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staceyobu
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With an infant mortality rate as high as ours, what makes us think we are so prepared to deal with an epidemic? I'll bet that infant mortality rates are a good indication of how well a country is prepared to deal with an epidemic.

 

http://www.cbsnews.com/news/us-has-highest-first-day-infant-mortality-out-of-industrialized-world-group-reports/

 

The top five countries to be a mom were Finland, Sweden, Norway, Iceland and the Netherlands. The bottom five were Niger, Mali, Sierra Leone, Somalia and the Democratic Republic of the Congo.

 

About 11,300 newborns die within 24 hours of their birth in the U.S. each year, 50 percent more first-day deaths than all other industrialized countries combined, the report's authors stated.

 

Also, why all the overfocus on just Liberia? There are other countries involved, and it only takes ONE person to spread the disease.

http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html#areas

 

Why Sealing Off West Africa Won't Stop Ebola

http://www.businessinsider.com/sealing-off-west-africa-wont-stop-ebola-2014-10

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With an infant mortality rate as high as ours, what makes us think we are so prepared to deal with an epidemic? I'll bet that infant mortality rates are a good indication of how well a country is prepared to deal with an epidemic.

 

http://www.cbsnews.com/news/us-has-highest-first-day-infant-mortality-out-of-industrialized-world-group-reports/

 

The top five countries to be a mom were Finland, Sweden, Norway, Iceland and the Netherlands. The bottom five were Niger, Mali, Sierra Leone, Somalia and the Democratic Republic of the Congo.

 

About 11,300 newborns die within 24 hours of their birth in the U.S. each year, 50 percent more first-day deaths than all other industrialized countries combined, the report's authors stated.

 

Also, why all the overfocus on just Liberia? There are other countries involved, and it only takes ONE person to spread the disease.

 

Why Sealing Off West Africa Won't Stop Ebola

http://www.businessinsider.com/sealing-off-west-africa-wont-stop-ebola-2014-10

 

I'll bet they aren't due to inconsistencies within infant mortality data that make comparisons more complex than a simply looking at rates.

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With an infant mortality rate as high as ours, what makes us think we are so prepared to deal with an epidemic? I'll bet that infant mortality rates are a good indication of how well a country is prepared to deal with an epidemic.

 

http://www.cbsnews.com/news/us-has-highest-first-day-infant-mortality-out-of-industrialized-world-group-reports/

 

The top five countries to be a mom were Finland, Sweden, Norway, Iceland and the Netherlands. The bottom five were Niger, Mali, Sierra Leone, Somalia and the Democratic Republic of the Congo.

 

About 11,300 newborns die within 24 hours of their birth in the U.S. each year, 50 percent more first-day deaths than all other industrialized countries combined, the report's authors stated.

 

Also, why all the overfocus on just Liberia? There are other countries involved, and it only takes ONE person to spread the disease.

 

Why Sealing Off West Africa Won't Stop Ebola

http://www.businessinsider.com/sealing-off-west-africa-wont-stop-ebola-2014-10

 

I don't think the infant mortality rate actually says much about how well prepared we are to deal with an epidemic. Higher infant mortality rates in the US are tied directly to a higher incidence of preterm birth, not to lack of quality medical care for babies once born. Preterm birth is linked to poor prenatal care, nutrition, etc. for mothers; we have real problems in that department, but I am not convinced those particular issues would prevent us from handling an infectious disease outbreak. Preventative care and emergent care/epidemic management are quite different problems.

 

 

Good analysis of the infant mortality problem:

http://stanmed.stanford.edu/2013fall/article2.html

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I don't think the infant mortality rate actually says much about how well prepared we are to deal with an epidemic. Higher infant mortality rates in the US are tied directly to a higher incidence of preterm birth, not to lack of quality medical care for babies once born. Preterm birth is linked to poor prenatal care, nutrition, etc. for mothers; we have real problems in that department, but I am not convinced those particular issues would prevent us from handling an infectious disease outbreak. Preventative care and emergent care/epidemic management are quite different problems.

 

 

Good analysis of the infant mortality problem:

http://stanmed.stanford.edu/2013fall/article2.html

 

I think our high infant mortality rates show our lack of ability to get proper care to all people. We have allowed this to continue because unhealthy mom and dead babies are not contagious. With our current infrastructure, I don't think we can get care to the poor efficiently and in a timely manner.

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I'll bet they aren't due to inconsistencies within infant mortality data that make comparisons more complex than a simply looking at rates.

 

This. It's not an apples to apples comparison.

 

I am a little confused in general about why a poster inserted infant mortality rates to the discussion. That is a health issue so far removed from infectious disease/immunology/communicability that I can't figure out how it fits into the discussion.

