The impact of the Ebola scare on healthcare workers

How many lives will be lost before we close our borders,
as 10 nations already have, to Ebola stricken nations.
Failure in this regard might be the deadliest mistake
 our country ever made. A huge, or two-thirds majority,
of Americans agree with me that our border needs securing.
Two nurses in Dallas are now infected with the deadly virus,
and all we had to do to prevent this from occurring
was prevent flights from Africa from landing in the U.S.
Banning travel to and from infected nations
is something that could easily be done.
Update:  While the U.S. refuses to close its borders,
five west African nations are proud to say,
they have stopped the spread of the disease
by securing their own borders.

I get the influenza vaccine every year because I have asthma and it's highly recommended.  Yet I honestly don't feel safer as a result of getting it as even the Centers for Disease Control and Prevention (CDC) says it only reduces your chance of getting the flu by 15 percent.

The CDC says that, unlike other viral infections like the common cold, the influenza virus can cause "severe illness and life threatening complications." Yet while 5-20 percent of the population will get the disease each year, with 200,000 requiring hospitalizations, the death rate remains at 0.5 percent.

While it should be taken seriously, and surely we should all do our part to try to eliminate the spread of this disease during the course of our work and our daily lives, this 0.5 percent is nothing when you compare it with the Ebola virus.

Surely your likelihood of getting Ebola is nothing to your chances of getting influenza, although if the Ebola virus makes its way to your hospital, and you your skin comes in contact with the virus, you will in all likelihood get the disease.

They used to say that Ebola wasn't airborne, although now they are saying that it can be spread by droplets in the air.  For instance, if a person with Ebola coughs onto a surface, the Ebola virus can live for up to seven days, infecting any person who touches that surface.  So you could also get it this way.

This might explain why even people who have been wearing Hazmat suits have still contacted the Ebola virus.  You won't hear this in the news, but of the 4,447 reported deaths this year due to the Ebola virus, 233 of those were trained nurses and doctors.

This death rate among the medical community included highly trained doctors, such as the Medical Director of the two largest hospitals in Liberia.  The number includes United Nations doctors.  The number includes two healthcare workers from Doctors Without Borders teams.

Most, if not all, of these medical workers were wearing full Hazmat gear.  So could you imagine if this disease comes to a hospital near you?  Are you equipped with Hazmat gear?  Probably not.

We should also look at the positive side here.  It was reported that about 70 healthcare workers were in Thomas Duncan's room, and 68 of these did not get the disease.  Still, the fact that two did get the disease leads us to believe there are holes in whatever protocols were followed.

That said, the World Health Organization (WHO) now report that the Ebola virus death rate is up from 50 percent to 70 percent.

This means that of the 8914 people reported to be infected with the virus this year, 4,447 (including 233 healthcare workers) died.

Yet WHO also notes that these numbers are probably not even the real numbers. They say the real numbers are probably much higher due to difficulties in reporting.  In fact, back in August one cemetery worker in Sierra Leone said tons of bodies had been delivered to the cemetery he works for, yet the Sierra Leone Health Ministry had reported only 10 deaths

WHO also estimates that, if the disease is not under control soon, as many as 10,000 people may diagnosed with the disease per week by December.

I described the history of this disease in my post Ebola now in the U.S.  While there is certainly no reason to panic, it's not such a bad idea to bescared, especially those of us in the health care industry, as fear causes people to become prepared.

Based on initial reports coming from the nurses union at Texas Health Presbyterian Hospital Dallas where two nurses have now apparently contracted Ebola from a patient named Thomas Duncan who later died of the virus, there were many breeches in protocol at that hospital.  In fact, two weeks after the fact the hospital is apparently still not prepared.

Based on what we are hearing from those investigating the response at this hospital, one has to wonder if other hospitals are ready.  We must wonder if the U.S. is as ready as we have been told by the CDC.  We were told the U.S. was ready for it.  We are not.

A Detroit area hospital, which is near Detroit Metro Airport where patients with Ebola are most likely to fly into if their destination is Michigan, tested their Ebola response yesterday.  Perhaps this is something we will see more of in the days and weeks ahead.

In the meantime, our government should keep infected people from Libia and other infected nations from crossing our borders, and it must educate hospital personnel as to what needs to be done to prepare for the worse case scenario.

It should stop the nonsense of screening patients for the disease before they board airplanes, because obviously this system is not working.

Obviously people can get on airplanes before they show symptoms, they can lie about where they've been, and they can get across our porous borders. It's been done since the beginning of time, when people become infected you quarantine them.

