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Old 10-15-2014, 12:18 AM   #161
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Actually it would be easy to use 40 foot containers for this purpose. It could be divided into a patient room and a vestibule for gowning up and down. Since they make housing out of the containers its a readily available and transportable solution.
Interestingly enough I just saw a report on using shipping containers to build everything from apartment buildings to restaurants, to child care facilities.

It does seem like an ideal solution, although not without challenges.
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Old 10-15-2014, 02:50 AM   #162
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The hospital that took the Liberian citizen said that they cleared out the entire ICU, and had to close their ER. I think I remembered reading somewhere that their ICU alone was something like 20 beds!

Do you realize the cost of this for just 1 day, let alone 1-2 weeks? Would be far cheaper to hire a contractor to do an emergency site prep for 1 or 2 pad preps virtually anywhere, compared to letting your entire ICU and ER sit vacant for 1 patient.

Yes I understand that the costs of closing an ER are huge. And I do believe that it would be cheaper for a contractor to do site prep for a couple of pads. But I'm citing possible logistics problems in getting utility services to the pods. Available existing utilities, contractor mobilization, materials, permits?

It seems to me that emergency medical facilities are needed immediately upon need. The medical pods cannot be put into service the minute that there is a need or immediately upon deliver of the pods. It could take a few days to supply utilities to a pod in a specific area once the need for the pod and location have been established.


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Ebola in Texas
Old 10-15-2014, 04:40 AM   #163
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Ebola in Texas

Prelim test reveal 2nd Ebola diagnosis in Dallas, awaiting confirmation from CDC test. This is another healthcare worker who was involved in care of Eric Duncan.



http://www.cnn.com/2014/10/15/health...eak/index.html
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Old 10-15-2014, 05:56 AM   #164
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Actually it would be easy to use 40 foot containers for this purpose. It could be divided into a patient room and a vestibule for gowning up and down. Since they make housing out of the containers its a readily available and transportable solution.
Why worry about containers? Trailer/manufactured housing modules are readily availble for all sorts of layouts. They can be connected and internal modifications can be done quickly.


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Great concept, but getting sewer, water, and electricity to these facilities would be hurdles in getting them up and running quickly.
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I could get all this put in within 24 hrs if the utilities were close to a suitable piece of land. Of course, I'd have to be able to tell the appropriate city to GTH as far as permits and inspections are concerned. I would make it go in according to code but if they wanted to see it they needed to be there while it was being done. The typical "file the permit and wait a few weeks for them to get around to it then make an appointment and they might be able to get out there in a few days to inspect it" won't cut it.
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Old 10-15-2014, 06:00 AM   #165
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Prelim test reveal 2nd Ebola diagnosis in Dallas, awaiting confirmation from CDC test. This is another healthcare worker who was involved in care of Eric Duncan.
This whole event where the CDC let this hospital with no experience in this sort of thing stumble around on their own is disgusting. It's proof positive that their management training was right out of the Keystone Cop play book.

I thought it was interesting that "budget cuts" are being cited as hampering the CDC. It isn't mentioned that the loss of CDC funding was due to HHS diverting money to pay for the federal ACA exchange.
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Old 10-15-2014, 06:46 AM   #166
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Our current treatment methods do not scale well at all. There aren't that many ERs that we can close down entirely. Transporting the patients to a central location would certainly not be nice for families.
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Old 10-15-2014, 07:25 AM   #167
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Transporting the patients to a central location would certainly not be nice for families.
That's the least of my concerns. Less risk of contagion, safety for the caregivers and better care for the patient are miles higher on my list of priorities.
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Old 10-15-2014, 07:42 AM   #168
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..............I thought it was interesting that "budget cuts" are being cited as hampering the CDC. It isn't mentioned that the loss of CDC funding was due to HHS diverting money to pay for the federal ACA exchange.
Good point. If it wasn't for the ACA I doubt that we'd even have an Ebola epidemic.
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Old 10-15-2014, 07:53 AM   #169
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This is a good thread but the mods will shut it down if you guys continue to go political on us. Please stop.
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Old 10-15-2014, 08:02 AM   #170
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I agree with REW. In fact, he's walking my horse out to me right now.

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Old 10-15-2014, 08:02 AM   #171
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This is a good thread but the mods will shut it down if you guys continue to go political on us. Please stop.
Thanks!