 

These are profoundly unrelated. The medical professionals and mechanisms developed to deal with communicable diseases are by in large rather unconnected with the practice of OBGYN's except as far as vaccination to MMR, tetnus, etc. come into the picture. Not similar. I can think of countries with very, very low infant mortality rates - Iceland comes to mind - that are in no way equipped to handle an ebola outbreak or anything similar to that despite their absolutely excellent healthcare system.

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I think this is an important article, and am glad that the issue is being highlighted/discussed:  U.S. nurses say they are unprepared to handle Ebola patients

 

The article discusses nurses, X-ray techs, transporters, and hospital janitors as not being sufficiently trained or having access to adequate equipment.  Beyond that:  What about the training of paramedics? How do you adequately clean/sterilize an ambulance after transport?  Who do you call to come in and clean and disinfect a house or apartment?  If people clean up a house/apartment themselves, how do they dispose of the waste?

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The inconsistencies in data gathering amount for a very small percentage of cases.

 

It isn't just how the data is gathered but also how definitions vary among countries. 

 

Regardless, Nigeria has successfully contained Ebola thus far and has an infant morality rate of over 80 (the US is 6 btw), so no, infant mortality rates don't seem to be a good indicator of determining future success of containing an outbreak.

 

Oh, and Senegal has also contained it so far and has an infant mortality rate of 49.  In the future I would suggest you do a little fact checking first.

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It isn't just how the data is gathered but also how definitions vary among countries. 

 

Regardless, Nigeria has successfully contained Ebola thus far and has an infant morality rate of over 80 (the US is 6 btw), so no, infant mortality rates don't seem to be a good indicator of determining future success of containing an outbreak.

 

Oh, and Senegal has also contained it so far and has an infant mortality rate of 49.  In the future I would suggest you do a little fact checking first.

 

I have absolutely checked my facts.

 

Being prepared to fight Ebola has less to do with how much equipment is in the country as a whole, and more to do with being able to deliver the needed care.

 

Ebola is likely to keep popping up in the same USA populations that have high infant mortality rates, and we are no more prepared to deliver the right Ebola care to this population, than we are to offer them prenatal care. It will always be too little too late. The fancy equipment used during delivery isn't enough to save these babies, and it's not enough to contain the Ebola in our low income and immigrant communities.

 

The foolishness we have seen in Dallas is indicative of how other cases will be handled. This is the way we work. We are not set up to do differently.

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It will be interesting, if it spreads, to see how Ebola likes the cold. If it does indeed spread, we may be very blessed winter is about to hit. Traditionally, I believe, there are fewer viruses in winter? Or is that a myth I wonder?

 

I read last night the US is creating seventeen ebola centers in various locations in the countries most affected.

 

I have a very hard time believing the man didn't know he was infected. However, I also believe the temptation to get to the US would have been INCREDIBLY high. " They" say he had to lie the Times and say he had not been in contact with sick individuals to get on the plane. An article last night said he would be tried in Liberia.

 

However, Manny people there just go to ebola centers, not to get treatment, it's too overcrowded, but to simply stay away from their families and die without hoping to infect them.

 

I can't imagine. I hope I can NEVER imagine. :( The chive if leaving your babies? The choice of comforting your sick baby or staying healthy for your others? Hopelessness in medical care? Unfathomable to me.... :(

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I have absolutely checked my facts.

 

Being prepared to fight Ebola has less to do with how much equipment is in the country as a whole, and more to do with being able to deliver the needed care.

 

Ebola is likely to keep popping up in the same USA populations that have high infant mortality rates, and we are no more prepared to deliver the right Ebola care to this population, than we are to offer them prenatal care. It will always be too little too late. The fancy equipment used during delivery isn't enough to save these babies, and it's not enough to contain the Ebola in our low income and immigrant communities.

 

The foolishness we have seen in Dallas is indicative of how other cases will be handled. This is the way we work. We are not set up to do differently.

 

I like how you just soldier on the past that two nations with extremely high infant mortality rates are handling the outbreak well.  Facts?  You don't need no stinking facts!

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I have absolutely checked my facts.

 

Being prepared to fight Ebola has less to do with how much equipment is in the country as a whole, and more to do with being able to deliver the needed care.

 

Ebola is likely to keep popping up in the same USA populations that have high infant mortality rates, and we are no more prepared to deliver the right Ebola care to this population, than we are to offer them prenatal care. It will always be too little too late. The fancy equipment used during delivery isn't enough to save these babies, and it's not enough to contain the Ebola in our low income and immigrant communities.

