Also there is no political will to do so. There would be outrage if we flew in hundreds of people into our hospitals. Plus who is going to pay the 500k per patient that it might cost to treat them?

We have one.

Transfer her and beef up training. There is obviously no margin for error in patient care here.

I won't even pretend to understand that.

rather than address the content of the post?

I was referring to Duncan as well. He should have been transferred immediately upon diagnosis. Those hospitals would have been much better equipped to deal with it.

If you disagree, please feel free to state why rather than picking apart the number of 's's in the post.

Why was he released on his first visit as he obviously was sick and met the criteria for ebola admission, especially since this hospital had just, according to media reports, done a thing about how to screen and treat such people?

I have no idea what his care was like otherwise as I was not involved and privacy issues apply to releasing information about him.

This is a learning situation for all, what to do and what to not do, how to react and not over or under react.

I do not know how the nurse got exposed, but am interested if more information is released.

ETA wiki info of where BSL4 facilities are.
http://en.wikipedia.org/wiki/Biosafety_level#List_of_BSL-4_facilities

to transferring the nurse to a BSL 4 facility while they investigate what protocol was 'breached' and shore up training?

Since they don't know what happened, how many more HCW are being put at risk caring for HER?

"what will be do with all the patients?" leads to "we only have one". So, aside from my irritations, to discuss the issue.

On the one hand, they will be much more careful there. On the other hand, not knowing how they are making sure no one else gets exposed based on their past does not reassure me much.

I did a quick search for bsl-4 hospitals and came up with mostly labs. Where are those hospitals? Will the state pay to send her there? Will the state be more likely to send a USA citizen vs non-citizen there?

I think a lot comes down to money.

And the University of Nebraska in Omaha. Apparently those four are the only hospital facilities in the country set up for BSL-4 and they have a very limited number of beds between them, but it's sufficient for the current very few cases.

See here for my source: http://missoulian.com/news/local/st-patrick-hospital-of-sites-in-u-s-ready-for/article_da521772-4839-11e4-b266-4342d105e33f.html

it's hard to find the list for sure.

And we need to put them to full use while the number of patients is low. To prevent further infection of HCWs while we review protocols and provide training.

I assumed you meant that ALL the Ebola patients in Africa should be transferred here.

As to why Duncan and this current patient weren't transferred, possibly it is felt that there is more chance of spreading the infection during the process of transfer. Or, maybe it would be considered too stressful for a dangerously ill patient to travel.

That would be impossible.

We have successfully transferred patients already. From Africa. A 2 hour flight should be simple in comparison.

Last edited Mon Oct 13, 2014, 01:52 PM - Edit history (1)

(isolated) did not remain home, and Dr. Nancy Snyderman*, who was asked to stay home (isolated) for 21 days was spotted out in a car with someone in front of a restaurant where she frequently goes to buy soup, then why are the authorities not imposing real quarantines from the start rather than merely "asking" those who might have been exposed to refrain from wandering around and potentially exposing many others?

*Snyderman is the NBC talking head whose cameraman came down with Ebola.
--------

ON EDIT: It turns out that there were two men in the car with Snyderman, and both were part of the NBC team that were supposed to remain under voluntary quarantine because of being with the camera when he contracted Ebola and for days afterward. One of the men went into the restaurant to pick up their order.

The authorities *now* have made their quarantine mandatory, since they've proven they can't be trusted despite agreeing to the voluntary 21-day quarantine.

especially with the very small number of Ebola patients we've had so far.

One worry I have is that with the start of the flu season, a lot of people will flood the ERs with what seem to be Ebola-like symptons, in a total panic because of the scare-mongering that's out there. Here in Santa Fe, it's quite common that one a family member goes to the ER, pretty much everyone else in the family comes along also: kids, grandparents, siblings, and so on. This is really stupid where ordinary infectious diseases like flu is concerned. Fortunately, Ebola really is hard to get, and that poor nurse or assistant or whatever she is, had direct patient contact. It's just that something in the chain of protection broke down.

It's not very likely that Ebola will spread far in this country, even if a few more people get here as Duncan did, having been exposed but not yet symptomatic.

The incubation period is very well known, which helps a lot.

in the works. I heard CNN refer to potential "regional centers" and that made some sense.

I wouldn't imagine that all the small hospitals/clinics in this country could all of a sudden be ready for a job of this sort. Whether it ends up being a handful of cases or hundreds I would think you'd want to keep those cases together and have many of the same (knowledgeable) folks working on them.