Ebola Patient to be treated in Atlanta

[ladyaudley]

Do you have a source asserting this outbreak is less deadly?

If you watch the "Ebola explained in 60s" video on the page you have linked, it tells you the current outbreak is killing 6 out of 10 patients. Which is 60%.

It looks like the Sierra Leona Commonwealth Games team are set to stay here longer because they're afraid of going back now. Can't say I blame them and I hope they get permission.

[alba]

If you watch the "Ebola explained in 60s" video on the page you have linked, it tells you the current outbreak is killing 6 out of 10 patients. Which is 60%.

It looks like the Sierra Leona Commonwealth Games team are set to stay here longer because they're afraid of going back now. Can't say I blame them and I hope they get permission.

Okay, I never watch the videos because I have crap headphones. But I thought more highly of the BBC than to contradict itself on basic maths :roll:

Aye, I hope the athletes can stay here, too.

[Firiel]

...I think one of these patients has familial connections with the organization I work for. Or, at least, I know that a missionary in Liberia who has Ebola has a connection with us. Sounds like it might be the same person. I'll keep my eyes open for updates.

[Becket70]

There is a headline in The Onion that says the we are fifty white people away from a cure for Ebola. There probably is an element of truth to that statement. I think it is a good thing that they are bringing two Ebola victims here under strict control where physicians can properly support them and other scientists can learn as much as they can to, hopefully, combat the disease.

[apple1]

I am a long-time healthcare professional (clinical laboratory scientist).

AreteJo's post is correct.

It is absolutely impossible - logistically, resource-wise, cost-wise, etc, etc, to manage every hospital patient that has pneumonia, MRSA, influenza, even pertussis, etc, in the extreme-containment manner the Ebola patient will be managed.

If I were employed by Emory in Atlanta, I would get up and go to work every day, and it would worry me less than what I deal with every day.

I work in a pediatric facility that has a huge volume of outpatient services. Sick kids (with the usual viruses, Strep, flu, etc, all the way through vaccine-preventable illnesses in non-vaxed kids) are all over the place every day. Our infectious disease director has been known to tell employees that sick toddlers are little germ factories walking around spreading everything everywhere constantly (toddlers are not good at handwashing, not good at properly using tissues, not good at keeping their hands away from their nose that is streaming green snot, etc, etc, you get the picture).

I have had a really hard time staying healthy - I periodically catch the latest viral crap going around - in spite of my own frequent/obsessive hand washing, being careful what stair rail, door knob, elevator button, etc, that I touch.

Patient management of Ebola in the US will be NOTHING like handling ordinary - that we have hundreds of - patients.

Oh, one more thing: If it were your brother, or sister - wouldn't you want them to have the option of Emory's care?

[Mama Mia]

People are comparing apples to oranges when they are extrapolating a US Ebola outbreak to nosocomial acquired infections in the US. First of all, an Ebola patient will be in a room that has its own, independent air system. The laundry, the medical waste, EVERYTHING touching that patient will be destroyed in a seperate autoclave that is dedicated to that suite with the seperate air system from the rest of the building it is in. They will be pulling in nursing staff who are trained in level3 microbial containment, as well as cleaners who train and specialize for these tasks with the CDC. These are not the same people cleaning toilets for 7 dollars an hour in a hospital. The cleaners, the medical staff, anyone who will enter that room will have to gown aspetically. This is not the bs gowning in a NICU. You have to certify to gown this way, be able to put on a gown without touching the outside, cover every last area of your skin including your face, double glove, googles, space boots, the works. You are going through multiple air locks that are negative pressure to the outside, meaning air and particles stay IN the room with the patient. As you are leaving, you "take off" all your gowning in reverse, once again touching the outside of the gown only to grab the zipper with your double gloved hand, then go into the inner cuff of the outer gloves to remove them, then remove other pieces in sequence in the proper order and air locks.

I don't care what anyone saw in which movie. Sterile containment is grossly misrepresented in those movies. Hospitals have procedures to limit the spread of micro organisms, but it isn't anything like the sterile containment that will be dedicated to this case. It is highly specialized, technically difficult, and grossly expensive, which is why it is reserved for something with a 90% kill rate with no known drug cure.

Stop panicking and don't spread panic. Worry about the cases that could be around the world in 24 hour jet travel that are not being controlled in a CDC facility.