 

The foolishness we have seen in Dallas is indicative of how other cases will be handled. This is the way we work. We are not set up to do differently.

 

Infant mortality doesn't have anything to do with this, so I shouldn't waste my breath, but we *are* prepared to offer prenatal care to the poorer populations. We do have the infrastructure and the resources to provide health care to the poor. We simply choose not to pay for it.

 

We are set up to handle Ebola. Will mistakes be made? They obviously already have. But is it a lost hope? Absolutely not. We are capable of handling this. Doom and gloom isn't going to help handle this. Common sense and rational thought will handle this.

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Infant mortality doesn't have anything to do with this, so I shouldn't waste my breath, but we *are* prepared to offer prenatal care to the poorer populations. We do have the infrastructure and the resources to provide health care to the poor. We simply choose not to pay for it.

 

We are set up to handle Ebola. Will mistakes be made? They obviously already have. But is it a lost hope? Absolutely not. We are capable of handling this. Doom and gloom isn't going to help handle this. Common sense and rational thought will handle this.

 

I'm not feeling doom and gloom. I just think this may force the USA to change how they deliver health care and deal with crises in general.

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I think this is an important article, and am glad that the issue is being highlighted/discussed:  U.S. nurses say they are unprepared to handle Ebola patients

 

The article discusses nurses, X-ray techs, transporters, and hospital janitors as not being sufficiently trained or having access to adequate equipment.  Beyond that:  What about the training of paramedics? How do you adequately clean/sterilize an ambulance after transport?  Who do you call to come in and clean and disinfect a house or apartment?  If people clean up a house/apartment themselves, how do they dispose of the waste?

 

My daughter is a medic. She has transported and treated patients with far more communicable diseases than ebola. She has personally been decontaminated, and she's completely disinfected her rig. You'd be surprised the amount of bleach her EMS company has on hand. Big hoses, safety gear. She suits up when necessary and bleaches out her rig along with her partner. Of course, one issue that you do have is that from state to state, funding for EMS differs wildly. So while Michigan and say New York provide tremendous care, training, equipment, and safety gear for their medics, other states not so much. That said, it isn't all that hard for one state to help another. DD is on a deployment list and could be sent at any time with other co-workers to help . They will bring their equipment and training with them and quickly bring the others up to speed. She could be there in a few short hours if need be. It's like being a version of national guard, but just for first responders.

 

I guess I'm used to it. When she lived at home, she disinfected her boots with bleach before entering the house after each shift, and uniforms went directly to the washer with proper antiseptics followed by drying on high. If she was exposed to something really, extra concerning, she was taken "off line" at the hospital along with her partner, and they would have a special shower then were given scrubs to wear while their uniforms were taken care of with special attention. LOL, the most diligent cleaning of her rig that she ever did was after transporting a patient with scabies. Man, I swear she itched for days! Good thing for those extra uniforms. That day she changed after cleaning the rig, put her uniform in a plastic bag and tied it up very tightly. I was really not thrilled about scabies, so left her uniform in that plastic bag for two weeks, then started a big stock pot of boiling water, put her uniforms in that - forked them over with a big grilling fork because I was NOT touching them until they'd been boiled, left them for 10 minutes, and then laundered them. You'd be surprised what military grade fabric will withstand, LOL!

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You know, ebola is not the only hemorrhagic fever out there, and not even close to the only one that's been transmitted by travelers to U.S. soil.  Why is nobody up in arms about Lassa fever, Marburg, Hantavirus (native to the U.S.) or other types of yellow fever?  Oh, that's right...because the news media hasn't beaten you into a frenzy over it with sensationalistic coverage.  Other diseases in the very same category have been safely handled by health professionals in this country WITHOUT causing a pandemic...shocking, I know.  And we will do the same thing with Ebola.  People are panicked over something that is not going to occur.  Waste your worry on something worth worrying about.  Ebola is not it.

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Good. We don't need any more doom and gloom. LOL.  Yeah, it could shake things up, that's for sure.

 

I have been saying for a long time that the USA is unprepared to deal with contagion. Whether it is this virus or another, or something entirely different, at SOME point the USA is going to need to maneuver a little differently on how they deliver healthcare and deal with crises.

 

I'm not afraid of getting ebola. I'm just sad about how we deal with vulnerable people in their times of need.

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I like how you just soldier on the past that two nations with extremely high infant mortality rates are handling the outbreak well.  Facts?  You don't need no stinking facts!

 

My comparison of infant mortality and ebola containment is a GROSS generalization, but I do believe we will see some correlation.

