Presby D Failures On Protocol ¶ Ebola Patients Transferred [Update]

25 Comments

1. 

   Oui on October 15, 2014 at 12:14 pm

   Is no one thinking straight? CDC should isolate Texas from rest of nation!

   Dallas Morning News:
   . @CDCgov wants all 132 people who flew
   Frontier 1143 from Cleveland to DFW on
   Oct 13 to call 1-800-232-4636 ASAP
   d-news.co/CNPMD  

   Healthcare worker who tested positive for Ebola flew on Frontier flight day before getting sick

   Amber Joy Vinson, who was admitted to the hospital Tuesday and placed in isolation, flew from Dallas/Fort Worth Airport to Cleveland on Frontier flight 1142 on Friday, October 10. She returned to DFW on Frontier flight 1143 on Monday, October 13.

   “Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13,” the Center for Disease Control said in a statement on Wednesday.

   Frontier is contacting the 132 passengers that were on the Airbus A320 aircraft that landed at 8:16 p.m. on Monday. The aircraft was cleaned overnight at DFW per the airline’s usual procedure before returning to service the next day.

   ABC News Report

   ○ Dallas hospital: Nurses Union on Ebola: “There Was No Protocol” | NBC |
   ○ Nurses’ union slams Texas hospital for lack of Ebola protocol | CNN |

   • 

     shan on October 15, 2014 at 6:00 pm

     I thought that these quarantined people had to call in each day and that someone was visiting them to also check on their health?  I agree, Texas needs to be a no fly zone.

     • 

       Marie2 on October 17, 2014 at 11:32 am

       Guess it was assumed that professional health workers, nurses, were capable of self-monitoring and reporting.  The contact tracers won’t make that mistake again.

   • 

     Marie2 on October 16, 2014 at 4:52 pm

     Should make you happy:

     Chain reaction: Concern about Ebola nurse’s flight prompts school closings in two states.

     Not that there is the slightest bit evidence that Ebola is infectious during the asymptomatic phase or the earliest, low-grade fever stage.  Not discounting that very close personal contact (like sex) could lead to transmission at the beginning of the symptomatic stage; only that it hasn’t happened in well enough documented cases.

     • 

       Oui on October 17, 2014 at 5:10 am

       ○ CDC: Nurse Vinson Was Contagious 4 Days Earlier
       ○ 13% Ebola Victims Have Symptoms w/o Fever

       • 

         Marie2 on October 17, 2014 at 11:28 am

         Oh, FFS.  Where’s your list of EVD victims that contracted the disease from someone before they had reached the observable, by others, symptoms of Ebola?  Or in the case of Thomas Duncan anyone that had had contact with him before the intense vomiting and diarrhea that ensued after he was taken to the hospital for the second time?  

         How many on the plane that Patrick Sawyer took from Monrovia to Lagos were infected?  And we know that by the time he was in the Lagos airport he was highly contagious because two of his ECOWAS colleagues that met him at the airport were infected.

         Transmission requires high viral load in the index contact and close (not near but close as in touching the person or his/her bodily secretions).  As one or more persons that were in close contact with Duncan before his hospital admission have yet to exhibit any Ebola symptoms and they are at or near the longest possible incubation period, concluding that he hadn’t reached the requisite viral load for transmission seem rational to me.

         But, hey, don’t let the data get in the way of fear mongering.

              

2. 

   Oui on October 15, 2014 at 5:11 pm

   Rep. Pete Sessions, R-Dallas: CDC director Tom Frieden should step down.

   ○ @DrFriedenCDC

3. 

   Oui on October 16, 2014 at 5:17 am

   “… and all I’m gonna say is Presby D has a reputation.”

   That was my conclusion observing from afar and listening to yesterday’s press conference of the head of ebola response team County Judge Jenkins.

   It appears PresbyD had a massive failure and breach of protocol. Plenty of criticism from nurses’ union about readiness and qualification to receive and treat an ebola patient in isolation. Does PresbyD have a fully equipped isolation chamber hazardous to biosafety level 4? Yesterday it appeared there was a competency battle between Texas State officials, Dallas officials and the CDC feds.

   To transfer Amber Joy Vinson to the Emory Hospital unit in Atlanta says it all!

