Nursing and the Ebola Virus

brandy1017, ASN, RN · Aug 8, 2014

I don't understand the minimization of the danger of dealing with Ebola and the dismissal of very valid concerns of safety and this when actual doctors and nurses are dying from Ebola! Not only our two Americans sick with Ebola, but other doctors and nurses have already died from it, but we are supposed to be unafraid and not flinch at the thought of getting infected and dying ourselves! As someone else mentioned Ebola is a level 4 danger and maximum precautions are taken at the CDC and labs when dealing with it! It is not a routine, safe virus to be dealing with! The Hot Zone talks about the dangers of this virus among other similar ones. It is not to be taken lightly as if it's just another virus. No big deal!

I'm concerned that Emory University has been working with Ebola to create a vaccines. I would think that would fall in the domain of the CDC not universities. I hope they have taken adequate precautions when working with this virus to prevent accidental exposure or release of it!

The claim because it's not technically airborne it is safe, and why are we worried and concerned about taking care of ebola patients. It is not safe! Why is everyone wearing Hazmat suits and Level 4 containment if this is so safe just because it is not supposedly airborne? Think about it!

brandy1017, ASN, RN · Aug 8, 2014

OK, even if someone had absolutely no one in his/her life that loves him/her, that doesn't mean that individual is expendable.
Happy now?

I agree and while I'm comforted by the many wonderful near death experiences of people who have died and been brought back that doesn't mean I'm ready to die! I think the truth is because of global travel healthcare workers in America will end up getting sick and some will probably die from caring for Ebola patients. It is only a matter of time!

The nurses at Emory are safer than the rest of us because of the special isolation wards, one of only 4 hospitals in the US. We don't have a hazmat suit where I work, they have one or two respirators for people that don't pass the TB mask test, but they aren't even regularly cleaned!

You can't even get hospitals to put in ceiling lifts to protect our backs, you think they are going to pay for special isolation protection for us? It took an Act of Congress to get safe needles in hospitals. You think they would pay for the special medicine that Samaritans Purse obtained for the Dr and nurse? They would probably say our life insurance is cheaper! Tell me if I'm wrong!

But those of us worried are simply overreacted and paranoid and don't know anything about microbiology etc? I don't think so!

brandy1017, ASN, RN · Aug 8, 2014

What I'm curious about is if they make a complete recovery will they go back to help and will they now be immune to Ebola and not need to take isolation precautions? Or would they still be susceptible to a different strain of Ebola.

Spangle Brown · Aug 8, 2014

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.

That is what I am worried about. Not the two people that were transported to Emory as known Ebola patients. Every protection thought is being used.

It's an unknown ebola patient, that is what scares me. People are leaving the area as quick as they can. That patient even lied, just to get out. And he KNEW he was exposed. He left because he was afraid. That first nurse wasn't given a choice to work with an Ebola patient, cause it was unknown that he was an Ebola patient.

In this, as in all things in life, is the risk we take for living. We do not know when it will happen here. But it' would be a good idea to wrap our mind around it. Learn to understand it. Get involved to set up procedures to deal with it locally. Thinking about it ahead of time, will help lesson the panic.

After thinking about it, I know that If I believed that I might have been around such a person, I would not be going home. That doesn't mean I would purposely expose my self after the fact. I would not assume I was part of the walking dead.

Guests · Aug 8, 2014

Probably already mentioned but a quote from Susan Grant's piece is worth emphasizing.

Further, Americans stand to benefit from what we learn by treating these patients.

This is a very strong reason to bring those two patients to the US and treat them, while maintaining the most stringent bioisolation that we can.

It is a near-certainty that Ebola *will* make its way to the US at some point... it's simply impossible to keep infectious pathogens geographically isolated in today's modern world with 24/7/365 transcontinental travel in a matter of hours. And beyond the inadvertent human vectors, the reality is that may even be done knowingly or intentionally. Think either (a) Andrew Speaker, or (b) bioterror.