 

I hope most countries can contain these outbreaks. If the USA cannot contain these outbreaks SHAME on us! We have the resources. If we fail it will be because we didn't use them.

 

I think we will see better containment in developing countries with low infant mortality compared to developing countries with high infant mortality. And I think we will see better containment in industrialized countries with low rates, than industrialized countries with high rates.

 

I think the USA is a wildcard and I cannot predict what will happen, as our infant mortality rate is far higher than expected. I fear that our infrastructure, despite all our resources just is not as prepared as it could be, and that people will die unnecessarily, as they have been for a long time.

 

If the disease spreads among the quarantined, our methods of delivery are probably to blame for that. Good equipment isn't going to fix that people got sick in the first place. The man went to the hospital before he started shedding or when he was shedding less. Then we locked people up without food and among contagion. Other countries don't act like this that have the amount of resources that we do.

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I think this is an important article, and am glad that the issue is being highlighted/discussed:  U.S. nurses say they are unprepared to handle Ebola patients

 

The article discusses nurses, X-ray techs, transporters, and hospital janitors as not being sufficiently trained or having access to adequate equipment.  Beyond that:  What about the training of paramedics? How do you adequately clean/sterilize an ambulance after transport?  Who do you call to come in and clean and disinfect a house or apartment?  If people clean up a house/apartment themselves, how do they dispose of the waste?

 

Great article.  Thanks for linking it.

 

 Hospital janitors...

 

In our local newspaper just this year,  I've read about a problem with a large number of hospital janitors being unable to pass a workplace proficiency test that would allow them to make a bit more money and supposedly improve "infection control" in the hospitals.   We can't just put all our trust in our superior "first world" doctors and nurses when many of the people cleaning the floors, etc. have come from "third world" countries and aren't able to read the directions/warnings on the cleaning supplies.   

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A possibility that might not be too burdensome would be to require people who had traveled to regions with high rates of Ebola to check in with a health clinic/health worker every day for monitoring for 21 days after arrival in the US. Since symptoms appear before a person becomes contagious, that seems like a reasonable way to stop the disease from spreading. If the Dallas man had been monitored in such a way by someone who knew what to watch for we would not need to be worrying now about who else may have been infected.

 

I think that sounds like a good plan to me.

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Great article.  Thanks for linking it.

 

 Hospital janitors...

 

In our local newspaper just this year,  I've read about a problem with a large number of hospital janitors being unable to pass a workplace proficiency test that would allow them to make a bit more money and supposedly improve "infection control" in the hospitals.   We can't just put all our trust in our superior "first world" doctors and nurses when many of the people cleaning the floors, etc. have come from "third world" countries and aren't able to read the directions/warnings on the cleaning supplies.   

 

If the hospital did have Ebola presumably there would be people there to help instruct them regardless of whether or not they could read a label. If strict protocols are required I would hope they wouldn't take such a cavalier attitude.

 

Of course, I wouldn't have expected someone to be standing around cleaning up Ebola-laden vomit with a power washer and no gear whatsoever either.  Those bushes likely have Ebola now.

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My daughter is a medic. She has transported and treated patients with far more communicable diseases than ebola. She has personally been decontaminated, and she's completely disinfected her rig. You'd be surprised the amount of bleach her EMS company has on hand. Big hoses, safety gear. She suits up when necessary and bleaches out her rig along with her partner. Of course, one issue that you do have is that from state to state, funding for EMS differs wildly. So while Michigan and say New York provide tremendous care, training, equipment, and safety gear for their medics, other states not so much. That said, it isn't all that hard for one state to help another. DD is on a deployment list and could be sent at any time with other co-workers to help . They will bring their equipment and training with them and quickly bring the others up to speed. She could be there in a few short hours if need be. It's like being a version of national guard, but just for first responders.

 

Yes to all of this. I have transported respiratory patients who turned out to have undiagnosed Tb -- guess who was on prophylactic care? I have transported a patient who had esophageal varices which ruptured and he also turned out to have Hep B -- guess who spent hours decontaminating the ambulance, gear, and self AND was on prophylactic care? AND I'm a known non-responder to the Hep B vaccine, carry a little card and everything. (And by the way, just for the majority of you who haven't cared for a patient whose esophageal varices ruptured, you can't imagine the amount of blood which comes gushing out of the mouth and you can't control that bleeding.) 

