Ebola

[veremchuka]

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Originally Posted by brewer12345 Anyone else deeply uncomfortable with the idiotic decision to bring known, infected Ebola patients into the US? I mean, what could possibly go wrong?

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Originally Posted by brewer12345 Or we could accept the assurances of the CDC, which mistakenly shipped out live anthrax cultures to researchers and belatedly discovered that it had allowed smallpox cultures to reside in an unguarded college lab (oops!).

Yeah I'm with you and shocked at the lack of concern. Oh well what could possibly go wrong huh?

The 2 infected Americans went there knowing the risks and purposefully put themselves in this position. Under no circumstance should either of them be brought here, they should have been treated there and if they died buried there as well but that's already a moot point now.

The incompetence of the government in general and lately the CDC has unexpected consequences written all over this. Oh well time for another warning I guess for having an unpopular opinion.

[M Paquette]

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Originally Posted by easysurfer Isn't The Donald already a germaphobe from the start?

Yah. I've always thought that was strange, considering the alien parasite he hosts on his head.

[razztazz]

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Careful preparation is one thing. Fear is quite another.

Semantics

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Preparation is helpful. Fear is not helpful at all.

Fear, great or small, or something like it is the reason for the preparation.

[Fermion]

It is probably ok but I didn't think it was the greatest idea. Some remote facility where the staff is not allowed to leave during the treatment would be preferable. Atlanta has a somewhat large population.

[Gumby]

@razztazz

Yes, there is a difference. Preparation is a rational thought process conducted with an appreciation for the risk. It addresses the logical steps that might be taken to address expected negative developments. Fear is an emotion.

[robnplunder]

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Originally Posted by brewer12345 Anyone else deeply uncomfortable with the idiotic decision to bring known, infected Ebola patients into the US? I mean, what could possibly go wrong?

I am very comfortable with the decision. It's not an airborne disease, and patients can be brought in safely. They can use American medical system & know how to get helped. One of the patients is a voluntary doctor who went to Africa to help others. Why should he remain there to die in less than ideal medical system? I fully support the decision and don't think it was "idiotic." We do our share of idiotic things but this is not one.

[clifp]

I listened to the director of the CDC explain the decision on the PBS Newshour and I felt pretty comfortable with the decision. America isn't a poor Africa country with lots of superstitious beliefs and burial ritual which involve handing the body.

The country involved don't have protocol to isolate and identify anybody who comes in contact with the Ebola virus. We also are fine with cremating the body of patients who die from the disease. Evidently in western Africa people want to touch the body of the dead people before burying it.

[eytonxav]

I'd be concerned if the disease was transmitted by airborne means, but its not. Also, this may provide a much better opportunity to study the disease and develop a treatment plan and/or vaccine.

[Willers]

I was a scientist working at the time for the company that experienced the Virginia incident, one our esteemed corporate office referred to as the "monkey problem". Our people were well trained and we thought we had the proper procedures in place. I can tell you that fear comes on quickly when the men in the level 1 suits show up.

I agree that there is little, if any, risk to the public if this goes as planned. The problems come when the unexpected happens. Have any of us ever had a project that went 100% as expected? I haven't. I'm not concerned with what they plan to do, but I do worry about their contingency plans. Lack of proper plans for the unlikely but possible is where the real danger lies.

I left that business, in part because of an assessment of the health risk vs. the reward. I have reasonable confidence that those involved will proceed with great care and have contingencies in place to contain the virus since it has been studied extensively. I say that knowing from experience that CDC assurances mean absolutely nothing...

[Fermion]

I am not particularly worried about Ebola escaping the facility in America but then again I would not have been worried taking a tour of the World Trade Center on the morning of Sept 11, 2001. I would not have given a lot of thought to building a house 10 miles from Fukushima, after all, Japan has very modern high tech facilities with multiple failsafe.

That pesky Murphy and his laws.

[frayne]

Personally I'd be more concerned with ebola entering the US via some world traveler. The incubation period is something like 8-21 days and I'm actually kind of surprised it hasn't happened already. In this case the CDC is doing everything possible to prevent an incident, exposure or spread of the virus. This actually may be the first comprehensive opportunity to understand, treat and get a better handle on the virus and possibly find methods to combat the spread of the disease.

[aaronc879]

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Originally Posted by DFW_M5 I'd be concerned if the disease was transmitted by airborne means, but its not. Also, this may provide a much better opportunity to study the disease and develop a treatment plan and/or vaccine.

Are you sure? Ebola has mutated several times over the years. How do you know that this mutation or the next won't be able to be transmitted through the air.

