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Monday, October 20, 2014

Dear Brian Williams - Monica Lewiniski is old news

Here's a list of real news stories to help the NBC Nightly News with Brian Williams. He appears to need advice about how to provide news viewers with information, rather than muckraking old political information from the 1990s, just to create buzz.

My top of mind list:

1.  Lead with Richard Engels. Please.

2.  Report on how caregivers in Liberia are facing Ebola.

3.  Interview Secretary of State Kerry about how Turkey is responding to negotiations about supporting international efforts to destroy the evil ISIS.

4.  Provide an investigative report about how America's roads, bridges and airports are in need of infrastructure support.

5.  How have the sequestration cuts imposed by the US Congress impacted the US infectious control response to the Ebola virus?

6.  Interview Cubans in Florida about immigration reform.

7.  Follow yachts out of Key West Florida, as they sail unencumbered into Havana harbor.

8.  Interview Russian President Vladimir Putin.

9.  Report about the Hong Kong protesters.

10.  Investigate Germany's military...does it even exist?  How  can Germany defend itself these days?  Is NATO the German defense Alliance?

So, Mr. Williams, I wrote these 10 ideas in less than 15 minutes. Your  news staff is surely paid many thousands of dollars to create dog features and muckraking stories, rather than report real news.
Maybe your  staff would appreciate my part time help.  

Monica Lewinski is old news.  Just because she's become a champion of anti bullying doesn't make her news. In fact, Monica Lewinski can mobilize Democrats faster than former right wing darling Sarah Palin ever could.

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Sunday, October 19, 2014

Ebola virus reality check- it has been here in the past

Transcending the Ebola virus with facts.

It’s odd to see otherwise pretty rational folks getting nervous about the news that the American Ebola patients are being treated in American hospitals.  

There are irrational fears about “What if Ebola gets out?” “What if it infects the doctors/pilots/nurses taking care of them?” “I don’t want Ebola in the United States!”  

Irrational fears are now extending to extreme reactions about "closing borders" with all countries where Ebola is reported, especially west African nations.  

Americans have overreacted to the risk of Ebola virus exposure, but with some justification. Even infectious disease experts won't provide 100 percent assurance about how to prevent transmission. 
Unfortunately, the mismanagement of Mr. Duncan's diagnosis by Texas Health Presbyterian staff in Dallas exposed dozens of people to the Ebola virus.  In fact, Mr. Duncan was infectious because he was experiencing symptoms of the disease when he was turned away from the emergency department at his first visit. Later, he traveled to the ED by ambulance, where he died in an isolation room.  Dozens of caregivers were unnecessarily exposed to the virus, as a result.

Nevertheless, it turns out, the Ebola virus has been in the US prior to the cluster of infections reported in Dallas Texas, after Mr. Duncan died and two nurses became infected from the virus.

Medical Examiner blog reports about the rare incidents of other highly infectious virus outbreaks, including Ebola.

How to contain the deadly hemorrhagic fevers that occasionally reach the United States, by Tara C. Smith.

This article originally appeared in the blog Aetiology.

It’s odd to see otherwise pretty rational folks getting nervous about a disease as rare as Ebola.  “What if Ebola gets out (in the US)?” “What if it infects the doctors/pilots/nurses taking care of them?” “I don’t want Ebola in the United States!”

Guess what?  Ebola has already been in the US.  

Ebola is a virus with no vaccine or cure. Any scientist who wants to work with the live virus needs to have biosafety level 4 facilities (the highest, most secure labs in existence, abbreviated BSL-4) available to them. We have a number of those here in the United States, and people are working with many of the Ebola types here. Have you heard of any Ebola outbreaks occurring here in the United States? Nope. These scientists are highly trained and very careful, just like people treating these Ebola patients and working out all the logistics of their arrival and transport.

Second, you might not know that we’ve already experienced patients coming into the United States with deadly hemorrhagic fever infections. We’ve had more than one case of imported Lassa fever, another African hemorrhagic fever virus with a fairly high fatality rate in humans (though not rising to the level of Ebola outbreaks). One occurred in Pennsylvania, another in New York, a previous one in New Jersey a year ago. 