 

My EMS system is well funded (though not by the state, different way to fund systems here). Bleach is cheap and kills just about everything IF you follow proper protocols. FM, I used to belong to my state's DMAT group (actually, here there are 4 (I believe; it's been a while) teams which comprise TX DMAT. Is this the group your dd belongs to (her state's group, obviously)? I quit once I had several young children running around the house. Now with 6 kids  (2 still in nappies) plus my <ahem> age I'm afraid I'd be more of a liability than an asset physically. <sigh>

 

I guess I'm used to it. When she lived at home, she disinfected her boots with bleach before entering the house after each shift, and uniforms went directly to the washer with proper antiseptics followed by drying on high. If she was exposed to something really, extra concerning, she was taken "off line" at the hospital along with her partner, and they would have a special shower then were given scrubs to wear while their uniforms were taken care of with special attention. LOL, the most diligent cleaning of her rig that she ever did was after transporting a patient with scabies. Man, I swear she itched for days! Good thing for those extra uniforms. That day she changed after cleaning the rig, put her uniform in a plastic bag and tied it up very tightly. I was really not thrilled about scabies, so left her uniform in that plastic bag for two weeks, then started a big stock pot of boiling water, put her uniforms in that - forked them over with a big grilling fork because I was NOT touching them until they'd been boiled, left them for 10 minutes, and then laundered them. You'd be surprised what military grade fabric will withstand, LOL!

Ooohhh! This reminds me of a call -- my partner and I pull up to a house for a "routine" sick call. As we approach the front door we notice that the wooden front porch is moving and not because it was unsteady. (If you're really interested at what we found, PM me. I'm quite sure many on here would be physically ill were I to type it out. I felt quite ill at the time and was a well-seasoned medic then.) We also noticed 2 cops standing much nearer than us to the house who looked a little green. Suffice it to say, the crew (eta: my partner and me) stopped to put on the full iso-kits; the patient was transported and an isolation room was reserved based on my report; and my partner and I spent the better part of 5 hours cleaning, disinfecting, decontaminating our unit and ourselves. 

 

Good times...

 

You know, ebola is not the only hemorrhagic fever out there, and not even close to the only one that's been transmitted by travelers to U.S. soil.  Why is nobody up in arms about Lassa fever, Marburg, Hantavirus (native to the U.S.) or other types of yellow fever?  Oh, that's right...because the news media hasn't beaten you into a frenzy over it with sensationalistic coverage.  Other diseases in the very same category have been safely handled by health professionals in this country WITHOUT causing a pandemic...shocking, I know.  And we will do the same thing with Ebola.  People are panicked over something that is not going to occur.  Waste your worry on something worth worrying about.  Ebola is not it.

 

:iagree:  Ayup.

 

I have been saying for a long time that the USA is unprepared to deal with contagion. Whether it is this virus or another, or something entirely different, at SOME point the USA is going to need to maneuver a little differently on how they deliver healthcare and deal with crises.

 

I'm not afraid of getting ebola. I'm just sad about how we deal with vulnerable people in their times of need.

 

I think, Hunter, you're conflating 2 different issues: the ability to handle an epidemic/pandemic and how the US delivers healthcare. I think the country is able to handle "contagion". I think the processes and protocols which are in place will work. I agree that the weak link is human error and when infectious disease protocols (which are good) butt up against local bureaucracy. I believe there have been mistakes made in Dallas on several levels. However, I don't think that means that as a country we can't deal with contagious communicable diseases as we've already proven we can. It means that (a) the healthcare systems have to drill and drill and drill again on proper protocols which should include "surprise quizzes" as well as table top exercises and ( B) the local, state, and federal bureaucracies need to cut through the red tape which prohibits standard decon procedures like cleaning/decontaminating the apartment(s). 

 

I completely agree with your last statement.

 

I also want to say, not to you necessarily, Hunter, but in general, that because I work 3 hours south of Dallas, my system has already reviewed the CDC guidelines/protocols for Ebola and other similar viruses. We have an extensive blood borne pathogen exposure protocol already in place. We've run tabletop exercises with the area hospitals. However, we are not panicking. Nor do we anticipate an epidemic headed down IH-35. I'm actually more concerned about those undiagnosed Tb patients as Tb is fast becoming unresponsive to standard therapies and the enterovirus making its rounds (though, fortunately, not so much in my neck of the woods).

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You know, ebola is not the only hemorrhagic fever out there, and not even close to the only one that's been transmitted by travelers to U.S. soil.  Why is nobody up in arms about Lassa fever, Marburg, Hantavirus (native to the U.S.) or other types of yellow fever?  Oh, that's right...because the news media hasn't beaten you into a frenzy over it with sensationalistic coverage.  Other diseases in the very same category have been safely handled by health professionals in this country WITHOUT causing a pandemic...shocking, I know.  And we will do the same thing with Ebola.  People are panicked over something that is not going to occur.  Waste your worry on something worth worrying about.  Ebola is not it.