This article talks a little about that: The Scariest Virus: Ebola Is Back, and It’s Worse Than Ever - Pacific Standard: The Science of Society

"Perhaps the most-feared potential Ebola mutation is efficient airborne transmission. Since at least the 1980s, epidemiologists have known it’s a possibility. Preston cited Gene Johnson’s 1986 experiment showing airborne transmission of both Ebola and Marburg between monkeys in The Hot Zone. More recently, airborne transmission between species has been documented in a laboratory setting. A BBC article on a recent study, published in Scientific Reports, suggested that airborne transmission could even have affected rates of contagion in some human outbreaks.

While the CDC has conceded that “all Ebola virus species have displayed the ability to be spread through airborne particles (aerosols) under research conditions,” its materials assert “this type of spread has not been documented among humans in a real-world setting, such as a hospital or household.” That’s not the same thing as saying it can’t happen, or that airborne transmission is not happening now."

[eytonxav]

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Originally Posted by aaronc879 Are you sure? Ebola has mutated several times over the years. How do you know that this mutation or the next won't be able to be transmitted through the air.

Possible, sure, anything is possible, but has not happened yet. There is also the possibility of a large asteroid striking the earth and wiping us out, or the super volcano underneath yellowstone erupting, but I do not worry about those possibilities.

[easysurfer]

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Originally Posted by frayne Personally I'd be more concerned with ebola entering the US via some world traveler. The incubation period is something like 8-21 days and I'm actually kind of surprised it hasn't happened already. In this case the CDC is doing everything possible to prevent an incident, exposure or spread of the virus. This actually may be the first comprehensive opportunity to understand, treat and get a better handle on the virus and possibly find methods to combat the spread of the disease.

This is one reason why I welcome the two infected to get treated at the hospital. So that we can better understand and treat the cases if/when ebola enters via a world traveler. Better to understand under controlled circumstances than uncontrolled.

[MRG]

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Originally Posted by Willers I agree that there is little, if any, risk to the public if this goes as planned. The problems come when the unexpected happens. Have any of us ever had a project that went 100% as expected? I haven't. I'm not concerned with what they plan to do, but I do worry about their contingency plans. Lack of proper plans for the unlikely but possible is where the real danger lies.

The real gist of the issue IMHO. We don't know what we don't know!

I'm not worried, as it's out of my control. However I'm much better equipped to face a zombie apocalypse than an outbreak that could happen. Sincerely hope this improves the world's knowledge of how to treat, vaccinate, deal with this problem.

[Meadbh]

I used to work close to this research facility where they are working on an Ebola vaccine (which has suddenly been fast tracked). I did a tour once, but they would not let us beyond the lowest level of security.

Inside the Winnipeg clinic working with one of the most dangerous pathogens known to man — ebola | National Post

You can take all the precautions you want, but the rogue ex-employee who stole biological samples for personal gain found a way to get around them.

[MooreBonds]

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Originally Posted by DFW_M5 I'd be concerned if the disease was transmitted by airborne means, but its not. Also, this may provide a much better opportunity to study the disease and develop a treatment plan and/or vaccine.

I did a quick look, and saw where a CBS story said "It is not contagious through the air"....

But then I read aaronc879's comment:

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Originally Posted by aaronc879 While the CDC has conceded that “all Ebola virus species have displayed the ability to be spread through airborne particles (aerosols) under research conditions,” its materials assert “this type of spread has not been documented among humans in a real-world setting, such as a hospital or household.” That’s not the same thing as saying it can’t happen, or that airborne transmission is not happening now."

If a virus can spread via airborne transmission (sneezing, etc.) in a lab, then it can spread through airborne transmission. IMO, if you see it happening in a lab, I don't see why there is an assumption it CAN'T happen in the 'real world'. Also, it's quite apparent that many places in Africa don't have elaborate indoor HVAC systems, or even electricity, so when you have simple open windows with fresh air constantly blowing around a one-room hut, and small buildings/homes, the transmission would be vastly different compared to the average Western building with recirculated HVAC systems.

However, this also brings up a point on general hospital infectious control procedures (for all infectious conditions, not just Ebola). As a plumbing engineer for construction projects, I've worked on a number of healthcare projects, not directly on HVAC systems, but have worked with HVAC engineers.

I'm honestly surprised that more infections don't break out with some hospitals than already happens, for the simple fact of how most ventilation is handled for 'isolation rooms' (note: I can't locate the design criteria or specs for the "one of only 4 rooms in the country" that Emory is putting the Ebola patient in, but I am familiar with nearly all other 'isolation rooms').