I truly am sorry for being snippy, but I have an EXCELLENT memory of the beginning of the AIDS outbreak. It is a big, fat, fucking lie to think only Republicans and Ronald Reagan said, "hey, it's too dangerous". Sophisticated, non God fearing liberals were proposing rounding up AIDS patients and forcing them into camp environments, because it was so deadly, there were no drugs, and people were that scared.

I would like to point out that my concern when commenting on hospital acquired infections is NOT with identified Ebola cases that are handled by the CDC. My concern is if someone shows up at a local ER and how it's handled BEFORE it's identified as Ebola.

At our local hospital, even after it was discovered that it was a hospital acquired pneumonia my dad had, the precautions were extremely spotty.

--The moved him to a different room in a part of the hospital, where I guess they were consolidating all of the patients who had been infected. You have to check in at a front desk when visiting anyone at the hospital, that would of been a good chance to tell visitors what was going on, they didn't.

---On the door they placed a sign saying visitors needed to don disposable protective gear before visiting. The sign didn't specify WHAT protective gear or WHY, just that it was a protection for communicable disease.

The first day we went to visit after the sign was up there was attached to the door a box of disposable gowns and gloves. Another day there were gowns and masks. At another visit there were all three, and hair covers. Different family members went to visit at different times, and would just put on whatever was on the door, because you would, naturally assume that whatever was there was what was required. Even when specifically ASKED the staff told us to use "whatever was there", even though that changed, randomly from visit to visit ( they weren't ratcheting up precautions, it would go up and down)

-- after visiting, we asked the nurse where to dispose of the items, the answer? " just find a trash can somewhere"

-- we assumed, at first, that the precautions were to protect my dad, who was going through chemo and radiation. He was unable to communicate very well at that time, being on deaths door and all, and was having a lot of trouble processing information and was confused, which the hospital staff was very well aware of. Yet no one thought to post something letting visitors know it was actually to protect US, and to limit any potential spread.

--- There were no restrictions put on physical contact with him, including things like wiping up saliva off his face, or taking a bloody Kleenex he had coughed into or anything else. Being as we assumed the protections were for him, due to his treatments, no one worried about doing these things. Even if the protective gear of the moment didn't include gloves or masks that day.

--- I'm immuno-compromised. Nobody thought to put up a sign or tell us as we came in that close contact might be a bad idea in that situation, and, again, no one thought it might be important for visitors to know the reason for the ( minimal, at best) precautions.

That is the sort of situation that worries me, and that's AFTER they knew they were dealing with a hospital acquired disease. If he had just showed up at the ER very I'll, but not knowing what the issue was, I can't imagine it would go well.

I really, really hope that people don't react to this the way they did to AIDs in the 80's, although I fear it will be worse, because of the Internet. Like I said I'm sure these high profile cases will be fine, I just hope local hospitals, especially in areas with a lot of international travel, get trained in spotting it and contacting the appropriate agencies immediately. It's extremely unlikely they'll ever encounter a case, but who knows, it might help them improve their current infectious disease procedures, which some of them desperately need to do anyway.

[louisa05]

It is important to remember that not every hospital is like your personal experience.

My father has been hospitalized twice during his cancer treatment when his white counts dropped to dangerous levels. Precautions were thorough and enforced.

[chaotic life]

Honestly, my son walked around in the community, hacking up a lung, for four years with known multiple drug resistant Psuedamonas. By the time he died, it had mutated to being resistant to Amikacin.

That sounds like nothing to most people, but let's just say anything you've been trained to fear about MRSA is child's play compared to what was in my child's lungs.

No one ever asked us to observe isolation precautions except around other Cystic Fibrosis patients. I was very careful to observe respiratory precautions if I *knew* we were around anyone immunocompromised. However, I am sure there were times I didn't know. I could not ask my community living, profoundly autistic son to mask up every time he left his home.

I hadn't been able to find which strain this current outbreak was. Given that BBC report, that seems to be confirming this is the Zaire strain, which historically has been a 90% fatality rate. The Uganda strain is typically a 50-60% fatality rate. Interestingly enough, the current outbreak is seeing a 60% fatality rate currently. So, if this is the Zaire strain, then the support and isolation efforts being done are phenomenal. Quite frankly, if that is the case, then the praise goes to both Doctors without Borders but also to Dr. Brantly who agreed to leave his family practice work he was doing in Monrovia and head up Liberia's ebola response and containment efforts.

Dr. Brantly is already at Emory now. The news is reporting that CDC is hoping to get Nancy Whitebol evacuated to Emory next week, but Dr. Brantly is there now. So, people are going to need to just get over the fear and prejudice on this. It's a done deal, and the response is the appropriate response for a US citizen and from an epidemiological perspective.