 

This bears repeating over and over and over again.

 

Measles - airborne highly contagious, infectious disease associated with high rates of death from respiratory complications - 594 cases this year in the US. (ww.cdc.gov/measles/) Worldwide, 20 million cases, and approximately 164,000 deaths per year.

 

Where is the epidemic? It's airborne, it spreads so much more easily than ebola that it staggers the imagination. Where is the pandemic, the quarantines, the restriction on travel? Vaccination rates are at an all time low. The Amish never immunize and often have measles in their communities. Our local, itty bitty, sad county hospital has dealt with measles in the past.

 

Oh wait, it's a fluke. Our grossly undertrained, highly incompetent medical professionals could not possible have contained it. This is just some strange miracle of nature. :banghead:

 

I really recommend that the worry be placed on viruses that can't be contained like enteroD68 which has killed four American citizens already and is causing permanent nerve damage and paralysis in some victims.

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I don't think education and drill will fix this. I think we need to CARE about ALL humans and WANT to deliver adequate healthcare to them ALL. 

 

Fix what? Delivering decent healthcare to all people at reasonable costs thereby eventually driving down the costs of healthcare for all parties involved? Sure, I agree with you.

 

Help with dealing with unusual outbreaks of communicable diseases? Yes, education (of both all healthcare workers and the general public!) and drill (for the healthcare workers) will absolutely help. It has already been proven to do so over the decades.

 

Delivering routine healthcare and ramping up for communicable disease outbreaks are two different beasts and require different skill sets. Both require caring about people.

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I don't think education and drill will fix this. I think we need to CARE about ALL humans and WANT to deliver adequate healthcare to them ALL.

I agree with your second statement 110%. But I am also pretty positive those on the front lines, so to speak, of addressing any possible outbreak feel the same way. Doctors, nurses, paramedics, etc., etc. I just don't see this particular point as entirely relevant.

 

 

(edited: relevant, not relative...)

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The guy in Dallas who has Ebola flew through Belgium on his way to the US?

 

So stopping direct US-Liberia flights isn't going to have any effect.  (Are there even any?)

 

Would they need a visa to enter the U.S.? I'm thinking a policy wherein anyone coming from Liberia would have to have either a 3-week quarantine, (perhaps for Americans), or be denied entry to the U.S.

 

I wouldn't dictate anything to Liberia, but make them aware of whatever policy we had.

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Hi Brehon, since dd has moved to NJ, I'm not certain what to call it. I was just getting used to the lingo in Michigan and then, bam, the dear girl got married and moved. We talk a lot on the phone, she's at work today and was just bled all over...power tool incident, so I'll have to ask her.

 

She doesn't have children yet so is willing to deploy.

 

Her favorite training exercise was the disaster drill that involved a simulated contagion. Second favorite, the simulated air plane crash with 200+ "injuries". In both cases, she worked triage.

 

I think that an awful lot of Americans do not realize that behind the scenes, first responders and hospital personnel are constantly being educated, constantly practicing, constantly taking new coursework, upgrading their skills, simulating disasters to improve response times and hone protocols. People aren't perfect. No one is. But, they will get it right a whole heck of lot more often than they'll get it wrong. If that were not so, we'd have already been wiped out in the last decade by this, that, or the other thing.

 

Most people I know have zero idea that county and state emergency medical services regularly simulate every manner of disaster in order to train for it the best they can. This vs. countries in West Africa who literally do not have an ambulance anywhere in the nation, much less people trained to take care of health concerns in the field.

 

Vanuatu - a Pacific Island nation - just got it's first ambulance and two EMT's back in 2009/2010. A dear friend with "Doctor's Without Borders" is hoping dd will come some day and help him outfit the first ambulance in his country and train an EMT. His hospital got it's first defibrillator in 2012 and the country he is in is not nearly as undeveloped as Liberia.

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I think this is an important article, and am glad that the issue is being highlighted/discussed:  U.S. nurses say they are unprepared to handle Ebola patients

 

The article discusses nurses, X-ray techs, transporters, and hospital janitors as not being sufficiently trained or having access to adequate equipment.  Beyond that:  What about the training of paramedics? How do you adequately clean/sterilize an ambulance after transport?  Who do you call to come in and clean and disinfect a house or apartment?  If people clean up a house/apartment themselves, how do they dispose of the waste?

 

Excellent article. It's interesting to read that the hospital in question had just had the ebola training, so it should have been fresh in everyone's minds.... so where did the system break down?

 

The points about everyone from the janitor to the guys pushing the wheelchairs, etc. need to know. I am glad nurses are speaking up, but then, that's what nurses do!

