Ebola: Protecting Our Healthcare Workers (and Ourselves)

In past Ebola outbreaks, most infections occurred in caregivers - and outbreaks tended to spread out from clinics. So we have a few lessons to learn from history.

According to Doctors Without Borders (MSF), the key to preventing infection in health care workers is: 1. spray down with bleach immediately before removing protective gear, and 2. have an "Infection Control Manager" present at all times to walk workers through suit removal step-by-step (because workers are likely compromised by the time they get to suit removal - tired, hot, a bit dizzy and not thinking clearly). ...Seems hospitals in the US and Canada do NOT have "Infection Control Managers."

Lest we forget.

Ontario Nurses’ Association appeals SARS lawsuit ruling: ONA says government must be accountable for nurses’ safety
August 06, 2009

TORONTO—The Ontario Nurses’ Association (ONA) has applied to the Supreme Court of Canada for leave to appeal the decision of the Ontario Court of Appeal that dismissed an action on behalf of 53 nurses who contracted SARS while caring for SARS patients in 2003.

The May 7th decision by the Court of Appeal said that the province of Ontario owes no private duty of care to the province’s front-line registered nurses. This ruling leaves RNs at risk as they care for patients during the current H1N1 flu pandemic and in other outbreaks of potentially deadly diseases, such as SARS.

The nurses allege that the province assumed responsibility for their health and safety when it issued detailed directives to health-care workers advising them what precautionary measures to take – and those measures proved to be inadequate. Nurse Tecla Lin died as a result of her contact with SARS. The other nurses all contracted SARS and while some have recovered sufficiently to return to work, many others continue to struggle with lingering symptoms, including constant fatigue and respiratory illness.

SPECIAL REPORT: Nurses Were Sacrificed

TEN YEARS AFTER SARS: WHERE ARE WE NOW? WHAT HAVE WE LEARNED?

Ten years ago this spring, Ontario was gripped by a terror we had never known: Severe Acute Respiratory Syndrome, better known by its acronym, SARS. In this special retrospective, we relive the nightmare our members on the front lines experienced with a province and employers ill-equipped to handle the deadly virus, the lessons learned, and why we are hopeful our members will never be put in a similar situation again.

Note: Hospitals in Canada are government owned and operated under universal health care.

ALSO SEE:
Dallas nurses cite sloppy conditions in Ebola care

A second Health care worker in Dallas diagnosed with Ebola
Nurses' Union: Shocking Ways that TX Presbyterian Hospital Bungled it!
A health care worker at Texas Health Presbyterian Hospital has tested positive for Ebola
National Call Goes Out For Ebola Nurses - Specifies Dallas 'In Desperate Need'
Ebola, exposing government lies

…..and more

Africa vs. America Hazmat gear. We are taking this real serious in America heh...
*Note in Africa they are not only covered head to toe but they use tape to seal any openings. In the America pic we have cheap walmart mask with regular eye glasses and the news reporter went on to say "they are geared up and taking this very seriously"


pic close up

Hi, sofi, glad to see you around

To tell you the truth we always look at the outbreak of ebola on "developing" countries as a thing that happens because they do not have the same kind of safety standards as we have in "affluent" countries.

But look at the fiasco in Dallas, Sofi, it is despicable, like you point out, it is real that outbreaks starts when those that care for the sick become infected too, to take their sickness into their homes and families unknowingly

Then you add a virus like ebola that is developing constantly with the right environment and you get a super virus.

Something that could have been control in with proper procedures becomes uncontrollable and all it takes is one infected person.

How hard it was just to isolate that infected person sofi. What we got in positions of power in this country are nothing but stupid incompetent morons.

I share your concerns. I work in healthcare and I want to see Dr Frieden replaced. Here's why:
www.abovetopsecret.com...

a reply to: Staroth

Darn that picture works millions right now, developed countries looking like third world countries when it comes to safety standards.

It makes you think who really is more advance than whom.

One time ... just once ... I would like to see the actual numbers of nurses, in contrast with the numbers of MDs, who have contracted this virus. Then, I'd like somebody to ask, "Why?"

All these hero docs so rarely cross past the cargo netting ... that it's frikkin' embarrassing. But, the nurses are ordered to, by those same cowardly-assed MDs.

a reply to: Staroth

How about the nurse who got Ebola reporting that all of the healthcare workers caring for Patient Zero in Dallas were told to wrap their exposed necks in medical tape? What next - Duct tape will be declared even safer? Yeesh!

Would it be possible to have a couple of doctors from Doctors Without Borders come to Dallas and oversee this operation? Texas Health could really use their help right now.

Honestly, if I was a healthcare worker at a place that might require me to come in contact with Ebola, I would find another place to work until their is more confirmed science on this disease. It is obvious we don't yet know all the facts and or are ill equipped to prevent its spread even in a major Hospital environment.

a reply to: Staroth

Man, that bleach is probably complicating matters not to mention risking lives as it affects the lungs. In the picture and not the fist I have seen it happening, the patient area soaked in bleach, wow, really a complication.

originally posted by: bludragin
a reply to: Staroth

How about the nurse who got Ebola reporting that all of the healthcare workers caring for Patient Zero in Dallas were told to wrap their exposed necks in medical tape? What next - Duct tape will be declared even safer? Yeesh!

The problem is even if they have all the proper gear....do they know how to properly decon...and how to properly store that waste.

