Ebola!

[sand_puppy (sand_kitty)]

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."

1.  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)

2.   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

3.   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…].

 

 

 

[lesphelps]

I have two daughters within 90 miles of Dallas.  I'm not even concerned for them, at this point.
What I don't understand is this.  A man, knowingly, directly exposed to the virus, without any form of protection chooses to fly half way around the world and no one is offended.  With a virus like Ebola, that sort of behavior should be criminal, carrying the heaviest penalty on the books, yet, not a peep out of anyone, that I've seen.

 

 

[michael_rudmin]

so then, Sand Puppy, protocols need to be developed that incorporate those things into the response. The protocols need to be instilled now, and practiced now and TESTED now.
I would advise mobile concrete pads the size of parking spaces, raised as high as necessary, and with a steel drain pipe coming out its middle, and coil rod around the edges. using pallets and greenhouse technology, you build disposable tent units, and install space heaters. Each tent becomes a triage unit, or a place for a HCW to sleep… and if occupied by an ebola patient, gets incinerated. incineration can be accomplished by dropping a modified con-x over top of it, and burning everything with gas fire, superheating the exhaust and sending it through a catalytic converter (auto exhaust pipe).
The HCWs need to be faced with ebola symptom complaints, and need to be tested to see where their response fails proper protocol.
The ambulance crews need to get some Uhaul-style box trucks, and outfit them with plastic sheeting, Air Force 3 style, and have them ready to transport probable patients – and then be thoroughly decontaminated. That system too needs to be tested.

[troika]

Dr Martenson's article was well written and no doubt reassuring to many.
I keep thinking that epidemics and pandemics happen for a (or many) reasons.  Mother Nature is teaching us, if only we are aware and willing to learn from the situations.  Something is out of balance, we are being sloppy, we are not paying attention.  Fear and death should be our wake up call. Fear, in my opinion, isn't such a bad thing, it prompts us to act, to pay attention, to make changes so we can survive.

I agree most of us are not currently in harms way but there may be a tipping point for this virus to be truly out of control and we won't know when that happens.  Plus the main stream media talks about "confirmed" cases.  So some official has to "confirm" a case before it's actually counted.  The question that begs to be asked is, are there two sets of numbers, "confirmed" cases and "actual" cases? Kind of like real inflation or jobs numbers or unemployment and the "official" numbers?

We learned that the virus originated in bats and that it can affect, humans, pigs, and monkeys.  The affected nurses dog is being quarantined so the virus could affect dogs as well.  The point here is that we might want to be concerned and aware that this virus can move to additional hosts.  This potential is a wild card and not statistically quantifiable, but a possibility.  

Human nature favors self preservation so if someone has a choice of getting sick and being treated in a clinic in a 3rd world country or traveling to the US to be treated in a state if the art, high tech hospital than I would think planes would be full of people opting to leave infected countries in order to be here in case they needed our healthcare. For this reason I think we will see many more cases in the future.

We are upping are preps and watching this situation like a hawk. 

My 2 cents, AK Granny

[cmartenson (Chris Martenson)]

