Ebola in the ER

a reply to: kruphix

Based on your illustrated bias, I assume you blame the epidemic's spread in West Africa on superstition and cultural practices.

In this light, lease explain how FIVE long-term researchers and fully trained personnel with the Ebola research facility in Kenema Government Hospital in Sierra Leone were infected (and died).

a reply to: intrptr

....If you don't have it and don't get it in quarantine, you are released to go back to your disrupted life. I wonder how many sitting here would submit to that…

…or run from authorities and hide. Thats one reason it is still spreading right now in Africa.

A VERY important perspective, that.

S&

It is about time we pack our sh*t, we need leave the universe, it will be the best, and the universe will be happier with humans gone

a reply to: Ares95PL

I say it's about time we recognize we're all connected in myriad and mysterious ways - and start taking care of each other. It's not a doom porn thing, just promoting basic life skills.

originally posted by: BobAthome
a reply to: soficrow

and no kissing with somebody u just met,,,saliva its a body fluid,,, 21 days,,then a kiss is ok.

Point taken.

originally posted by: intrptr
I hope this is on topic. Just a few thoughts…

In the region of outbreak in Africa, when the procedures are working (and thats debatable over there), the search for potential victims from contact with known cases is a difficult matter. Even when found, the "suspect" is guilty until proven innocent. First an examination and blood sample to be cultured are procured. This takes a few days to return a "result". Even then, to be sure, people are quarantined anyway. There is no 100 % guarantee that the culture was done correctly and that the results are sure. What if pronounced clean only to be released into the population with the virus?

The only sure thing with people suspected to have been exposed is to quarantine them for three weeks.

Think about that.

Imagine that sudden interruption in your life. Can you afford to go missing in your life for three whole weeks? What about your job, family, bills?

People are quarantined together, what if you don't have it but then contract it from someone else there in the ward?

Would you volunteer to forsake yourself to spend three weeks with other potential victims who may or may not have it themselves?

If you don't have it and don't get it in quarantine, you are released to go back to your disrupted life. I wonder how many sitting here would submit to that…


…or run from authorities and hide. Thats one reason it is still spreading right now in Africa.

I believe you are spot-on here with your thought process. This IS part of the problem of the spread of this insidious disease in West Africa. People with symptoms that may or may-not be Ebola take the wait & see approach (while they inadvertently infect everyone around them) because they do not want to be shut up in a petri-dish of a room that is likely seething with runaway Ebola germs. Something that I do not think has been mentioned: Let's say a person is confirmed to have Ebola whilst in quarantine. Let's say 3 other people are also confirmed, while a lucky 7 are deemed 'clean.' Two things here:

1. The 7 lucky ones had the test 2 days ago, and waited for the results in the ward with the sickos. They WERE clean, but are they clean still after 2 days of exposure in quarantine? After 21 days, I guess we'd know for sure. Twenty-one days roaming around town maybe justa incubating what they caught while they were waiting to find out their happy news. (Could this explain the false negatives we hear about?)

2. Changing gears: It only takes ONE virus 'organism' (they're not called cells apparently) to infect a person. If a person in quarantine ends up having Ebola, extra virus 'organisms' will only make them sicker, right? (Hate to be gross, but think of it this way... one maggot vs. 15 maggots eating rotten food-- Will it be consumed more quickly by 15? By the same token, will extra Ebola virus 'pieces' make the person's survival less likely?

a reply to: new_here

Yes. ....This is why "isolation" is a better solution than "quarantine."

...Not to change the subject, but do you realize that being in jail during a deadly pandemic is pretty much a death sentence?

originally posted by: Lyxdeslic
This is something that unfortunately happens everywhere and probably won't change. Well, it would if people would stop going to the E.R. because they have a hangnail, or need a pregnancy test.

I've never had Ebola, and I pray that I will never get it in my future. I do know from experience though, that unless you are bleeding from your eyesockets and missing an arm, you are not a priority.

