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Ebola epidemic

http://www.nationalnursesunited.org...hospitals-to-follow-highest-standards-for-be/

Press Releases
Nurses Call on Obama to Direct Hospitals to Follow Highest Standards for Beating Ebola

National Nurses United Press Release, 10/15/14

Contact Information | Media Center
As News Breaks that Second Health Worker in Dallas Tests Positive for Ebola, 11,500 RNs Join National Conference Call for Nurses on Preparedness

With concern escalating across the U.S. about the threat of a wider Ebola outbreak, National Nurses United today called on President Barack Obama to “invoke his executive authority” to order all U.S. hospitals to meet the highest “uniform, national standards and protocols” in order to “safely protect patients, all healthcare workers and the public.”

The request, send in a letter to the President, came on a day in which NNU, the largest U.S. organization of nurses, hosted a national call-in conference in which 11,500 RNs from across the U.S. joined to discuss what steps should be taken to confront a virulent disease that the World Health Organization has termed the most significant health crisis in modern history.

On the call, RNs from California, the District of Columbia, Florida, Massachusetts, Michigan, New York, Oregon, and Texas described widespread concerns in their hospitals about inadequate preparedness at a time at least two nurses have been tested positive for the Ebola virus in a hospital where one patient infected by the disease has died.

The call came just hours after NNU released a statement by RNs who work at Texas Health Presbyterian Hospital in Dallas voicing frustration and concern over what they viewed as a lack of preparation and training at their hospital, the first in the U.S. to see, first a patient with Ebola who subsequently died, and now an RN who has been infected with the virus.

In the statement, the Texas RNs described confusion in the hospital over policies in responding to patients with Ebola, inadequate advance training and availability of proper personal protective equipment, and changing guidelines. In the end, the nurses, said they felt “unsupported, unprepared and deserted to handle the situation on their own.”

“Sadly, the problems expressed by the heroic Texas Health Presbyterian RNs was predictable in our fragmented, uncoordinated private healthcare system, and it mirrors concerns we’ve heard from nurses across the U.S.,” said NNU Executive Director RoseAnn DeMoro.

It is the circumstances in Dallas, which have mirror the concerns nurses across the U.S. have been expressing, both on the call and via an online NNU survey filled out by more than 2,500 nurses that have prompted NNU to call on President Obama to mandate improved safety standards in U.S. health facilities.

“Not one more patient, nurse, or healthcare worker should be put at risk due to a lack of health care facility preparedness,” DeMoro said in the letter to President Obama. “The United States should be setting the example on how to contain and eradicate the Ebola virus.”

The letter also states:

“Every healthcare employer must be directed to follow the Precautionary Principle and institute the following:

Optimal personal protective equipment for Ebola that meets the highest standards used by the University of Nebraska Medical Center
Full-body hazmat suits that meet the American Society for Testing and Materials (ASTM) F1670 standard for blood penetration, the ASTM F1671 standard for viral penetration, and that leave no skin exposed or unprotected and National Institute for Occupational Safety and Health-approved powered air purifying respirators with an assigned protection factor of at least 50 – or a higher standard as appropriate.
There shall be at least two direct care registered nurses caring for each Ebola patient with additional RNs assigned as needed based on the direct care RN’s professional judgment with no additional patient care assignments.
There will be continuous interactive training with the RNs who are exposed to patients. There will also be continuous updated training and education for all RNs that is responsive to the changing nature of disease. This would entail continuous interactive training and expertise from facilities where state of the art disease containment is occurring.
If the Employer has a program with standards that exceed those used by the University of Nebraska Medical Center, the higher standard shall be used.

The Ebola pandemic and the exposure of health care workers to the virus represent a clear and present danger to public health.

We know that without these mandates to health care facilities we are putting registered nurses, physicians and other healthcare workers at extreme risk. They are our first line of defense. We would not send soldiers to the battlefield without armor and weapons.

In conclusion, not one more patient, nurse, or healthcare worker should be put at risk due to a lack of health care facility preparedness. The United States should be setting the example on how to contain and eradicate the Ebola virus.

Nothing short of your mandate that optimal standards apply is acceptable to the nurses of this nation,” the letter from DeMoro to the President concludes.
Click to expand...
 
Statement by RN’s at Texas Health Presbyterian Hospital as provided to National Nurses United

National Nurses United, 10/15/14

http://www.nationalnursesunited.org...at-texas-health-presbyterian-hospital-in-dal/

This is an inside story from some registered nurses at Texas Health Presbyterian Hospital in Dallas who have familiarity with what occurred at the hospital following the positive Ebola infection of first the late Thomas Eric Duncan and then a registered nurse who cared for him Nina Pham.