When it finally strikes - and as an ED nurse from an urban hospital, I'm probably at higher risk than most (besides EMS crews) - I would like there to actually be EBP guiding the treatment decisions... which "E" can only be derived by "P"... that is, real-life treatment of real live patients... especially ones who were previously healthy and well-nourished (that is, American and Western Europeans... not impoverished Liberians).

This entire episode provides another tangible benefit: The political will to invest government resources toward developing vaccines and therapeutics... which, without some fear of personal impact in the general public, will never happen -- and without which will never be developed (Ebola is the ultimate orphan disease).

While I still question the tepid and non-detailed assurances provided by various organizations -- and while I am certain that my facility is thus far completely ill-equipped to safely care for these people, especially in the ED where they are likely to languish for many, many hours or days -- I think I am glad that these two are being cared for here.

MassED, BSN, RN · Aug 10, 2014

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.

Symantics. Bottom line, it is out of control. Call it sensationalism, call it whatever you'd like. You may rest assured Ebola is not airborne, but the rest of us can have a bit more skepticism about the unknown of this virus and its virulent nature. We know viruses mutate. I'm glad there are so many that post about how it's ok to have Ebola now on our shores, where it has NEVER been in a human. At least there could have been some control over a global outbreak if it was contained within one continent. Let's just help it along and bring known humans with it.

Think about those connections that are talking about Ebola on mainstream media. Dr. Sanjay Gupta (on CNN) is an associate professor at Emory University - who speaks of how Ebola is not that big of a concern - so do you think you can trust someone who has a bias? Is that a conflict of interest? Are you all taking the blue pill?

macawake, MSN · Aug 10, 2014

Symantics. Bottom line, it is out of control. Call it sensationalism, call it whatever you'd like. You may rest assured Ebola is not airborne, but the rest of us can have a bit more skepticism about the unknown of this virus and its virulent nature. We know viruses mutate. I'm glad there are so many that post about how it's ok to have Ebola now on our shores, where it has NEVER been in a human. At least there could have been some control over a global outbreak if it was contained within one continent. Let's just help it along and bring known humans with it.
Think about those connections that are talking about Ebola on mainstream media. Dr. Sanjay Gupta (on CNN) is an associate professor at Emory University - who speaks of how Ebola is not that big of a concern - so do you think you can trust someone who has a bias? Is that a conflict of interest? Are you all taking the blue pill?

What do you mean by semantics? I’m an eternal optimist so I’m hoping that it means that you’ve read the original article, spent some time analyzing and reflecting and that you now realize that the source you linked to actually didn’t prove anything? Have you perhaps spent some time pondering and comparing the pattern of a typical influenza outbreak to this Ebola outbreak and realized that this too negates your earlier theory?

No, I don’t take any “blue pills”. I prefer reality, warts and all. While I believe that it borders on conspiracy theory territory to infer too much of the Emory Hospital and Dr. Gupta connection, it doesn’t really matter either way in this case. I don’t rely on CNN or mainstream media for scientific facts on medical issues. I look to a lot of sources, but primarily PubMed.

About the Sanjay Gupta/Emory Hospital connection. I agree that it’s always prudent to note affiliations and potential bias. It’s mandatory in scientific research. I just don’t see your point here. The connection between the two is duly noted. But what possible sense would it make that Dr. Gupta has information that the virus is much more dangerous than “they” let on, but because he works at Emory Hospital he wishes to hide this from the public. The logic here being, what exactly? He wants this supposedly uncontrollable virus at his place of work, why?! Please, enlighten me.

The control that you think you’ve relinquished by transporting two individuals stateside is an illusion. You never had it in the first place. Any of the thousands upon thousands of international travelers who disembark airplanes on a daily basis could be a carrier. The two persons treated in isolation by professionals in Atlanta aren’t a threat to the public. An infected individual out in society poses a larger threat but is in no way equivalent to a doomsday scenario.