I once went to the E.R. because I thought I had appendicitis. I was running a high fever, could hardly move... I looked like death. I waited in the E.R. waiting room for six hours. Thankfully I did not have appendicitis, but what if I did?

E.R. services need to change, just as much as most other medical things need changed.

My Step-dad fell off a ladder and broke his wrist and when I rushed him to the emergency ward, we had to wait for three hors while a bunch of people with minor cuts, bruises, sniffles and sore throats got preference...

ER's really need to start dealing with people on a "level of injury", basis instead of first in first served.

a reply to: new_here

Thanks for the reply, sorry for the delay.

I'm not sure about how the isolation and quarantine is actually being handled in the different countries in Africa right now. In a region where the facilities are up and running any one that is confirmed is completely isolated from others.

How that affects the quarantine I guess depends on how busy staff are. I imagine they will retest periodically the people in quarantine, monitoring them often for signs of fever, for instance. They might then be retested and isolated.

It is a dilemma since resources there are fewer than in larger population centers with more advanced health care "systems".

And a sure anxiety for people stuck there waiting to be pronounced "clean". Imagine how hard it would be not to bolt from that kind of place. Like you said, the spread from people that hide and deny or down play their symptoms to remain free is part of the problem.

Viruses are tiniest life forms, so small that a thousand can sit on the period at the end of this sentence. And they hide in the host, too. The first thing they do is gain entrance to living cells where they multiply and make hundreds of copies before bursting forth to contaminate other cells and so on. While in the cell they are safe from the immune system that may be hunting them. It is only when they are in the blood stream outside the cells that they can be removed by immune defenses.

Good book on the subject is The Hot Zone by Richard Preston. It describes this virus replication. Coupled with the long incubation period and rapid demise of victims (let alone no vaccine) Ebola is the near perfect militarized bio weapon. But they didn't make it, it already existed in the wilds of Africa.

a reply to: intrptr

Not sure, but you might appreciate this article: EBOLA-DENIAL | Ghosts of colonial past add to difficulty of battling deadly outbreak.

And after the ER....

….a man escaped from an Ebola quarantine centre in Monrovia on Monday and sent people fleeing in fear as he walked through a market in search of food, a Reuters witness said.

….Another witness said patients at the treatment centre did not receive enough food.

….Shortages of basic goods, foodstuffs and medical equipment have been worsened by a decision by some airlines to stop flying to the worst hit countries. Several neighbouring states have closed their borders and many international organisations have pulled out their foreign staff. ….

Hopefully this will help:

Japan creates 30-minute Ebola test

originally posted by: soficrow
a reply to: new_here

Yes.

....This is why "isolation" is a better solution than "quarantine."

...Not to change the subject, but do you realize that being in jail during a deadly pandemic is pretty much a death sentence?

I hear ya... a jail, a public school, a university, a doctor's office... heck, even a grocery store!!!

a reply to: intrptr

I'm not sure about how the isolation and quarantine is actually being handled in the different countries in Africa right now. In a region where the facilities are up and running any one that is confirmed is completely isolated from others.

Perhaps it is being handled differently in different areas over there, because the doc that came to Atlanta used to 'suit up' and then go into an Ebola ward (looked like a big tent) with patients in one big room. So in that situation, they were exposed to the other sick people.

So, again I wonder, does repeated exposure of an already sick Ebola patient compound the assault on their system?

a reply to: new_here

So, again I wonder, does repeated exposure of an already sick Ebola patient compound the assault on their system?

Um, gosh darn golly that's a real poser.

Um, yes?





[Thank you for playing.]

“It’s bad now, much worse than the numbers show. It’s going to get even worse in the very near future.”

CDC Director on Ebola Outbreak: “It’s going to get even worse”

(CNN) — The Ebola outbreak in West Africa is much worse than official figures show, and other countries are unintentionally making it harder to control, Centers for Disease Control and Prevention Director Tom Frieden told CNN Tuesday.

“We’ve seen outbreaks of Ebola before. This is the first epidemic spreading widely through many countries and it is spiraling out of control,” said Frieden, who recently returned from a trip to the region. “It’s bad now, much worse than the numbers show. It’s going to get even worse in the very near future.”