Obviously the CDC, including its director Thomas Frieden, has no clue how to handle the disease. The outbreak was first reported by the CDC in march, and here we are in the middle of October and it still has no clue what to do. When he was working for Mayor Bloomberg he had no problem telling people they couldn't buy anything bigger than 16  ounces that contains Coke or Pepsi for their own good, but he can't restrict travel to prevent the spread of a deadly disease for our own good. This makes no sense to me.

We should not be politically correct by not banning flights just because of fear this might hurt the economy of a nation that was founded in the 1820s or 1830s because of American Slavery.  Nothing against the people of Liberia, but if the Ebola virus continues to find new hosts, more economies than just the Liberian economy will suffer.

In my opinion, saving lives trumps saving economies.  If we can save lives by restricting travel, it should be done.  Period!

Surely a pandemic in the United States or Europe is unlikely, and we should keep it that way by restricting travel to West Africa.  At least ten other countries have already done it, and it can easily be done here too.  Even people who previously championed against restricting travel are now opposed to it.

For some reason, those responsible for preventing an Ebola outbreak in the U.S. are asleep at the switch, and it's scary sad.  Yet fear not, because we got our flu shots.

Here is a demonstration of how CDC recommended protocol may not prevent the spread of the disease.

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Ebola outbreak may be worse than suspected

The Ebola outbreak in West Africa may be worse that first suspected. Deaths caused by the virus may be severely under reported, and the disease may have found a new way of spreading from one victim to another.

The New York Times published the story of a grave digger working in the capital of the Republic of Sierra Leone, a city of over a million inhabitants, who said copious bodies have been dumped for burial.  Protective gear worn by grave diggers is indicative of the fear that these bodies were the victims of Ebola.

Yet while this is true, the New York Times reports, the Sierra Leone Health Ministry has reported only 10 deaths due to the Ebola virus since the outbreak was first reported over six months ago.  

As I reported in August, the virus is highly infectious, meaning that it easily jumps from one person to another.  It is not, however, very contagious, meaning that to get it you have to touch the bodily fluids of someone who has the disease, something that rarely occurs unless you are a healthcare worker.

However, there are investigators in Canada who suspect that the disease may have figured out a way to spread between species and victims through the air; that it has found a way to be airborne.  If this is true, the disease may also be deadlier than first suspected.

This epidemic appears to have gotten so bad that Obama is planning to send 3,000 U.S. troops to West Africa to help stop the spread of the disease. One can only wonder what kind of success the military could accomplish regarding this task, especially when we know that the role of the military is to smash things and kill people.

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Ebola virus now in U.S.

Ebola is perhaps the deadliest disease in the world.  There is no cure, so if you get it there's a 90% chance you will die.  The disease Ebola haemorrhagic fever, or what is now called Ebola virus disease, was first discovered in 1976, and the disease has never made it into the United States, until recently.

It first appears as flu-like symptoms, and then it starts to cause internal bleeding. So, basically, those who get it bleed out, and this ultimately results in organ failure, followed by death.  The only treatment is supportive, and basically involves hydrating patients.

Worse, the disease is very contagious.  Patients suffering from it bleed out, so anyone exposed to the person may easily come in contact with bodily fluids.

The disease originally only appeared in 1976 in Nzara, Sudan, Yambuka, and the Democratic Republic of Congo.  The disease takes its name from the Ebola River which is situated near the Democratic Republic of Congo.  Presently there is an outbreak in Guinae and Liberia.  Overall, the disease is thought to have killed over 800 people in Africa.

The disease is transmitted from one host to another through bodily fluids, which generally seep from the infected person.  It initially presents as flu-like symptoms here, or Malaria-like symptoms in Africa, although, and, quite often, these are brushed off as minor symptoms treated by home remedies.  Yet as the disease progresses, internal bleeding begins to occur, which ultimately leads to weakness, high fever, intestinal problems, and eventual death.

The disease originally affected wild animals in the tropical rain forests of Central and West Africa, and was transmitted to primitive people living in small villages living near these rain forests.  It is suspected that the original host was fruit bats of the pteropododidae family.

It's thought to have been transmitted to humans by these primitive people handling animals infected with it, such as fruit bats, porcupines, monkeys, and forest antelope.  Then it spreads quickly from one sick person to another, as loved ones yearn to help animals, or their fellow men and women, struck with illness.

