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Once again, it is a nurse who has taken the Ebola media spotlight this week. Kaci Hickox, a nurse who cared for Ebola patients in Sierra Leone found herself quarantined against her will in New Jersey upon her return to the US, in spite of the fact that she tested negative for the virus. After a 3 day isolation in less than desirable accommodations, she was transported home where she was supposed to remain under home quarantine but is now declaring that the quarantine is unnecessary and counterproductive, and is openly defying the order by going out in public.
Additional breaches in voluntary quarantine from those returning from Ebola-plagued Africa occurred when NBC medical correspondent, Dr. Nancy Snyderman in New Jersey and Dr. Craig Spencer in New York left their homes and ventured out into public spaces.
On Monday, the U.S. Centers for Disease Control and Prevention (CDC) called for voluntary home quarantine for workers with the highest risk for Ebola infection. It also specified that most medical personnel returning from Sierra Leone, Liberia and Guinea would not need to be kept in isolation.
In spite of this, New Jersey Gov. Chris Christie, mandated a 21-day mandatory quarantine policy for all healthcare workers exposed to Ebola. Although this move has received much criticism, it did get the support of Dr. Bruce Beutler, an American doctor and researcher and Nobel Prize winner for Medicine and Physiology for his work researching the the body’s overall immune system. He is currently the Director of the Center for the Genetics of Host Defense at the University of Texas Southwestern Center in Dallas. He favors Christie’s quarantine policy “because it’s not entirely clear that they can’t transmit the disease,” referring to asymptomatic healthcare workers like Kaci Hickox.
New York and Illinois have also have followed suit and mandated mandatory 21-day home quarantine policies. Although there is plenty of scientific evidence indicating there’s very little chance that a random person will contract Ebola unless they touch bodily fluids of an infected person, the thought is that the authorities need to do something to calm Americans’ fears. As Mike Osterholm, an infectious disease epidemiologist at the University of Minnesota, says, "You want to try to eliminate not just real risk, but perceived risk."
There are thoughts on both sides of this issue which has led to heated discussions at times. There are concerns about the potential impact with both pathways of re-entry requirements for Ebola healthcare workers. What are your thoughts about this? Please take our survey to share your opinions. Let your voice be heard.
I think you should do some reading about Ebola and scientific facts before citing your opinion on what politics are, and facts about what virologists have uncovered about this virus. Opinion in the matter is a dime a dozen - plenty of people are being infected in Africa because they have their own opinions of what is safe and what is not - over what is fact. And the virus is still spreading.
Then post these facts and not your opinions. The people in Africa with countries with a high prevalence of ebola have extremely poor healthcare facilities, minimal to no PPE, and are taking care of ebola patients in crowded hospitals. Poor healthcare facilities in some African countries does not equate a need for mandatory quarantines of asymptomatic healthcare workers.
Specializes in NICU, PICU, Transport, L&D, Hospice.
I think you should do some reading about Ebola and scientific facts before citing your opinion on what politics are, and facts about what virologists have uncovered about this virus. Opinion in the matter is a dime a dozen - plenty of people are being infected in Africa because they have their own opinions of what is safe and what is not - over what is fact. And the virus is still spreading.
I would love to read what you are reading about this virus and how we should respond in the USA. Please share your links.
What about the Canadian Health Department and the study done by the US Army in 1995? We can disregard those experts because they don't agree with your scientific evidence? Science is infallible, and medical science falls under the same consensus. I choose to believe that prevention vs maintenance is more prudent.
If Ebola comes here via infected individuals from affected overseas areas, and spreads from these cases to American medical personnel, the damage to our society would be greatly magnified. Not only would we lose doctors, nurses and other medical workers who could no longer provide care to Ebola victims (not to mention loss of care for the normal influx of patients), the medical team would its self become sources of Ebola transmission to others. Considering the deadly virulence of the Ebola virus, with a 50-90% death rate, it be behooves us to err on the side of safety rather than on the side of risk by increasing the level of respiratory and eye protection for our medical teams.
This article was written by an MD in August, 2014, not a CDC spokesperson/nurse.
I think the attacks on all those who oppose your views, how did you refer to your self, "the grumpy dwarf type" ? are unnecessary. This is a forum to discuss intelligently, without bias, other viewpoints. The CDC is changing it's protocols and for the better, I might add. I am sure they have this under control. It only is the arrogance of the, nurse who traveled from Texas to Ohio,the medical doctor from NBC, this Maine nurse, the NY doc who rode the train, that reflects "lack of concern" on their part, to the public. The public who need to have confidence in the medical profession to act prudently.
Specializes in Leadership, Psych, HomeCare, Amb. Care.
If the president thinks there is nothing to worry about let him bring the returning doctors and nurses coming back from there to live with him and his family for a couple weeks, then maybe I will believe what he says.
Will not happen.