 

I thought that ebola patients would be cared for in hospitals with specialized isolation rooms like Emory has. Does every hospital have rooms with reverse air flow, etc.?

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Would they need a visa to enter the U.S.? I'm thinking a policy wherein anyone coming from Liberia would have to have either a 3-week quarantine, (perhaps for Americans), or be denied entry to the U.S.

 

I wouldn't dictate anything to Liberia, but make them aware of whatever policy we had.

 

I am pretty sure he would need a visa (unless an US citizen). Where would you want the quarantine to happen? At the US entry port? Or in Liberia? Not sure this is really feasible (at least at this time).

 

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People are panicked over something that is not going to occur.  

 

Are people panicked?  That isn't my impression.  Not my takeaway from any discussion here, and anyway, I don't equate chatting online with panic mode.  I've not heard a single person in "real life" mention it.  (Now, in two weeks when the Cowboys are here, up against Beast Mode, et al ~ then & only then will Dallas register in the minds of Western Washingtonians. ;-) )  

 

The story isn't being treated with any unnecessary fervor by my news sources (none of which are televised).  Awareness is raised, concern is piqued, conversation & coverage increased ~ but that doesn't translate into a state of panic.

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Are people panicked?  That isn't my impression.  Not my takeaway from any discussion here (granted, I don't equate chatting online with panic mode).  I've not heard a single person in "real life" so mention it.  The story isn't being treated with any unnecessary fervor by my news sources (none of which are televised).  Awareness is raised, concern is piqued, conversation & coverage increased ~ but that doesn't translate into a state of panic.

 

IRL, we have two people in our local community panicked. They are packing their houses with massive amounts of supplies and arming for Iwo Jima. Actually, the arming up so that their supplies can't be stolen scares me! That's the kind of hysteria that leads to tragedy.

 

One of the two read somewhere that the government ordered 160,000 hazmat suits, and so she thinks there are 160,000 cases of ebola in the US being hidden by the government. My father, 71 and in not so good a shape in terms of critical thinking skills since he had open heart surgery and lung surgery in a six week period wants my mom to stockpile food, prescriptions, drinking water, fuel, antiseptic, and bleach....like a lot of bleach. I think he told her the other day to get 20 gallons.

 

Sigh...so I have seen panic locally. I'm trying to talk my dad off the wall. His doc tells me that now that they've taken him off a med he was reacting to, that his outlook will improve drastically, and he'll be easier to talk to about this kind of thing. I hope so.

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So you saw one picture and that is how it must be all the time?

 

Liberia would NOT have this epidemic if they had higher health standards than we do.

 

 

 

The people cleaning in Africa are wearing full protective gear and areas are cordoned off so civilians do not have access.  The picture is in one of the earlier links.

 

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Infant mortality doesn't have anything to do with this, so I shouldn't waste my breath, but we *are* prepared to offer prenatal care to the poorer populations. We do have the infrastructure and the resources to provide health care to the poor. We simply choose not to pay for it.

 

We are set up to handle Ebola. Will mistakes be made? They obviously already have. But is it a lost hope? Absolutely not. We are capable of handling this. Doom and gloom isn't going to help handle this. Common sense and rational thought will handle this.

 

Where's the common sense?  

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This bears repeating over and over and over again.

 

Measles - airborne highly contagious, infectious disease associated with high rates of death from respiratory complications - 594 cases this year in the US. (ww.cdc.gov/measles/) Worldwide, 20 million cases, and approximately 164,000 deaths per year.

 

Where is the epidemic? It's airborne, it spreads so much more easily than ebola that it staggers the imagination. Where is the pandemic, the quarantines, the restriction on travel? Vaccination rates are at an all time low. The Amish never immunize and often have measles in their communities. Our local, itty bitty, sad county hospital has dealt with measles in the past.

 

Oh wait, it's a fluke. Our grossly undertrained, highly incompetent medical professionals could not possible have contained it. This is just some strange miracle of nature. :banghead:

 

I really recommend that the worry be placed on viruses that can't be contained like enteroD68 which has killed four American citizens already and is causing permanent nerve damage and paralysis in some victims.

 

 

I thought this was a great article on NPR. I believe someone posted this link earlier in the thread or in the locked thread but it bears repeating.

 

http://www.npr.org/blogs/health/2014/10/02/352983774/no-seriously-how-contagious-is-ebola

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Hi Brehon, since dd has moved to NJ, I'm not certain what to call it. I was just getting used to the lingo in Michigan and then, bam, the dear girl got married and moved. We talk a lot on the phone, she's at work today and was just bled all over...power tool incident, so I'll have to ask her.

