"Houston we have a problem" This just got very real

Published

And so it begins....

A health care worker who treated Thomas Eric Duncan, the first person in the U.S. diagnosed with Ebola who later died, has preliminarily tested positive for the deadly virus, the Texas Department of State Health Services said in a statement today.

The health care worker at Texas Health Presbyterian Hospital has been isolated since reporting a low-grade fever Friday, the department said. The Centers for Disease Control and Prevention will conduct further testing to confirm the diagnosis.

"We knew a second case could be a reality, and we've been preparing for this possibility," Dr. David Lakey, commissioner of the Texas Department of State Health Services said in the statement. "We are broadening our team in Dallas and working with extreme diligence to prevent further spread."

http://abcnews.go.com/Health/texas-health-care-worker-tests-positive-ebola/story?id=26135108
Specializes in Oncology/Haemetology/HIV.
Agree - I think a US epidemic could be a very real occurrence. This possibility should be forcing the CDC and WHO to be looking QUICKLY into developing a vaccine or effective treatment.

The problem. Several administrations have periodically cut appropriations for the CDC, decreasing its abilities to do their work. In fact, there have been a number of right wing candidates for office over the past 15 years, even presidential candidates that have wanted to dismantle the CDC, saying that private interests would do a better job.

Now if an agency is continually getting funds, is it going to allocate more resources into researching and treating the diseases that are the main killers, many of them, things that harm US citizens most (as it is s US agency), or sink much higher amounts of resources into an uncommon disease requiring very expensive treatments (antivirals), that has not affected most Americans. When your funding depends on political goodwill, guess which is going to get the money?

Second, ebola is a virus, making it much harder to treat. I guarantee that both CDC and WHO having been investigating to find effective treatments for the last 30 or more years for ebola as it has flared and burned out, repeatedly killing people in Africa on a regular basis. Telling them to "hurry up" and fix this disease, when they trying to do so for decades is insulting. (Yes, I know a few CDCers). The time to have "hurried up" was a few decades ago, back before it reached our shores. But I doubt if any private US interests found working for that treatment/vaccine financially beneficial.

Add in, ZMapp, one of the experimentally meds that has some

promise, consists of three monoclonal antibodies. That is not a drug that can be easily or quickly made. When you are looking a Mabs as a major treatment for anything, getting an effective treatment will be very hard to come by.

Specializes in Med/Surg, Academics.
We were ALL taught how to apply and remove PPE. Over the last few years I have seen an ever increasing lackadaisical attitude toward the removal of PPE and soiled linen and trash from isolation rooms from ALL personnel. I think we lost or "fear" of contagions.

But I still believe we should double bag.

To note: We do not know for sure it was a break in technique. We don't' even know what type of PPE the nurse was wearing. It just may well be that the nurse performed flawlessly....but that there is more to learn about Ebola.

That nurse and her family must be terrified. Dallas Nurse you are bored and reading this...we are praying for you (as well as all the personnel) and sending good vibes.

Thank you for that. I am upset that so many of my colleagues are jumping to say that this nurse did something wrong with her PPE. We don't know what PPE was used or the condition of the PPE, but she MUST have done it wrong!

Sad, sad, sad.

Specializes in Med/Surg, Academics.
What nurse taking care of an ebola patient would not use the best practice? Now on CNN they are saying that the Buddy system should have occurred meaning a second person should have been observing for breech in practice ( I do not know one hospital that would double staff).

There has been talk of euthanizing this nurse's pets.

So far my take is. They really do not know how this virus is transmitted and being a nurse puts your life in risk ( Duncan's family did not have one good thing to say about the nurses) for ungrateful patients and family. Your life may change to the point were your pets maybe in danger.

And if we nurses demand the buddy system and better PPE, we will be vilified as not doing the jobs we were "called" to do.

Specializes in Med/Surg, Academics.
I'm only speculating, but I suspect there's a small chance it can be transmitted from person to person via the aerosolized route even though the CDC states it is spread via direct contact. Again, I'm only speculating...

And it could have been aerosolized during intubation

Specializes in Emergency/Cath Lab.

I'll keep playing Infection 2 on my phone in hopes that this doesn't really happen. Ill watch Contagion also just to freak me out a bit more.

