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My Imaginary GF posted:This was stepped back, presumably after the electronic medical records company sent a very polite letter to the hospital. The nurse and doctor were both aware of travel history to West Africa. It was stepped back but it also doesn't say the doctor was aware of the travel history. Sounds like the travel history was available and the doctor didn't check that page or something similar. quote:We would like to clarify a point made in the statement released earlier in the week. As a standard part of the nursing process, the patient's travel history was documented and available to the full care team in the electronic health record (EHR), including within the physician's workflow. The key word here is available, which implies it was there but not seen. Still a gently caress up of risk management.
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Oct 10, 2014 02:21
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axeil posted:I think "you should care about Ebola in West Africa because the outbreak there has already impacted the world economy" is a fairly relevant post but don't look at me I'm just an economist. I think that's the difference between "an economist" and "The Economist." I can't wait until the Economist comes out with an article about the price of bananas and lead with a para about a young belgian family trying to eat healthy on a budget, followed by scenes of burning corpse-ditches in Liberia. And then the article vanishes the next day.
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Oct 10, 2014 02:22
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"This book on the Great Ebola Pandemic of 2014-2016 focuses too much on the millions of deaths caused by the disease and not enough on the economic ramifications it had on my portfolio!"#EconomistBookReviews
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Oct 10, 2014 02:25
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My Imaginary GF posted:This was stepped back, presumably after the electronic medical records company sent a very polite letter to the hospital. The nurse and doctor were both aware of travel history to West Africa. I'm curious when this was, because it contradicts what I'd heard from the horse's mouth, as it were.
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Oct 10, 2014 02:26
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Discendo Vox posted:I'm curious when this was, because it contradicts what I'd heard from the horse's mouth, as it were.
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Oct 10, 2014 02:28
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Discendo Vox posted:I'm curious when this was, because it contradicts what I'd heard from the horse's mouth, as it were. The day after the first announcement. E: New Division posted:"This book on the Great Ebola Pandemic of 2014-2016 focuses too much on the millions of deaths caused by the disease and not enough on the economic ramifications it had on my portfolio!"#EconomistBookReviews "Each death in West Africa raises the marginal cost of labor in America without concurrent productivity increase. Therefore, it is the editorial opinion of The Economist that Ebola must be stopped in West Africa last month. No expense should be spared for this affect." My Imaginary GF fucked around with this message at 02:33 on Oct 10, 2014 |
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Oct 10, 2014 02:31
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My Imaginary GF posted:The day after the first announcement. Yeah, so I'm not particularly confident in that walkback being accurate, then- I heard it was a systems problem on Monday from someone who couldn't afford to lie about it. My guess is that the entered information was available in the EHR, but the flag condition wasn't set properly. That would make the walkback technically accurate, but also fit what I was told. It's possible this person hadn't heard the new explanation for what happened 9it's not their department), but that would be unlikely. Discendo Vox fucked around with this message at 02:43 on Oct 10, 2014 |
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Oct 10, 2014 02:33
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As it stands the hospital has gone back to giving no reason for the fuckup:quote:The hospital said it also wanted to “correct some misconceptions that have been reported about Mr. Duncan’s first visit.” He was taken to Presbyterian on Sept. 25 with a mild fever and complaining of stomach pain. He was given antibiotics and sent home.
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Oct 10, 2014 02:34
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Discendo Vox posted:I'm curious when this was, because it contradicts what I'd heard from the horse's mouth, as it were. According to the article, it would have been on Friday 3 October that the hospital released their clarification of there not being a flaw in recordkeeping or procedure adherence. Again, a failure to be proactive. They were likely unaware by fault of ignorance and sent an Ebola patient home because nobody was clued in to the travel history despite it being on the screen and/or in the chart, available to the provider as well as the nurse, because they weren't in the habit of checking for that risk factor. Despite being in a large city and Ebola being a news item.
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Oct 10, 2014 02:34
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El Pais, my terrible translation with a big assist from Google Translate The Ebola patient gets worse after overcoming respiratory failure (dated 9 OCT 2014 - 21:39 CEST [9:30 AM EDT]) [bits and pieces, all paraphrased unless in quotation marks] Teresa Romero's health got worse on Thursday. "Yesterday morning [Wednesday?] she was on the verge of respiratory failure, according to hospital sources, after having spent the previous day calm and without fever in her room." Her brother says that her condition has worsened. Lots of people in authority used phrases like "serious", "her life is at high risk", "serious condition", and "critical". [I have no idea what the medical terms and divisions between conditions are in Spanish. The nurses' union were the ones who described her condition as Spanish 'grave', colloquially translated as 'serious', which may not be the same 'serious' as in English medial terms.] "They didn't have to intubate, said her brother José Ramón, nor did she have multiorgan failure yesterday [again Wednesday], but the situation may change in a few hours (the crisis that killed Garcia Viejo [one of the missionaries] lasted about three hours). In this situation, the doctors decided to add another experimental drug treatment, reports Emilio de Benito. This is similar to Zmapp serum, i.e. a serum with compounds that bind to the virus, and increase the efficiency of the immune system to destroy the patient." "Counting this, there are now three experimental therapies being tested in the case of Romero. From the beginning they've been giving her managing a broad spectrum antiviral, Favipiravir, that had never been tested in people, but does seem to work in mice. In addition, they are providing sera of patients who have overcome the disease, with the idea of using the antibodies to fight the virus. " "Besides Romero, 13 others who were in contact with her are currently in the Hospital Carlos III: Her husband, ten health professionals, and two hairdressers, all asymptomatic. On Thursday evening, seven new patients were put under observation and one was discharged after negative test results." [I think the total of 13 was before the 7 new patients were admitted, but I'm not certain; it boils down to which English tense "están ingresadas" corresponds to in this particular case.] "The people who are being monitored include two nurses from the team who treated the two missionaries (now deceased), and several doctors who had contact with Romero when she had symptoms but was not diagnosed. In the morning, a resident of the Emergency Hospital Alcorcón. In the afternoon, an emergency service doctor 112 Summa [?]. None of these had symptoms, all are considered to have had 'high-risk contacts'." The trade union is angry that Romero was pressed to make a statement about how she was contaminated, and question whether the doctor who interviewed her was authorized to do so. The spokesman questions how much weight to give a statement that she made when sick and feverish. What she said in Spanish was "pudiera ser que me tocara la cara," [Note that this is in the Spanish subjunctive tense, which can be used to cast doubt on whether an event actually happened, to posit a hypothetical, among many other things. One literal translation is "it could be that I touched my face".] The spokesman points out that this doesn't mean that she's sure that's what happened. "On Thursday afternoon, the Carlos III patients were distributed in two floors. The sixth floor is for the two nurses, a man and a woman, who actually treated the dead missionaries. In the fifth, which was cleared Wednesday of other patients, are isolated four doctors who had contact with her, as well as the husband of the patient. None of these five people have shown symptoms. As of late yesterday [again Wednesday] they were waiting for the results of the first Ebola test on the nurses; if those results give the expected positive, they should be confirmed with a second test." "Although in principle she did not detect any irregularity in the protective suit, Romero yesterday told El Pais that the contamination could have occured when the overalls were removed after the last visit to García Viejo: "I think the mistake was in removing the suit. I see it as the most critical moment, in which it could have happened, but I do not know for sure. "
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Oct 10, 2014 02:48
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I wonder if a medial draft has been discussed by the serious people in charge yet. Like at what point they have to start considering one. I'd bet it has at least come up.
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Oct 10, 2014 02:51
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La Vanguardia, updated 1AM CEST Friday / 4PM EST Thursday.Raw Google Translate posted:Madrid, (Efe) .- The nursing assistant Teresa Romero , the first patient of Ebola infected in Europe is in a "very critical" situation, as reported by the Minister of Health of the Community of Madrid, Javier Rodriguez. During an interpellation in the Madrid Assembly, the Minister has realized the health of Romero , following criticism of the three opposition parties to its management in this case.
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Oct 10, 2014 02:59
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ReidRansom posted:I wonder if a medial draft has been discussed by the serious people in charge yet. Like at what point they have to start considering one. I'd bet it has at least come up. Its a good idea and personally I would volunteer (although I doubt they would accept me and I would not blame them) but in my probably wrong opinion enacting this would have a very serious risk of starting actual civil insurrection. Cliven Bundy was done to save some cows. And those people were dead serious about going down as martyrs in the first battle of the 2nd American Civil War. Forcing people to join the NWO's world army to go get infected with government created Ebola as part of Agenda 21's population reduction plan? That's like the rapture for these people. It would be their destined holy hour to stand up for 'Murica or die a patriot.