Case #2 is shocking, I tell you!

Texas is doomed!
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Old 10-15-2014, 09:06 AM   #172
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There are stories being pushed on internet that nurse's boy friend was admitted to THPH on Sunday with symtoms of ebola. He works at Alcon Labs in Ft. Worth. However, the CEO of Alcon issued a memo that the boy friend was admitted to the hospital only to monitor for potential signs and symptoms. A subtle difference, but one that could lead to more panic in other cities.
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Old 10-15-2014, 09:08 AM   #173
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That the family contracted nothing is very encouraging. But pity the poor health care workers!!!
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Old 10-15-2014, 09:22 AM   #174
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Good point. If it wasn't for the ACA I doubt that we'd even have an Ebola epidemic.
I wasn't attempting to be political. The CDC's mission is too important to have funds diverted to an unrelated use just because "they can."
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Old 10-15-2014, 09:27 AM   #175
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I wasn't attempting to be political.
Of course you weren't.
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Old 10-15-2014, 09:30 AM   #176
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If true (and I suspect it is true) this is a scathing indictment of emergency preparedness. Sloppiness like this kills people. I expect many other facilities would be no better prepared. The bar needs to be raised, now. No wonder the CDC will be sending a Swat team with equipment to every new case.

http://t.thestar.com/#/article/news/...es_charge.html
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Old 10-15-2014, 09:31 AM   #177
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At least it looks like the CDC is going to be more aggressive going forward.

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The acknowledgment came as C.D.C. officials vowed to send a newly created response team to any hospital in the country that has a confirmed case of Ebola, and as they bolstered the amount of expertise, oversight and training at Presbyterian hospital. They have sent some of the world’s leading experts on Ebola to Dallas, as well as two nurses from Emory University Hospital in Atlanta who cared for Ebola patients safely and who will train hospital staff on infection control and the use of protective equipment.

“I wish we had put a team like this on the ground the day the patient, the first patient, was diagnosed,” Dr. Thomas R. Frieden, the director of the C.D.C., said at a news conference on Tuesday. “That might have prevented this infection. But we will do that from today onward with any case, anywhere in the U.S.”
http://www.nytimes.com/2014/10/16/us...T.nav=top-news
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Old 10-15-2014, 09:35 AM   #178
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That the family contracted nothing is very encouraging. But pity the poor health care workers!!!
I'm not sure they are through with the potential incubation period. It would be good if they were. I would expect them all to be reguarly checking their temperatures. If none of them are infected, I will be very surprised. The original case lived in a small apartment with several of them. He was clearly very ill for several days with contanct with many of them. If he didn't infect them with this sort of close contact, why are so many people catching it in Liberia? They can't all be health care workers exposed in the final stages.

The first nurse was pretty quickly diagnosed after her exposure. Based on the sloppiness of the supposed quarantine procedures, many more are probably going to be infected.

It does seem a little premature, excessive if the boyfriend is being put in a hospital without demonstrating any symptoms.
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Old 10-15-2014, 09:38 AM   #179
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That the family contracted nothing is very encouraging. But pity the poor health care workers!!!

+1. I pity the health care workers as well. They are out there on the front lines trying to do their jobs to save lives, using procedures and equipment as they are trained, and yet Ebola is spreading to some of the workers. And by unknown means. I can't imagine what it's like to do one's job knowing that your life may be in jeopardy while doing it.


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Old 10-15-2014, 09:39 AM   #180
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[...]C.D.C. officials vowed to send a newly created response team to any hospital in the country that has a confirmed case of Ebola, [...]
But how long does it take to confirm a case of Ebola? Honestly I don't know, but I wonder if those tests would take a day or two, perhaps? Then, I am envisioning another day or two for the newly created response team to travel to the hospital in question and report in at that location. I am wondering if by the time they get there, the hospital may have been making unintentional mistakes for days.

I do hope that the CDC is at least e-mailing informational packets immediately to hospitals with even unconfirmed cases of ebola, and perhaps consulting with the proper folks at these hospitals via Skype or telephone.

We live in the 21st century, not the 19th, and sending out a response team sounds like sending mail via the pony express, to me. Sure, having experts actually physically there would be wonderful. But also, information can be sent by much faster methods.
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