Personally, I think that there is more to learn about ebola. I think that while it may be a difficult virus to catch in that it is not airborne, that it is spread more easily than the CDC wants to advertise. It's naive to think that we are not susceptible to an epidemic at this point. Sure, our sanitation (in general) is better, we have access to healthcare- two of our biggest advantages- but it cannot be taken lightly. I see lackadaisical PPE donning and doffing. It needs to be addressed, everywhere. I'm in RI, which has the largest Liberian population in the entire country. I'm nervous. My hospital has said they will not be treating ebola patients- that they will be sent to a bigger facility in the state equipped to handle ebola. But, we should all be ready. It can be spread by saliva, sweat, vomit, etc. The CDC isn't doing anyone any favors by trying to tell people there is 0 chance of epidemic here.

But I also wonder- aside from widespread global travel, why now? Why has ebola been around for decades and is only now a problem? Is it this particular strain? Does anyone know?

I don't get why regular floor nurses are taking care of these patients? Seems like the CDC would have nurses who've had extensive training and the best equipment for these patients.

Specializes in Maternal - Child Health.
Thank you for that. I am upset that so many of my colleagues are jumping to say that this nurse did something wrong with her PPE. We don't know what PPE was used or the condition of the PPE, but she MUST have done it wrong!

Sad, sad, sad.

Yes, it bothers me that some here are perpetuating the notion that the nurse must have done something wrong. In other words, blame the victim.

But, in all fairness, that statement came straight from our "top" public health officials, Dr. Anthony Fauci and Dr. Thomas Frieden, who although neither has met, examined, or interviewed the nurse, and one wasn't even sure it WAS a nurse who was infected, blamed the infection on a breach of protocol.

Top US doctors: Hospital worker infected with Ebola by 'breach in protocol,' changes in handling patients are coming | Fox News

In this article, these two alleged experts disagree on the very topic at hand, whether proper use and handling of PPE is easy and safe, or a likely source of breach...

Frieden announced a five-part plan “to prevent how this occurred from happening again" that includes the number of health care workers treating an Ebola patient being “kept to a minimum” and limiting the number of medical procedures performed on the victim.He said Duncan was on kidney dialysis and respiratory intubation as “desperate,” life-saving measures.

The plan also includes examining how a health care worker removes protective gear, which Frieden said has “a major potential for risks.”

“It’s not easy to do right,” he said, adding that a health care worker putting on more protective gear “doesn’t make it safer.”

Fauci told ABC’s “This Week”: “There had to have been an innocent breach of protocol in taking care of a patient within protective equipment. That … rarely happens. We’ve been taking care of Ebola since 1976. It is unfortunate for this courageous health care worker.”

CDC director: Second case of Ebola in US result of 'breach of protocol' | Fox News

I also find it unsettling that the best these "experts" can come up with is"

1. Limit the number of caregivers exposed to critically ill and highly infectious patients...DUH!

2. Limit the procedures performed on these patients to only those necessary ones..........DUH!

3. Teach and observe the use, removal and disposal of PPE..........................................DUH!

I'm pretty sure the students in any Nursing 101 beginning laboratory class could have come up with those gems.

Specializes in Med/Surg, Academics.
I don't get why regular floor nurses are taking care of these patients? Seems like the CDC would have nurses who've had extensive training and the best equipment for these patients.

Best equipment, yes, but "extensive training"? In what? We aren't providers. The only brush up on training would be for proper donning and doffing of PPE. Nurses who have been extensively trained in infection control may not be best equipped knowledge-wise to take care of a very sick, intubated, hemodynamically unstable ICU patient.

Specializes in Med/Surg, Academics.

And didn't Brantley get infected despite use of PPE, but where was the CDC in throwing him under the bus? I rarely get angry with news reports--I'm a little more easy-going than that--but this is making me nearly tearful. Are we nurses that expendable to the PTB?

Specializes in Maternal - Child Health.
And didn't Brantley get infected despite use of PPE, but where was the CDC in throwing him under the bus? I rarely get angry with news reports--I'm a little more easy-going than that--but this is making me nearly tearful. Are we nurses that expendable to the PTB?

In a word, yes.

But I'm glad you brought up Brantley. I recall news stories initially reporting that he was infected despite use of PPE. I remember thinking, "Uh Oh" to myself when I read that. But I also recall that the story quickly changed to, "He wasn't wearing full Ebola gear because he was working with laboring women, and not in an Ebola unit." But as we OB nurses know, typical delivery garb essentially IS Ebola gear, minus the respirator mask, which supposedly unnecessary anyway, because Ebola isn't airborne.

If you believe that.

+ Join the Discussion