Nursing and the Ebola Virus

Nurses COVID

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For those of us in unaffected countries, are you concerned about the ebola virus spreading? Would you care for ebola patients? I live in an area with a very high density of African immigrants and come into contact with these individuals regularly. We have a lot of African immigrants who bring back tuberculosis from their home countries and at my unit we end up caring for them. We take care of a lot of rare infectious diseases. I was reading an article and it dawned on me how plausible it would be for me to encounter this virus. And I admit, it's terrifying and I might refuse that assignment. Many healthcare workers in Africa are dying because of caring for the ill.

So the hazmat suite worn by the ambulance AND the patient were simply for public consumption?

The CDC, WHO, our government, the Graham organization, were simply pandering to our worst fears? Just so we'd all feel safe????

This oddity is what makes me nervous about the CDC

They'll just say/do anything to make the public "feel safe" even if it's not 100% accurate

If they're incorrect in they're portrayal of healthcare workers in hazmat suits, who knows what else they're not being honest about/hiding from the public/downplaying/sensationalizing

Specializes in ER.
We agree on this.

I’ve not identified any truth or scientifically proven fact that’s being suppressed. I’m not sure what you believe is hidden from us but I’m reasonably sure that your fears are unfounded. Since I sincerely believe this it follows that I think that preventing panic is indeed the reasonable thing to do.

Is still don’t think that you fully understand the difference between droplet spread and airborne transmission, what airborne transmission really means and why it’s alarmist and completely inaccurate to say that the Ebola virus is transmitted that way. I’ve obviously failed to explain it properly, I hope someone else can do a better job of it.

They do know how and the efforts have been and are still taking place even as we sit here and write.

The HOW: Identify patients, isolate and provide care. Locate persons the patients have been in contact with after they got sick. Educate the public on disease transmission and prevention. Use suitable PPE/follow infection control protocols strictly. It’s not rocket science but due to factors mentioned several times before in this thread and the other Ebola virus thread it’s a task fraught with difficulties. There are many obstacles to overcome. This is why the outbreak is still going on, not because we don’t know the “how”.

Factors that make containment a challenge: Shortage of healthcare professionals, shortage of medical supplies and personal protective equipment, poor infrastructure, poor sanitation, mistrust of medical professionals (if you think that they’re just trying to lure you to the hospital to actually infect you with something nasty, or steal your organs you tend to stay put, you don’t go with them), crowded housing and equally crowded hospital wards (an infected patient doesn’t exactly get a single room or even necessarily a bed), burial practices that includes close contact with the deceased. Basically, it’s poor just about everything and shortage of just about everything. This is why it’s crucial that the region receives the knowledge, supplies and support needed to combat this ongoing tragedy.

The pattern and rate of infection would be different if it were. Think influenza and compare.

I haven't seen any research/study that indicates that it is either.

I have no personal experience with the Ebola virus. I haven’t been infected with it or cared for an infected patient. What I do have is a firsthand experience of living in two third world countries. Granted, I lived in those countries as a sheltered, privileged Westerner but I’ve seen enough to have a reasonably good idea of the culture and the conditions people live in. Two people very close to me have added to the knowledge I have about the region. One has been on two UN missions in Liberia and I’ve spoken to this person at length. The other is a surgeon who has done numerous stints with MSF. This is a person I admire deeply. Through the years I’ve been spellbound and also profoundly saddened by this person’s account of what s/he has experienced. S/he has extensive experience in working under conditions that most of us couldn’t even imagine.

The above was just a little background of where I’m coming from but more importantly, I’m a nurse and as such I’m educated in the scientific process. I have analyzed the information available to me to the best of my ability and knowledge and arrived at the conclusion that although the Ebola virus outbreak is very serious, is see no reason whatsoever not to trust the information given by for example the WHO. I see no reason at all to panic.

I find this statement rather ironic.

I’m uncomfortable with a lot of things. Trust me, challenging information brought to me, isn’t at all one of them. That’s actually something I quite enjoy ;)

As much as I enjoy challenging information I don’t really have the energy (I’d feel too much like poor, old Sisyphus with his boulder) to comment at length about your link. Suffice it to say that in my opinion Alex Jones’ Infowars really isn’t a good place to look for factual, scientific, unbiased information on the Ebola virus. It really isn’t.

I hope that I am just being overly cautious. I really do. I don't think so.

