived if he had received supportive care sooner, since the mortality rate from this condition is very high.</p>
<p>HImom, we’ll never know if Duncan might have survived if he’d been diagnosed correctly at the first visit. He was already pretty sick at that point, it sounds like. </p>
<p>But I think it should be noted that, of the cases treated outside of Africa, the survival rate appears to be much higher than it is in Africa (so far). Dr. Brantly and Ms. Writebol survived. The photojournalist appears to be getting better, as does the Spanish nurse’s aide. The two Texas nurses, I have a good feeling, will survive (Nurse Pham is said to be in “fair condition” and “not deteriorating”). A Spanish missionary died in Madrid, but he was elderly and perhaps less susceptible to care for that reason. A British nurse was treated in London and survived. A Dr. Sacra was treated at the Nebraska facility and survived. There’s another patient at Emory (besides Ms. Vinson) who has wished to remain anonymous; he/she is set to be released soon. So the death rate outside of Africa seems to be maybe in the low teens, not the 70% that’s commonly cited for African victims.</p>
<p>It’s hard to know why these people lived through it. Probably a combination of early diagnosis, and excellent supportive care.</p>