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Trabisnikof posted:I'm working from the Guardian Article (http://www.theguardian.com/world/2014/oct/07/ebola-crisis-substandard-equipment-nurse-positive-spain) that outlines a number of ongoing concerns: Yeah, my criticism is on the article not on you personally. How the PPE is described seems perfectly adequate as per the WHO, though possibly not optimal. Carting around possibly infectious waste in a elevator is not strange at all. Or would stairs have been considered the better option? If the suspected patient was not placed in isolation but kept in a separate bed shielded with curtains for some time then that is indeed against WHO recommendations, and a serious error by the hospital. Though this has probably not increased the risk of infection for anyone in the ED in my slightly worthless opinion not based on data but on general management of contact infectious patients.
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Oct 7, 2014 19:16
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IAMNOTADOCTOR posted:Yeah, my criticism is on the article not on you personally. How the PPE is described seems perfectly adequate as per the WHO, though possibly not optimal. Carting around possibly infectious waste in a elevator is not strange at all. Or would stairs have been considered the better option? The article is mainly quoting staff at the hospital so while I also don't know the facts on the ground, I imagine the staff at the hospital might have a clue. Texas Methodist is looking better and better by the day (no wait at their ER btw!).
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Oct 7, 2014 19:21
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AP posted:MADRID (AP) — Madrid's regional government says it's going to kill the pet dog of a Spanish woman who became infected with Ebola. No! Poor doggie. 
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Oct 7, 2014 19:30
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Caconym posted:Ah,but this patient is white... Zmapp is only available in extremely limited quantities and there's no clinical evidence that it has any more effect on Ebola than waving a chicken foot over someone's head while reciting the resume of Ric Ocasek would. That said, the FDA has made it available for export at the request of the Government of Liberia. IIRC, the patients that they gave it to still died.
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Oct 7, 2014 19:32
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Trabisnikof posted:The article is mainly quoting staff at the hospital so while I also don't know the facts on the ground, I imagine the staff at the hospital might have a clue. I assume the staff there has a clue aswell, the people contacting the newspaper however appear to be out of clues based on the issues rased. For instance the taping of gloves indicating that the gown is not impermeable. Bonus picture: MSF doctors also having taped gloves, clearly meaning that the MSF also disregards the WHO recommendations. 
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Oct 7, 2014 19:32
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IAMNOTADOCTOR posted:I assume the staff there has a clue aswell, the people contacting the newspaper however appear to be out of clues based on the issues rased. For instance the taping of gloves indicating that the gown is not impermeable. If there were MSF doctors whistleblowing to the media that their PPE was inadequate (following an infection of a healthcare worker in a modern hospital) then yes, I would be suspicious that the WHO recommendations were not being followed.
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Oct 7, 2014 19:43
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IAMNOTADOCTOR posted:I assume the staff there has a clue aswell, the people contacting the newspaper however appear to be out of clues based on the issues rased. For instance the taping of gloves indicating that the gown is not impermeable. Having watched a shitload of videos of MSF doctors dressing and undressing my impression is that the tape is only used on the outer layer of 3 layers of gloves, and I believe the 2nd layer is impermeable.
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Oct 7, 2014 19:44
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Three Olives posted:No! Poor doggie. At least test it 
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Oct 7, 2014 19:45
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IAMNOTADOCTOR posted:I assume the staff there has a clue aswell, the people contacting the newspaper however appear to be out of clues based on the issues rased. For instance the taping of gloves indicating that the gown is not impermeable. Curious as to how one can safely get out of the pictured gear. I assume there is some sort of chemical shower before disrobing, but there seem to be a large number of folds and crevices that it would be difficult to clean thoroughly.
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Oct 7, 2014 19:46
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Sheikh Djibouti posted:Curious as to how one can safely get out of the pictured gear. I assume there is some sort of chemical shower before disrobing, but there seem to be a large number of folds and crevices that it would be difficult to clean thoroughly. Everything but those googles is disposable.
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Oct 7, 2014 19:50
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Sheikh Djibouti posted:Curious as to how one can safely get out of the pictured gear. I assume there is some sort of chemical shower before disrobing, but there seem to be a large number of folds and crevices that it would be difficult to clean thoroughly. Very carefully with the help of a coworker.