[quote=AkGrannyWGrit]Dr Martenson's article was well written and no doubt reassuring to many.
I keep thinking that epidemics and pandemics happen for a (or many) reasons.  Mother Nature is teaching us, if only we are aware and willing to learn from the situations.  Something is out of balance, we are being sloppy, we are not paying attention.  Fear and death should be our wake up call. Fear, in my opinion, isn't such a bad thing, it prompts us to act, to pay attention, to make changes so we can survive.
[/quote]
My sincere hope is the Ebola is a wake-up call for many, and that they use it to deepen their preparations, and as a means for observing how their government (the CDC) actually functions, or fails to, in the face of a very real threat, no matter how small it happens to currently be.
The much larger threat in my mind is the eventual arrival of a real pandemic threat that spreads rapidly and easily and causes enough mortality that it massively overwhelms the healthcare system (which actually isn't that hard to do…just add up the hospital beds in your city or town, and then divide that by the total population of your area and see what happens).
Somewhat jarringly, when this article was posted to ZeroHedge in the comments beneath I detected the distinct flavor of disappointment from some folks that my stance was not appropriately doomish enough, not enough fear based, and not pointing to the imminent demise of society as we know it.
That gave me some pause and I had to sleep on it because I have to carefully consider my own role in fueling the desires of those who long for change so much that it has become a belief system.  One that you either support or refute.  If supported, your views and data are met with glee and happiness.  If refuted, then it's anger and derision.
In both cases it is the emotional tone that reveals what is actually at work, and that is a belief system invested in certain outcome.
While I carry my own beliefs, so I'm neither elevating myself nor lowering others here, I work hard to assure that these beliefs do not prevent me from taking action.
I honestly care not whether someone shares my own limited concern about Ebola or has a highly elevated state of fear around the matter, but I do care, a lot, about whether that person (in either state) is taking prudent actions to become more resilient.
My assessment is that a majority of people at ZH who dumped on the article because it was not doomerish enough were also not doing anything new about becoming more resilient.  If they were in a dispassionate state around the materials, the responses would have been different and along the lines of, I disagree with the author's assessment and here's fact X and fact Y to support my case.  Accordingly, because of the view I hold, I have done this, bought that, and am increasing my own level of readiness along these lines, and I think others should consider the same…
All of that is perfectly reasonable to me.
But for anyone who found themselves angry at my views on the matter but has also not taken any concrete steps towards greater resilience and preparation I would offer up the idea that there's something there to be looked at because living in fear without action is the very definition of being a victim.
We are all responsible for ourselves, our reactions, and what we choose to allow to enter our minds and control our emotional state.  More regularly I choose to live calmly, and without fear, which means I filter out an enormous amount of popular culture and news.  
Said more directly, I choose not to be a victim.
Finally, I reserve the right to change my views on Ebola, or anything, as more data becomes available, and I hope you all know that.  :)

[nickbert]

My wife is an RN at a Denver hospital, and she says the hospital hasn’t done ANYTHING AT ALL in preparation or training for the possibility of encountering a suspected Ebola case.  Not so much as a 5-minute briefing regarding the possibility of needing to isolate or treat a suspected Ebola infection.  I’m less concerned about a widespread, devastating pandemic and more concerned about the hospital’s lack of timely preparedness and foresight exposing her and other nurses & doctors & patients (and their families) to possible infection.  I understand the risks of encountering such an infected individual are low (so far anyway) but the seriousness of the impact should it happen surely merits some response.  I don't expect them to turn the hospital upside-down and inside-out, but even a couple hours of briefing the staff on clues to look for and proper procedures to follow would at least be a step towards something.  It is criminal to not offer reasonable protection and training to the employees that through the course of their job are susceptible to substantially increased risk.  My wife says she frequently has to deal with patients who cough and sneeze on her with no thought to cover their mouths or turn their heads or anything.  And that's just the people who are mildly-to-moderately sick… how bad will it be when said patients are seriously or deathly sick?
I've said it before, but all I can say is I’m glad this isn’t something equivalent to the Spanish Flu around 100 years ago.  If it was I’d be begging her to quit.

[snydeman]

"That gave me some pause and I had to sleep on it because I have to carefully consider my own role in fueling the desires of those who long for change so much that it has become a belief system.  One that you either support or refute.  If supported, your views and data are met with glee and happiness.  If refuted, then it's anger and derision.

In both cases it is the emotional tone that reveals what is actually at work, and that is a belief system invested in certain outcome."

 

It is a very, very important point you make there, and I had not considered how my own burning hatred of the "system" that we live in would merge with my fear/knowledge that Big Change is Upon Us and create a paradigm that I myself am having trouble seeing beyond. I definitely find myself gravitating to anything that speaks doom and gloom now, almost with a morbid glee that finally the corrupt edifice of civilization will crumble, and the true freedom of anarchy will prevail once again (a rosy view of what collapse would bring, no doubt). I will need to ponder this, greatly, because it is hard to act rationally and logically in preparing for the future if I am wearing blinders of any kind. In any case, thanks for the reminder.

 

My wife and I continue to try to maintain some semblance of a balance in the struggle to prepare and the struggle remain optimistic and sane.