The RNs contacted National Nurses United out of frustration with a lack of training and preparation. They are choosing to remain anonymous out of fear of retaliation.

The RNs who have spoken to us from Texas Health Presbyterian are listening in on this call and this is their report based on their experiences and what other nurses are sharing with them. When we have finished with our statement, we will have time for several questions. The nurses will have the opportunity to respond to your questions via email that they will send to us, that we will read to you.

We are not identifying the nurses for their protection, but they work at Texas Health Presbyterian and have knowledge of what occurred at the hospital.

They feel a duty to speak out about the concerns that they say are shared by many in the hospital who are concerned about the protocols that were followed and what they view were confusion and frequently changing policies and protocols that are of concern to them, and to our organization as well.

When Thomas Eric Duncan first came into the hospital, he arrived with an elevated temperature, but was sent home.

On his return visit to the hospital, he was brought in by ambulance under the suspicion from him and family members that he may have Ebola.

Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present.

No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training.

Subsequently a nurse supervisor arrived and demanded that he be moved to an isolation unit– yet faced resistance from other hospital authorities.

Lab specimens from Mr. Duncan were sent through the hospital tube system without being specially sealed and hand delivered. The result is that the entire tube system by which all lab specimens are sent was potentially contaminated.

There was no advance preparedness on what to do with the patient, there was no protocol, there was no system. The nurses were asked to call the Infectious Disease Department. The Infectious Disease Department did not have clear policies to provide either.

Initial nurses who interacted with Mr. Duncan nurses wore a non-impermeable gown front and back, three pairs of gloves, with no taping around wrists, surgical masks, with the option of N-95s, and face shields. Some supervisors said that even the N-95 masks were not necessary.

The suits they were given still exposed their necks, the part closest to their face and mouth. They had suits with booties and hoods, three pairs of gloves, no tape.

For their necks, nurses had to use medical tape, that is not impermeable and has permeable seams, to wrap around their necks in order to protect themselves, and had to put on the tape and take it off on their own.

Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids.

Hospital officials allowed nurses who had interacted with Mr. Duncan to then continue normal patient care duties, taking care of other patients, even though they had not had the proper personal protective equipment while caring for Mr. Duncan.

Patients who may have been exposed were one day kept in strict isolation units. On the next day were ordered to be transferred out of strict isolation into areas where there were other patients, even those with low-grade fevers who could potentially be contagious.

Were protocols breached? The nurses say there were no protocols.

Some hospital personnel were coming in and out of those isolation areas in the Emergency Department without having worn the proper protective equipment.

CDC officials who are in the hospital and Infectious Disease personnel have not kept hallways clean; they were going back and forth between the Isolation Pod and back into the hallways that were not properly cleaned, even after CDC, infectious control personnel, and doctors who exited into those hallways after being in the isolation pods.
Advance preparation

Advance preparation that had been done by the hospital primarily consisted of emailing us about one optional lecture/seminar on Ebola. There was no mandate for nurses to attend trainings, or what nurses had to do in the event of the arrival of a patient with Ebola-like symptoms.

This is a very large hospital. To be effective, any classes would have to offered repeatedly, covering all times when nurses work; instead this was treated like the hundreds of other seminars that are routinely offered to staff.

There was no advance hands-on training on the use of personal protective equipment for Ebola. No training on what symptoms to look for. No training on what questions to ask.

Even when some trainings did occur, after Mr. Duncan had tested positive for Ebola, they were limited, and they did not include having every nurse in the training practicing the proper way to don and doff, put on and take off, the appropriate personal protective equipment to assure that they would not be infected or spread an infection to anyone else.

Guidelines have now been changed, but it is not clear what version Nina Pham had available.

The hospital later said that their guidelines had changed and that the nurses needed to adhere to them. What has caused confusion is that the guidelines were constantly changing. It was later asked which guidelines should we follow? The message to the nurses was it’s up to you.

It is not up to the nurses to be setting the policy, nurses say, in the face of such a virulent disease. They needed to be trained optimally and correctly in how to deal with Ebola and the proper PPE doffing, as well as how to dispose of the waste.

In summary, the nurses state there have been no policies in cleaning or bleaching the premises without housekeeping services. There was no one to pick up hazardous waste as it piled to the ceiling. They did not have access to proper supplies and observed the Infectious Disease Department and CDC themselves violate basic principles of infection control, including cross contaminating between patients. In the end, the nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own.

