Ebola - slow to spread, hard to catch. So something like AIDS?

The nurses roommate in Africa caught Ebola and didn't know how.

So again what is wrong with a quarantine? The nurse probably doesn't have it but again for the thickheaded in this thread: you don't know you've got Ebola until after you get sick and contagious.

http://www.breitbart.com/InstaBlog/2014/10/31/America-s-Favorite-Ebola-Nurse-Wins-In-Court

I volunteered myself not to get a pandemic infectious disease overseas and drag it back home to virgin soil and spread it around, putting tens of thousands of lives at needless risk. Fighting an outbreak this severe takes an effort akin to war. The Pentagon didn't allow "volunteers" to go over to places like Iraq for three weeks so they can get their ticket punched, take some selfies with a rifle, and then abandon the fight and fly home as soon as they got bored or scared. That would be war tourism, and it's not only ineffective, it's disruptive to everyone who's committed to winning. With a disease that has a significant incubation time where it remains undetectable, rotating health care workers through an epidemic hot spot just makes them the most likely vector to turn an outbreak into a worldwide pandemic. Almost everybody knows this, which is but one reason why polls say 70 percent of the public thinks Ebola could strike hard in the US and that our health care officials are not prepared for it.

Rotation of healthcare workers after a short period of time, is essential. MSF, Doctors Without Borders, is the only organisation with 20 years of experience with ebola, and they know how to fight this, and have set the standard. That includes rotation even as fast as after 4 weeks. First, because it is an extremely intense and exhausting job (I assume mentally as well as physically), but also, because after only a couple of weeks, you start to get used to what you are doing. At that point, you have to be replaced, because the chance of making mistakes increases when start doing things automatically. [source: interview with an MSF worker, but I can't remember where I saw it). Maybe they do multiple rotations after taking a break for a couple of weeks, I don't know, but considering the shortage of medical staff, I can easily see why they would still accept someone who wants to stay 6 weeks and then go home: because a single rotation of a healthcare worker is far better than nobody showing up at all.

As for the 70% poll figure - Yawn. What else is new? And how has fear suddenly turned into truth?

How is rotation essential? The African health care workers don't get to rotate. If we had a massive outbreak of Ebola here, do you think our doctors would work for three weeks and then fly off to France for two-months of vacation? No, they'd work double shifts till the job was done. And the only mistakes an Ebola doctor can really make is exposing themselves to Ebola. Doctors Without Borders has already done that plenty of times, with 34 of their workers catching the disease, and it seems to be a bigger risk to people just getting started.

See the post above yours. Zenow is absolutely right that humans get complacent fast. The more tired they are, the more likelihood of fatal mistakes like poor donning/doffing of clothing.

Massive poverty rates, little education for the population, and centuries of exploitation from the Westernized world doesn't make for too many opportunities for more docs to come by. Funny how that goes.

In fairness, this is correct, but also because we too face a shortage of nurses as it is already...one that will get worse once Obamacare rolls out full force in just over a year.

I work in the Navy, and have seen first hand the effects of having a lack of sleep does to people. Sorry, I prefer my doctors and nurses well rested and alert.

Cool, so I guess you'll stop with the hystronics and the Chicken Little routine.

Thanks for stopping by

Given how it's been raging across the U.S. since you started screaming about it, what's your time line? A year? Ten, a hundred?

How many blue-haired FOX viewers have dropped dead of coronaries in the past week from fear of teh Ebola?

Meanwhile, in the world outside gturner's disease-raddled brain:


Death or Full Recovery? Ebola Outcome May Depend on Your Genes

If it was important to have a well-rested doctor, we wouldn't make them work an average of 80 hours a week in residency. The norm used to be 100 hours a week. They also have a recommended limit of working only 30 consecutive hours in a shift. Studies done before the new standards were put in place found no difference in patient mortality between working doctors till they fall over versus giving them a less extreme schedule.

Second, it's not like they're over there performing non-stop open heart surgery. It's a virus, and most patients die from it. We mostly try to keep the victims hydrated. Invasive procedures would just expose health care workers to higher risks. The African health care workers fighting this outbreak have been on the job, continuously, since late spring and early summer. Many of them don't even see their own families, afraid to risk infecting them.

