Perry
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Posts posted by Perry
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I'm juggling a dozen things at home and have a miserable cold, so I'm not up to fact checking right now. BUT, I caught a snippet that said the 2nd nurse was actually caring for Duncan before his official diagnosis. Before his most contagious stage. Before the 1st nurse who is apparently in better shape. Yeah, that makes me a bit nervous!
Both Dallas health workers had "extensive contact" with Duncan on September 28-30, when he had "extensive production of body fluids" such as vomit and diarrhea, Frieden told reporters in a conference call. -
Here's the thing though, "told to stay home"? The nurse was told not to travel on an airplane. That didn't work so well. How is any of this being enforced?
Clearly the honor system doesn't work.
I don't know how they're going to enforce it. That's a giant headache.
I do know that they don't have enough staff to do twice-daily face-to-face checks on the hundreds of people now being monitored. They will probably have to resort to fines or penalties of some sort to convince people to do what they're supposed to do.
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The report about the hospital makes what CDC head Frieden said more clear. He was blamed for criticizing the nurse, but I don't think he was ever blaming her. He probably learned immediately of the hospital's poor handling of the situation, and was addressing that, without coming right out and saying "the hospital screwed up."
"I think the fact that we don't know of a breach in protocol is concerning, because clearly there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients.
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Unfortunately, it is possible in the coming days that we will see additional cases of Ebola. This is because the healthcare workers who cared for this individual may have had a breach of the same nature of the individual who appears now to have a preliminary positive test,†Frieden said."
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I have an "N95" on the label respirator for home repair activities. It seems to stop particulates like from sawing, but I can smell things right through it. I understand that if one can smell something it is because particles of the whatever it is containing the smell are reaching one's scent receptors in one's nose. And also that the inner nose has more direct entry to brain than for other senses, like touch, and so on.
Most of our senses are reacting to things that are relatively external to the body, but in the case of scents, there are actually molecules of the stuff smelled going to nose.
So I am a bit doubtful about N95. Or at least not any respirator with that on the label.
N95 respirators are designed to block 95% of particulates over a certain size. They don't do very well at blocking very small viruses, under about 80 nm. Ebola is right around 80 nm in diameter. It has been thought that the virus itself isn't airborne, but travels in droplets, which are much larger than that. N95 respirators are best at blocking particulates like droplets (sneezing, coughing, etc) and blood.
Odors are molecules that travel through air. Viruses are made of hundreds of thousands of molecules, and although tiny, they are vastly larger than an odor molecule. You don't want the respirator to block molecules, or you wouldn't be able to breathe oxygen.
So smell isn't a very good indicator of whether a respirator is blocking a virus.
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That's awesome. I heard that over and over in nursing classes and hospital safety refreshers.
I wonder if that's a regional thing...
Anyone else ever been taught that?
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What I've never understood about double gloving is that when you're working with an HIV patient you're warned to NOT double glove, because the friction can increase the risk of glove tearing. But when it's something really dangerous, you're instructed to double glove.
I have never found anyone who has been able to explain why to me.
I've never in my life heard that.
Double gloving clearly improves protection.
A number of studies were designed to look at the efficacy of double gloving and other possible alternatives. Quebbeman has published a number of studies on exposure in the surgical environment and all recommend the practice of double gloving. His 1992 study reported a 51% hand contamination rate of those who single gloved versus a 7% contamination rate for those who double gloved.16 Korniewicz and Rabussay in their studies have stressed the high in-use failure rates of gloves.5 Albin reports that surgical gloves worn in double-glove fashion, tested every 15 minutes, had leaks 25% of the time while those worn singly had leaks 59% of the time.17 Chapman and Duff reported data on double gloving in obstetric surgical procedures. Of 67 sets of double gloves studied, 66 holes were found in the outer gloves and seven holes in the inner glove. Their summary found that the difference in the frequency of injury of inner and outer gloves to be highly significant. Their recommendations included routine double gloving to decrease the potential for patient fluid contact.18 In Infection Control and Hospital Epidemiology, Tokars found that hand contact with patient fluids were 72% lower for those surgeons who double gloved.19 A study by Greco and Garza supports the data stating that perioperative personnel's risk decreased by 70% in comparison with single glove use.20 In the European Journal of Cardiothoracic Surgery, Hollaus, et. al. concluded, "The perforation rate of 78% lies in the highest range of reported perforation rates in different surgical specialties. Double gloving effectively prevented cutaneous blood exposure and thus should become a routine for the thoracic surgeon to prevent transmission of infectious diseases from the patient to the surgeon."21 In summary, the research data supports the practice of double gloving.