This is what occurred recently, as 2 American missionaries in Liberia to help out the needy became infected with the virus.  These infected missionaries have made this issue political in the United States, as many have called for Americans to go there with supplies to help, some have insisted we bring them here for treatment, and others think we should just let them alone.  All arguments are reasonably respectable and understandable, considering the deadliness of this disease, and the ease to which it may spread.

To give you an idea of how easy this disease spreads, doctors taking care of them wear protective gear.  Yet despite this gear, it did not stop one of the doctors from becoming infected. Perhaps the doctor made a mistake somewhere along the line. Perhaps he did not zip up a zipper or he had a hole in his suit.  Perhaps he took off his gloves while handling the patient.  Regardless, it shows how possible it is, how easy it is, for this disease to spread.

President Obama, or at least members of his administration, made the decision to go get these two sick missionaries and bring them here. They were transported via an aircraft specially designed to handle such situations, and are now patients at Emory Hospital in Atlanta.

Whatever the motives, political or other (some say the Ebola victims were given a secret remedy), are beyond the concerns of this blog. However, it is our concern to consider the potential consequences of having Ebola in the U.S.

What this action means is that American healthcare professionals will come into contact with these two infected missionaries.

Some say, despite wearing protective gear, if one of them makes even the slightest mistake, the disease will sneak into one of them, and the disease will make its way to Atlanta.  It will fly with a host to New York, drive with another to California, and take the train to Denver.  An epidemic of Ebola virus disease may occur, secretly invading unsuspecting hosts.

Of course the virus could just as easily cross the border by means of one of the people illegally crossing our unprotected border.  People who come to America legally are screened for infectious diseases, but those who come in illegally are not screened. So the risk was present even without these two known infected missionaries being moved to Atlanta.

If the infected come to your hospital you will not be able to deny them treatment. In this way, every physician, nurse, respiratory therapist, x-ray technician, laboratory tech, and nurses aide is at risk for unknowingly coming into contact with the virus, therefore unknowingly assisting the virus in its quest to stay alive.

Considering the severity of this disease, every voice should be heard on this subject, including the words of Donald Trump, who Tweeted: "The U.S. cannot allow Ebola affected people back.  People that go to far away places to help out are great but must suffer the consequences."

He also Tweeted: “Stop the EBOLA patients from entering the U.S. Treat them, at the highest level, over there. THE UNITED STATES HAS ENOUGH PROBLEMS!”

Some people, including actor Whoopie Goldberg and former republican campaign aide, Nicolle Wallace, on ABCs the view, mocked such concerns.  In fact, Wallace said:

Think about who else goes to faraway places, Whoopi. We send our soldiers to faraway places. I think that we should put them in one of Donald Trump's hotels in New Jersey. I don't think they're doing very well. And I think one of his hotels would be a great place.

Such mockery is not helpful, and only discouraged people from speaking out their concerns.

While many Americans are fearful of a potential epidemic that might be caused as a result of Ebola in an Atlanta hospital, The Washington Post reports that some infectious disease experts say that is highly unlikely as the disease is spread by direct contact with blood, urine or feces of the patient, and not by airborne pathogens.  They say diseases like the bird flu is far more contagious, as it can easily be contacted from anyone who coughs or sneezes.

While it's possible, you are highly unlikely to catch the Ebola virus by a hand shake, or by simply being in contact with someone with the disease.  You could be on a plane or train with someone who has the Ebola virus and not be contaminated.

The experts say that the disease is easily spread in Africa because the people there directly handle infected victims, particularly animals both dead and alive, and are readily exposed to bodily fluids.  They also have extreme burial procedures where they bury their own family members and friends.  We do not do those things here, or are highly unlikely to.

Yet if you are a healthcare giver, on the other hand, you may be exposed.  So there lies the concern for us. This may be a good time to review universal precautions, and remind healthcare givers to wear gloves and gowns when the risk of exposure to secretions is eminent.

However, this may not even be necessary, as most hospitals, most healthcare staff, already do this.  Pretty much, the risk of this disease spreading in the U.S. like it did in Africa is highly unlikely, mainly because the preventative measures in place in this country are far better than those in Africa.  So even healthcare givers are highly unlikely to become infected with Ebola.

However, the Ebola virus would never come to the United States on it's own, and it's here now.  The fear is real, as patient who recently returned from a trip to West Africa was admitted to a New York hospital was tested for the Ebola virus, and the CDC admits six people in the U.S. have been tested for Ebola.

People who note their concern over the virus coming here and risking an epidemic should not be made fun of.  This is a serious issue that should entice a serious debate in the arena of ideas.  Because, as CBS News report, the Ebola outbreak may be more serious than thought.

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