This outbreak has a doubling time of about 28 days if you let it get ahead of you. That means that a year after case 0, there would be 8192 victims. Two years after case 0 you have 67 million victims, but by then the virus will have gone through 26 infection cycles and may have mutated pretty profoundly to become more transmissible.

Well, if it hasn't gotten through your hazmat suit and the duct tape by then, it'll be fun to revisit this thread on 11/01/2015.

I work in the Navy, and have seen first hand the effects of having a lack of sleep does to people. Sorry, I prefer my doctors and nurses well rested and alert. - Anna
Preaching to the choir! Being in the Air Traffic Control side of the military, the way they jack those controllers around on sleep/work schedules is certifiably insane.
It seems (in The Army at least, your results might vary) the more important your job/more people you can endanger, the least amount of sleep you get.
You're a 20 year old strong and healthy private filling sandbags? You get six hours sleep by regulation.
You're a 30 year old Company Commander trying to keep 50 people safe and alive and are also a pilot? You get five hours.
You're a 40 year old Brigade Commander running the whole she-bang with hundreds/thousands in your charge facing shit-storms from
every direction 24/7? You get four hours.
BTW this for the entire duration of the deployment. The fucking mind boggles!

Ah, but medical expert gturner says being rested doesn't matter.

And if there were more quslified doctor, ys think maybe--just maybe--there would be less need for 80 hour work weeks?

@LizK @Mrs. Albert @Ghost of Muad

That's truly alarming.

Thankfully, the Navy's air program is considerably less ass backwards on this and mandate that every E-1 airman to the O-6 pilot get eight hours a night. Normally catnapping in workspaces is discouraged, but Naval pilots realize that hopping in a safe plane is better than looking pretty for the captain and that berthings on carriers are quite noisy with the planes taking off fifty feet. So the guys get their rest when needed to get the job done. Makes me really regret not picking Aviation Boatswain Mate when I had the chance.

And how about all those cases of ebola in NYC after that one guy went across town?

I'm sorry, I really try hard to take you seriously, but if your brain starts leaking sentences like this, you really need to go find some help. Preferably from a well rested doctor.

You mean studies like this one?

Source

Or this one?

Source

I mean, really...?

Shit, at least when Dayton was lying out his ass he had enough sense to misquote from credible sources. gturner OTOH is little more than a well spoken @Baba.

Actually no. When the EU restricted the hours interns can work as part of the EU-wide "rules for everbody", as if they were just factory workers, many medical associations protested, especially in the US and UK, saying that becoming a doctor takes intensive and immersive training. They don't think that you could learn to practice medicine to the same high standards while putting in only 40 hours a week, even if the internship was twice as long. It is the doctors who insist on the brutal training regimine. They make some compromises towards sleep, saying that an intern shouldn't accept new patients after the first 24 hours on a shift, and no shift should extend longer than 30 hours (which allows for follow up with patients from the first 24 hours). Perhaps they do this because sometimes shit happens and doctors have to deal with it, such as when there's a big train wreck right at the end of their normal shift, and after that Mrs. Ramirez starts going into labor.

Keeping a whole bunch of Ebola patients hydrated, especially as they're all suffering from the same disease, should not wear a doctor down. In fact, just look at what they do as soon as their feet hit US soil. They run all over New York and the Bronx, go bowling, etc, even if they have Ebola. And now, with self-monitoring and self-imposed three-week isolation for returning health care workers, just going to Africa for three weeks at a stint will obviously mean that half of their time is completely wasted anyway. You can bet the military won't be rotating people through the hot zone on three-week TDYs.

Would you consider NPR as a credible source?

Fuck NPR and the EU.

Just curious, did you actually read that story before you linked to it? Because while it does acknowledge that there's debate over the issue -- which of course there is -- it doesn't exactly back up your position either.

I'll be sure to save that post the next time gtardo bitches about NPR and liberal bias. And he will because he's a our special lil boy.

The issue is rather tangential to our discussion, which is that we don't need to rotate doctors through Africa on short little stints just so they don't get tired. They are trained to be totally exhausted and still function. Heck, some of the doctors kept working even as they came down with Ebola. One worker from the UK was featured on the PBS Nova special on Ebola a few weeks ago, and she related that when she arrived the doctor was dead on the hospital toilet, and they left his body there for three days. You've certainly seen M.A.S.H. Wounded keep rolling in - for years - and they keep on operating on them. So these short little stints by little-miss self-important strike me as little more than Ebola tourism. "I went and helped. Look at me!" And frankly, she possibly never touched a single patient because her job is CDC media relations. She was probably putting together poster campaigns and doesn't want to admit it.