[Firiel]

They were who I thought they were. Nancy had been doing better, though she's not out of the woods yet. Her fever has been lower.

[Coconut Flan]

I'm a 1000 times more worried about the pre-schooler who coughs on or near me at Costco than I am about an Ebola patient being in Emory Hospital. One is a clear and present danger and the other will be handled with extreme protocols. Do I have a little thought about flying later this month and will I be zealous hand washing and using sanitizer? Yes.

[ViolaSebastian]

I have an honest (not snarky) question. How did these two contract ebola in the first place? Weren't they presumably educated and practicing the necessary precautions when they became infected?

[RachelB]

I have an honest (not snarky) question. How did these two contract ebola in the first place? Weren't they presumably educated and practicing the necessary precautions when they became infected?

I don't know the two people affected, but the Vox article talks about how it is much more tempting to skimp on necessary precautions when you're working in a facility that is not air-conditioned and located in a tropical climate. That protective gear is designed not to be breathable for safety reasons.

[apple1]

I have an honest (not snarky) question. How did these two contract ebola in the first place? Weren't they presumably educated and practicing the necessary precautions when they became infected?

The primitive areas they were in are unable to do rigorous isolation procedures. And in that environment, they sacrificed their own safety to care for those patients. That's the bottom line.

[ViolaSebastian]

Thanks, RachelB and apple1, that makes a lot of sense. In that context, it makes one realize the heroic nature of both Dr. Brantly and the aid worker involved in this scenario.

[chaotic life]

Whitebol is doing better because Dr. Brantley declined the only dose of the experimental medicine to treat Ebola and insisted the nurse get the serum. She is doing better, and he may have signed his own death sentence. Both are unbelievably heroic. It is the right thing to do to evacuate both of them (they hope to pick her up next week and get her to Emory as well) and to hope the available care at Emory can save both of them.

[naatashamaru]

i live 20 minutes away from Emory...i know they are in great hands but Hollywood has got me petrified and i honestly wished today that i don't die a virgin from getting Ebola...like i can't escape it on my fb newsfeed or my tv.... :pink-shock:

[Childless]

I'm very disappointed in Americans right now. What a bunch of cowards! They expect military soldiers to run off to foreign lands and put their lives at risk to protect American citizens, but they themselves go ballistic when asked to take a nearly non-existent risk to help those same citizens. Can people get anymore self-centered?

I have no qualms about bringing Ebola patients to the U.S. There's a bigger chance that some kid in my son's pre-school might spread SARS than one of these patients spreading Ebola. Hell, even someone with Ebola, but not yet symptomatic flying over on a commercial jet isn't likely to start a pandemic. People need to educate themselves before running around shouting that the sky is falling. They just make themselves look like fools. And uncaring ones at that.

[GeoBQn]

Whatever happened to SARS, anyway?

[Arete]

Thanks, RachelB and apple1, that makes a lot of sense. In that context, it makes one realize the heroic nature of both Dr. Brantly and the aid worker involved in this scenario.

I just wanted to add, as someone who has actually gowned this way and had to work in self contained environments, you are literally hermetically sealed in this type of gowning. Absolutely no skin is exposed to air. It can be extremely claustrophobic. Did I mention you will sweat like a PIG if the environment you are gowned in is not minutely controlled for temperature and humidity? It is an absolute testament to the work and dedication being provided by all the healthcare workers on the front line in Africa that not only are they doing the job, but so far only 2 have been infected. Like chaotic life, I have been looking at pictures of their gear. The gloves aren't up to the task, they don't have some crucial protection pieces they need, but they are using what they have and are treating the sick regardless. That is moral calculus, that is heroism.

[Ralar]

Brantly surprised all when he WALKED from an ambulance into the hospital. http://abcn.ws/1ktQt1N

[Guest]

I'm very disappointed in Americans right now. What a bunch of cowards! They expect military soldiers to run off to foreign lands and put their lives at risk to protect American citizens, but they themselves go ballistic when asked to take a nearly non-existent risk to help those same citizens. Can people get anymore self-centered?

I have no qualms about bringing Ebola patients to the U.S. There's a bigger chance that some kid in my son's pre-school might spread SARS than one of these patients spreading Ebola. Hell, even someone with Ebola, but not yet symptomatic flying over on a commercial jet isn't likely to start a pandemic. People need to educate themselves before running around shouting that the sky is falling. They just make themselves look like fools. And uncaring ones at that.

