An extraordinary number of Bellevue Hospital staffers called in sick on Friday rather than treat the city’s first Ebola patient — and those who showed up were terrified to enter his isolation chamber, sources told The Post.Shepherd of the Gurney's (SoG) predicted this would happen.
“The nurses on the floor are miserable with a ‘why me?’ attitude, scared to death and overworked because all their co-workers called out sick,” one source said.
“One nurse even went as far as to pretend she was having a stroke to get out of working there, but once they cleared her in the ER they sent her back up,” the source added.
Dr. Craig Spencer is being treated by nurses working in teams of two, “with one serving as a buddy watching the other,” said Health and Hospitals Corporation spokeswoman Ana Marengo, who denied there was a sickout.
The Doctors Without Borders volunteer — who is in stable condition — has even been putting his medical skills to use, lecturing the staff about proper treatment.
“As a doctor, he knows a lot about medicine, so he would call the nurses station all day and going back and forth with doctors on what to do,” the source said.
The sick doctor has been passing time in his pressurized room by watching TV and eating hospital food.
Our vaunted medical system is just like our economy. Much more fragile than it looks and in danger of collapse with the first serious bump.
But if you want to cling to the idea that all is well with "this Ebola"...if you want to claim that more American's have sucked Clinton's dick than died of Ebola...then enjoy.
But be advised. There is a reason why the governors of Illinois and New York have stated that people coming from Ebola nations will be placed in a mandatory 21 day quarantine. Assume that they're acting out of self interest. Assume that they're attempting to protect their states. AND have knowledge that they have much larger populations of Africans in their states than many others.
I'm a health care worker (paramedic) and I can tell you that from DAY ONE of my training one thing is emphasized above all else: PROTECT YOURSELF FIRST!
ReplyDeleteI can't help anybody if I'm sick or injured. I don't risk my life or limb. If I do, then I become a liability, not an asset. This goes double for infectious disease scenarios. Health care workers are at a much higher risk of contracting a communicable disease, as well as spreading it. Better one guy stick it out alone in a hospital room than have a nurse spread it around the entire floor, the bus ride home, her family, or everybody at the bar that night.
That being said, there is plenty of equipment and training available. Ebola, being a "contact precautions" infection, is much easier to deal with than something like tuberculosis, SARS, or H1N1. As long as proper training and equipment is provided, it shouldn't be much of a problem.
The issue with situations like this is that proper policy, procedures, and protocols are not yet in place. Health workers may be told to "make do" with what is available at the time without proper training. In that case, they are completely justified with refusing unsafe working conditions.
Not to sound like an asshole, but I'm not going to risk bringing ebola home to my family just become some wing-nut decided it would be fun to vacation in a proverbial leper colony.
Doug:
DeleteEbola isn't "contact" precautions, it's contact and droplet precautions.
Both the .gov spokesholes and news hairdos reading the stories were so incoherent on the difference, the CDC finally had to make an updated explanation sheet, with pictures, for the stupid people. One of my commenters linked to it:
http://www.thegatewaypundit.com/2014/10/cdc-yes-you-can-catch-ebola-from-being-sneezed-coughed-on-or-by-having-sex/
I'm well aware of droplet precautions. Droplet precautions is part of contact precautions, not separate.
DeleteAll it takes is a simple surgical mask (something worn anyway) to block droplets. Not a big deal. In certain cases, protection can be "doubled up" by placing a surgical mask on both the health care provider AND another on the patient.
In the end, proper precautions and adequate hand washing is enough. The virus can't live long outside of the human body and needs a warm, moist environment.
True airborne diseases (like TB) are way more scary. They require full N95 particulate mask with an airtight seal. Simply having 5 O' clock shadow could disrupt that seal and put you at risk. Simply being in the same room as someone with TB could be deadly.
And for those worried about fear mongering, TB is far more prevalent in the USA than ebola.
http://www.cdc.gov/tb/publications/factsheets/statistics/tbtrends.htm
Uh, no, they're separate, and droplet precautions are not "part of contact precautions", you've got it exactly backwards. Contact precautions are the least stringent beyond standard precautions, and additional levels add to it.
Deletehttp://www.cdc.gov/HAI/settings/outpatient/basic-infection-control-prevention-plan-2011/transmission-based-precautions.html
Note that despite the fact that Ebola in this outbreak isn't airborne, the level of precautions recommended are functionally airborne precautions, plus full head-to-toe droplet barrier precautions.
A "simple surgical mask" doesn't protect your eyes, which is why you need goggles.
And an N95 mask is of questionable use when we're talking about aerosolized virions, which are much smaller than bacteria. This is why a respirator is recommended, not a simple mask, even an N95 mask. They simply aren't effective enough.
http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html
Bear in mind that two ICU nurses in not-quite-entirely head-to-toe PPE still managed to get the disease.
Then cruise over to MSF/DWB's PPE or that used by the BL4 wards for donning protocol for working around Ebola: it's nothing like standard precautions and hand washing.
http://app1.unmc.edu/nursing/heroes/ppe_posters_vhf.cfm
And the virus lives for weeks outside a warm, moist environment, in fact it lasts longer in cold.
http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php
TB has a mortality rate of TB is 4%, and it takes decades.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62173-3/fulltext
Ebola in this outbreak has a mortality rate of 50-90%, in less than a month.
http://www.who.int/mediacentre/factsheets/fs103/en/
And simply being in the same room as someone with Ebola can be deadly.