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Oct 7, 2014 19:51
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Three Olives posted:No! Poor doggie. I was under the distinct impression that dogs only really became Ebola carriers if they were eating a shitload of infected meat.
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Oct 7, 2014 19:56
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Caconym posted:Ah,but this patient is white... I think it's more about "We do not have any Zmapp left. Please do not get on a plane and fly to the USA with your Ebola to get this treatment. I repeat, we do not have any Zmapp left."
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Oct 7, 2014 19:58
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This Documentary is really excellent and probably a must watch. It provides a fairly balanced view and goes into a ton of fascinating detail about ZMAPP, goees into detail about the British and American survivors who were administered ZMAPP, and goes inside a a few of the treatment centers. https://www.youtube.com/watch?v=C6c27iBq9_8
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Oct 7, 2014 19:58
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Trabisnikof posted:If there were MSF doctors whistleblowing to the media that their PPE was inadequate (following an infection of a healthcare worker in a modern hospital) then yes, I would be suspicious that the WHO recommendations were not being followed. As would I, but what we have now is *people* complaining about issues with the PPE that are clearly not very familiar with the WHO recommendations. Prester John posted:Having watched a shitload of videos of MSF doctors dressing and undressing my impression is that the tape is only used on the outer layer of 3 layers of gloves, and I believe the 2nd layer is impermeable. We used to do the same with two gloves of different colours, so you could see when you busted through one of the gloves. To be fair, double gloving has some issues as well, if i recall correctly it actually increases the risk of a tear in one of the gloves due to increased friction. Similar to using two condoms. As far as I know the tape is used to make sure that the gloves remain snug over the outer wear and don't roll up etc. The tape in no way affects permeability and is not required, in surgery similar single gloves as used in the picture are also used while operating in someone's aids infested bowels without any extra tape. Sheikh Djibouti posted:Curious as to how one can safely get out of the pictured gear. I assume there is some sort of chemical shower before disrobing, but there seem to be a large number of folds and crevices that it would be difficult to clean thoroughly. The gown is discarded, no shower needed. Have a pdf explaining how to get out of ebola PPE: http://www.who.int/csr/disease/ebola/remove_ppequipment.pdf?ua=1
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Oct 7, 2014 20:01
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GreyjoyBastard posted:I was under the distinct impression that dogs only really became Ebola carriers if they were eating a shitload of infected meat. Dog to human transmission of Ebola has never been observed. Sero conversion has been proven in dogs that ate people who died of Ebola, but actual shedding of the virus has not been proven. It is unknown whether or not they can spread the disease. Killing a pet seems very hasty to me.
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Oct 7, 2014 20:11
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What's the current news on EV-68 and Chikungunya? At the moment, i'm far more afraid of those and West Nile than I am of ebola, especially as Chikungunya and WNV are both mosquito spread, and aint no stopping those things. And as someone whose had a relative with Malaria and Dengue (poor guy, did two tours of the peace corps, both got cut short by tropical diseases) something that's "worse" than either like Chikungunya has me scared shitless. Right now, i'd say that would be the biggest fear with an ebola mutation. Not it becoming airborne (masks do just fine stopping airborne things like SARS, and still require being in proximity to someone who's infected, so isolation will still prevent spread), but if it mutates to use mosquitos as a vector, that's it, we're hosed.
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Oct 7, 2014 20:38
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Good CDC presser, hopefully there will be a transcript up soon.
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Oct 7, 2014 20:38
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AA is for Quitters posted:What's the current news on EV-68 and Chikungunya? At the moment, i'm far more afraid of those and West Nile than I am of ebola, especially as Chikungunya and WNV are both mosquito spread, and aint no stopping those things. I'm a current peace corps volunteer in the Caribbean and Chikungunya is everywhere. It seemed like every other person on the island had it at some point in September. I don't think I've gotten it yet, but if I did it was super mild. It's not really something to worry about. Yea you'll be in a lot of pain but it usually stops after a week. It only really sucks for older people who can have muscle and joint pains for weeks or even years after recovering from the disease. Also, I've heard that once you get it you can't get it again, which is nice. So a part of me just wants to get it over with so that I can stop thinking that I'm about to get it every week. Also, the people on my island are going crazy about ebola. There is a large medical school here with a small amount of African students and professors. Apparently a Nigerian guy landed on the island yesterday and all sorts of stupid rumors are spreading about him possibly having ebola. The chances of anyone coming over with ebola are super low but this tiny island would have a really hard time dealing with it if it did somehow make its way over.