Another point is that it may not matter a bit how many doctors we actually send. The doctors may be largely irrelevant to containing the outbreak, at least regarding treating Ebola patients. As a hypothetical, suppose this strain of Ebola had a fatality rate of 100 percent (and it's not that far from it). That would mean that everybody who walked into the hospital with Ebola would go out in a body bag regardless of what goes on inside. All the doctors could do is just watch everyone die, perhaps making them a bit more comfortable in their final days, but that's it. The only important people working in the hospitals would be the locals who safely dispose of the infected corpses, because that could reduce disease transmission.

Outside the hospital, the important people are those who identify and isolate people who have Ebola and those who have been exposed to it. Some medical diagnostic skills help with that (distinguishing Ebola from malaria), but the main task is ferreting out information about contacts. For that, people with a police or social work background might be more useful than doctors or nurses, as might locals who seem to know everybody's business. Essentially, it's a farmer's task of separating the healthy chickens from the infected chickens, so that a communicable disease can be stopped before it wipes out the entire farm. Most importantly, the farmer should not be shipping chickens abroad.

Using such simple, science-based wisdom, Canada has stopped issuing visas for people from the hot zone, because the only way someone in Canada can catch Ebola is from contact with someone newly arrived from west Africa, because Africans can't projectile vomit across the Atlantic ocean. Australia has likewise shut off contact with the hot zone. Even Monrovia has quarantined 75,000 people in one of their slums, because the rest of the Monrovian's don't want to die bleeding from both ends either. The US seems to be one of the only countries stupid enough to allow Ebola to travel here freely, as if we want to catch it because we're jealous of all the attention the victims are getting.

I, for one, welcome our new Ebola overlords

The medical council is the ones who came up with the rule capping hours at no more than 16 per day. They cited safety reasons and increased mistakes when people work 24 hour shifts.

I think this is you saying: Okay I was wrong, but let's talk about something else.
But no, this is not tangential. And the discussion was not 'that we don't need to rotate doctors through Africa on short little stints just so they don't get tired' - no, it was your claim that 'we don't need to rotate doctors through Africa on short little stints', period. Nobody said it was 'just so they don't get tired'. We have just established that long working hours and thus long rotations equal getting tired and complacent, which equal an increased risk of making mistakes and getting infected.
In addition to the risk exhausted health care working working on automatic pilot may pose, there is also the fact that there is a shortage of tens of thousands of volunteers (source: New England Journal of Medicine editorial). That means you can't be too picky about how long someone is willing and able to stay. Better 1 short rotation than nobody at all, as I said before.
And finally there is your downplaying of exactly how exhausting the work they do is. I don't know about you, but every single health care worker interview I have seen, mentions how totally exhausting it is to work in their PPE in that heat, being 100% aware and focussed on your every single move, controlling every reflex movement you may have as the sweat pours down your face. Someone trained in hazmat procedures describes it like this:

That doesn't sound like a breeze to me, really.

I agree that the care given is only palliative. But fatality is not 'not far from 100%', it is 70%, and the remaining 30% have to be nursed back to health, requiring them to be in a treatment unit as their families won't do anything for them once it is established they have ebola. THey need food and IV fluids, and that last can't be given by untrained volunteers. That is probably why they need a lot more nurses than doctors.

Your info is seriously outdated. The quarantine in West Point, Monrovia, only lasted from August 20 till August 30, and was most likely only politically motivated. Also, calling Canada's paranoid move science based is nonsense. Again, see the editorial in the New England Journal of Medicine I linked to at the beginning of this post. Here's a quote - or rather, the whole thing, my emphasis added:

"Thankfully, the Navy's air program is considerably less ass backwards on this and mandate that every E-1 airman to the O-6 pilot get eight hours a night." - Anna

Here's the Army "loophole" on that (when not in a deployed scenario generally). In a fixed base situation (where civilian aircraft may be a factor) the Army has to follow FAA rules.
The rules dictate 8 hours of "crew rest" which covers pilots, controllers, etc. "Crew rest" means total time away from the stick or microphone.
It doesn't specify actual sleep. So that 8 hours includes eating, traveling to and from the ATC facility or hangar, showering, etc.
In other words the minute you punch out from work you magically get transported to your bed. After 8 hours of uninterrupted sleep you are magically transported to your workplace.
It works fine on paper anyway.

