The doctors and nurses in our Emergency Department don't have a real high opinion of the CDC. They point out that it is a political post that sets social policy. They are the shepherds, and we are the sheep. Big Pharm, Big Medicine and all kinds of secret political dealings influence their "science."
- Not even one health care worker in our ED tonight thought that the paper gowns recommended by the CDC (and purchased by the hospital) would stop a splash of virus ladened diarrhea from penetrating to the skin of the HCW. And since Ebola patients produce about 2.5 gallons of diarrhea a day, this is a big issue.
A couple of the nurses are Military Reserve Officers and one is in the chemical and biological weapons response unit at the USAMRIID. So we had some insider viewpoints tonight. The recommendation was "Watch what they do not what they say." Here is picture of a CDC BSL-3: battery powered HEPA ventilator (air is drawn from the room, filtered and delivered to the head/face piece), head cover, face shield, impermeable suit, work done behind a splash shield, chemical shower on exiting. [This BSL-3 set up is much more rigorous than the recommendations they have provided to community hospital HCWs.]
And here is BSL-4. Room air is NOT breathed but is pumped in from the outside filling the suit. A 7 minute chemical decontamination shower while wearing the suit is required, then passage through multiple air pressure locks, then when stripped naked, another decontamination shower, then another air lock, then redress in street clothes. Not one item of personal clothing enters or leaves. This is how Ebola is treated by the CDC. (Thanks Claire)
- Even if our paper gown were to actually be impermeable, no one thinks that the act of doffing (removing) the PPE can be done consistently and perfectly everytime by every nurse. Errors will occur. People will be infected. Several specific steps seemed likely to cause contamination. Absolutely not one doctor or nurse thought it was reasonable to assume that each and every HCW was sterile after doffing. And no one was willing to be touched by a HCW who had just left the Ebola room.
http://www.cdc.gov/HAI/pdfs/ppe/ppeposter148.pdf
- Absolutely no one, no one single doctor or nurse, would return home to spouse or children after caring for an Ebola patient. Everyone planned on checking into a motel and "avoiding humanity" for the duration of the epidemic. Yet it is the official position of the CDC that once you have removed your PPE you pose no infection risk at all and you may return to normal patient care activities and go home to your family. Absolutely no-one believes that that is true. [And tonight the CDC back tracks and says that the "Dallas number 2 infected nurse" should not have traveled after Ebola care…].