World Bank: Poor response to Ebola causing needless deaths

The world's "disastrously inadequate response" to West Africa's Ebola outbreak means many people are dying needlessly, the head of the World Bank said on Monday, as Nigeria confirmed another case of the virus. ….

……….Doctors Without Borders has warned about a worldwide shortage of the full-body protective suits worn by Ebola health-care workers. Sierra Leone’s Ebola emergency operations center said it faces a six-week wait for the specialized ambulances needed to transport Ebola patients.

a reply to: soficrow
Thanks for the link in your other reply.

Shortages of basic goods, foodstuffs and medical equipment have been worsened by a decision by some airlines to stop flying to the worst hit countries. Several neighbouring states have closed their borders and many international organisations have pulled out their foreign staff. ….

Going Medieval…



Off topic… LOL, I just now resolved the image in your Avatar. Great angle.

a reply to: soficrow

Thanks for the fright with my morning coffee, soficrow.

When they say "going to get worse", they mean a scenario that has hordes of people fleeing in panic ahead of the quarantine (or whats left of it)… some of them will be carrying the plague, festering within them.

Some of them won't feel safe until they are as far away as they can get from there. A very few will make it out of Africa.

It only takes one. As sure as it only took one person to start it there in the first place.

Stay tuned.

a reply to: new_here

Morning new_here…

So, again I wonder, does repeated exposure of an already sick Ebola patient compound the assault on their system?

Once you got it, you got it. Like you say further up, potentially it only takes one filovirus to start. Once in the body it begins by invading the nearest cell. Once that happens hundreds of virus will be created within that one cell. Exposure to more virus from outside matters little at that point.

If I understood your question correctly.

Get out you fortitude cap for this one...

originally posted by: intrptr
a reply to: new_here

Morning new_here…

So, again I wonder, does repeated exposure of an already sick Ebola patient compound the assault on their system?

Once you got it, you got it. Like you say further up, potentially it only takes one filovirus to start. Once in the body it begins by invading the nearest cell. Once that happens hundreds of virus will be created within that one cell. Exposure to more virus from outside matters little at that point.

If I understood your question correctly.

Get out you fortitude cap for this one...

...or a barf bag! I was ok until the "Tapioca Pudding" analogy. It only got worse from there!

So back to the repeated exposure... you may well be right, because it sounds like once it's in the system there's no turning back. Extra Ebola particles introduced into that system from the outside would only speed up the inevitable.

Then again... people DO survive infection with Ebola (rarely, and I'd like to know why/how that plays out exactly!) It is those, who can potentially overcome, that I mostly have this question about. I think of it like invading armies. The body is already fighting and winning against one army that entered thru a cut in the skin, then another one invades when a droplet of spewed blood lands on the left big toe, from a fellow patient. IF the person had half a chance against the initial 'invasion,' this second onslaught will surely sign his death papers? I just wonder, and I feel there is no way to know the answer for sure.

But it leads me to a thought I had about people in Africa avoiding/escaping quarantine. Some call them 'backwards' or 'superstitious' and say that things would go differently with an outbreak (God forbid) in the western world. But I challenge that notion. People are people, and I think it is just as likely that your average American or European, on being sought because of known exposure during an outbreak, would hide from authorities-- out of fear, denial, false-hope-- because the very idea of being 'locked away' in quarantine for 3 weeks with a growing number of potential cases, is something they are not prepared to deal with--- economically, psychologically, you name it.

They will 'head for the hills' --with the ones actually infected brewing and spewing their replicating Ebola-armies until they die. And on the surfaces of everything they came into contact with whilst on the run, it shall live on (for up to seven days.)

I do not understand why governments in the western world seem so uppity about their ability to handle an outbreak in their own countries. I don't see why they don't realize they won't hold all the cards... cannot foresee public reaction... cannot control how people react. What part of 'Better safe than sorry' is lost on them, that they shrug at this elephant in the room?