But getting tired is a function of how many hours they work in a day, not how many weeks they work. If they need time off, they can take time off in Africa instead of Manhattan. If they can't deal with just being in Africa, they shouldn't have gone there in the first place. The more people who circulate in and out of the hot zone without any quarantine procedures, the more likely it is that Ebola will escape from the hot zone to start new outbreaks elsewhere. For example, the workers we're sending to West Africa aren't allowed to then go to most of the other African countries, because many of those countries wouldn't be any better at containing Ebola than Guinea and Liberia were. New York now has 470 health-care workers who have to track the 170 people who may have been exposed by one return doctor. Some of those countries hardly have 470 health care workers.

Thus, the current Ebola tourism.

And do you know who doesn't have to wear any PPE at all? The 5,000 people who've already recovered from this strain of Ebola. Our health care workers should be training those people to take care of Ebola patients, instead of taking the subway to go bowling.

And the editorial in the NE Journal of Medicine gets the science wrong. 13 percent of Ebola patients never develop a fever. The CDC variously admits and denies that Ebola can be spread with a sneeze. The idea that to stop the disease at its source to stop the disease is likewise wrong. To keep a contained disease from spreading, you have to stop the disease at the front, not the back. The source of the the current outbreak is Guinea. By their logic, we don't have to fight it in Sierra Leon or Liberia because they're not the source, they're just overrun with Ebola, which will stop once we defeat it in Guinea, and especially in a particular village in Guinea - that probably doesn't even have Ebola anymore. It's illogical nonsense. If you had a pandemic that was 100 percent fatal, there wouldn't be anyone left alive at the source, rendering the source completely irrelevant.

A better analogy would be that they have to hold the line at all costs, while conducting extensive operations behind the line to rapidly separate those who have been exposed from those who haven't. If they had done this in Guinea, Ebola wouldn't have spread to Sierra Leon and Liberia. But people who carried Ebola traveled into those neighboring countries, and now three countries have Ebola. Why should we make it five, or ten, or twenty? Well, according to the New England Journal of medicine, that would be "not scientifically based" and "unfair and unwise". It's a lethal hemorrhagic disease, and they're worried about fairness?

Some have tried to figure out the mental model that Friedan and the NIH are using that has them spouting this stuff, and the nearest I've seen is that they view Ebola as a pressure that could keep going up until it bursts its container and spreads everywhere, and the way to prevent that from happening is to make sure the container leaks - so the pressure won't build up. Early on they argued that it was imperative to our efforts to allow west Africans to freely travel to the US, which doesn't make a lick of sense other than under the pressure analogy. But by their logic, if west Africans all decided to cancel their Disney vacations, the world's efforts to stop Ebola would collapse - because in both cases there wouldn't be any west Africans flying to the US. It's Mickey Mouse logic.

What seems to be happening is group think at WHO, NIH, and CDC, with the directors of those organizations all locked into the pressure vessel model of the outbreak, and although many doctors and epidemiologists have argued strongly against it, the directors and their organizations hold all the purse strings and all but control the medical journals. Few who ever want to see a grant will buck the nonsense. If you look at countries outside their control of research dollars, like Canada and Australia, you find countries banning or restricting arrivals from West Africa - and doing so based on science: Ebola can't arrive in those countries unless somebody brings it. If Ebola gets past their first line of defense and even a little of it spreads through the population, all the handy indicators like "have you met anyone from West Africa?" fly out the window, and they'll have to assume that any case of the flu might be Ebola, and take the appropriate precautions. As the first American doctor to have Ebola has said, he's certain he caught it in the waiting room screening potential patients, not in the isolation wards, and that has bad implications. Further, every case of Ebola pretty much shuts down a wing of a hospital and knocks fifty or more health care workers out of action. It won't take much to stress our systems, while the level of worry ratchets higher and higher. All this can be prevented simply by isolating anyone who's been to west Africa for three weeks, but somehow that's racist and unfair - say the medical professionals in the US, now distracted from the important work of battling large sodas, trans-fats, social stigmas, and assuring gender-neutral equality-based outcomes that are fair to all.

Tldr

-------------------------------------------Tapatalk is limiting my typing speed.

Paging @gturner: