Just found a blog that is a must read when it comes to the Ebola situation in the US and where it might go in the future.
Its called the "Shepherd of the Gurneys" and can be found here. I know that many people are saying that there is no cause for concern but I seriously doubt that. Under reported is another virus that is attacking children all around the country and now we're dealing with this?
Something evil is brewing and I simply don't trust the govt to effectively deal with these new threats.
Its called the "Shepherd of the Gurneys" and can be found here. I know that many people are saying that there is no cause for concern but I seriously doubt that. Under reported is another virus that is attacking children all around the country and now we're dealing with this?
Something evil is brewing and I simply don't trust the govt to effectively deal with these new threats.
Sol, I think you need to look at public health problems, reports, and opinions the same way you would look at combat reports. The more hyperbole and scared sounding, the more you need to wonder about the reporter and their interpretation of the situation.
ReplyDeleteDo we need to be worried about Ebola? Absolutely. Has there already been some mismanagement? Absolutely. But there is too much panicky talk on the internet and elsewhere; and the rule is the same here as in combat: accurate information and clear thinking is what's needed to best effectively deal with the existing problem. The more excited and exaggerated the talk gets, the harder it is to pinpoint where the fire is coming from and how big the enemy, and how to maneuver to defeat it.
Thanks for the link and the kind words, Solomon.
ReplyDeleteAnd @Mordechai, nothing I write nor have written has been "panicky".
I've done nothing but take open-source information and news, synthesize it, and make rational and logical conclusions.
The proof is in the pudding: I called the actual outbreak dimensions days and weeks ahead of official reports. As Casey Stengel said,"You could look it up."
I pointed to the probability that this disease would get here, and how, when TPTB were still spewing the farcical notion that such was "unlikely".
And though it's an extremely low bar to set, at this moment I'm smarter than the head of the CDC, the WHO, and anyone in the White House who's come out publicly on the issue from His Majesty HopeyDopey I on down. That and a buck gets me coffee at Denny's.
Where I've gone beyond information into supposition and conclusion, I identify it as such, and make it obvious that my opinions are only my opinions.
But not being the head of the CDC, I read as much as I can before putting the words out there. I'll happily alter anything I've said if that information is changed by subsequent news or discoveries. (Personally, I'd love nothing more than for them to solve this problem, so I can stop calling play-by-play on a global pandemic apocalypse. I'm funny like that.)
But there is no virtue in calmly sitting in a chair with a pencil and pad to evaluate your situation when your whole damned house is fully and gloriously aflame.
If anything is true regarding Ebola here, now, it's that my analogy is probably only a pale approximation of the truth. And repeating government platitudes doesn't make them truer simply because one wishes it so.
Aesop, you also wrote that triage nurses should have been in hazmat suits. That is way beyond the precautions needed/recommended even for practitioners doing direct contact patient care. It was hyperbole intended to set the tone, and influence the readers, and it was without regard for professional accuracy or clinical realities. And someone walking through bloody, Ebola vomit won't catch it either (another bit you alluded to) - unless they're barefoot. You ignore educated, informed professionalism in favor of hyperbole intended to scare (beyond the already scary possibilities).
ReplyDeleteI gather from your blog you were in the military. Well, when folks in the field employ exaggeration and scare tactics for their situation report - no one listens to them. Even when they might be right. This is a topic that needs to be treated like writing a chart; not like entertaining or influencing the emotions of the sheeple.
Go ahead, have fun with words. But then there will be a lot of level-headed people who won't pay you any mind; when they might have and maybe should have.
Right.
ReplyDeleteIt's irresponsible to observe that the precautions for working in a setting where someone with Ebola can walk right up to you, they should observe the exact CDC precautions that they sent out to every American hospital two weeks before Duncan arrived here, exactly as is done now in Liberia, Guinea, and Sierra Leone.
http://s3.documentcloud.org/documents/1301646/hospital-checklist-ebola-preparedness-2014-sep.pdf
As usual Mordechai, your logic remains flawless. And completely bassackwards from reality.
You are the living breathing example of a south-pointing compass, purely from pride and personal pique.
Maybe you hadn't heard, but it's too late to put your parachute on after you left in the plane and jumped out.
I don't know, maybe when confronted by a patient vomiting bloody splatter in triage, your kung fu allows you to leap between the droplets of death and dive into your handy undonned tyvek coveralls, booties, gloves, hood, goggles and mask instantly, before they hit you. I'm sure you can run between raindrops too.
Having done both the triage thing and the hazmat in real life for a measly decade or two, I'm calling bullshit though.