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

"suggesting possible transmission through aerosol droplets"

"airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated (1, 6, 13). The importance of this route of transmission is not clear"

The CDC's Ebola Catch-Up Game - Forbes

Last week I asked, “Who invited Ebola to Atlanta?,” andCDC Director Thomas Frieden has now answered: not the CDC, not the State Department, not the United States Military. Frieden told CNN’s Dr. Sanjay Gupta that he didn’t think it was his job as a public health official to decide whether or not the first American cases of Ebola should be flown back home while actively infectious.

Several Britons Quarantined For Ebola Amidst Claims The Virus May Be Airborne

Case closed.

Specializes in ER.

Blog: Dr. Sanjay Gupta's Ebola Errors

CDC: Nosocomial transmission refers to the spread of a disease within a health-care setting, such as a clinic or hospital. It occurs frequently during Ebola HF outbreaks

Specializes in NICU, PICU, Transport, L&D, Hospice.

Pleae note that a hypothesis is not the same as verifiable fact.

We should be able to tell the difference.

I am concerned about the choice to bring these folks into the country. That is not out of some notion that we are somehow safe from exposure from a traveling vector, but rather a suspicion that we are often our own worst enemies in these matters because we are so arrogant in our notion of American exceptionalism.

I am thankful that I do not work inpatient or in direct care as I would not want to have to choose whether or not to care for these poor people.

Amidst-

in the middle of; surrounded by; among.

in or throughout the course of; during.

“Several Britons Quarantined for Ebola amidst claims the virus may be airborne”

So first of all, amidst does not equal “because”. Also note that they write “MAY” be airborne. They actually don’t have enough evidence to even justify the use of “may”.

The claim with or without the may lacks scientific foundation.

What they’re doing with this attention-grabbing headline with the clever use of a preposition is to attempt to make it sound like one thing is affecting the other, that people are being quarantined because the virus may be airborne. This is just a sleight of hand, or word rather. Also, the wording “quarantined for Ebola” is a rather sloppy considering the persons it refers to aren’t sick and haven’t been diagnosed with the Ebola virus.

In fact the one thing (quarantine) hasn’t got anything at all to do with the other (airborne). This becomes very clear when you look at the original article in the British newspaper The Telegraph.

http://www.telegraph.co.uk/health/healthnews/11014177/Ebola-Welsh-national-who-returned-from-West-Africa-a-week-ago-in-quarantine-at-home.html

The title of the original article is: Ebola: Several Britons across the UK quarantined at home after returning from West Africa. Dramatic for sure, but not quite as scary the breitbart.com title, wouldn’t you agree?

If you read the article in The Telegraph you’ll find out that it’s about a person in Cardiff, Wales who after returning from a trip to West Africa is staying away from work and limiting his contact with other people voluntarily due to the fact that he may have been in contact with people infected with Ebola during his trip. This person has no symptoms but is staying at home as a precaution during the incubation period and is in regular contact with healthcare professionals. The article mentions that there are several persons/recent travelers across the UK that have placed themselves in quarantine and are being monitored during the incubation period.

Don’t you see there’s nothing in your link that proves or gives concern for airborne transmission? It’s sensationalistic journalism without scientific foundation.

If a passenger on an airplane had a serious infectious disease and the infection route was indeed airborne (like your link sort of implies) do you think you’d only quarantine the sick person or every single person aboard that aircraft? The answer to that one is obvious and it’s not what’s happening in the UK. You can rest assured that the Ebola virus isn’t airborne.

Specializes in NICU, PICU, Transport, L&D, Hospice.

So it would seem that, once again, BreitBart is not reporting facts with the intention of informing or educating people. Rather it is reporting information intended to generate an emotional response from it's readers. This is a good example of writing with a "slant".

Not much critical thinking going on in the midst of those regular readers I suspect.

Specializes in L&D, Women's Health.
The Scariest Virus: Ebola Is Back, and It's Worse Than Ever - Pacific Standard: The Science of Society

"All it takes to contract Ebola is to be in contact with an infected person or bodily fluids, even sweat or saliva. It can take up to three weeks for someone who's been infected to begin to suffer symptoms, according to the World Health Organization. The CDC, working to control a panic, emphasized at its Monday press conference that sufferers may not be contagious until that point--but who hasn't ignored flu-like symptoms and gone out in public?"

In this thread, if nothing else, the threat of Ebola should cause worry. For the head of the CDC to say "we're not worried" is ludicrous.