The standard design for an isolation room is this: depending on the condition that the patient has, they put them in a special negative (or positive) pressure isolation room, that either keeps the funky stuff in the room from escaping (negative pressure) or they can make it positively pressured to keep anything from entering the room (like for a lukemia patient with no immune system). This is typically handled with the flip of a switch. However, when it's negatively pressurized to keep the funky stuff in, all that air does is get sucked up through the building and out the roof (or side of the building) by an exhaust fan. Sometimes, they have one fan shared among several isolation rooms in older hospitals, or even newer ones.

So not only do you have the chance that some MRSA or other aerosolized bad thing could work its way down the ventilation system into other isolation rooms, but (more importantly), the exhaust air from the 'standard' isolation room is NOT sterilized or contained before ejecting it outside the building. (again, I'm not referring to the special Emory Ebola room, but every "standard" hospital isolation room)

And guess what? New HVAC codes require more fresh air intake for all buildings, especially healthcare settings. And guess where all that fresh air is coming from?

It's from outside the building.

Do you think the HVAC engineers think about the air they are exhausting from the exhaust fans for those isolation rooms with all that funky stuff? Sometimes yes...but surprisingly, many times, no. But even if they do place the exhaust fan discharge 'far away' from the fresh air intake, do you realize how relatively small the exhaust fan air flow volume is, and how relatively massively large the fresh air intake is for an entire hospital?

Not only is that exhaust air with possible funky airborne pathogens just pushed out of the hospital, free to gradually rain down on people entering/leaving the hospital, but it can also get sucked up by the massive fresh air intake to get redistributed back through the hospital ventilation system to all of the other rooms. Especially depending on how the prevailing winds are any given day.

Some HVAC air handling units have ultraviolet 'air cleaners' to have SOME level of disinfection - but that's typically only on the air that's recycled from the building directly back into the building. Not on the 'fresh outside air'. And the exhaust fans don't have ultraviolet disinfectors to sterilize the air before exhausting it.

No, I'm not typing this with a tinfoil hat. Just offering a dose of realism on how things are in the 'real world', and a small snippet observation that things aren't necessarily perfect just because we don't see massive outbreaks on the news every week. There are plenty of opportunities for things to go wrong in many settings. Often times we simply don't know or it's not publicized.

[ls99]

Fear is a good motivator, learn and overcome. Fear maintained inhibits clear thinking and ability to solve problems under pressure.

Overcome it or die.

[LOL!]

A few years ago while in the UK, I toured the little town of Eyam which tried to isolate itself after residents came down with The Plague. Eyam

Will parts of Atlanta have to isolate itself? What about the aircraft and ambulance used to transport the infected?

Is this a ploy to get more funding for the CDC and NIH to study Ebola? More funding for other infectious diseases such as MRSA, MERS, West Nile, tuberculosis, malaria, chikungunya, measles, smallpox, mumps, whooping cough?

Someone with ebola will eventually fly on a regular commercial flight to the US. This controlled introduction of an infected person is a better test of what to do than waiting for the uncontrolled version.

[FireBug]

In my opinion, probably one of the more sound decisions the U.S. could have made. First and foremost, this disease has an incubation period of weeks…virtually no symptoms whatsoever. This disease will spread and it’s laughable to think we can prevent its arrival by isolating our country. This alone, requires that we understand and prep for it.

Which among us would be the first to say that a son, daughter or spouse, a U.S. citizen, should be prevented from coming ‘home’ because of the illness (which has a 40-50% survival rate).

More to the critical thinking side of things, I would urge all of us to research the containment, equipment, policies, and procedures being used in the efforts to understand and combat Ebola. They are very stringent and leading state-of-the-art.. Think about it. We’ve all seen the footage from Africa. The patients are sometimes being treated in tents! Imagine the talent and resources we have here. The computing and power brain power we can thrust at it. And yes, the patients have to be ‘here’ to maximize that effort. While the CDC has been in the news recently for lapses, keep in mind that it was ‘us’, the people, the workers that were to blame. Policies were not followed. Policies that had become ‘rote’, after 50 yrs of use. I’m far more confident that this will not be the case with Ebola. This is not Hollywood. It’s science...the same voodoo that lets a machine keep a dead persons heart beating until it is removed and placed into someone else. How that would have been viewed 75 years ago.

Finally, I lived in the SF Bay Area during the late 70’s. I remember vividly how hysteria ruled the Aids crisis. People back then would not even be in proximity of a patient (this, after being explicitly told by the medical community that there was zero danger). Go back over hysteria of news reports. All you have to do is substitute “Aids” for “Ebola” and you will get my point. I know this board covers a lot of different spectrums regarding politics, $, etc., but given its track record, the medical community in cases like this, still has my trust and is our best hope to combat this disease.