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Oct 10, 2014 03:04
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ReidRansom posted:And not a single person said it's time to hide in the woods. What people are and have been saying is to not be surprised at the domino effects if and when it gets worse. What that means for any individual person depends on their particular situation. Let's be honest, if Ebola spreads in a first world nation, there isn't much to be done for you either way. There's not 5000 beds in special biohazard level 5 wards. The best bet nations like America is to contain it as soon as possible so that it doesn't spread. But if that is somehow bungled, it's not going to be all that different from Liberia. The Chimerix drug apparently doesn't work, there's no more ZMapp, and I can't imagine the special containment wards can hold more than a couple of dozen people max.
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Oct 10, 2014 03:13
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Vladimir Putin posted:Let's be honest, if Ebola spreads in a first world nation, there isn't much to be done for you either way. There's not 5000 beds in special biohazard level 5 wards. The best bet nations like America is to contain it as soon as possible so that it doesn't spread. But if that is somehow bungled, it's not going to be all that different from Liberia. The Chimerix drug apparently doesn't work, there's no more ZMapp, and I can't imagine the special containment wards can hold more than a couple of dozen people max. Are you seriously implying the US couldn't isolate 5,000 patients? Because you're in fact very wrong. Besides, you don't need fancy biohazard wards for Ebola, only private rooms. The
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Oct 10, 2014 03:19
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Trabisnikof posted:Are you seriously implying the US couldn't isolate 5,000 patients? Because you're in fact very wrong. Besides, you don't need fancy biohazard wards for Ebola, only private rooms. To me it sounds like if the CDC has to keep track of several hundred people with confirmed Ebola and all their 1st, 2nd and 3rd degree contacts, then it's already a monumental task. I think if it grows into the thousands, it will basically be out of control.
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Oct 10, 2014 03:25
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New York Times, paywalledThe good bits version posted:The deterioration in the nurse’s condition came as the authorities announced that one more health care worker had been quarantined, in addition to three others who were isolated overnight at the same hospital where the nurse works. Moved up from much, much later in the article: quote:Criticism has centered on just why the medical team that treated Ebola patients included people with relatively low qualifications, like Ms. Romero, who volunteered, and why such staff members were then handed risky duties that involved direct access to the patient, including the removal of infected material from his room. So she isn't a nurse. She's a nurse's aide. quote:
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Oct 10, 2014 03:25
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Vladimir Putin posted:To me it sounds like if the CDC has to keep track of several hundred people with confirmed Ebola and all their 1st, 2nd and 3rd degree contacts, then it's already a monumental task. I think if it grows into the thousands, it will basically be out of control. No. The CDC only has to track 1st degree contacts. You can't get Ebola from someone who is not infected with Ebola.
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Oct 10, 2014 03:31
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Trabisnikof posted:No. The CDC only has to track 1st degree contacts. You can't get Ebola from someone who is not infected with Ebola. No, it tracks multiple degrees of contact, the 1st degree most closely, but it has to keep track of multiple degrees of contact. If the 1st degree contact turns out to be infected, the 2nd degree contacts become 1st degree ones and so on.
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Oct 10, 2014 03:34
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By the time Ebola got to 100 cases in America, everyone would be wearing PPE as casual wear.
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Oct 10, 2014 03:37
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Vladimir Putin posted:No, it tracks multiple degrees of contact, the 1st degree most closely, but it has to keep track of multiple degrees of contact. If the 1st degree contact turns out to be infected, the 2nd degree contacts become 1st degree ones and so on. No that's not how infection works. Ebola is not transmissible until symptomatic so only after that 1st degree contact has symptoms does contract tracing need to be run. For example, even if the whole family of Duncan's gets Ebola, they will not need to run down everyone they have interacted with since Duncan got sick, only interactions since they were symptomatic. If 1st degree contacts are isolated, which is relatively easy in our semi-police state, then no new contacts need to tracked if the 1st degree contacts contract.
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Oct 10, 2014 03:38
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Trabisnikof posted:No that's not how infection works. Ebola is not transmissible until symptomatic so only after that 1st degree contact has symptoms does contract tracing need to be run. The CDC seems to be tracing some second degree contacts for reasons that aren't exactly clear (wild rear end guess, they might be worried about second hand contact to infectious materials), but this is largely correct. Tracing contacts of contacts of contacts is really pointless.
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Oct 10, 2014 03:55
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Arsenic Lupin posted:The nurses' union were the ones who described her condition as Spanish 'grave', colloquially translated as 'serious', which may not be the same 'serious' as in English medial terms.
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Oct 10, 2014 03:57
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England Sucks posted:South America should be easy to avoid. There are no direct flights between it and West Africa, the countries there do little if any business with Africa. If anything they'll shut down all flights to Africa. The only way it's going to spread is through indirect travel through Europe and North America. Someone has completely forgotten about Cuba, which has a ton of medical professionals in ebola-stricken countries right now, has a long history of sending doctors all over and of training a lot of South American doctors as well as having extensive trade with several South American countries.