We want our facility to be recognized as a leader in responding to this crisis. We also want to recognize the other nurses as heroes who put their lives on the line for their patients every day when they walk in the door.
Click to expand...
 
This is an inside story from some registered nurses at Texas Health Presbyterian Hospital in Dallas who have familiarity with what occurred at the hospital following the positive Ebola infection of first the late Thomas Eric Duncan and then a registered nurse who cared for him Nina Pham.

The RNs contacted National Nurses United out of frustration with a lack of training and preparation. They are choosing to remain anonymous out of fear of retaliation.

The RNs who have spoken to us from Texas Health Presbyterian are listening in on this call and this is their report based on their experiences and what other nurses are sharing with them. When we have finished with our statement, we will have time for several questions. The nurses will have the opportunity to respond to your questions via email that they will send to us, that we will read to you.

We are not identifying the nurses for their protection, but they work at Texas Health Presbyterian and have knowledge of what occurred at the hospital.

They feel a duty to speak out about the concerns that they say are shared by many in the hospital who are concerned about the protocols that were followed and what they view were confusion and frequently changing policies and protocols that are of concern to them, and to our organization as well.

When Thomas Eric Duncan first came into the hospital, he arrived with an elevated temperature, but was sent home.

On his return visit to the hospital, he was brought in by ambulance under the suspicion from him and family members that he may have Ebola.

Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present.

No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training.

Subsequently a nurse supervisor arrived and demanded that he be moved to an isolation unit– yet faced resistance from other hospital authorities.

Lab specimens from Mr. Duncan were sent through the hospital tube system without being specially sealed and hand delivered. The result is that the entire tube system by which all lab specimens are sent was potentially contaminated.

There was no advance preparedness on what to do with the patient, there was no protocol, there was no system. The nurses were asked to call the Infectious Disease Department. The Infectious Disease Department did not have clear policies to provide either.

Initial nurses who interacted with Mr. Duncan nurses wore a non-impermeable gown front and back, three pairs of gloves, with no taping around wrists, surgical masks, with the option of N-95s, and face shields. Some supervisors said that even the N-95 masks were not necessary.

The suits they were given still exposed their necks, the part closest to their face and mouth. They had suits with booties and hoods, three pairs of gloves, no tape.

For their necks, nurses had to use medical tape, that is not impermeable and has permeable seams, to wrap around their necks in order to protect themselves, and had to put on the tape and take it off on their own.

Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids.

Hospital officials allowed nurses who had interacted with Mr. Duncan to then continue normal patient care duties, taking care of other patients, even though they had not had the proper personal protective equipment while caring for Mr. Duncan.

Patients who may have been exposed were one day kept in strict isolation units. On the next day were ordered to be transferred out of strict isolation into areas where there were other patients, even those with low-grade fevers who could potentially be contagious.

Were protocols breached? The nurses say there were no protocols.

Some hospital personnel were coming in and out of those isolation areas in the Emergency Department without having worn the proper protective equipment.

CDC officials who are in the hospital and Infectious Disease personnel have not kept hallways clean; they were going back and forth between the Isolation Pod and back into the hallways that were not properly cleaned, even after CDC, infectious control personnel, and doctors who exited into those hallways after being in the isolation pods.
Advance preparation

Advance preparation that had been done by the hospital primarily consisted of emailing us about one optional lecture/seminar on Ebola. There was no mandate for nurses to attend trainings, or what nurses had to do in the event of the arrival of a patient with Ebola-like symptoms.

This is a very large hospital. To be effective, any classes would have to offered repeatedly, covering all times when nurses work; instead this was treated like the hundreds of other seminars that are routinely offered to staff.

There was no advance hands-on training on the use of personal protective equipment for Ebola. No training on what symptoms to look for. No training on what questions to ask.

Even when some trainings did occur, after Mr. Duncan had tested positive for Ebola, they were limited, and they did not include having every nurse in the training practicing the proper way to don and doff, put on and take off, the appropriate personal protective equipment to assure that they would not be infected or spread an infection to anyone else.

Guidelines have now been changed, but it is not clear what version Nina Pham had available.

The hospital later said that their guidelines had changed and that the nurses needed to adhere to them. What has caused confusion is that the guidelines were constantly changing. It was later asked which guidelines should we follow? The message to the nurses was it’s up to you.