   In the US there are 4 Hospitals geared up to handle Ebola:

   • The National Institutes of Health (NIH) Clinical Center, Bethesda, Maryland, has 3 beds.
   • Nebraska Medical Center, Omaha, has 10 beds.
   • Emory Hospital, Atlanta has 3 beds.
   • St Patricks Hospital, Missoula, Montana  has 3 beds.

   As I wrote in my diary yesterday, Germany has seven hospitals fully equipped to handle ebola and marburg viruses with BSL-4 facilities, including its laboratory.

   ○ ‘In 1976 I discovered Ebola – now I fear an unimaginable tragedy’ | The Guardian |
   ○ U.S. Patent 20120251502 A1: Human Ebola Virus Species and Compositions and Methods Thereof

   • 

     Oui on October 16, 2014 at 3:34 pm

     Dallas nurse Nina Pham with Ebola to be transferred to NIH Maryland hospital

     McClatchy reports that Nina Pham, one of two nurses diagnosed with Ebola after treating a Dallas patient who died, will be moved to an isolation unit at a National Institutes of Health facility in Bethesda, Maryland.

     2nd Dallas Nurse With Ebola Arrives In Atlanta For Treatment

     Meanwhile, a health official says the Centers for Disease Control and Prevention cleared Vinson to fly from Cleveland to Dallas. Vinson spoke with the CDC official responsible for monitoring her health before she boarded the flight Monday, CDC spokesman David Daigle said.

     Daigle says the 29-year-old Vinson reported her temperature was below 100.4 degrees and she had no symptoms. Ebola sufferers aren’t contagious until they show symptoms. The official said she could board Frontier Airlines Flight 1143.

     ○ CDC examines protective gear protocols amid U.S. Ebola cases
     ○ A look at sick nurses contact with Ebola patient | AP |

     • 

       Oui on October 20, 2014 at 8:51 pm

       Per today, Oct. 20, 2014 …

       Tightened Guidance for U.S. Healthcare Workers on Personal Protective Equipment for Ebola | CDC |

       The Centers for Disease Control and Prevention is tightening previous infection control guidance for healthcare workers caring for patients with Ebola, to ensure there is no ambiguity.  The guidance focuses on specific personal protective equipment (PPE) health care workers should use and offers detailed step by step instructions for how to put the equipment on and take it off safely.  

       Recent experience from safely treating patients with Ebola at Emory University Hospital, Nebraska Medical Center and National Institutes of Health Clinical Center are reflected in the guidance.

       The enhanced guidance is centered on three principles:  

       • All healthcare workers undergo rigorous training and are practiced and competent with PPE, including taking it on and off in a systemic manner
       • No skin exposure when PPE is worn
       • All workers are supervised by a trained monitor who watches each worker taking PPE on and off.

       All patients treated at Emory University Hospital, Nebraska Medical Center and the NIH Clinical Center have followed the three principles. None of the workers at these facilities have contracted the illness.

       Principle #1: Rigorous and repeated training
       Focusing only on PPE gives a false sense of security of safe care and worker safety. Training is a critical aspect of ensuring infection control. Facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment, especially in the step by step donning and doffing of PPE. CDC and partners will ramp up training offerings for healthcare personnel across the country to reiterate all the aspects of safe care recommendations.

       [Read on …]

4. 

   Oui on October 16, 2014 at 10:30 pm

   Just learned from two doctors who worked in a hospital in Sierre Leone, they were confronted with sick patients – vomiting and diarrea – with no fever. They turned out to carry the ebola virus. The doctors returned to The Netherlands, were tested in AMC Leiden and stayed in quarantine for 21 days on a house boat in Amsterdam with no visitors.

   The doctors are part of the Lion Heart Foundation who run the hospital and will return asap to Sierre Leone to help and care for the ebola victims.

   ○ Doctor under observation for ebola had contact with dying patient in Sierra Leone

   Ebola research: Fever not a surefire sign of infection | LA Times |

   … yet the largest study of the current outbreak found that in nearly 13% of “confirmed and probable” cases in Liberia, Sierra Leone, Guinea and elsewhere, those infected did not have fevers.