The CDC has a new word for people in Dallas as "level-headed" as you:
they now call them "contacts".
"STANDARD, contact and droplet precautions. Ensure an adequate supply, for all healthcare personnel, of:
Delete Impermeable gowns (fluid resistant or impermeable), Gloves,
Shoe covers, boots, and booties, and
Appropriate combination of the following:
o Eye protection (face shield or goggles),
o Facemasks (goggles or face shield must be worn with
facemasks),
o N95 respirators ( for use during aerosol-generating procedures)
Other infection control supplies (e.g. hand hygiene supplies)."
NO mention of hazmat suits. Though you did write on your blog, with your usual penchant for overblown rhetoric, that triage should have been wearing "hazmat suits". But hazmat suits sounds way scarier than "standard precautions", as we might employ for any infectious disease outbreak.
So I'm calling BS and Chicken Little. You can keep amusing yourself with your writing, but try to inform the public in a professional manner. And try taking attributable responsibility for your misleading rhetoric. The problem is potentially big enough and real enough without the Chicken Little act.

It's a pity you couldn't read all the way to Page 4:
DeleteReview, implement, and frequently exercise the following elements with first-contact personnel, clinical providers, and ancillary staff:
Appropriate infectious disease procedures and protocols, including PPE donning/removal,
Appropriate triage techniques and additional EVD screening questions,
Disease identification, testing, specimen collection and transport procedures,
Isolation, quarantine and security procedures,
Communications and reporting procedures, and
Cleaning and disinfection procedures.
Unlike you, even the CDC doesn't believe that triage personnel should be unprotected sacrificial lambs.
And if, instead of kneejerk assuming that you're right, you'd give your eyes a chance instead of your fingers, and actually read the information that you're hopelessly and tragically unfamiliar with, you could have spared yourself yet another embarrassing post demonstrating such a critical lack of basic reading comprehension skills, on such a clinically relevant subject.
BTW, for your fund of no information, a full-body impermeable coverall with hood, booties, gloves, respirator, and goggles, is in fact a "hazmat suit" to anybody but the terminally pedantic.
The ensemble is anything but "standard precautions", unless one works in bio-hazard lab.
It's painful to watch you do this. Please, give yourself a break, and stop.
just a heads up guys. news reports this morning state that YOU CAN catch ebola from sneezes, sweat etc...they have backed off the "only blood, vomit or feces" statement from earlier. soon we will hear that this form of ebola is "different"
DeleteSol, that would be an important update. What's the source? Is it conjecture, or established now? There is a different kind of Ebola which is spread differently. Are you sure they're not talking about that? I'm not at work today, and not keeping current right now.
DeleteAesop, you continue to distort the information (and my comments). Do you really act like that at work, too?
I never said triage personnel shouldn't be protected. I said they could do well with the CDC recommendations for STANDARD (that emphasis was in the CDC document) infectious disease precautions. Not hazmat suits.
That's a nice attempt on your part to back away from your own published statement. 'Hazmat suit' has a particular meaning. You invoke 'terminally pedantic' (again with the hyperbole. Is that pathological?) to try and discount your own misuse of the term. Since you are writing for the public on the internet, shouldn't you stick to the plain meaning of the terms so as not to mislead the readers?
You threw respirator into the list, but CDC only recommended it as a precaution for "aerosol generating procedures". NOT triage. Again, that is a standard infectious disease precaution at any time. But that wouldn't satisfy your need to exaggerate. You also added 'hood' to the list, but it isn't part of the recommendations either.
Visit any hospital ward (ICU, ER, even some general med/surg rooms) any day of the week, and you will find masks and eye protection, gowns, gloves, and booties in use. Goes on easy, comes off easy. Patient care workers and family members alike use them for a variety of situations to prevent possible spread of all manner of easily spread pathogens. Common (in healthcare) disposable items. It isn't a big deal, and it is used with all sorts of infectious or potentially infectious patients; at least until/unless established that there is no need.
Sadly, I can't simply say you lack reading comprehension skills (though I suspect you do). I think you maliciously, willfully distort the information. I think you take a situation which already warrants concern and some precautions, and intentionally engage in fear-mongering. I think your act is Chicken Little and FOS.
Of course, as long as you remain anonymous, you can say anything and be unaccountable. If you tried to talk like this with your colleagues and patients, they'd probably laugh you out of the workplace. I suspect some of them already are wary about taking what you say at face value.
via CNN....
DeleteAnd by 'bodily fluids,' you mean?