"Close contact
Close contact is defined as
a.being within approximately 3 feet (1 meter) of an EVD patient or within the patient’s room or care area for a prolonged period of time (e.g., health care personnel, household members) while not wearing recommended personal protective equipment (i.e., standard, droplet, and contact precautions; see Infection Prevention and Control Recommendations); or
b.having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment."
http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html
And yes, TB is more prevalent, but that's because it has a multi-century head start. Ebola has only been here for 36 days. At current rates of spread, Ebola will have expanded to the entire population by about Christmas 2015.
There are more mosquitoes than there are 747s too, but the critical factor is how fast the 747 is moving when it's headed straight for you, not the fact that there's only 1.
In short, you've misstated the facts on just about everything you said.
If you think otherwise, you need to bone up some more.
Your prudence in wanting to protect yourself first is right on.
But what a person thinks they know about Ebola that isn't right can get them infected, and dead.
Not exactly psychic abilities for SoG. It's self-preservation.
ReplyDeleteThe US Healthcare systems is not setup for infectious diseases. It's setup for hip replacements, heart bypass, transplants, etc.
They shouldn't be forcing nurses or Doctors to work in such environs. Given that there are so few cases of Ebola, there should be health professionals who volunteer and are trained to that level. Give them a shit load of hazard pay, too.
Expecting it to be part of their normal duties (at normal pay) is going to get high absentee rates. And threatening their employment status isn't going to work considering the demand for healthcare professionals. They can print off a resume and start a new job in a week.
Sounds like a good idea to me for next time around if they can muddle though this one.
DeleteOne of these nurses needs to hand Mr. I don't give a shit expert a full bed pan of shut the fuck up.
ReplyDeleteHow dare he lecture anyone about proper Ebola treatment, hell he needs to die from Ebola for what he did.
This is promising. It seems having tried every other approach, common sense is getting a turn at bat.
ReplyDeleteAnd if it catches on, it could force TPTB to re-think their jackassical moves, and try the same approach while there's still time for it to work.
Free-market capitalism FTW!
""...if you want to claim that more American's have sucked Clinton's dick than died of Ebola..."
ReplyDeleteBad analogy. Neither are a known quantity.
The idea that a regular hospital, like Bellevue, can treat Ebola patients is total nonsense. Only BSL-4 facilities can do experiments with the Ebola virus, according to federal rules. This is, of course, one of the reasons why almost nothing is known for certain about Ebola: controlled experiments can only by done in a few BSL-4 (or European equivalent) facilities.
ReplyDeleteA BSL-4 facility, according to the CDC, needs the following features:
“The laboratory is in a separate building or in an isolated and restricted zone of the building.
The laboratory has dedicated supply and exhaust air, as well as vacuum lines and decontamination systems.”
Also, work in a BSL-4 facility “must be performed within an appropriate Class III BSC, or by wearing a full body, air-supplied, positive pressure suit.” A BSC is a “gas-tight sealed container that is designed to allow for the manipulation of objects, hazardous substances, or infectious disease agents.” For treating patients, a BSC will not work.
If experiments with Ebola require a “full body, air-supplied, positive pressure suit,” why assume that anything less is sufficient when taking care of Ebola patients? Why lower standards for healthcare workers than for scientists? This leaves us with less than 10 beds for Ebola patients in the whole country. There is no time to create more Ebola beds and to train the people needed to staff them. The US healthcare system will be swamped by 5 to 7 Ebola patients, as SoG and Solomon say.
There are zero BSL-4 facilities in West Africa, yet most Doctors and Nurses who treat ebola patients do not get ebola. You don't need BSL-4 facilities.
DeleteWhat you need is sounds equipment, training and disposal protocols to be followed
nonsense. first we don't have a real count on the number of doctors that have gotten ebola but what we do know is that the head of mission caught it and died after treating patients. what we do know is that we had an american trained doctors that were fully trained up in PPE gear and they don't know how they contracted ebola. what does that tell me? it says that this shit is being transmitted in a way that is unknown right now. additionally when you have governors putting up quarantines and you're still not alarmed then you are not someone i would want to share a foxhole with. your survival instinct is much too low to stand watch while i catch some sleep.
Delete1 “Most” is not good enough. Not for me, not for the healthcare workers of this country.
Delete2 It is a FACT that BSL-4 is required for research on Ebola. So why not for patient care?
3 From the University of Minnesota CIDRAP:
“Ebola is a highly contagious virus that causes a hemorrhagic fever and is lethal in about 50% to 90% of cases. Because the Ebola virus is so dangerous, the US government lists it as a category A bioterrorism agent. There is no vaccine or specific treatment for the disease.”
Because Ebola is a category A bioterrorism agent, Obama, Fauci and Frieden can be prosecuted under the PATRIOT Act. Obama has to be impeached first, of course.
I have a pretty good image of those health care workers calling in *sick.* Glad I'm not a patient at Bellevue.
ReplyDelete