I think this is a bit exaggerated. I don't see anyone here here, or anywhere else for that matter, calling for the US to leave these patients to die in Africa. You have to admit, the news was a bit shocking at first, and many people had very legitimate concerns. Now that more information has become available about the precautions that are being taken to stop this disease from spreading, it is still a bit unsettling. It's like when you have to check behind the shower curtain when you enter the bathroom. Has there ever been an axe murderer in there waiting for you to brush your teeth before he axe murders you? No, but the infinitesimal chance that there is makes you uneasy.

People have been taught to fear disease, and rightfully so. There have been pandemics in human history that have wiped out large swaths of the population, and in the jet age, another one could spread so quickly. Ebola probably won't be that pandemic, based on the nature of the disease, but I don't think the fear of it makes us "uncaring fools" or "cowards."

[Onomatopoetikon]

I wouldn't be worried at all about a controlled situation like this, every single part of the process is tightly controlled and people are all aware of the dangers involved. If you're gonna worry about something, I'd worry about random people travelling from the affected countries to the US and other parts of the world, without any safety measures in place.

I hadn't been able to find which strain this current outbreak was. Given that BBC report, that seems to be confirming this is the Zaire strain, which historically has been a 90% fatality rate. The Uganda strain is typically a 50-60% fatality rate. Interestingly enough, the current outbreak is seeing a 60% fatality rate currently. So, if this is the Zaire strain, then the support and isolation efforts being done are phenomenal. Quite frankly, if that is the case, then the praise goes to both Doctors without Borders but also to Dr. Brantly who agreed to leave his family practice work he was doing in Monrovia and head up Liberia's ebola response and containment efforts.

From what I heard in an interview with a Norwegian woman from Doctors Without Borders who had helped set up a hospital in Sierra Leone (Ane Bjøru Fjeldsæter, she's a psychologist), before and during when they set up their hospital, people got very sick before they entered the hospital, so the death rate was very high (90%). But after their hospital was set up, they managed to get the death rate down to about 60% because people came in earlier, so those numbers make sense. This article seems to suggest that it's very likely that it's the EBOV (Zaire) strain of the virus, which yes, means that the efforts are phenomenal if they're getting the death rate down to 60%.

[Childless]

I think this is a bit exaggerated. I don't see anyone here here, or anywhere else for that matter, calling for the US to leave these patients to die in Africa. You have to admit, the news was a bit shocking at first, and many people had very legitimate concerns. Now that more information has become available about the precautions that are being taken to stop this disease from spreading, it is still a bit unsettling. It's like when you have to check behind the shower curtain when you enter the bathroom. Has there ever been an axe murderer in there waiting for you to brush your teeth before he axe murders you? No, but the infinitesimal chance that there is makes you uneasy.

People have been taught to fear disease, and rightfully so. There have been pandemics in human history that have wiped out large swaths of the population, and in the jet age, another one could spread so quickly. Ebola probably won't be that pandemic, based on the nature of the disease, but I don't think the fear of it makes us "uncaring fools" or "cowards."

You obviously haven't read the comments sections on news articles about these two aid workers being brought to the U.S. They are rife with cowardly and foolish panic. It's pathetic. And I stand by my statement that these same people have no problem shouting from the roof tops that the U.S. needs to send the military to war zones to destroy whomever they feel is doing wrong at that moment. They have no issues with insisting soldiers put their lives at grave risk to save their sorry asses, but they are not willing to return the favor (at significantly less risk). That is the definition of cowardly and uncaring. Being a tad bit apprehensive is fine (I'm sure the soldiers are very apprehensive when going into battle), but insisting we leave two brave aid workers to die in Africa simply to save their skin is not acceptable. And yes, many, many, many comments were suggesting we leave them there.

[ViolaSebastian]

Also there's been a storm about it on Twitter...search the hashtag #ebolaoutbreak america. They'll make you shake your head, that's for sure. Spoiler Alert: It's all Obama's fault.

[apple1]

Also there's been a storm about it on Twitter...search the hashtag #ebolaoutbreak america. They'll make you shake your head, that's for sure. Spoiler Alert: It's all Obama's fault.

Almost 100,000 people have signed a whitehouse.org petition to not allow the patients into America...

https://petitions.whitehouse.gov/petiti ... s/m5ScQ0X0

Once again, I am disappointed because once again I believed most people to be better than they have turned out to be. Terribly sad and discouraging.