    « click for more info
   Ebola: Mapping the outbreak (BBC News)

   The study, sponsored by the World Health Organization and published online late last month by the New England Journal of Medicine, analyzed data on 3,343 confirmed and 667 probable cases of Ebola.

   The finding that 87.1% of those infected exhibited fever — but 12.9% did not — illustrates the challenges confronting health authorities as they struggle to contain the epidemic. U.S. health officials have repeatedly emphasized that fever is a reliable sign of infectiousness.

   ○ Ebola outbreaks in Congo, western Africa, have different sources in nature, virus study finds

5. 

   Oui on October 16, 2014 at 11:05 pm

   Emory freshmen determined to build a fast, portable Ebola test | Emory News Center |

   On Sept. 12, Goldstone and Zafari launched a video appeal for REDS on the crowdfunding site Indiegogo. As of Sept. 26, they’ve received pledges for $8,620, over halfway to their goal of $14,500. The online campaign will continue until Oct. 12. [Total raised $14,605]

   “We have access to the materials, the experts, and the literature of Emory’s excellent medical research facilities, they explain in their video. “Since we found ourselves at the crossroads of the right time and the right place, we felt obligated to take action.”

   “The next step is finding a lab willing to let us do this project,” Zafari says. “Then we’ll focus on getting our proof of concept, developing a prototype and optimizing it to the highest quality to endure temperature fluctuations and all the different kinds of variables seen along the West Africa coast.”

   For Zafari and Goldstone, the past month has been an intense-but-thrilling introduction to college life. “It feels like we’re always working on our project — in the lobby, between classes, late at night,” explains Zafari, who describes himself as “happily exhausted.”

   Yet he’s already found the experience rewarding: “My passion has always been humanitarian causes,” he says. ” The right to medical care? I view that as a human right. I think everyone should have the opportunity to succeed. It’s something I want to spend my life addressing.”

   h/t Marie2 – Ebola – Race Against Time.

6. 

   Oui on October 16, 2014 at 11:19 pm

   Vaccines and global health :: ethics and policy | Nature Medicine | Editorial |

   Ebola virus first emerged in the Democratic Republic of the Congo (DRC) and in South Sudan in 1976 and reappeared in South Sudan in 1979, but it caused no further outbreaks until 1994. Since then, there have been several outbreaks in Africa, but none approached the magnitude of the current outbreak. The natural reservoir of the virus remains unclear, but it is suspected to be the fruit bat. However, Ebola virus also infects nonhuman primates, a species of antelope and porcupines, all of which could be sources of human transmission.

   The unusually rapid and far-reaching spread of the virus during the current outbreak has been facilitated by insufficient treatment and containment facilities in West African nations that had no prior experience with Ebola; a distrust of Western medical practices; the stigma associated with infection, causing failure to seek early treatment; as well as the long asymptomatic incubation period of the virus (up to 21 days), which enables dissemination through travel.

   What’s more, unlike with malaria, drugs or vaccines for SARS and Ebola cannot be tested in the setting of experimental human infection. Demonstrating their efficacy and safety is restricted to animal models, which themselves have limitations. For example, preclinical testing of treatments against ebolavirus is generally initiated within hours or a few days after infection, whereas in humans the virus may be first identified weeks after initial infection, and the viral load–and its sequelae–may or may not be comparable to those in animal models.

   Two Americans, a Spanish priest and three Liberian doctors infected with Ebola have received ZMapp, a cocktail of monoclonal antibodies produced by Mapp Biopharmaceutical that was shown to neutralize the virus in monkeys but had not been tested for safety in humans. But the supply of ZMapp is now exhausted, and the company estimates it will take several months before more is available. The WHO is also weighing the possibility of the use of serum from individuals who recovered from Ebola infection. And Canada has committed up to 1,000 doses of an experimental Ebola vaccine–VSV-EBOV–to the WHO. Other companies and governments also have drugs and vaccines in various stages of development.

   [Links added are mine – Oui]

7. 

   Oui on October 16, 2014 at 11:45 pm

   Preoccupation with bioterrorism hobbles preparations for natural spread of deadly viruses | Homeland Security |

   Preoccupation with hypothetical bioterrorism attacks is leaving America more vulnerable to the threat of natural spread of deadly viruses. Since the 9/11 attacks, the federal government has poured billions of dollars to prevent and monitor threats of bioterrorism, yet the United States was ill-prepared for the swine flu outbreak of 2009. Experts say it is time to rebalance public health priorities so that preparations for the real threat of the outbreak of infectious diseases will not take a back seat to preparations for the more remote threat of bioterrorism.