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Oct 7, 2014 20:56
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AA is for Quitters posted:What's the current news on EV-68 and Chikungunya? At the moment, i'm far more afraid of those and West Nile than I am of ebola, especially as Chikungunya and WNV are both mosquito spread, and aint no stopping those things. And as someone whose had a relative with Malaria and Dengue (poor guy, did two tours of the peace corps, both got cut short by tropical diseases) something that's "worse" than either like Chikungunya has me scared shitless. How you can be less worried about a disease that's projected by the CDC to kill up to 10% of the population of entire countries by next January than two diseases limited by mosquito vectors with very, very low mortality rates?
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Oct 7, 2014 21:05
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I would trust whatever MSF is doing over anyone else at this point because so far they're the only ones who haven't been incredible fuckups. They're the ones who went in at the start and were hammering at everyone they could saying this was a Big Deal and people needed to start dealing with it immediately, and everyone else said said LALALALALALALALA NOTHING BAD WILL HAPPEN
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Oct 7, 2014 21:10
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One of the things that Dr. Frieden discussed in the CDC press conference was that infections of healthcare workers have primarily occurred when the healthcare center is either unfamiliar with dealing with Ebola or overwhelmed and that fatigue is a large risk for healthcare workers. The CDC recommends limiting doctors to 4-6 weeks of frontline treatment because fatigue sets in and mistakes happen. This in itself is a reason why closing international borders would only worsen the crisis.
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Oct 7, 2014 21:16
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AA is for Quitters posted:What's the current news on EV-68 and Chikungunya? At the moment, i'm far more afraid of those and West Nile than I am of ebola, especially as Chikungunya and WNV are both mosquito spread, and aint no stopping those things. And as someone whose had a relative with Malaria and Dengue (poor guy, did two tours of the peace corps, both got cut short by tropical diseases) something that's "worse" than either like Chikungunya has me scared shitless. I wouldn't worry about vector transmission as a possibility even through mutation. Filoviruses appear to be mammal only viruses. http://www.biomedcentral.com/1471-2148/10/193 http://jid.oxfordjournals.org/content/179/Supplement_1/S127.full quote:Turell et al. [8] reported that EBO virus, subtype Reston (EBO-R), failed to replicate in Culex or Aedes mosquitoes and in Ornithodoros ticks. Also tissue tropism limits host possibilities for viruses. http://www.ncbi.nlm.nih.gov/books/NBK8149/
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Oct 7, 2014 21:24
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AA is for Quitters posted:What's the current news on EV-68 and Chikungunya? I thought this was pretty fascinating -- obviously it's completely anecdotal information that was posted on a bullshit libertarian blog, but still pretty interesting. (I don't read dailypaul; found this while googling "ebola lysine" for any connections since I know lysine is a cheap antiviral with efficiency against a bunch of things that are totally not ebola, and was curious if any research had been done): http://www.dailypaul.com/324049/the-virus-chikungunya-lysine-and-a-possibility-of-reducing-the-mortality-rate-of-ebola quote:After NUMEROUS over 30, success stories, I learned how to fine tune the Lysine for maximum effectiveness. I had only one mild failure, but quickly learned what we did wrong. The trick with the other people. The earlier the better. If they take the pill in the first 6-12 hours, the symptoms in many cases dissapeared, after 12-24 hours, it stopped the symptoms from worsening. It came to a platau. After 24 hours, seemed to be least effective. Only 2 out of 7 did it really help lowering the symptoms. Bad news was, it worked well but if you waited to long, and the rash broke out, Lysine did not seem to help the rash. PEOPLE who took the lysine early, NONE came out with the rash.
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Oct 7, 2014 21:36
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We were all thinking it right? http://pix11.com/2014/10/07/former-sc-gop-director-ebola-patients-should-be-put-down-immediately/ quote:A prominent pro-life Republican in South Carolina has a plan to stop an Ebola outbreak in the United Nations.
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Oct 7, 2014 21:40
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Todd Kincannon is a professional twitter troll.
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Oct 7, 2014 21:43
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Trabisnikof posted:We were all thinking it right? Wow. That's the most southcarolina.txt thing that I've read in years.
