<p>Agree that it could have gone a lot worse, Bay. But I assume you’ll agree that mistakes were made. Do you not see the usefulness of knowing precisely what those mistakes were?</p>
<p>BTW, everything we know about the mistakes at Texas Pres comes from the nurses who have spoken out. The hospital has gone into circle-the-wagons mode. At the very first press conference, the hospital spokesman was asked why Duncan was released after his first ER visit, and the rep brushed off the question, saying he didn’t want to engage in “navel gazing.” Sorry, but in this particular situation, that’s a dangerous attitude. I understand their embarrassment and fear of legal consequences. But in this case, that’s outweighed by public safety concerns. It is important for hospitals to know what happened at a hospital which thought it was prepared, and wasn’t.</p>
<p>I agree with this part of your post, but the “no fault” part misses something, i.e., known efficacy information.</p>
<p>For context, I cannot imagine sending different instructions for the same product to different countries and then say my company is not to blame if someone gets hurt, just because it is different country. Same instructions for the same product to ensure safe usage, regardless of country. </p>
<p>In this case, the CDC knew what protocols were effective in Africa. Therefore, it does become negligent if new protocols were created and released without first verifying against what they knew actually works, i.e., the protocols sent to US hospitals were wholly different, compared to those used in Africa. And the inadequacy is obvious just by looking at them - Sanjay Gupta did a great job on dissecting that at a glance. </p>
<p>The disease is the same, and just because it is a different country does not relieve an entity of ensuring the same high-level of protective measures are used.</p>
<p>For even more context, if a private company did what the CDC did, there would be no “do not blame anyone” going on. The line going around the block to sue would be endless and people would be showing examples of the different instructions and pointing out why they got hurt, as compared to someone else. That company would settle because it clearly negligent if it did that. </p>
<p>Saintfan,
I understand your point, but I don’t know whether one can necessarily conclude that the hospital’s lack of readiness was due to financial reasons only. Unless a business has unlimited financial and personnel resources, decisions are going to have to be made based on risk analysis, and best use of resources. I don’t know whether the fact that “Ebola was out there,” is enough to have bumped it higher on the priority list when no random cases had ever been seen in this country. </p>
<p>Yes, it doesn’t make sense to me why CDC would create new defective protocols instead of at least starting with the ones effective in Africa, where they have been treating ebola for so long. There is now word that there will be new protocols “soon.” Wonder when that is and how much it will use lessons learned from Africa rather than building on the defective protocls.</p>
<p>Himom,
Yes Duncan did have other symptoms like headache, abdominal pain and dizziness, but they were described as “unremarkable.” Perhaps because they often go hand-in hand with a fever? I don’t know. </p>
<p>saint fan is now making up economic data about things to fit a meme that comports with a particular private and public view of things. Just like people saying they can simply look and assess the health the Dallas economy, as proof there is no damage. It is all fabricated. </p>
<p>They did test him for appendicitis, so obviously at least someone didn’t find them totally “unremarkable.” We only have bits and pieces of what was said and done anyway–the temp of 103! didn’t set off alarm bells and he wasn’t kept for observation or anything else. When folks have a fever, it can present with other symptoms, like headache, and dizziness. I guess if you have the flu or a GI issue, you can also have some abdominal pain.</p>
<p>I’m positive that there are plenty of viruses that cause high temperatures, headache, dizziness and abdominal pain, and for which the right response is to send the person home. I thought the story was that they should have noticed that he had come from West Africa, not that someone with his symptoms, but who had come from Akron instead of Liberia, should have been hospitalized.</p>
<p>Yes, the address he listed was Dallas NOT Liberia, so it was likely not on the radar of folks unless he or whomever he was with kept telling everyone he saw that he had just flow in from Liberia. So many mild conditions can mimic the initial symptoms of ebola, including common colds and flus. When only partial information is given and the entire history isn’t known, the staff is more likely to think of the more common health issues instead of an exotic disease that has never diagnosed in the US before Duncan brought it.</p>
<p>Unless I missed it, I didn’t see anywhere that Duncan had actually said he was from Liberia, as opposed to Africa. I think just “Africa” was entered into the recorded information. And yes, he listed himself as living locally… Perhaps he was afraid he wouldn’t get treated if he said he was visiting from Liberia, who knows. Apparently he also said he had not been in contact with anyone ill, and maybe it is true that he did not know it, but one wonders why, if he already suspected ebola, he didn’t volunteer that no, he didn’t know any sick people personally, but came from an area of lots of very sick people.</p>
<p>I am not making up economic data and appear to have been erroneously quoted. Someone may have said this but it wasn’t me . . .</p>
<p>"…one can necessarily conclude that the hospital’s lack of readiness was due to financial reasons only.</p>
<p>saint fan is now making up economic data about things to fit a meme that comports with a particular private and public view of things. Just like people saying they can simply look and assess the health the Dallas economy, as proof there is no damage. It is all fabricated."</p>
<p>The answer is pretty simple really, and private execs have discussed this at length because it boggles our minds that the CDC did not admit this and simply say the majority of hospitals here are not ready.</p>
<p>It is irrelevant if the the hospitals in the US are private or public because, outside of the ones with isolation units, hospitals do NOT have the money to outfit healthcare workers, as they do in Africa. Much less the budget to quarantine healthcare workers, if exposed, and pay their salaries when quarantined etc.</p>
<p>That could easily represent a doubling of the hospitals costs because they need to hire people to replace the quarantined personnel - so the hospital literally doubles part of its staff when dealing with just one Ebola patient, while having a direct loss in revenue with a closed wing and less people coming in the door because they do not want to risk exposure. In short, one Ebola patient pretty much threatens the economic viability of a standard hospital. </p>
<p>For perspective, public or private, money does not grow on tress for any hospital and having to shut down a wing or floor is like telling a restaurant it needs to dedicate a 1/4 of its tables to one person. </p>
<p>Therefore, the CDC had to work with what it knew existed at 99%+ of US hospitals, not what exists in Africa. And it thought it could get away with less costly alternatives. It turns out the virus won this round. </p>
<p>I made a very general observation about the private sector possibly not having perfect cost/benefit vision in this case and labeled my observation as such. I also commented that many institutions both public and private may have made similar calculations RE patient #1. Your accusations seem to be more a case of the pot and kettle to me and with that I will move on. </p>
<p>According to a NYT article, Mr. Duncan had been living in the same house as someone who died from Ebola and had direct contacts with her. The woman also infected 4 other people who later died. Duncan must have known he had Ebola when he first arrived at the hospital but somehow withheld information.</p>
<p>What is going to happen eventually is some of these doctors will either have to layoff personnel, move (which costs money to break their lease), or declare bankruptcy. The costs of such offices far outstrips what they can pull in revenue-wise without a 75% or higher appointment load. </p>
<p>If that happens and some move, new tenants will be harder to find and entire building and development could be underwater. It could recover for sure, but some people will have to take huge losses for a year or two or three. </p>
<p>Duncan is going to go down, as the most expensive single patient in the history of the US, costing Dallas in excess of $100M+ this quarter alone. That is the reality of the situation.</p>