   The larger emphasis on bioterroism, rather than on natural virus outbreaks, is legitimate considering the global terrorism threat, and it is also in keeping with the traditional America approach.of putting the military in charge of fighting epidemics.

   Post 9/11 and the anthrax letters targeted at U.S senators and media figures, consultants for the CDC proposed the “Model State Emergency Health Powers Act,” advocating legalization requiring compulsory quarantine of the sick in the case of a bioterror attack.  

   ○ The Global Infectious Disease Threat and Its Implications for the United States | FAS Jan. 2000 |
   ○ USAMRIID – United States Army and anthrax attacks of 2001
8. 

   Oui on October 17, 2014 at 3:42 am

   Right, the hospital was ill-equipped and lacked training to handle any patient with the deadly ebola virus. The best medical advice would have been to transfer patient Duncan out to one of four specialized facilities. With ebola, compassion cannot replace medical competence.

   Dallas hospital learned its Ebola protocols while struggling to save mortally ill patient

   The hospital that treated Ebola victim Thomas Eric Duncan had to learn on the fly how to control the deadly virus, adding new layers of protective gear for workers in what became a losing battle to keep the contagion from spreading, a top official with the Centers for Disease Control and Prevention said Tuesday.

   “They kept adding more protective equipment as the patient [Duncan] deteriorated. They had masks first, then face shields, then the positive-pressure respirator. They added a second pair of gloves,” said Pierre Rollin, a CDC epidemiologist.

   “On the one hand, they did everything they should have done for someone who was very sick. On the other hand, they were doing things that we, because of our experience with Ebola, would never do.”

   Doctors and nurses did many things right, including donning proper equipment early, isolating the patient and meticulously disposing of soiled sheets and other waste. But they also took potentially lethal risks, like peeling off gloves and gowns without proper supervision and connecting Duncan to a dialysis machine while he was in the throes of the virus.

   Rollin said it’s hard to pinpoint what, exactly, made nurses Nina Pham, 26, and Amber Vinson, 29, contract the deadly virus, despite wearing protective gear. But lack of experience and proper training was evident.

   Two-thirds of Americans are concerned about the spread of the Ebola virus in the US: Poll

   Dr. Rollin on the ebola outbreak in Guinea | CDC | April 2014 |

   This time the featured speaker was CDC’s Dr. Pierre Rollin, a scientist comfortable with presenting complex information to audiences of both experts and lay people. Manning, a health communication specialist with CDC/NCEZID’s Viral Special Pathogens Branch, was ready. He brought a microphone and video camera to capture Rollin’s update about the ongoing Ebola outbreak in Guinea.

   In Guinea, the public’s appetite for knowledge and nervous disposition was understandable. Ebola has a fierce reputation and on March 25 Guinea’s Ministry of Health formally reported an outbreak to WHO. By the time Rollin, Manning and three other experts from CDC arrived on March 31, the number of confirmed or suspected cases had grown to 112. Even more disturbing, 70 people died, meaning a death rate of 62 percent.

   Early in the outbreak cases appeared in Conakry, Guinea’s capital with a population of about 2 million. That was a new and potentially disruptive element for a public health emergency that in the past had largely been limited to rural and remote areas in other countries.

   ○ Imported Marburg Hemorrhagic Fever: One That Got Away | CDC 2009 |
   ○ Health Care Response to CCHF in US Soldier infected in Kandahar, Afghanistan

9. 

   Oui on October 17, 2014 at 5:05 am

   Health officials believe Amber Vinson was contagious four days before her official diagnosis | NE Ohio Media Group |

   Amber Joy Vinson may have had Ebola symptoms as early as Friday, a Centers for Disease Control and Prevention official said, and passengers on the Oct. 10 flight the Dallas nurse took to Cleveland will be contacted. She was officially diagnosed on Tuesday of this week, four days later.

   “We had started to look at the possibility that she had symptoms going back as far as Saturday, (Oct. 11),” CDC Dr. Chris Braden said. “This has to do with the bridal shop. Some more information that has come through recently says we can’t rule out that she might have had the start of her symptoms on Friday.”

   Disease control specialists are being sent to Ohio to help monitor people she came into contact with there.

   President Obama commented on the Vinson case saying:

   “It is very important that we are monitoring and tracking anyone who was in close proximity to this second nurse.” [source]

   Officials are now tracking the contacts she made on that flight, and those she came into contact with in Ohio, as well as those people on the return flight to Dallas.

   “Today, we learned that Cleveland Clinic and The MetroHealth System had employees – mostly nurses – aboard the Frontier flight from Dallas to Cleveland on October 10, returning from a nursing conference in Texas. That flight included the Dallas nurse who was diagnosed with Ebola when she returned to Dallas on October 13. Both health systems have put all of our employees who were on that flight on paid leave while we will monitor their health daily. We are confident that these nurses are at low risk of exposure since we understand that the Dallas nurse did not have symptoms at the time … ”  [!] [source]

    Amber Joy Vinson’s family releases statement

   ○ Dallas health-care worker who handled Ebola specimen self-quarantines on cruise ship
10. 

    Oui on October 17, 2014 at 10:44 am

    Sources: Obama will name Ron Klain Ebola Czar

    President Barack Obama will appoint Ron Klain his “Ebola czar,” knowledgeable sources tell CNN.

    Klain is highly regarded at the White House as a good manager with excellent relationships both in the administration and on Capitol Hill. His supervision of the allocation of funds in the stimulus act — at the time and incredible and complicated government undertaking — is respected in Washington. He does not have any extensive background in health care but the job is regarded as a managerial challenge.

    A former chief of staff to Vice President Joe Biden and also to then-Vice President Al Gore, Klain is currently president of Case Holdings and General Counsel of Revolution, an investment group. He has clerked for the U.S. Supreme Court and headed up Gore’s effort during the 2000 Florida recount.

    Ron Klain Admits 2000 Election Still Hurts: ‘I’ll Never Be Over It’

11. 

    Oui on October 17, 2014 at 4:58 pm

    Once ebola was diagnosed at Dallas Presbyterian, the doctors acted with criminal neglect how nurses were exposed to patient Duncan and performing their duty to care for a very ill person. In any European state, the responsible doctors would face a disciplinary board. Evola is not a flu, treatment in a modern setting requires a BSL-4 facility. Mandatory for medical assistants a full body suit with double respiratory filters in The Netherlands, Belgium, France and Germany for sure.

    Ridiculous CDC Protocol …

    Why do responders in Africa wear so much personal protective equipment (that can include full body suits) for this Ebola outbreak when CDC says hospitals here could safely manage the care of an Ebola patient without a full body suit?

    There are important differences between providing care or performing public health tasks in Africa versus in a U.S. hospital. In field medical settings, additional PPE may be necessary to protect healthcare workers. In some places in Africa, workers may not have the ability to prepare for potential exposures. For example, in some places, care may be provided in clinics with limited resources (e.g., no running water, no climate control, no floors, inadequate medical supplies), and workers could be in those areas for several hours with a number of Ebola infected patients. Additionally, certain job responsibilities and tasks, such as attending to dead bodies, may also require different PPE than what is used when providing care for infected patients in a hospital.

    ○ Texas Biomedical Research Institute – Virology and Immunology
    ○ Outbreak of Ebola virus disease in West Africa
       Main conclusions and options for risk reduction [pdf]

12. 

    Oui on October 18, 2014 at 5:06 am

    In a judgement why the ebola virus could cause such a vast outbreak in West Africa compared to earlier outbreaks, an expert mentioned this Zairian form of ebola virus seems more infectuous than in the past. Like any virus, it evolves in time. There is an extreme high count of infected cells in organs, blood and bodily fluids.

    ○ Chart: what makes ebola so deadly

    The chance of contamination by airborn virus transmission is minimal, near zero, according to info I’ve read. True?

    Posted in lamh31’s new diary – What’s Bugging You… A Microbiologist Answers Your Questions….

13. 

    Oui on October 18, 2014 at 5:08 am

    How Ebola Sped Out of Control | WaPo |

    The WHO, an arm of the United Nations, is responsible for coordinating international action in a crisis like this, but it has suffered budget cuts, has lost many of its brightest minds and was slow to sound a global alarm on Ebola. Not until Aug. 8, 4 1 ⁄ 2 months into the epidemic, did the organization declare a global emergency. Its Africa office, which oversees the region, initially did not welcome a robust role by the CDC in the response to the outbreak.

    Previous Ebola outbreaks had been quickly throttled, but that experience proved misleading and officials did not grasp the potential scale of the disaster. Their imaginations were unequal to the virulence of the pathogen.

    “The epidemic has exposed a disconnect between the aspirations of global health officials and the reality of infectious disease control. Officials hold faraway strategy sessions about fighting emerging diseases and bioterrorism even as front-line doctors and nurses don’t have enough latex gloves, protective gowns, rehydrating fluid or workers to carry bodies to the morgue.”

    “We cannot wait for those high-level meetings to convene and discuss over cocktails and petits fours what they’re going to do,” exclaimed Joanne Liu, international head of Doctors Without Borders, when she heard about another U.N. initiative. Her group was among the first to respond to the viral conflagration, and it kept its staff in West Africa throughout the crisis.

    West Africa was ill-equipped for an Ebola disaster because civil war and chronic poverty had undermined local health systems and there were few doctors and nurses.

    London and Berlin have come under criticism for its hitherto sluggish response to the epidemic.  

    ○ Cuban medical response to fight ebola Africa + Video

    WHO declares ebola contained in Senegal or “ebola-free”, the state of Nigeria will reach that status on Monday.

    ○ Senegal: WHO Declares Senegal Free of Ebola | DW |
    ○ West Africa: Are the Ebola outbreaks in Nigeria and Senegal over?

14. 

    Oui on October 19, 2014 at 5:35 pm

    Spanish nurse’s aide found to be Ebola-free in third test | CNN |

    Officials have previously said that the amount of the Ebola virus in Romero’s blood had decreased dramatically from the time she was rushed to the hospital two weeks ago. Romero has recovered enough to produce antibodies.

    “It means she’s making her own protection, so any virus fooling around probably will be destroyed or neutralized.”

    Even though Romero received the negative result for the Ebola virus on this third key test in a week, she will surely remain in hospital for days, possibly a few weeks, in order to recover, Luis Enjuanes, an expert on viruses, said in a phone interview.

    She has received two main treatments in her battle against Ebola, for which there is still no vaccine. The first was an IV drip with the antibodies of an Ebola survivor — a Catholic nun who survived the disease in West Africa. And Romero also received an experimental anti-viral drug, Favipiravir, Enjuanes said.

15. 

    Oui on October 22, 2014 at 1:02 pm

    Nigeria: Brave Doctor Adadevoh Loses Ebola Battle | All Africa |

    Frontline medical Doctor, Ameyo Stella Adadevoh, who saved the country from potential epidemic of the Ebola Virus Disease, EVD, fell to the vise-grip of the disease which she contracted while attending to the index (first) Ebola case, the late American-Liberian, Patrick Sawyer.

    Dr. Adadevoh was infected when she forcefully restricted Mr. Sawyer to his bed after he tried to remove the drip administered on him.

    Observers said, yesterday, that her action probably saved many Nigerian lives because, if Sawyer had succeeded in forcing himself out of the hospital, it would have been difficult to trace those who had contact with him.

    Minister of Health, Professor Onyebuchi Chukwu announced the death, yesterday evening, of Dr Adadevoh.

    Dr. Adadevoh, an experienced consultant physician and endocrinologist was Lead Consultant with First Consultants Medical Centre, Obalende, Lagos, came into the limelight shortly after the dramatic visit of Sawyer, and will be remembered as the first Nigerian confirmed to test positive to the Ebola virus. A holder of an MBBS from the University of Lagos, UNILAG, as well as a Diploma in Endocrinology from the University of London, the deceased practised in the United Kingdom and Nigeria for more than three decades.

    She was a member of the Nigeria Medical Association, NMA, the British-Nigerian Association and a Fellow of the National Postgraduate Medical College.

    Son of Nigeria doctor who spotted Ebola patient speaks of pride – BBC News

16. 

    Oui on October 29, 2014 at 3:38 pm

    Today’s news headline:

    ○ AP IMPACT: Even small clusters of Ebola cases could overwhelm parts of US medical care system

    Lessons from Ebola: The Infectious Disease Era, And The Need To Prepare, Will Never Be Over

    With the wall-to-wall news coverage of Ebola recently, it’s hard for many to distinguish fact from fiction and to really understand the risk the disease poses and how prepared we are to fight it.

    Fighting infectious diseases requires constant vigilance. Along with Ebola, health officials around the globe are closely watching other emerging threats: MERS-CoV, pandemic flu strains, Marburg, Chikungunya and Enterovirus D68. The best defense to all of these threats is a good offense — detecting, treating and containing as quickly and effectively as possible.

    And yet, we have consistently degraded our ability to respond to these new, emerging and re-emerging threats by underfunding and undercutting existing capabilities and expecting the country to ramp up overnight when new threats emerge.

    • Public Health Emergency Preparedness (PHEP) Cooperative Agreement Funding–which awards funds to states, territories and urban areas to build and sustain public health preparedness capabilities to respond to potential acts of bioterrorism and threats from Mother Nature–has dropped from a high of more than $1 billion in 2006 to a low of $585 million in 2013.
    • The Strategic National Stockpile (SNS)–a national repository of antibiotics, chemical antidotes and other medicines and medical supplies–does not have enough funds to replenish expiring items against a variety of threats.
    • On the health care side, the Hospital Preparedness Program (HPP) has experienced almost yearly cuts, from a high of $515 million in fiscal year 2004 to just $255 million in FY 2014.

    Executive Order 13486 Working Group on Strengthening the Biosecurity of the United States – Jan. 9, 2009

    ○ Swine flu outbreak shows U.S. public health system not ready for a major influenza pandemic – 2009
    ○ The H1N1 Pandemic: Summary Highlights | CDC – 2009 |

17. 

    Oui on November 11, 2014 at 5:33 am

    U.S. was ill-equipped to handle Ebola rescues, State Dept. contract reveals | Yahoo News |

    The U.S. government spent millions last decade to develop and build two of the world’s only isolation chambers for flying contagious patients — but as the epidemic raged in West Africa this summer and American aid workers there needed evacuating, the medical inventions were packed away in a small-town Georgia warehouse.

    The Aeromedical Biological Containment System (ABCS), a tent-like structure that allows caregivers to treat a single patient in flight without infectious germs escaping, was engineered by the Centers for Disease Control, Department of Defense and a private flight company, Phoenix Air Group, between 2007 and 2010 after the scare over SARS, severe acute respiratory syndrome.

    …
    The isolator was never used, and the CDC decided it could no longer afford to keep a jet on standby. So the agency — whose mission includes controlling the introduction and spread of infectious diseases in the United States — asked Phoenix Air to shelve the gear in 2011.

    By late July this year — with CDC workers and American aid volunteers in West Africa and the Ebola outbreak nearing its eighth month — the health agency had made no inquiries into its expensive life-saving equipment.

    It wasn’t until Aug. 18 that the U.S. government had a contract in place to get the ABCS and Phoenix Air back on 24/7 alert status.

    Cartersville air crews trained for Ebola transport

18. 

    Oui on November 12, 2014 at 12:49 pm

    Thomas Duncan’s Family & Hospital Reach Resolution

    DALLAS (CBSDFW.COM) – Texas Health Presbyterian Hospital in Dallas has reached an agreement with the family of Ebola patient Thomas Eric Duncan, who died in October at the medical facility.

    The agreement comes after allegations of wrong-doing, protocols not being followed, and claims that the hospital did not do enough to protect the patient. It has been just over one month since the 42-year-old man from Africa lost his fight with Ebola.

    Duncan’s sister and nephew were present as the family’s attorney announced a multi-faceted agreement, which included a financial settlement and a charitable contribution.

    “This has been a tragic loss for the children and the parents,” said attorney Les Weisbrod. “We’re here today to announce a settlement that will take care of all the children and parents.”

    Weisbrod said the family’s mission was to “raise awareness of preventable medical errors in the US.”  

    See my earlier diary – Presby D Failures On Protocol ¶ Ebola Patients Transferred.