Blood, sweat, feces, vomit, semen and spit. Basically any kind of fluid that comes from the body. People in West Africa are avoiding hugs and handshakes because the virus can be spread through the sweat on someone's hand.
The uninfected person would have to have a break in the skin of their hand that would allow entry of the virus, CNN's Dr. Sanjay Gupta says. But "we all have minor breaks in our skin. And there is a possibility that some of the virus can be transmitted that way."
http://www.cnn.com/2014/09/30/health/how-ebola-spreads/index.html
notice that they're now saying "sweat" and "spit"...they took pains to say that you couldn't get if from a sneeze but that's utter bullshit if its contained in saliva. all a sneeze is, is spit in aerosol form...or so this layman thinks.ero
DeleteMordechai, that you're "not keeping current right now" is the worst-kept secret on the Internet long about now, and the blog understatement of the year.
DeleteYou've demonstrated that beyond all contrary argument. Bravo. Recognizing your problem is the first step to getting help.
BTW, "Aerosol generating procedures" would happen to include, inconveniently for you, someone hurling their guts out, and coughing bloody sputum, both activities that unsurprisingly happen with patients coming in the front door. I have some wee first-person experience from the other side of the triage desk with those situations.
And while the CDC statement says "gown", the reality is "impervious coverall", since putting on a mere floor length bib does nothing to stop infectious material like vomit and diarrhea from splashing back up and onto one's scrub clothes from any direction after ricochetting off the bed, the floor, or the caregiver(s). A mere 100,000 or so other actual ER workers like myself know this experientially without having to verbally swordfight themselves there, and know how far from "standard precautions" the donning of same, let alone the entire ensemble, is in actual clinical practice, but evidently that is another item beyond your clinical ken.
So all you do is flail about the punctilious arcana of terminology beyond any accurate or useful distinction to the average reader, and generally wrong even there. You vomit your bitter aspersions, spew your innuendo, and crap your accusations like an acute Ebola patient, backed up by...nothing, except your own bottomless fund of presumed infallibility and inner bile, as if that's the same as actual evidence. It's only evidence of desperation. Like much in this discussion, that's obviously news only to you.
Factually, you still have precisely...nothing.
Your ceaseless and baseless attacks and dearth of substance only paint you as a sad little man, notably under-informed, ill-equipped to participate in an intelligent discussion, and embarrassed to the point of increasingly futile responses in reply.
You've conclusively demonstrated on every thread that you're nothing but a self-important troll on a mission to destroy any credibility you imagine you have. Give it a rest, man.
The harder you try to attack, the fewer blows you land. Pray, spare yourself, regroup, and try to find something you can contribute, instead of merely continuing on your self-destructive rantfest. We know you have a backside without you incessantly showing it.
You've lost the argument, your manners, your credibility, and your mind.
Get a grip on yourself, and move on.
You were wrong. It happens. Admit it, dust yourself off, leave the mudpit, and come back to the table.
BTW, yet another bit of information that'll be news to some folks here is exactly how out of the standard realm these precautions are, from a description about one of the four existing US infectious disease wards:
Deletehttp://missoulian.com/news/local/st-patrick-hospital-of-sites-in-u-s-ready-for/article_da521772-4839-11e4-b266-4342d105e33f.html
"When we started putting them [doctors and nurses] through the PPE (personal protective equipment) exercise, everyone was excited, trying to be first in line to try on the gear,” Hurley said. “But then they’d get it on and start moving around for 30 or 40 minutes and realize – this is kind of tough.”
Ebola clinic staff must wear full-body protective suits including complete face shields. Hurley said the hardest thing for her to get used to was the condensation that would fog over the mask, limiting her vision to the places where sweat had trickled down.
“You can’t touch your face,” Hurley said. “You can’t move your hands above your shoulders. You can’t sit down. And you stay in this for three or four hours at a time. It got to be all about the hydration.”
Hurley said clinicians used a buddy system to check that gear was worn properly, procedures were done carefully and no one was getting too tired to work competently.
So those are only standard precautions for a ward dealing with BL4 patients in strict isolation, and far from the norm in standard everyday clinical practice elsewhere.
You can believe that from me, and the doctors and nurses - like the quoted ICU Nursing Director -who work in one on the actual front lines of such care, or you can believe knowledge-deficient uninformed internet blowhards with their pants around their ankles.
It's a free country.
?????? Is the virus or what not that kids are getting sick with the mystery sickness the illegal children brought with them??
ReplyDeleteYes.
DeleteEnterovirus D68.