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Oct 10, 2014 04:02
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Prester John posted:Its a good idea and personally I would volunteer (although I doubt they would accept me and I would not blame them) but in my probably wrong opinion enacting this would have a very serious risk of starting actual civil insurrection. Cliven Bundy was done to save some cows. And those people were dead serious about going down as martyrs in the first battle of the 2nd American Civil War. Forcing people to join the NWO's world army to go get infected with government created Ebola as part of Agenda 21's population reduction plan? That's like the rapture for these people. It would be their destined holy hour to stand up for 'Murica or die a patriot. A libertarian friend of mine thinks that this is a ploy from Obama to extend his term under some emergency powers or whatever and also that this demonstrates the failure of Keynesian economics.
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Oct 10, 2014 04:03
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Vladimir Putin posted:Let's be honest, if Ebola spreads in a first world nation, there isn't much to be done for you either way. There's not 5000 beds in special biohazard level 5 wards. The best bet nations like America is to contain it as soon as possible so that it doesn't spread. But if that is somehow bungled, it's not going to be all that different from Liberia. The Chimerix drug apparently doesn't work, there's no more ZMapp, and I can't imagine the special containment wards can hold more than a couple of dozen people max. Ok, earlier today I posted something where didn't appreciate how much different Liberia is from the U.S., but there are a number of reasons to think that spread in the U.S. wouldn't be like in Liberia. I posted this earlier, but parts of Monrovia have sanitary conditions that really don't compare to anything in the U.S. - one toilet or tap per thousands of population. Sewage collects in low-lying spots and has to be pumped out by truck. The average household is 5.1 persons compared to 2.55 for the U.S. For a combination of reasons, handwashing is uncommon. And Liberia has between 1/3 and 1/4 the hospital beds per person the U.S. does. For all of the awful conditions on the ground there, the average infected person has infected 1.8 additional people. If you don't think that curve would be significantly less steep in the U.S., I don't know what to tell you.
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Oct 10, 2014 04:03
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CSPAN Caller posted:By the time Ebola got to 100 cases in America, everyone would be wearing PPE as casual wear.
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Oct 10, 2014 04:12
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CSPAN Caller posted:By the time Ebola got to 100 cases in America, everyone would be wearing PPE as casual wear. Thought experiment: An outbreak of 100 cases could potentially save more lives from infective diseases than ebola would kill. It would make people more germ conscious and help remove the stigma of wearing masks in public. Most importantly, people who voluntarily go to work while sick would get added pressure to stay the gently caress home.
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Oct 10, 2014 04:14
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Reordered this telegraph article on the Briton in Skopje to read from top down: http://www.telegraph.co.uk/news/worldnews/ebola/11152472/Briton-dies-of-Ebola-in-Macedonia-live.html 19:11 posted:More from Reuters on the British man with symptoms of the Ebola virus who has died in Macedonia: 20.10 posted:An official has said tests will be carried out on the body of a British business traveler who died in Macedonia to see if he had the Ebola virus, AP reports. 20.32 posted:Further confusion has emerged over how - and more specifically, where - the 'Briton' who has reportedly died of Ebola in Macedonia may have contracted the virus. 20.46 posted:A Public Health Center vehicle is parked in front of the Macedonia hotel where a 58-year-old man, reported to be British, was taken to hospital and died of severe internal bleeding from what may have been Ebola, in Skopje: 21.40 posted:Sources in the Macedonian government say the British man who died in Skopje had hemorrhagic fever but likely not to be Ebola. A second man has been admitted to hospital, however neither have visited Africa recently. 23.00 posted:Public Health England has said it believes the death of a British man in Macedonia is "unlikely" to have been caused by Ebola, despite some similar symptoms.
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Oct 10, 2014 04:14
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MaximumBob posted:Ok, earlier today I posted something where didn't appreciate how much different Liberia is from the U.S., but there are a number of reasons to think that spread in the U.S. wouldn't be like in Liberia. I posted this earlier, but parts of Monrovia have sanitary conditions that really don't compare to anything in the U.S. - one toilet or tap per thousands of population. Sewage collects in low-lying spots and has to be pumped out by truck. The average household is 5.1 persons compared to 2.55 for the U.S. For a combination of reasons, handwashing is uncommon. And Liberia has between 1/3 and 1/4 the hospital beds per person the U.S. does. Here's an arxiv paper on R0 during this particular outbreak: http://arxiv.org/pdf/1408.3505v4.pdf These numbers seem about right. A doubling every 21 days on a disease with an incubation period of ~5-15 days indicates a Ro a bit under 2.
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Oct 10, 2014 04:14
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The Onion has a FAQ about ebola: http://www.theonion.com/articles/what-you-need-to-know-ebola,37137/ quote:How dangerous is Ebola? Meatwave fucked around with this message at 04:21 on Oct 10, 2014 |
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Oct 10, 2014 04:17
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AstheWorldWorlds posted:A libertarian friend of mine thinks that this is a ploy from Obama to extend his term under some emergency powers or whatever and also that this demonstrates the failure of Keynesian economics. I want to say it was Alex Jones I heard on the radio say the same thing about Bill Clinton in 1999. Not about Ebola, but the emergency extension of powers thing.
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Oct 10, 2014 04:19
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Meatwave posted:The Onion has a FAQ about ebola: Given The Onion's frequent accidental prescience...
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Oct 10, 2014 04:28
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Meatwave posted:The Onion has a FAQ about ebola: How do you contract Ebola? Ebola is contracted through contact with a health care system that vastly overestimates its preparedness for a global pandemic.
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Oct 10, 2014 04:35
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In case anyone missed it, last week there was another good Onion ebola article: How To Protect Yourself Against Ebola http://www.theonion.com/articles/how-to-protect-yourself-against-ebola,37085/
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Oct 10, 2014 04:42
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Grouchio posted:Who's the quack who just said that Ebola's bigger a challenge than AIDS? That's true though. AIDS is now something where people can live normal lifespans with medications (so long as the money's available). And spread of it is relatively easy to halt, as evidenced by how its prevalence hasn't gotten particularly worse in recent years. We don't have something like that for ebola. Prester John posted:Doesn't the majority of Coltan, a rare earth mineral that is vital for computer chips, come from Africa? Also I think a sizeable chunk of the worlds copper, a huge portion of its rubber, and a not insignificant amount of oil etc etc? I'm no expert but I am under the impression that though the various African economies are small in terms of dollars that is mostly because the West vastly underpays them for what are some incredibly important raw materials. Yeah, maybe the stock market isn't going to fall because the economy of the DRC collapsed. But if Goodyear had to suddenly start rationing tire sales well..... You... you do know that 2/3 of global rubber usage is synthetic rubber right, particularly in mass market tires? And that copper is so recyclable and high value people steal it from vacant lots constantly, let alone straight up selling it for scrap? You misunderstand the vulnerability of these resources. It is no longer WWII so loss of access to a portion of global natural rubber isn't the economy risker it used to be. ComradeCosmobot posted:I think the scenarios discussed in this thread (workaholic culture esp. in customer-facing positions, the indigent, lovely handling of patients within health care systems, the fact that health care workers are among my those at highest risk leading to increased propensity of health care system collapse and concomitant accelerated infection rates, etc.) disprove any argument that the first world won't sustain a pandemic. Yes because everyone's going to hang out at the lovely retail store where the ebola guy's still working the counter instead of going to the next store over where the super sick dudes get fired. Arsenic Lupin posted:New York Times, paywalled Just FYI: all NY Times articles that appear in press and are less than about 15 years old are unpaywalled as long as the viewer clicked a link from somewhere else.
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Oct 10, 2014 05:33
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Regarding Nigeria: http://leadership.ng/news/386602/ebola-scare-1332-nigerian-soldiers-quarantined-liberia 1,332 Nigerian soldiers under quarantine for contact with fatal Sudanese ebola case in Liberia.
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Oct 10, 2014 05:49
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My Imaginary GF posted:Regarding Nigeria: That's quite the quarantine for one dude.
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Oct 10, 2014 05:57
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My Imaginary GF posted:Regarding Nigeria:
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Oct 10, 2014 06:03
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Meatwave posted:That's quite the quarantine for one dude. I'm unfamiliar with the exact rituals related to Eid, I'd imagine laying on hands may be apart of them. In Guinea, the story of one village of 500~ individuals and spread of Ebola: From 19 August, reports of "18 or more deaths" From 16 September, reports of "more than 60 deaths" http://www.africaguinee.com/articles/2014/10/09/ebola-en-guinee-comment-le-virus-s-est-propage-dans-le-village-de-n-zenie http://guineematin.com/?p=4155 Known import of index case in June, more than 60 bodies by 16 September. Calculate your amateur R0 from there.
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Oct 10, 2014 06:09
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