 

She doesn't have children yet so is willing to deploy.

 

Her favorite training exercise was the disaster drill that involved a simulated contagion. Second favorite, the simulated air plane crash with 200+ "injuries". In both cases, she worked triage.

 

I think that an awful lot of Americans do not realize that behind the scenes, first responders and hospital personnel are constantly being educated, constantly practicing, constantly taking new coursework, upgrading their skills, simulating disasters to improve response times and hone protocols. People aren't perfect. No one is. But, they will get it right a whole heck of lot more often than they'll get it wrong. If that were not so, we'd have already been wiped out in the last decade by this, that, or the other thing.

 

Most people I know have zero idea that county and state emergency medical services regularly simulate every manner of disaster in order to train for it the best they can. This vs. countries in West Africa who literally do not have an ambulance anywhere in the nation, much less people trained to take care of health concerns in the field.

 

Vanuatu - a Pacific Island nation - just got it's first ambulance and two EMT's back in 2009/2010. A dear friend with "Doctor's Without Borders" is hoping dd will come some day and help him outfit the first ambulance in his country and train an EMT. His hospital got it's first defibrillator in 2012 and the country he is in is not nearly as undeveloped as Liberia.

 

We saw in New Orleans how supplies were rotting and first-responders sitting idle, because they didn't have permission to enter the area.

 

Recently in an area that was locked down for days because of a shooter, a man went to go get food and wasn't allowed back into the area because it was "too dangerous" but his wife and children were unfed and unprotected and no one cared.

 

Here in Dallas, again, it was similar. Logic and compassion took a back seat to money and red tape and maybe some racism, again and again and again. 

 

Being rich enough to own stuff and even being trained how to use stuff doesn't save lives when powerful people are being selfish and cruel.

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I'm not afraid of getting this disease, but I do think it is a disease the world will maybe not be able to ever get back down to zero again, like we have done in the past. I think it will keep popping back up again and again. With it's high fatality rate and no treatment, it's a scary disease. And when it comes to caregivers of sick people, it's very contagious, obviously. And poor people will die far more often than rich people.

 

Do rich whites need to fear this disease? Probably not. But that doesn't mean it won't affect a whole lot of other people. All rich white Americans might need to fear is maybe finally having to embrace the types of medical systems other countries were forced to adopt earlier if they wanted to protect themselves from contagion.

 

 

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I'm not afraid of getting this disease, but I do think it is a disease the world will maybe not be able to ever get back down to zero again, like we have done in the past. I think it will keep popping back up again and again. With it's high fatality rate and no treatment, it's a scary disease. 

:confused:  There have been yearly cases ever since the disease was first identified in 1976.  Yes, this is the largest outbreak but it hasn't been eradicated in the past.  I'd heard of ebola years before it hit the news this time around.

 

And there is treatment.  It may not be 100% successful but many treatments aren't.  That's why there are mortality rates for all sorts of diseases with treatment like cancer.  

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I thought this was a great article on NPR. I believe someone posted this link earlier in the thread or in the locked thread but it bears repeating.

 

http://www.npr.org/blogs/health/2014/10/02/352983774/no-seriously-how-contagious-is-ebola

 

Eh, I'm a stats girl & NPR addict, but I found that article less than impressive.  Yes, Ebola is less contagious than mumps or measles.  But the vast majority (yes, even now it's an overwhelming majority) of people in the United States vaccinate against the former diseases.  It stands to reason that they'd exhibit concern about a mutating virus with no available vaccine.  That and the fact that Ebola has an exponentially higher mortality rate.

 

The fact that these are historical R nought values makes them less relevant in the here & now, too.  And then, as footnoted, one has to consider that the R nought is time integrated.  The significance of that is obvious when comparing HIV and Ebola.  (Apples & oranges, which is really what this graphic boils down to.)  HIV has a higher R nought, with the understanding that the time integration may be a year or more.  Ebola is more on par with a few weeks.  

 

But all else aside, the article's patronizing opening line ("Holy moly! There's a case of Ebola in the U.S.!") causes the author to lose credence.  Colbert can pull that off.  NPR?  Eh, not so much.

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Hunter, I said in my first post is that one of the problems we in the US have is when health and safety protocols (which include haz-mat, ID, etc) collide with bureaucracy. That's NOT "powerful people being selfish and cruel"; rather, that's the irresistible force meeting the immovable object. And you're right that *that* needs to change.

 

And here we can and are treating ebola quite effectively -- IV fluids, electrolytes, anti-nausea/emetic medicines, dialysis should that become necessary, etc. In other words supportive care which is all that is currently available. Our infrastructure allows this.

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