In the army we rehearsed this # constantly and I was only in the infantry.....at least 2 times a year we retrained on proper decon.

a reply to: rockpaperhammock

Yes, I watched some video of the precautions being taken by healthcare workers in West Africa. I saw none of that going in in Dallas.

Here is an eye-opening article from a Dr who was on the front lines at John F. Kennedy Memorial Hospital in Monrovia, Liberia back in June of this year when you could count the cases of Ebola on one hand...

For Dr. Joshua Mugele, the counting began one morning in June when he showed up for work at the John F. Kennedy Memorial Hospital in Monrovia, Liberia. Mugele, an ER doc and associate professor of clinical emergency medicine at Indiana University School of Medicine, was on a fellowship, working with staff to develop disaster readiness programs. The project had nothing to do with Ebola.

On that particular morning, Mugele showed up at the hospital to find a colleague in the parking lot, nervously making phone calls. When the man saw Mugele he told him the news: "We have a patient with Ebola."

In the end, they decided the most important thing was to move the man into an isolated room with its own trash can. Not a lot to ask for and yet there just weren't any empty rooms to spare; a small enclosed area at the back of the emergency department would have to do.

They began gowning up. Mugele says everyone was nervous, yet they were joking around. At one point, he reached for a pair of gloves and grabbed for a gown when Borbor stopped him. "He laughed at me and said there's no way you're going to be touching this patient. He said, 'I'm not going to make the international news for letting the first white man catch Ebola.'"

Once they decided he needed his own room in isolation and needed to be moved...

Between the four of them, they were able to navigate the patient and his mattress around the iron bed. They needed to take a break, so they put the patient and mattress down. They then shoved the mattress through the doorway as much as they could and climbed over it, "pulling it the rest of the way into the small isolation room," says Mugele. "It's terrifying watching it." It was equally terrifying for the custodians and for Brisbane, who came perilously close to an Ebola patient with no protective equipment except a pair of gloves.

"The patient is septic so he's covered in sweat," Mugele says. "And these guys are now all in this hot little room and they're covered in sweat. Dr. Borbor's mask actually slips down over his mouth at one point." Mugele reached over to adjust the mask but Borbor snapped at him: "Get Brisbane to do it, he's already touched the patient."

and the tally continues...

Brisbane died a few days later. So did Borbor, the man who just might have saved Mugele's life by preventing him from getting close to the patient.

The custodians, those two nervous young men who helped move the patient, left the hospital that morning and have not been heard from since.

I think i have mentioned this before but I work as a nurse in a area that has been designated as a area where ebola patients will be treated should their be a outbreak in the uk.

We have all had to go on a course on ebola infection control (which was pretty much "don't let yourself become in contact with infected bodily fluids) and have been told that further training will be coming up should things get worse. We already have the suits and masks down in a store should we find that we end up needing them.

The CDC has failed miserably. Period. We have had how long to prepare for a pandemic that we know is eventually going to happen????? The events in Dallas just should open your eyes to how ill prepared and arrogant the CDC and the US government is by thinking it can't happen here or they know what to do. Pathetic and scary at the same time.

If this was airborne from the beginning it would be global and deadly like nothing we have ever seen. We can't even treat one guy in Dallas without getting others sick. The hospitals in America have no idea what to do and are not set up to treat patients with a virus like Ebola. Can you imagine what would happen to the system if Ebola was spreading in America? The whole country would shut down. No doubt about it.

Im of the mind that the CDC and others involved with provided the right education and equipment to these hospitals to deal with this....

Should be brought up on criminal charges.......its negligence at the very least......

From the passing off blame, to the improper instruction, to the lack of information, to the lack of preparation to not even having the right equipment!

It was weeks in and they STILL hadnt briefed these places on what to do......

not to mention cleanup, look at the duncan house, the fact that even under quarantine they were allowed to leave, the school, the powerwashing of vomit by Joe blow with no gear on.......

The CDC and those in charge should have NEVER allowed these things to happen, the cleanup should have been done with proper gear and proper tools by qualified people to handle this........

More lives will suffer if this negligence continues....

These people need to be held accountable.........period

a reply to: soficrow

In past Ebola outbreaks, most infections occurred in caregivers - and outbreaks tended to spread out from clinics. So we have a few lessons to learn from history.

I was wondering about this, given that the only other patients in Dallas at the moment are care givers. Did the west African communities most hit by this virus have pre-outbreak access to clinics for vaccinations and other medical help? In Gabon after an earlier out break, researchers found that up to 20% of the population were actually carrying anti-bodies but had never suffered the illness. From what I can see the more rural areas have a much higher natural resistance to Ebola. Is there a genetic edge to this whole thing?

There is no vaccine for Ebola - so immunity would be naturally acquired, and 'acquired immunity' is not genetic. If it's inheritable, the mechanism(s) would be epigenetic.

originally posted by: antar
a reply to: Staroth

Man, that bleach is probably complicating matters not to mention risking lives as it affects the lungs. In the picture and not the fist I have seen it happening, the patient area soaked in bleach, wow, really a complication.

If not bleach for disinfecting, then what?

a reply to: antar

Yes you are right, my daughter caught a nasty upper respiratory infection from walking into a room that was just cleaned with heavy disinfectants in the hospital she works at without a mask, she didn't know.

The fumes caused her burning.