 

[jbarney]

[/quote]
Somewhat jarringly, when this article was posted to ZeroHedge in the comments beneath I detected the distinct flavor of disappointment from some folks that my stance was not appropriately doomish enough, not enough fear based, and not pointing to the imminent demise of society as we know it.
That gave me some pause and I had to sleep on it because I have to carefully consider my own role in fueling the desires of those who long for change so much that it has become a belief system.  One that you either support or refute.  If supported, your views and data are met with glee and happiness.  If refuted, then it's anger and derision.
[/quote]
I read your article yesterday Chris, and I wasn't disappointed with your assessment, although it was not what I was expecting.  I have been reading your work for years, and while I have not read the responses over at ZH, I find it odd that some people would react with anger to your calm, "take a breath" approach.
With respect to the threat level of ebola, your perception about people needing to look at the numbers, be aware, and go on with preps AND their regular lives came across loud and clear.  I wouldn't take too much from those who seemingly get too caught up in the moment.
That said, I think what is happening in Dallas should be a major cause for concern.   From Duncan being able to get into the U.S., to his being turned away from the hospital, the nurses not having the proper equipment, to American health care workers getting ill…and now the story about the 2nd nurse actually flying while having an elevated temperature…it all speaks to how ill prepared our institutions are to rapidly changing events. 
The percentages are small.  These events, right now, are only hitting a small number of people.  However, I can't help but think about how much worse this could get.

[time2help]

Some Fear Ebola Outbreak Could Make Nation Turn to Science

NEW YORK (The Borowitz Report)—There is a deep-seated fear among some Americans that an Ebola outbreak could make the country turn to science.

In interviews conducted across the nation, leading anti-science activists expressed their concern that the American people, wracked with anxiety over the possible spread of the virus, might desperately look to science to save the day.

“It’s a very human reaction,” said Harland Dorrinson, a prominent anti-science activist from Springfield, Missouri. “If you put them under enough stress, perfectly rational people will panic and start believing in science.”

Additionally, he worries about a “slippery slope” situation, “in which a belief in science leads to a belief in math, which in turn fosters a dangerous dependence on facts.”

At the end of the day, though, Dorrinson hopes that such a doomsday scenario will not come to pass. “Time and time again through history, Americans have been exposed to science and refused to accept it,” he said. “I pray that this time will be no different.”

[wendy-s-delmater-2 (Wendy S. Delmater)]

I loved the nice, scientific tone of your article above, Chris, and wanted to thank you for a cool head and sticking to the facts, especially since those facts may change and you've stated that you're open to changing any stances based on facts.
Facts are the difference between rational debate and irrational demagoguery.

Those of us who have done the best we can to get ready for the coming shift remind me of motorists reacting to a highway patrolman. If you're speeding, or have no auto insurance, or have a violation like a badly cracked windshield or missing headlight you are going to respond differently than if you are doing the speed limit in an insured, physically-sound car. It does not matter if you are driving an expensive car or a cheap one; you will not be caught out if you are doing the right thing.

When we're doing the right thing, although various crises pop up we probably have the skills and tools to play whack-a-mole with these crises if they intersect our lives. And the level of preparedness does not have to be perfect, it just has to be "the best you can do." Then you can be calm, and take a rational stance.

In our case our daily routine has not altered much. We pay attention to the news, and watch and listen. The political/societal/economic impact of this ebola outbreak may very well be damaging than the disease itself. Does anyone want to take bets that the way our government is "handling" this crisis is not impacting faith in the dollar, for example?

[dwig]

Ebola aside, Chris, I'd like to see you do an interview with Mary Odum.  She's the daughter, and "intellectual heir" to Howard Odum, who spent a lifetime doing ground-breaking work on an energy-based approach to ecology (which for him included all human activities).  The title of her blog, A Prosperous Way Down, is also the title of her father's last book, in which he summarizes his theories, and applies them to create recommendations for "policies appropriate to descent".  You can find much of his work in articles on the blog.  (For one thing, given your background, I think you'd enjoy learning about Odum's concepts of "emergy basis" (not a misspelling) and transformity, as well as his "pulsing paradigm" that puts our current situation into a larger context.

[gaborzol]

One of the things I appreciate about this site is the wide variety of people with experience and actual knowledge, rather than just information. This article from Chris is a prime example: clear on both the background on the infectuousness and danger of Ebola, as well as what it may mean inserted into our current political and economic environment. Much more interesting that to figure out about all these apocaliptic stories and possibilities from the media or other discussion sites. But maybe it is like watching a documentary instead of a thriller, and that turns some people off, I imagine. For me the world is complex and entertaining enough already, I don't need the extra stimulation, and Peak Prosperity has a tendency to explain things on my level (the good old laymen's terms), without hyping it up to make it interesting and entertaining. Thank you for that! 