MassED, BSN, RN · Aug 10, 2014

What do you mean by semantics? I’m an eternal optimist so I’m hoping that it means that you’ve read the original article, spent some time analyzing and reflecting and that you now realize that the source you linked to actually didn’t prove anything? Have you perhaps spent some time pondering and comparing the pattern of a typical influenza outbreak to this Ebola outbreak and realized that this too negates your earlier theory?
No, I don’t take any “blue pills”. I prefer reality, warts and all. While I believe that it borders on conspiracy theory territory to infer too much of the Emory Hospital and Dr. Gupta connection, it doesn’t really matter either way in this case. I don’t rely on CNN or mainstream media for scientific facts on medical issues. I look to a lot of sources, but primarily PubMed.
About the Sanjay Gupta/Emory Hospital connection. I agree that it’s always prudent to note affiliations and potential bias. It’s mandatory in scientific research. I just don’t see your point here. The connection between the two is duly noted. But what possible sense would it make that Dr. Gupta has information that the virus is much more dangerous than “they” let on, but because he works at Emory Hospital he wishes to hide this from the public. The logic here being, what exactly? He wants this supposedly uncontrollable virus at his place of work, why?! Please, enlighten me.
The control that you think you’ve relinquished by transporting two individuals stateside is an illusion. You never had it in the first place. Any of the thousands upon thousands of international travelers who disembark airplanes on a daily basis could be a carrier. The two persons treated in isolation by professionals in Atlanta aren’t a threat to the public. An infected individual out in society poses a larger threat but is in no way equivalent to a doomsday scenario.

It is evident that we will just have to disagree on the supposed safety of having Ebola brought to the United States. It is the point that we have ASSISTED the process of aiding the global threat of Ebola. If I am needing to repeat this point, I am at a loss, because it's quite obvious why this is a ridiculous move.

Regarding Gupta:

He has expressed two sides of Ebola publicly. Knowing his conflict of interest with working at Emory, working with CNN and making these statements about Ebola is certainly not me making any conspiratorial connection.

Watch this video of Sanjay and Tom Frieden - Dr. Gupta was clearly against the two being brought back to Atlanta, initially.

http://www.cnn.com/2014/08/01/health/ebola-outbreak/index.html?hpt=hp_inthenews

Then the Doc was sent to Emory University....

This video speaks for itself regarding respiratory precaution (as reported by the CDC - abundance of caution)

Dr. Sanjay Gupta goes inside the CDC's Ebola war room – Anderson Cooper 360 - CNN.com Blogs

The bottom line being "abundance of caution." It's as though comments regarding "have compassion for our own" somehow negates practicing with an abundance of caution. One can have compassion without putting the innocent in jeopardy.

In regards to semantics. Your remark "Amidst-

in the middle of; surrounded by; among.

in or throughout the course of; during. "

You are inferring your desired meaning into the link I posted. It all boils back down to an abundance of caution. Attempting to contain an outbreak should be just that; containment. All of our resources are available to our own in the Ebola-ridden areas. See above links.

Horseshoe, BSN, RN · Aug 10, 2014

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

Okay, call me confused as well. What do you mean "case closed"?

I am particularly interested in the question of whether or not this virus is spread through the airborne route. I am reading everything I can find on the subject. I saw nothing, absolutely nothing in your link which shows any credible evidence that this virus is airborne.

In the link you posted, I found this paragraph:

The World Health Organisation has also claimed that the virus is spreading faster than they can control. This may be because of a misunderstanding about how the virus is transmitted, in 2012 a study suggested that Ebola may be transmitted through the air.Whilst the study was not conclusive the BBC reported that Canadian scientists had found that Ebola had been transmitted between animals that had never come into direct contact. This suggests that the current theory that it is only transmitted by exchange of bodily fluids may be wrong.