I agree that we all must use common sense in protecting ourselves and definitely not rely even on what a pt with flu-like symptoms tells us. Patrick Sawyer took care of his sister in Liberia. She had ebola and died. He then boarded a plane headed for Nigeria. According to reports, he was having diarrhea and vomiting while on the plane, which had 70 passengers. Although he was taken to the hospital, 24 hrs passed before he was diagnosed with ebola and THEN precautionary measures were taken! No wonder one of the nurses caring for him died. Of the 60-70 contacts (39 are hospital contacts), 5 have been diagnosed with ebola (and the 21-day isolation will end Sat).

Several things to learn from this story. If Ebola were airborne (not just droplet), I would imagine everyone in the whole plane would've been exposed. (I'd also imagine it would be spreading MUCH faster than it is.) This guy denied coming from a country with ebola (he changed planes), was not put in isolation for over 24 hours once the plane landed, and even when isolated was an exposure risk because of HIS behavior. Yeah, the fact that he lied, that he got on the plane sick, that he was not immediately isolated, and that he deliberately exposed healthcare workers . . . yeah, that's indeed worrisome.

It's been in Nigeria for 15 days now. Curious to see how it's contained there as it is separated from the areas of main outbreaks.

Airborne transmission occurs through the dissemination of either:

  • airborne droplet nuclei (small-particles [5 micrograms or smaller] of evaporated droplets containing microorganisms that remain suspended in the air for long periods of time) or
  • dust particles that contain an infectious agent

Standard, contact, and droplet precautions are recommended for management of hospitalized patients with known or suspected Ebola hemorrhagic fever (Ebola HF), also referred to as Ebola Viral Disease (EVD)

http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html#.U-LoUB3113o.facebook

Microorganisms carried by the airborne route can be widely dispersed by air currents and may become inhaled by a susceptible host in the same room or over a long distance form the source patient - depending on environmental factors such as temperature and ventilation.

Airborne Precautions - Minnesota Dept. of Health

[h=1]Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals[/h]Standard, contact, and droplet precautions are recommended for management of hospitalized patients with known or suspected Ebola hemorrhagic fever (Ebola HF), also referred to as Ebola Viral Disease (EVD) (See Table below). Note that this guidance outlines only those measures that are specific for Ebola HF; additional infection control measures might be warranted if an Ebola HF patient has other conditions or illnesses for which other measures are indicated (e.g., tuberculosis, multi-drug resistant organisms, etc.).

Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals | Ebola Hemorrhagic Fever | CDC

Specializes in L&D, Women's Health.
So the hazmat suite worn by the ambulance AND the patient were simply for public consumption?

The CDC, WHO, our government, the Graham organization, were simply pandering to our worst fears? Just so we'd all feel safe????

Yeah. Didn't work so good, did it?

Specializes in L&D, Women's Health.
I feel like so much info is contradictory. It's not that contagious, it's highly contagious. Full PPE is required, routine PPE is enough, Hazmat suits are needed. I've read that Biosafety level 4 precautions are required to study Ebola. That uses negative pressure rooms, positive pressure suits, UV rooms, showers, decomnation of the air and water, etc. Of course the media will sensationalize the danger and the experts seem to downplay it. This is what bothers me and makes me skeptical of knowingly bringing ebola pts here.

Maybe consider it a dry run:(

]I so appreciate the experiences and knowledge being shared here at allnurses. Its good to have various sources of information including laymen or anecdotal data. Worth considering while we all try to inform ourselves about the current concerns relating to the spread of Ebola and how possibly aside from re-use of PPE gear - how it was possible for those healthcare workers in Sierra Leone to become infected?

From OSHA Fact Sheet which discusses the merit of Surgical Masks and Respirators.

https://www.osha.gov/Publications/respirators-vs-surgicalmasks-factsheet.html

]

"Surgical masks are used for several different purposes, including the following:

  • Placed on sick people to limit the spread of infectious respiratory secretions to others.
  • Worn by healthcare providers to prevent accidental contamination of patients' wounds by the organisms normally present in mucus and saliva.
  • Worn by workers to protect themselves from splashes or sprays of blood or bodily fluids; they may also keep contaminated fingers/hands away from the mouth and nose.

]Surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants. These particles are not visible to the naked eye but may still be capable of causing infection. Surgical masks are not designed to seal tightly against the user's face. During inhalation, much of the potentially contaminated air can pass through gaps between the face and the surgical mask and not be pulled through the filter material of the mask. Their ability to filter small particles varies significantly based upon the type of material used to make the surgical mask, so they cannot be relied upon to protect workers against airborne infectious agents.

Hoping for good information and positive results to become available to the public relating to the two Americans being treated in Georgia.:unsure:

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