[aaron-m-2-2 (Aaron M)]

It's interesting how we are used to seeing people with the Normalcy Bias who figure since something different hasn't happened yet, it probably won't. But this disaster bias seems to be working its way into our society more and more. 
Snydeman candidly summed it up - people who are just sick of our current "business as usual" policy towards political scandal, a valueless social system, a economic policy that promises gratification at the cost of satisfaction and legions of deeply rooted ponzi ticks out to screw you out of your money (I'm looking at you, local traffic courts) in the most absurd ways possible, are ready to just watch it burn. 
I would love to see our 'leadership' take notice of this and say "holy smokes, we should probably fix this rtfn". But, like Friden, we will probably see dialog more like "Well, it's YOUR fault! You didn't wear enough PPE!" And then a couple days later say "It's your fault! You wore TOO MUCH PPE."
It's the modern language of "Let them eat cake", and as with the Roman Empire, I have no doubt that Ebola is straw on an morbidly overloaded, weary camel with shaking knees and mange.
From that perspective, I thought this article illustrated the point nicely.
Cheers,
Aaron

[time2help]

Obama calls up reserves to deal with Ebola in Africa

[gallantfarms]

I also am not too concerned about Ebola in the US at this point, although it looks like it may be pretty devastating in Africa before it's over, and I think we will very likely see increasing "scare" cases here.  I would not want to be a Health Care worker never knowing if that "flu" patient I'm treating might have ebola.  It is reassuring that the close contacts of Duncan in Texas do not seem to have caught it, so it seems not super contagious until the later stages with very close contact.  
However, in the interest of "preps"  I thought I would share a link to an article that explains how to use Vitamin C to fight viruses.  Taking normal amounts of C will not do much, there is a specific dosing protocol that needs to be understood if you want it to work.   A virus replicates exponentially, like a fire, so it is extremely important to begin dosing at the very first signs of illness.  The great thing about vitamin c is that you don't need to know what it is you are sick with, it will help with a cold, flu or ebola, but only if you get the dosing right.

Here is the link:  http://orthomolecular.org/resources/omns/v10n13.shtml

Quote:  "The mechanism of action of high dose vitamin C is known and understood. In normal healthy tissues it acts as an antioxidant. In other tissues, it generates hydrogen peroxide, the chemical that platinum blondes use to bleach their hair. This happens in sick and inflamed tissues, for example in a malignant tumour. The process is typically a form of Fenton reaction, generating free radicals. The oxidation and free radicals arising from the hydrogen peroxide kill bacteria and inactivate viruses. In other words, vitamin C acts as a targeted bleach and antiseptic.

Vitamin C is unique, because it has low toxicity and can be taken safely in massive amounts. Other antioxidants and supplements will not have a similar effect." 

[agitating-prop-2 (agitating prop)]

…worry more about anti-biotic resistant strains of bacteria, like C. difficile.  How about necrotizing fasciitis? The only explosive diahrea I worry about is irresponsible journalism scaring the sh** out of everybody. 
Ebola is only a very small potential hazard to those on the front lines.   Sure it could become a problem.  Lots of things could become problems. Many viruses come and go without ever becoming a significant problem because their  numbers remain small enough that they never gain enough traction to cause a serious epidemic. 

Ebola is a disease of filthy conditions.  Feel for the people who live on a continent so beleaguered and beset with so many problems it can't deal with something as simple as basic hygiene.  That is the real tragedy.  Africa, as a continent, is the disease.  

[mikkel]

I apologize if this is addressed in the subscription only part, but the most likely catastrophic effect from ebola will be further rejection of the system.
Simply read the comments on this post at Naked Capitalism to get a gist of what I mean. The most noteworthy is

While it was sinking, could anyone have been said to be any trustworthy leaders on the Titanic? Regardless of status and position, those who were not only out for themselves were delusional and clueless. Add in a generous helping of incompetence and you have the Titanic in a nutshell. This analogy effectively describes not just the Dallas Presbyterian Hospital, but also America as a whole. Today, the best bet for self/family/group-preservation is to view everything with extreme cynicism and trust no one you don’t personally know. The alternative is empty life boats while people drown in freezing water.

Almost everyone has lost faith completely in the financial system, politics, journalists and statesmen; many have lost it in the police and educational system; and Fukushima/Deep Horizon contributed to putting scientists and engineers on the list, while all the abuse scandals are severely damaging religious institutions. About the only thing that has general support left is the medical system (and military), which is still considered good even though it is outrageously expensive.