Okay, I am really wondering why this article did not go on to reveal that the SAME scientist who did the study referenced above (and published in 2012) has continued his research and has more recently published his newest findings:

Study Confirms That Ebola Is Not Transmitted Through The Air | IFLScience

From that study:

Kobinger’s current research demonstrated that infected macaques were unable to transmit the virus to uninfected macaques without direct contact. The study used the species responsible for the current epidemic of 1,700+ human infections. The two groups of primates were near enough where aerosols could have spread the virus through the air, but they were not able to touch. While the infected macaques died in under a week, the other two never contracted the virus.

So does this mean that only certain strains of Ebolavirus can be transmitted through the air? Or is it perhaps that pigs have a specialized ability to make Ebola airborne? Was the virus transmitted via an unknown source of cross-contamination? Those questions could very well be settled with further research, but until then, one thing is for certain: There is absolutely no evidence that primates can transmit Ebola to one another through the air. The only evidence of primate-to-primate transmission is from direct bodily contact.

I find it really irresponsible that the author of that linked article above did not reveal that there has been additional research done by the very people who did the study referenced. I am left to wonder if the author is simply lazy and chose to cite a study done two years ago without researching if there has been any more recent work done or if the author purposely omitted that fact for very questionable reasons.

What we know about research studies is that the most we can usually take from them is that they reveal the need for further study that will be able to replicate the results of the first study. Fortunately that is what is happening and I am glad these researchers are taking the need for further evaluation very seriously.

MassED, BSN, RN · Aug 10, 2014

Horseshoe, see my previous links regarding respiratory precautions. I agree that this current strain needs more studying. Abundance if caution is what stands out to me from my previous post. .. Rather than the general response to be flippant and so sure it's not airborne. Primate to primate transmission is one thing. We have experience with Ebola from monkeys to humans in Virginia in 1989. This is more virulent than prior outbreaks in history. If anything, it demands respect and prudent attention.

OCNRN63, RN · Aug 10, 2014

I agree and while I'm comforted by the many wonderful near death experiences of people who have died and been brought back that doesn't mean I'm ready to die! I think the truth is because of global travel healthcare workers in America will end up getting sick and some will probably die from caring for Ebola patients. It is only a matter of time!
The nurses at Emory are safer than the rest of us because of the special isolation wards, one of only 4 hospitals in the US. We don't have a hazmat suit where I work, they have one or two respirators for people that don't pass the TB mask test, but they aren't even regularly cleaned!
You can't even get hospitals to put in ceiling lifts to protect our backs, you think they are going to pay for special isolation protection for us? It took an Act of Congress to get safe needles in hospitals. You think they would pay for the special medicine that Samaritans Purse obtained for the Dr and nurse? They would probably say our life insurance is cheaper! Tell me if I'm wrong!
But those of us worried are simply overreacted and paranoid and don't know anything about microbiology etc? I don't think so!

You quoted my post. I do not think my post meant what you think it meant.

Horseshoe, BSN, RN · Aug 11, 2014

Horseshoe, see my previous links regarding respiratory precautions. I agree that this current strain needs more studying. Abundance if caution is what stands out to me from my previous post. .. Rather than the general response to be flippant and so sure it's not airborne. Primate to primate transmission is one thing. We have experience with Ebola from monkeys to humans in Virginia in 1989. This is more virulent than prior outbreaks in history. If anything, it demands respect and prudent attention.

Okay, but where is the "case closed" coming from? That suggested to me that you were getting from your link that this disease is airborne, therefore "case closed." First of all "case closed" does not say to me that anything needs more studying, since it's clearly established. Second, I don't see why you linked that article, as it did not indicate to me AT ALL that airborne transmission has been established as a mode of transmission.

I'm all for caution, I'm not flippant, and I don't believe many are in the face of such a virulent infection. However, I believe strongly in looking to science and SOUND research methods. I take issue with anyone who follows a poorly backed up assertion with "case closed," regardless of which side of the argument they are taking.