October 15, 2014 archive

Ebola: A Challenge for US Healthcare System

Up Date: The second Dallas nurse infected with ebola will be transferred to Emory University Hospital in Atlanta, GA. The  Infectious Disease Unit is where the first two U.S. Ebola patients, both health missionary workers stationed in Liberia, were treated and released in August.

The Texas Department of State Health Services confirmed that a second health care worker has tested positive for ebola. The hospital, although it claims it is “equipped to care for patients in isolation,” it has become fairly apparent that there is a flaw in its protocols. The hospital has admitted it doesn’t know how the two hospital workers contracted the virus. That’s huge problem that continues to put the staff at great risk.

Dallas nurses have now come forward citing the flawed conditions in Ebola care

Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan. [..]

The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling. [..]

The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.

When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital. [..]

The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored.

This is unacceptable.

The CDC is now sending a team to oversee isolation procedures, especially the personal protection equipment (PPE) used by the staff, as well as, putting it on and removing it. It is the last part, removing the PPE, that is critical and, the most likely how these two nurses were infected. The PPE should be impervious to fluids. There should be no skin exposed and, as most news reporters have observed, it takes longer to take it off than don it. That’s the hard part and is done carefully, methodically and in multiple stages with decontamination at each stage.

The international medical aid organization, Médecins Sans Frontières (MSF), or Doctors Without Borders, has been in the lead with taking care of ebola patients in Africa and has written the book on safety procedures.

Doctors without Borders training, Belgium photo DWB-Belgium_zps547e3b30.jpg

The New York City Department of Health has designated Bellevue Hospital in Manhattan as the center for treatment of the Ebola virus in the city. But if this picture is an example of the PPE the staff will be wearing, they are need to make so improvements and fast.

Bellview Hospital, New York photo Bellview-NY_zps5d6ccc75.jpg

MSNBC’s Rachel Maddow examined the challenges for U.S. medical facilities of meeting the exacting protocols for handling Ebola, She pointed out how something as simple as a checklist can help as the rate of Ebola’s spread is forecast to increase rapidly.

In the day of i-pads and tablets, the use of a checklist in donning and removing PPE would help eliminate errors, make it easier to find flaws (human or mechanical) and lessen the possibility of a contagious disease like ebola from spreading to care givers and beyond.  


TBC: Morning Musing 10.15.14

I have 3 articles for your perusal today.

The first, just lovely:

California Aquifers Poisoned by Fracking While State’s Water Shortage Becomes Grim

In the midst of the worst drought in California’s history comes news that hydrofracking operations are polluting the state’s dwindling water supplies.

In July, during the height of the drought, state regulators halted operations at 11 injection wells used to dispose of wastewater used in hydraulic fracturing. The state found that the wastewater might have contaminated aquifers used for drinking water and farm irrigation. The Environmental Protection agency had ordered the state to send them a report regarding the situation within 60 days.


Jock (a derogatory term)

1:  athletic supporter.

2:  an enthusiast or participant in a specified activity.

This week in Sports-

NFL’s Jacksonville Jaguars apologize for Ebola prank by mascot

(Reuters) – The National Football League’s Jacksonville Jaguars apologized on Monday after their mascot used the Ebola epidemic to taunt fans of the Pittsburgh Steelers.

The mascot, Jaxson DeVille, held up a handwritten sign to the crowd that read “TOWELS CARRY EBOLA” while carrying a yellow “Terrible Towel” in his right hand.

HS soccer players allegedly hurl Ebola taunts at West African opponent

NAZARETH, Pa. – A West African player on a Pennsylvania high school soccer team was allegedly taunted by opposing players with chants of “Ebola!” during a game last week.

The Allentown Morning Call newspaper reports it received two letters from fans who attended the game last Thursday and alleged that racist remarks were hurled by Northampton High School players at a black player for Nazareth High School.

Sierra Leone’s Soccer Team Struggles With Stigma Over Ebola Outbreak

YAOUNDÉ, Cameroon – Fans taunt them with chants of “Ebola.” Some opponents have hesitated to shake their hands or engage in the traditional swapping of jerseys. Humiliating medical screenings have become routine.

And in Cameroon, when the players on Sierra Leone’s exiled national soccer team checked into their hotel to prepare for an important match Saturday, some guests grew alarmed, and the police were called, a team spokesman said.

In Yaoundé, Sierra Leone’s players continue to face constant reminders of the virus: the daily temperature screenings, an isolated team hotel, hand sanitizer dispensers in the lobby and police officers stationed outside to shield the team from harassment.

Drone, banner force end to Euro soccer qualifier

BELGRADE, Serbia (AP) — A small drone dangling an Albanian banner and circling the soccer field touched off fighting between Serbian and Albanian players and fans Tuesday, forcing a European Championship qualifier to be called off.

English referee Martin Atkinson halted the match in the 41st minute when a Serbian player grabbed the banner and Albanian players tried to protect it. Several Serbian fans ran onto the field and clashed with Albanian players. The score was 0-0 at the time.

The Union of European Football Associations said the match was later abandoned because of a ”disturbance” on the field.

New Jersey High School Football Team Loses Season Following Hazing, Sexual Assault Accusations

A disturbing report concerning Sayreville War Memorial High School of Sayreville, NJ surfaced today courtesy of NJ.com, uncovering details about hazing and sexual assault allegations against the school’s football team. In the wake of these accusations, the area superintendent announced this week that the remainder of the team’s season would be canceled, effective immediately.

The punishment seems fair given the weight of the allegations. NJ.com’s full report on these accusations offers a clearer picture of the alleged incidents. Initiated by older players on the team, the story details daily incidents of scare tactics and sexual assault bordering on rape.

   In the darkness, a freshman football player would be pinned to the locker-room floor, his arms and feet held down by multiple upperclassmen. Then, the victim would be lifted to his feet while a finger was forced into his rectum. Sometimes, the same finger was then shoved into the freshman player’s mouth.


   According to the parent, whose identity is being protected because the parent feared retribution against the family and the player, the routine was initiated when an upperclassman would enter the locker room and make a wolf call or howling noise.

   “[For] 10 seconds, the lights would go off and they would grab a freshman and they would go on,” the parent said. “Right on the floor. … It was happening every day. They would get the freshmen.”

   He added: “Kids would just sit around and witness [stuff] like this.”

In related news: DC NFL team considers name change to “Washington Jocks”

Stay tuned for further developments via Deadspin

Late Night Karaoke

TDS/TCR (Ohio)


The Power of Christ compels you!

What an excellent day for an exorcism.

You would like that?


The Party’s Over

As I said when this broke, what I intend to do is live blog Larry Wilmore and list Colbert’s Late Show line up.  You don’t need to despair that the Sausage Grinder of Snark, a little segment of sanity, is going away.

The real news and next week’s guests below (fortunately Jon didn’t do an web exclusive extended segment with Bai).