Except of course it's not. The people within those systems know that they suffer from all the problems that the rest of society is facing. They are plagued by incompetent leadership focused on image and profits at the expense of service. They mistreat their core workers physically and emotionally, while lavishing rewards on hyper-educated but widely varying (in both skill and decency) technical workers. They arguably exist primarily to extract resources rather than benefit the public good.

As the Mary Odum post says:

Spanish nurses are defecting from the fight in Madrid, citing poor pay and inadequate PPE...hospitals these days are run by MBAs in suits, who know more about profitability than healthcare. What would stop me from quitting, and saving my ammo to care for my family, if I knew that a deadly pandemic was coming, and my hospital would not listen? Those journalists who promote headlines blaming the spread of EVD on nurses need to reconsider the slant they are promoting. And the MBAs running hospitals had better give nurses a seat at the table to manage these issues, now, before this pandemic heats up and we go into crisis mode

Similarily, from a Naked Capitalism comment "when a man with suspected Ebola arrived at Lewisham Hospital (South London, UK) recently, staff panicked and ran off, leaving the man untreated and unquarantined. One of the reasons why trained medical staff behaved this way, it was claimed, was that the business managers who run the UK National Health Service allocate protective gear in line with the perceived risk; that is, if someone turns up in A&E with a 10% chance of Ebola, staff only get low grade (ie “10%”) protective equipment."

Even a small pandemic has the potential to be the straw that breaks the camel's back, with widespread strikes and revolts. Of course, incompetent authoritarianism will only fuel that fire.

While most likely nothing extreme will happen, this will further cement distrust in not only authority, but society itself. Once people learn they can't even trust their doctors, who knows what will happen.

From this perspective, I find it foolish not to worry about ebola, regardless of its medical potential. But instead of that worry leading to passivity or further entrenchment, it should inspire peak-oriented people to capitalize and rebuild local trust by utilizing our worldviews.

[vitger]

The CIDRAP says Ebola should be treated as airborne/aerosol driven disease:
http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola

 

“We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.¹

 

I do not think we can yet grasp the potential enormity and consequences of this problem.

[wendy-s-delmater-2 (Wendy S. Delmater)]

Jamaica bans travellers from Ebola-affected areas

Nurse Who Treated French Ebola Patient 'in Hospital With Fever' (NDTV)

Europe Evaluates Ebola Measures as Possibility of New Cases Arises in France and Spain (NYT)

Rand Paul Contradicts Experts, Says Ebola Is 'Incredibly' Contagious (huffPo)

CDC: Nurse may have had symptoms earlier (CNN)

Ebola nightmare scenario unfolds: Infected nurse takes commercial flight with 132 passengers; plane makes 5 more flights (Intelihub)

Amber Vinson’s Flight: An Ebola Nurse and the C.D.C. (The New Yorker) "The C.D.C. can’t act as though this is a matter of a young woman’s recalcitrance if the true problem is the organization’s own incompetence. "

America's 4 Ebola Hospitals Can Only Hold 9 Patients (Mashable)

Changes to Ebola Protection Worn by U.S. Hospital Workers (NYT)

Obama Says He’s Open to Ebola Czar, Rejects Travel Ban (BBG)

Alarm after vomiting passenger dies on flight from Nigeria to JFK (NY Post)

Lawmakers demand answers about handling of Ebola cases (ABC)

Ebola vs. Civil Liberties: In abnormal circumstances, we must recalibrate the balance in the interest of safety. (Nat Rev)

Ship that left Jacksonville has Ebola scare in Baltimore (WJXT)

Obama Authorizes National Guard, Reserves for Ebola Fight (NBC)

‘OH HELL NO!’ Outrage meets Obama plan to send Natl. Guard to Liberia to fight Ebola (BizPacReview)

Islamic Burial Rituals Blamed For Spread Of Ebola (IBD)

 

[concobb2 (Mark Moran)]

<![endif]–>

I came across and interesting Ebola article in the Journal of Infectious Disease that I think warrants sharing and discussing.

 Here is the link:

           http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full

The paper strikes me as rigorous, the authors are from reputable academic institutions, and the journal has a solid technical record.

 From the article, I quote:

"The isolation of EBOV from semen 40 days after the onset of illness underscores the risk of sexual transmission of the filoviruses during convalescence. Zaire EBOV has been detected in the semen of convalescent patients by virus isolation (82 days) and RT-PCR (91 days) after disease onset"

So, it looks like survivors can potentially transmit the virus through intercourse for as much as 3 months after they are otherwise asymptomatic.

Respectfully

http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full