No, you probably wouldnt then believe. You appear to have joined just to express an unsubstantiated opinion. Some people refuse to believe no matter how many facts they are confronted with.
The people that work in level 4 containment labs work with all sorts of highly concentrated pathogens utilizing a variety of instruments (needles and glass etc) that could easily break and transmit the pathogens. Those suits in level 4 containment aren't designed just for ebola they are designed to prevent exposure of any pathogen no matter what the mode of transmission is.
The conditions in those labs is completely different than working in a hospital where the pathogen is likely not to be as concentrated and they are dealing with only a single pathogen.
First of all, there are different levels of containment and PPE at the CDC labs which depends on the pathogen. Ebola does qualify for the highest level, level 4. It is placed there on it's own merits and not because it shares a bench with other pathogens.
Secondly, in the labs they only work with one pathogen at a time. They don't grab a bunch of test tubes to juggle. It is in healthcare where we have multiple pathogens at work at a time. I often have patients who simultaneously have HCV, HIV, MRSA, and more at work within their bodies.
The CDC works with needles and glass, oh my! I work with needles and glass too. I also work with patients who may spit, cough, sneeze, vomit, etc. I have never had an ampule sneeze at me.
Even when the CDC is working with concentrated pathogens, it still takes contact for transmission. Unless they are doing something that could create an aerosol, there is little risk. Remember, Ebola is not airborne.
Specializes in NICU, PICU, Transport, L&D, Hospice.
What about the Canadian Health Department and the study done by the US Army in 1995? We can disregard those experts because they don't agree with your scientific evidence? Science is infallible, and medical science falls under the same consensus. I choose to believe that prevention vs maintenance is more prudent.
If Ebola comes here via infected individuals from affected overseas areas, and spreads from these cases to American medical personnel, the damage to our society would be greatly magnified. Not only would we lose doctors, nurses and other medical workers who could no longer provide care to Ebola victims (not to mention loss of care for the normal influx of patients), the medical team would its self become sources of Ebola transmission to others. Considering the deadly virulence of the Ebola virus, with a 50-90% death rate, it be behooves us to err on the side of safety rather than on the side of risk by increasing the level of respiratory and eye protection for our medical teams.
This article was written by an MD in August, 2014, not a CDC spokesperson/nurse.
I think the attacks on all those who oppose your views, how did you refer to your self, "the grumpy dwarf type" ? are unnecessary. This is a forum to discuss intelligently, without bias, other viewpoints. The CDC is changing it's protocols and for the better, I might add. I am sure they have this under control. It only is the arrogance of the, nurse who traveled from Texas to Ohio,the medical doctor from NBC, this Maine nurse, the NY doc who rode the train, that reflects "lack of concern" on their part, to the public. The public who need to have confidence in the medical profession to act prudently.
I appreciate your post and link.
I do respect the opinion of that one physician but I agree more with the preponderance of medical and scientific opinion (supported by repeated observation in the field) that isolation/quarantine is unnecessary prior to development of symptoms.
If one believes that this RN should be quarantined then, logically, shouldn't every nurse who cared for the patients at Emory or Nebraska Med or Dallas Presby ALSO be required to isolate for 21 days?
Can you imagine? Take care of a patient for a shift and go into isolation for 3 weeks. Lather, rinse, and repeat for each patient, each nurse, each shift, each day. That is going to be impressive. Especially if we include ANYONE who enters the room. Oh my. Who is going to take care of the patients and who is going to pay for all of the quarantine costs?
If we stand by and allow public fear and ignorance to drive these policies now, where will it stop? Why will it stop? If facts and science and calm thoughtful voices don't work now why will they work in a week or a month or a year?
I envision a certain skiddish population across the country entering influenza and cold season terrified that every fever will be ebola. The ED staff better hold onto their panties...
What about the Canadian Health Department and the study done by the US Army in 1995? We can disregard those experts because they don't agree with your scientific evidence? Science is infallible, and medical science falls under the same consensus. I choose to believe that prevention vs maintenance is more prudent.
If Ebola comes here via infected individuals from affected overseas areas, and spreads from these cases to American medical personnel, the damage to our society would be greatly magnified. Not only would we lose doctors, nurses and other medical workers who could no longer provide care to Ebola victims (not to mention loss of care for the normal influx of patients), the medical team would its self become sources of Ebola transmission to others. Considering the deadly virulence of the Ebola virus, with a 50-90% death rate, it be behooves us to err on the side of safety rather than on the side of risk by increasing the level of respiratory and eye protection for our medical teams.
This article was written by an MD in August, 2014, not a CDC spokesperson/nurse.