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Oct 7, 2014 21:44
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Ebola Roulette posted:I wouldn't worry about vector transmission as a possibility even through mutation. Filoviruses appear to be mammal only viruses. Ya, mosquito transmission isn't a simple deal. Chik infects the mosquito (not just hangs out in the blood it ate). It even replicates best in the salivary glands, facilitating transmission. Ebola won't do that any time soon (until the governments that are responsible for engineering it add those genes (haha))
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Oct 7, 2014 21:47
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Zeroisanumber posted:Wow. That's the most southcarolina.txt thing that I've read in years. motherfucker gets quoted once every 3 months or so in all the general threads in D&D. He is basically Rush Limbaugh on Twitter. Note the "former" qualification of his title, even the party doesn't want anything to do with him. That said he is sadly representative in a blatant fashion of a whoooole lot of the more PR-savvy assholes running this state. Has the article about charging TED with the crime of getting sick been posted here yet? What's the Very Serious People line on demanding that everyone become dispassionate zombies as well as virologists? Edit again: I reckon this is old news by now. Texas, y'all. Gunshow Poophole fucked around with this message at 22:00 on Oct 7, 2014 |
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Oct 7, 2014 21:47
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whitey delenda est posted:motherfucker gets quoted once every 3 months or so in all the general threads in D&D. He is basically Rush Limbaugh on Twitter. Note the "former" qualification of his title, even the party doesn't want anything to do with him. Ebola is great because it's basically a "black" disease so you can say stuff like "execute every person who gets it" and you can wink and nod at your audience and they will all get it. It's like AIDS in the 80s and how we didn't care until we discovered straight people could get it, too.
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Oct 7, 2014 22:02
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[s]Sheng-ji Yang posted:How you can be less worried about a disease that's projected by the CDC to kill up to 10% of the population of entire countries by next January than two diseases limited by mosquito vectors with very, very low mortality rates? Because as an american, those are two that are far more likely to infect me/people i care about? Let's face it, in a country where isolation units are a thing, and HCW's don't have the extreme fatigue that they're suffering in africa due to being so short-staffed, transmission here is going to be next to nil. See: the dude in texas, who managed to not infect a single person. The reason why it's spreading like wildfire in africa is entirely due to them just being so overwhelmed by the proportions of things, and not being able to get a response scaled up in time, by the time they started sending in huge chunks of HCW's, poo poo had already hit the fan in Africa. See: how well Nigera got a handle on things, due to it having a more adequate response/more adequate health care than "the village healer". Libera's still reeling from a civil war that has devastated the country over the past few decades, Sierra Leone has never been on the forefront of things, and both of those countries were not at all prepared for any sort of outbreak of anything. Even a rotavirus outbreak would have taxed their healthcare systems, they just aren't set up for controlling epidemics. I'd hardly call anything spread by mosquitos as limited though, given how quickly mosquito-based diseases spread.
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Oct 7, 2014 22:03
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Tim Raines IRL posted:I thought this was pretty fascinating -- obviously it's completely anecdotal information that was posted on a bullshit libertarian blog, but still pretty interesting. (I don't read dailypaul; found this while googling "ebola lysine" for any connections since I know lysine is a cheap antiviral with efficiency against a bunch of things that are totally not ebola, and was curious if any research had been done): Not to be a dick, but the anti-viral properties of lysin are not well supported by the literature. Moreover, someone proscribing lysin "treatments" for viral infections are pretty much direct proof that your dealing with an alternative medicine practitioner, colloquially known as a quack. I think you have been had by someone. Please don't ever self medicate chikungunya or even ebola with lysin.
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Oct 7, 2014 22:03
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IAMNOTADOCTOR posted:Not to be a dick, but the anti-viral properties of lysin are not well supported by the literature. Moreover, someone proscribing lysin "treatments" for viral infections are pretty much direct proof that your dealing with an alternative medicine practitioner, colloquially known as a quack. I think you have been had by someone. er, the vibe I got from the blog post was that it was people with no better alternatives trying anything that might or might not help. As for the antiviral properties of Lysine, there's strong evidence for efficiency against herpes viruses in felines, and my personal experience is that if I start taking it the second I notice that I'm getting a cold sore, I don't go on to develop a cold sore. I realize that's equally anecdotal bullshit, but I think I was pretty explicit about pointing this out as a point of curiosity only, and was not at all suggesting that people stop going to doctors or something. I definitely was not trying to imply that this was established medical wisdom, and of course I realize that there are huge differences between herpes viruses in cats, people, and ebola viruses anywhere at all.
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Oct 7, 2014 23:16
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bassguitarhero posted:It's like AIDS in the 80s and how we didn't care until we discovered straight people could get it, too. loving AIDS. Something that started as a gay disease is suddenly killing a ton of people in Africa, and regardless of whom died in the US, gently caress Africa was the public ideal. I'm not even kidding about this, this idea still exists today. People that die from AIDS deserve it, so if Africa has a lot of people dying from AIDS, they deserve it. When things calmed down a bit, we heard about killing infants and albinos and other things. Everyone in Africa was killing and eating infants and albinos. The public dialogue today about Ebola is not much different, and it will get much much worse.
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Oct 7, 2014 23:48
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Tim Raines IRL posted:er, the vibe I got from the blog post was that it was people with no better alternatives trying anything that might or might not help. As for the antiviral properties of Lysine, there's strong evidence for efficiency against herpes viruses in felines, and my personal experience is that if I start taking it the second I notice that I'm getting a cold sore, I don't go on to develop a cold sore. I realize that's equally anecdotal bullshit, but I think I was pretty explicit about pointing this out as a point of curiosity only, and was not at all suggesting that people stop going to doctors or something. Did not attack you, more so lysine and the guy in your post yelling that anyone should buy lysine for every sniffle. I'm not very qualified to discuss Lysine in felines, though I must admit that a cursory glance over the reported trials in felines does no yield strong evidence of efficacy: two very small trials ( 8 and 14 cats). The trial with 14 cats found no significant difference in symptoms, only in viral shedding. The trial with 8 cats found a difference in symptoms but not viral load, naturally statistics on this small sample size are not possible. Not a strong evidence basis at all in my non veterinarian opinion. No effect for lysine was found in felines with a respiratory viral infection. In humans the results are pretty clear cut that in placebo controlled trials lysine is not effective in treating or preventing cold sores( Have a Lancet publication http://www.sciencedirect.com/science/article/pii/S0140673678916586) What you experience with lysine is the placebo effect coupled with conformation bias. Does not mean your dumb, only human.
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Oct 7, 2014 23:56
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The complaints that Ebola PPE in Spain were inadequate are coming from the healthcare workers' union. The Guardian again again quote:Several associations representing health professionals in Spain painted a picture of a healthcare system reeling from cutbacks, drastically underfunded to tackle the challenge of Ebola, and led by a health ministry creating policy on the fly. The article also mentions that the sick nurse changed the patient's nappy (diaper), so that's a high-risk exposure right there. edit: Whoops, missed a bit. quote:Spanish health authorities said medics treating Ebola patients in Spain followed the protocols laid out by the World Health Organisation, but their claims were widely disputed. While level 4 protective equipment is required to attend to Ebola patients, healthcare workers in Spain who treated the missionaries had only level 2 equipment, said Juan Carlos Mejias, of Satse, a union that represents nurses. “Level 4 is what’s being used in other European countries.” Arsenic Lupin fucked around with this message at 00:31 on Oct 8, 2014 |
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Oct 8, 2014 00:22
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So, yesterday Sierra Leone's website was down.....and its up today but its missing the last 4 Sitreps.
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Oct 8, 2014 00:43
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Someone probably got in trouble for telling the truth and posting that huge death total for the 5th.
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Oct 8, 2014 00:50
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Arsenic Lupin posted:The complaints that Ebola PPE in Spain were inadequate are coming from the healthcare workers' union. That looks bad, I do agree that based on the little information we have this patient should have been seen ASAP and earlier then has been done now. I hope that this crisis increases the funding for healthcare in Spain, but I'm biased on that department. Regarding the level of PPE, I must be and idiot but I really don't know what the level 2 and 4 she is referring to mean. Anyone got an idea?
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Oct 8, 2014 00:54
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 Ebola doggie. I wonder if Spain goes through with killing it, it seems like people are getting pretty worked up over it, at best the optics are really poor if they don't put it in isolation for a while and test it.
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Oct 8, 2014 00:59
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