Ebola!

I’m very confused by the current efforts to contain Ebola. First, there were cries for a total travel ban from West Africa. Now some areas have implemented a less aggressive measure requiring a quarantine following arrival in the USA if you’ve had exposure to Ebola patients. But the same people who were crying for a travel ban are now opposing the quarantine. Make up your minds, people!

I think the quarantine is silly too. The general population has nothing to worry about as far as Ebola goes. If you see someone sweating profusely and vomiting blood, yeah, stay away from them. No quarantine needed for people who are asymptomatic. It isn’t some deep mystery how Ebola has spread so widely in Africa. Their funeral rituals involve kissing and bathing the deceased, and shortly after death, Ebola is highly contagious. So of course, the disease spread rapidly at first. Since then, it has been limited resources and ignorance that have prevented control of the disease. The countries with large outbreaks have been too strapped for resources to effectively quarantine all their symptomatic Ebola patients.

In the USA, even with the usual bumbling of the government and corporations, a grand total of two people have caught Ebola in the USA. This was due to the ridiculously insufficient PPE (Personal Protective Equipment) provided to those carrying for Duncan in the early days of his care. Our yellow gowns and single layer of gloves are a joke in the face of essentially anything contagious. They haven’t been effective in preventing the spread of MRSA and C Diff, so obviously won’t be effective in preventing the spread of Ebola. Once proper PPE was implemented, transmission was stopped completely.

So we need to have two effective steps in stopping Ebola:
1) Identify those who may have Ebola. Have you or any close contacts traveled to West Africa in the past three weeks? Have you had any contact with the three people who are currently symptomatic with Ebola in the USA? No to both? Not Ebola.

2) Isolation. Place the handful of possible Ebola cases in real isolation. No one in or out except essential medical personnel. Train a team at each hospital to provide care for Ebola patients. Provide real training and practice in full coverage PPE. Training for everyone else should be to stick any possible Ebola patient in the nearest room and stay the hell away from them. Offer double pay for the Ebola Response Team if an Ebola patient does show up, and you’ll have people volunteering for it.

Our government sucks at implementing anything like this, so hopefully hospitals will reach this conclusion on their own. My hospital hasn’t, last email I saw still had us going in with yellow gowns, booties, gloves, and a mask. Our ‘training’ consisted of an online training module. No Ebola Response Team in place. Supposedly we’re supposed to consider upgrading to full body coverage PPE if the patient has copious amounts of bodily fluids, but none of us have seen this PPE, much less practiced donning and doffing. So while the general populace doesn’t have much to worry about, those of us who provide medical care to patients should be pushing hard to get a better response plan at our hospitals! I’ve let my director know my concerns, and supposedly they’re working on a better plan.

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