It is not up to the nurses to be setting the policy, nurses say, in the face of such a virulent disease. They needed to be trained optimally and correctly in how to deal with Ebola and the proper PPE doffing, as well as how to dispose of the waste.

In summary, the nurses state there have been no policies in cleaning or bleaching the premises without housekeeping services. There was no one to pick up hazardous waste as it piled to the ceiling. They did not have access to proper supplies and observed the Infectious Disease Department and CDC themselves violate basic principles of infection control, including cross contaminating between patients. In the end, the nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own.

We want our facility to be recognized as a leader in responding to this crisis. We also want to recognize the other nurses as heroes who put their lives on the line for their patients every day when they walk in the door.
Click to expand...

If this is the best response in the world, we are in real trouble. If anyone thinks there is a overreaction, you really need to listen to the people that are putting their lives on the line right now.

I hope everyone takes the time to listen to the audio.
 
A passenger died on a Nigeria-to-JFK flight after a vomiting fit Thursday

A passenger died on a Nigeria-to-JFK flight after a vomiting fit Thursday — and a top lawmaker said officials gave the corpse only a “cursory” exam before declaring that the victim did not have Ebola.

Rep. Peter King said in a letter to Homeland Security and Customs and Border Protection that the handling of the remains exposed serious flaws in airport preparedness for an Ebola outbreak.

Between 70 and 100 passengers a day arrive at JFK from the Ebola epicenter countries of Liberia, Sierra Leone and Guinea, King noted, and they have access to public restrooms and mingle with other travelers before their first screening.

“Given the high volume of travelers at JFK, it is essential that extraordinary measures are taken to intercept possible Ebola-infected passengers,” while keeping the public and first responders safe, King (R-LI) wrote to Homeland Security Secretary Jeh Johnson and Customs Commissioner Gil Kerlikowske.

“These individuals transit the airport with the rest of the traveling population, including using the restrooms,” King wrote.

Protection primary screening location that they are separated and sent to secondary inspection for a medical check and to complete the questionnaire,” he wrote Johnson.

His letter demands Homeland Security immediately beef up protocols for potentially infected passengers both in flight and at the terminal itself, prior to their reaching the screening location.

The letter also demands better training and safety equipment for the Port Authority police and Customs and Border Protection officials who can come into contact with high-risk passengers.

The unnamed passenger, age 63, had boarded an Arik Air plane Wednesday night out of Lagos, Nigeria, which has had 19 Ebola cases this year though no new cases in the past month.
Click to expand...


http://nypost.com/2014/10/16/alarm-after-vomiting-passenger-dies-on-flight-from-nigeria-to-jfk/
 
If we do get overwhelmed with an Ebola pandemic I can't see how this will come as a big surprise to anyone really following all this. With a 70 percent mortality rate lawsuits for malfeasance in public office will be the least of our worries.
 
Possible Ebola Case at the Pentagon
http://wtop.com/120/3724393/Ebola-scare-at-the-Pentagon


----------------------------------------------------
Obama’s New Ebola ‘Czar’ Does Not Have Medical, Health Care Background

http://washington.cbslocal.com/2014...does-not-have-medical-health-care-background/



-------------------------------------------------------

Hospital worker is now in quarantine on cruise ship.

http://nypost.com/2014/10/17/texas-hospital-staffer-in-self-quarantine-on-cruise-ship/
 
How stupid is that, to put a professional politician in charge of the Ebola crisis, one with no medical background. :ack2:
 
Lucille said:
How stupid is that, to put a professional politician in charge of the Ebola crisis, one with no medical background. :ack2:
Click to expand...

In two words, "pretty damned"...... :rolleyes:

And how stupid is the person who put him in that position?

Ditto....
 
In other news,

I also think a lot more attention needs to put on the enterovirus D-68.

1970 through 2006 we had 26 cases total in the U.S.. Now 700 in one year.
So far, five children are dead.
 
http://www.independent.co.uk/news/w...and-belize-refuse-to-let-it-dock-9804428.html

So do I understand this correctly? That health care worker was a risk of having Ebola, and still not outside the 21 day "all clear" period and went on a cruise ship with over 3,000 other passengers, destined to dock at ports in other countries?

And then, coincidentally, came down with "ebola-like" symptoms, that are now claimed were not ebola?

:notallthe

At least some countries showed a LOT more brains than the USA has by not allowing that ship to dock at their ports.
 
On that 21 day period... it's not all clear after 21 days, that's just when 95% of the people who were exposed start to show symptoms. You have to go out to 42 days post-exposure before 98% of the cases show symptoms.
 
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