I think the attacks on all those who oppose your views, how did you refer to your self, "the grumpy dwarf type" ? are unnecessary. This is a forum to discuss intelligently, without bias, other viewpoints. The CDC is changing it's protocols and for the better, I might add. I am sure they have this under control. It only is the arrogance of the, nurse who traveled from Texas to Ohio,the medical doctor from NBC, this Maine nurse, the NY doc who rode the train, that reflects "lack of concern" on their part, to the public. The public who need to have confidence in the medical profession to act prudently.
"Airborne transmission of Ebola virus has been hypothesized but not demonstrated in humans. While Ebola virus can be spread through airborne particles under experimental conditions in animals, this type of spread has not been documented during human EVD outbreaks in settings such as hospitals or households.1 In the laboratory setting, non-human primates with their heads placed in closed hoods have been exposed to and infected by nebulized aerosols of Ebola virus.28,29 In a different experiment, control monkeys were placed in cages 3 meters away from the cages of monkeys that were intramuscularly inoculated with Ebola virus.30 Control and inoculated monkeys both developed Ebola virus infection. The authors concluded that “fomite and contact droplet” transmission to the control monkeys was unlikely, and that airborne transmission was most likely,30 but they did not discuss the potential behaviors of caged non-human primates (e.g., spitting and throwing feces) that might have led to body fluid exposures.31 Similarly, an outbreak of Reston virus (Reston ebolavirus species, which does not cause EVD in humans) infection occurred in a quarantine facility housing non-human primates in separate cages and the transmission route could not be confirmed for all infected primates. Multiple animal handlers developed antibody responses to Reston virus suggesting asymptomatic infection was occurring in humans with direct animal contact and implicating animal handling practices in transmission between primates.32 In a different study, piglets that were oronasally inoculated with Ebola virus were able to transmit infection to caged non-human primates that were placed 20 cm from the piglets.33 The piglet and primate cubicle design did not permit the investigators to distinguish among aerosol, small or large droplet, or fomite transmission routes, and it was noted that pigs are capable of generating infectious short range aerosol droplets more efficiently than other species. A more recent experiment that was specifically designed to further evaluate the possibility of naturally-occurring airborne transmission of Ebola virus among non-human primates showed no transmission of Ebola virus from infected to control primates placed 0.3 meters apart in separate open-barred cages and ambient air conditions, but with a plexiglass divider that prevented direct contact between the animals."
I have read the three studies on the potential for airborne ebola, and they are summarized above. The last line is the most important. It shows that ebola is not airborne. The other two studies can easily be exaplained: 1. Pigs through normal behavior sling respiratory mucus/snot several feet away. This alone means you cannot conduct airborne transmission experiment where this is possible i.e. you cannot have infected ebola pigs within snot range. The one experiment had the animals close enough where the pigs could snot on the other animals. The last experiment showed when the infected animals could only share air with uninfected animals the uninfected animals never got sick even though they only about a foot apart.
The last experiment showed nothing, but I will explain it anyways. The scientists took monkeys placed them in a box with a sealed hood over their heads. The scientists then took 25ml of concentrated ebola virus and at 20psi infused into the hood over the monkeys heads. Anyone that has ever given a nebulizer treatment will realize aerosolized solution will form droplets when it comes into contact with a surface. In other words what the scientists got was a very artificial way of delivering concentrated ebola droplets to infect monkeys. http://www.cdc.gov/vhf/ebola/transmission/human-transmission.html
I don't know about the other commentary article as I didn't see a direct link to the article. I will review it if you provide a direct link to the article.
She did not follow the CDC guidelines, nor the guidelines set up and established by medical professionals and scientists. Quite frankly, if you work in any position of the health care profession - and you refuse to follow the codes/safety/ethics you should be barred from any future practices. The guidelines that have been outlined are for the protection of everyone - and the only kind of individual that would argue and dispute what is being asked of them, whether it is to not incite fear/panic or to ensure there is no chance of spreading an infectious biological agent, is either someone looking for publicity and controversy or someone that has 0 concern for other people in their community and country for that matter.
There should be no alternative to this situation. She should be stripped of her ability to function in an environment - that others are looking for her to aid their illness or recovery - her story may show many things, but as far as a health care professional, she is a charlatan
Sounds reasonable to me -- so let's revoke the licenses of all the healthcare workers who refuse to get annual flu shots. They are also refusing to follow the established and recommended safety protocols and putting people at risk of a serious illness. After all, "the guidelines that have been outlined are for the protection of everyone."
So now we are not going to trust the thermal scanners at the airport? No way will they go the oral route for their screening. They need to have confidence in their screening methods and act on those results. It's always something....
wtbcrna, MSN, DNP, CRNA
5,128 Posts
Then post these facts and not your opinions. The people in Africa with countries with a high prevalence of ebola have extremely poor healthcare facilities, minimal to no PPE, and are taking care of ebola patients in crowded hospitals. Poor healthcare facilities in some African countries does not equate a need for mandatory quarantines of asymptomatic healthcare workers.