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Food for one thing. The family reported that they weren't allowed to leave, but didn't have food for part of the time.
I agree, but I have to say, when I heard the family was quarantined, I didn't immediately wonder if they had enough food. I sort of assume (wrongly, obviously) that people have food in the house, since I know I could go for weeks living on what's in my cupboards. Did the authorities know they didn't have food and ignore it? Or did they not know?
On the other hand, as pet owner, the first thing I'd think of is how they are going to eat, since they are completely dependent on humans for that.
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You aren't likely to lose any weight that way, and you are likely to injure yourself. I agree with hornblower. To lose weight, you really have to change what you eat. Exercise is great for fitness, but overweight people really damage their knees and backs when they run. Swimming or bike riding is much better.
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From ABC
Dallas County Judge Clay Jenkins' office confirmed earlier today that the nurse's dog remains in the apartment. Water and food have been delivered for the dog, a King Charles spaniel, and authorities are developing a longer-term plan for how to deal with the dog while it's owner is being treated.
"If that dog has to be the boy in a plastic bubble... We are going to take good care of that dog," Jenkins said earlier today.
Jenkins said the dog would not be euthanized. A dog named Excalibur that belonged to a Spanish nurse with Ebola was destroyed despite a worldwide outcry.
I <3 Judge Jenkins.
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The family identified the nurse and provided a picture of her and her dog. I can't help but think of the Spanish nurse's dog. I wonder what the local officials will do in this situation.
Last I heard they have someone feeding the dog and there are no plans to euthanize.
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Why are the CDC's recommendations so minimal
I imagine that they are wearing those protective suits at the hgh level biosecurity facilities, but it is completely impractical for every community hospital in the US to have those. Here is an article describing them.
There is just no way that all the caregivers of an Ebola patient are going to be able to wear those for every interaction.
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The cameraman guy and I think another person went to Nebraska. (Not sure why.)
Nebraska is one of four high level biosecurity patient care units in the US.
The three other high-level biocontainment facilities in the U.S. are at St. Patrick Hospital in Missoula, Mont., the National Institutes of Health in Maryland and Emory University Hospital in Atlanta, where two infected patients were treated this summer.From NPR
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Because it is so easy to make these mistakes, we should be taking measures to not put our healthcare workers in this position.
We already are.
CDC’s RoleUnder 42 Code of Federal Regulations parts 70 and 71, CDC is authorized to detain, medically examine, and release persons arriving into the United States and traveling between states who are suspected of carrying these communicable diseases.
As part of its federal authority, CDC routinely monitors persons arriving at U.S. land border crossings and passengers and crew arriving at U.S. ports of entry for signs or symptoms of communicable diseases.
When alerted about an ill passenger or crew member by the pilot of a plane or captain of a ship, CDC may detain passengers and crew as necessary to investigate whether the cause of the illness on board is a communicable disease.
But once they are here, we should take care of them, shouldn't we?
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Before these cases I just would have assumed that the better facilities in the West would make it much safer for health care workers.
I'm sure it is. These patients are critically ill. Health care workers will have many, many encounters with them throughout the day. Each patient will be in direct contact with many different workers each day-nurses, orderlies, physicians, lab techs, xray techs, doctors, housekeepers. So even though it is just a handful of patients, we are talking about many thousands of contacts with the potential for transmission. And so far we have one case of trasmission in this country.
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There are many children in Africa who are now orphans who didn't get Ebola even though they were in their home with parents with Ebola.
This is an important point. In any Ebola outbreak, children are much less likely to get Ebola, because they aren't typically the caregivers. It's the people exposed to the bodily fluids that get sick- family caregivers and healthcare workers.
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Keep in mind that these people are coughing, sneezing, vomiting, bleeding, having diarrhea... It's a very messy business and someone has to clean all that up.
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What is the deal with news stories like these?
Well, mainly the problem is the news doesn't have all the information, nor should they because of patient confidentiality. If they aren't testing, it's because they really don't think it's possible that the child has Ebola.
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OMG that Quest bar looks divine! :drool5:
Thanks for the blog recommendation...I'll be checking it out.
They are AWESOME. Just FYI, in case anyone is worried about the carbs, you can subtract the fiber from the carbs, leaving 4 net carbs per bar.
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I wanted to add, I lost 30 pounds in about 2 months doing that, and now that I am at my goal, I eat healthy fats (dairy, avacados, nuts, butter, etc) and have maintained my weight without any problems. But if you want to continue to lose, cook with olive oil but skip the other fats and add them back in later.
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For breakfast, Quest Chocolate Chip Cookie Dough protein bars.
For lunch, salad with protein (chicken, ham, etc) or taco salad
For dinner, 8 oz protein, veggies, and a salad. I don't get creative with the meat, but do lots of different things with veggies.
Tons of great recipes at Andover Diet Center
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Tonight's news is they were saying the spread throughout Europe in inevitable.
I can't imagine the U.S. would be very far behind, but who knows.
The "news" may have said the spread throughout Europe is inevitable, but that is not what the WHO is saying. They are saying sporadic cases are unavoidable. Big difference, and should not be a surprise to anyone.
"Europe will almost inevitably see more cases of the deadly Ebola virus within its borders but the continent is well prepared to control the disease, the World Health Organization's regional director said on Tuesday.
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"It is quite unavoidable ... that such incidents will happen in the future because of the extensive travel both from Europe to the affected countries and the other way around."
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"But the most important thing...is that Europe is still at low risk and that the western part of the European region particularly is the best prepared in the world to respond to viral hemorrhagic fevers including Ebola."
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"With case numbers in West Africa rising exponentially, experts say it is only a matter of time before Ebola spreads internationally. But they stress the chances of sporadic cases leading to an outbreak in Europe, the United States or elsewhere beyond Africa are extremely low.
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Well, that's probably true. But it may also be true that it's in the interest of public health to lie to people, because sometimes panicking can cause more damage as a whole than a handful of people catching of a rare virus.
I've worked in public health, and deliberate lying is never policy. The public doesn't always get every last detail, because it isn't necessary and can cause lots of unnecessary damage. But outright lying? No way. How would that even work? Every state and county has their own health department. You'd have to have hundreds of agencies, thousands of people, agreeing to tell the same lie. That's beyond ludicrous.
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Given the recent worries about pictures of celebrities posted on this forum, you might want to check if your picture is copyrighted or not.
I must have missed that. I don't come here often anymore.
I'll delete it.
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I am ignorant of the past history of posters here and what the group dynamics here are, but, to be fair, not many of us on these boards are epidemiologists either.
:seeya: :seeya: :seeya:
But I learned my lesson with Swine flu. :001_tt2:
My son doesn't know when to stop.
in The Chat Board
Posted
All kids do something annoying occasionally. But when it is a persistent pattern that is constantly disruptive and causes issues with other kids or in groups, it's more than just normal kid behavior.
My 16 year old son is, and has always been like this. It has been very difficult. I have no advice, just commiseration. :crying: