Just totally lost my temper with some folks in a phone conference, as they tried to figure out a multi-site Ebola response in case someone walks up and says "I've been to West Africa and I have a fever."
Since all USA Ebola infections have been in people who were caring for the infected, I got furious with them trying to develop a lot of teams at a lot of sites who would, locally, be mobilized. If you haven't seen the protective gear required, it's difficult to put on/take off properly. Try training dozens of people for this and you're sure to get a lot of people who think they're safe - but they're going to end up on CNN as the next victims.
So I made the argument that step one is to isolate the silly person that walks up saying "West Africa/fever" and not care one bit that they might be inconvenienced. This is just gonna take a while. Step two is mobilizing a highly trained, very practiced team from somewhere up to an hour away, and that team comes over and does what they've been trained, repeatedly, to do - safely.
Otherwise, we're just exposing a lot of well-meaning but poorly-trained folks, which is a guarantee for failure.
Oh, and there's precedent for this. Pick a small group of highly trained/protected people and send them to the place where the Ebola patient presents.
First aid logic diagram:
Does it have to be dealt with?
No —> have a Coke
Yes —> Can you call someone else to deal with it?
Yes —> Call someone else and have a Coke
No —> Can you deal with it safely?
No —> Call someone else anyway and have a Coke.
Yes —> Are you trained to deal with it?
No —> Call someone else anyway and have a Coke.
Does the person allow you to deal with it?
No —> Call someone else anyway and have a Coke.
Yes —> Call someone else, deal with it, then have a Coke.
But folks are looking at me like I'm lazy, or trying to avoid the problem.
I always questioned the logic of construction sites requiring visitors to wear hardhats. If you're the only guy not wearing one, maybe you won't do anything stupid.
Put on a hazmat suit without adequate training and you're very likely to get yourself in some haz mat.
First I'd heard, and of course "tested positive in the states" would lead one to think perhaps he contracted the virus "in the states." He is with Doctors Without Borders and had recently returned from serving in Africa.
From Wikipedia, now that a doc has been tested positive in the states:
First I'd heard, and of course "tested positive in the states" would lead one to think perhaps he contracted the virus "in the states." He is with Doctors Without Borders and had recently returned from serving in Africa.
Now imagine the cost in PPE and in having 2 people do what is normally a one person job. And imagine trying to maintain an adequate level of patient care when everything takes that much longer.
BTW, they would be smart to have a disposable plastic sleeve to cover the respirator hose - it would make the process a fair bit easier.
doesn't certain light kill (or can kill) the nasties?
seems that we could use light to mitigate the funk
To stave off infection, there are some things you probably know you should do: wash your hands, be careful when you sneeze, gets lots of sleep, don't rub your eyes (especially after touching your nose), eat lots of fruits and vegetables. After all, a cold virus can survive on someone's hand for a couple of hours or for several days on some materials.
Even those hand sanitizers that many people use don't kill everything. And once they're in the body, viruses are quite tough to kill — antibiotics are powerless against them and vaccines for influenza and some other viruses must be changed every year to adapt to new strains. Fortunately our immune systems can fight off many viruses, but some, like Ebola or even influenza, can be deadly. It may then surprise you to learn that something viruses are exposed to all the time — visible light — can be used to kill them.
An interesting look at just how lengthy and intricate the process of using a hazmat suit is.
There are literally no germs left after this (we hope).
Now imagine the cost in PPE and in having 2 people do what is normally a one person job. And imagine trying to maintain an adequate level of patient care when everything takes that much longer.
BTW, they would be smart to have a disposable plastic sleeve to cover the respirator hose - it would make the process a fair bit easier.
I have read and listened to other accounts of similar volunteers. My thanks and admiration to those who have stepped forward, anyway they can, but especially to those who have actually gone to the front lines in Africa. I am very familiar with W. Africa— and the prospect of being there now, working with Ebola patients, is daunting.
I’ve volunteered to go to west Africa because I heard that Médecins Sans Frontières (MSF) was getting desperate for people.
When I tell Mary in HR, she says she has three questions: “1) Do you know that you don’t have to go? 2) Do you know that if you get sick, we won’t bring you home? 3) Do you know that if you die, we won’t bring your body back and you’ll be buried there?” I know MSF is famous for being straight-talking, but I’m still a bit taken aback. I answer yes to all three and go home to look for my passport. My children are unphased – “Yeah, whatever” – but promise to email.
In Brussels, two days later, my medical briefing is entirely in French. It’s a long time since I was at school, but I get the gist: don’t shake hands, rub shoulders or brush fingertips – let alone hug, kiss or have sexual relations – with anyone. In fact, keep 1.5-2 metres away from all people at all times.
Don’t go to markets. Don’t take public transport. And don’t EVER touch your face. By the time I board the plane I have developed a healthy paranoia. And I’m not alone. The cabin crew are wearing face masks, as are many of the passengers. When we touch down in Guinea, another 100 people push their way on. “Ah, it’s Ebola time – everyone is fleeing,” the jovial Liberian beside me says. (...)
Hope your weekend is going well.