All told, there have been at least seven cases of Lassa fever imported into the United States—and those are just the ones we know about, people who were sick enough to be hospitalized, and whose symptoms and travel history alerted doctors to take samples and contact the Centers for Disease Control and Prevention. It’s not surprising this would show up occasionally in the United States, as Lassa causes up to 300,000 infections per year in Africa.

How many secondary cases occurred from those importations? None. Like Ebola, Lassa is spread from human to human via contact with blood and other body fluids. It’s not readily transmissible or easily airborne, so the risk to others in U.S. hospitals (or on public transportation or other similar places) is quite low.  (In public health language, the concept of "not readily" means it's difficult, but not impossible, for the Ebola and Lassa viruses to be airborne....)
Also, there's an imported case of Ebola’s cousin virus, named Marburg. One of those was diagnosed in Colorado in 2008, in a woman who had traveled to Uganda and apparently was sickened by the virus there. Even though she wasn’t diagnosed until a full year after the infection (and then only because sherequested that she be tested for Marburg antibodies after seeing a report of another Marburg death in a tourist who’d visited the same places she had in Uganda), no secondary cases were seen in that importation either.

And of course, who could forget the identification of a new strain of Ebola virus within the United States. Though the Reston virus is not harmful to humans, it certainly was concerning when it was discovered in a group of imported monkeys. So this will be far from our first tango with Ebola in this country.

Ebola is a terrible disease. It kills many of the people that it infects. It can spread fairly rapidly when precautions are not carefully adhered to: when cultural practices such as ritual washing of bodies are continued despite warnings, or when needles are reused because of a lack of medical supplies, or when gloves and other protective gear are not available, or when patients are sharing beds because they are brought to hospitals lacking even such basics as enough beds or clean bedding for patients. But if all you know of Ebola is from The Hot Zone or Outbreak, well, that’s not really what Ebola looks like. I interviewed colleagues from Doctors without Borders a few years back on their experiences with an Ebola outbreak, and they noted:

As for the disease, it is not as bloody and dramatic as in the movies or books. The patients mostly look sick and weak. If there is blood, it is not a lot, usually in the vomit or diarrhea, occasionally from the gums or nose. The transmission is rather ordinary, just contact with infected body fluids. It does not occur because of mere proximity or via an airborne route (as in Outbreak if I recall correctly). The outbreak control organizations in the movies have no problem implementing their solutions once these have been found. In reality, we know what needs to be done, the problem is getting it to happen. This is why community relations are such an issue, where they are not such a problem in the movies.

So, sure, be concerned. But be rational as well. Yes, we know all too well that public health and hospitals can make mistakes. 

Although there's no such thing as a "zero chance of something going wrong", the risk of catching Ebola in the US is low.

It's far easier to become ill with influenza or many other “ordinary” viruses than Ebola. 

Tara C. Smith, an associate professor of epidemiology at Kent State, studies zoonotic diseases* and blogs at Aetiology, discussing causes, origins, evolution and implications of disease and other phenomena.

*A zoonotic disease is a disease that can be passed between animals and humans.

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Calling all Democrats! Two branches of government for one will influence nation for foreseeable future

Americans must take this mid term election as seriously as the last presidential campaign. Although voter malaise seems to set in during the mid term campaigns, the 2014 election, particularly, is extremely urgent for Democrats. Our US Supreme Count is in the balance along with the US Senate. Surely, one of the current justices will need to be appointed within the next several years. Therefore, it's a "two branches of government for one" leadership election!

Republicans have used their minority status to create fear among the electorate about immigration, health care reform, women's health and guns. In creating fear, they will bring out their supporters while Democrats appear to be become "mid term passive" by staying home rather than respond in the voting booths.  

Democrats must get out the vote!

There's no way Republicans can push forth their anti immigration, anti voter, anti health care reform and anti women's health agendas if all Democrats make the unequivocal statement by voting these conservatives out of office.

Unfortunately, media reports continue to report how the conservative agenda is creating voter apathy rather than energizing a push back response.  It's time to see momentum in the voting polls and the number of "undecided" may tip the balance.  Usually, the undecided have made their statement by not supporting the status, perhaps the outcome of the mid term election may be in their votes.  Nevertheless, if all Democrats would vote to finally remove Republicans from our nation's leadership, our nation could pass immigration reform and assure women access to health care.....and maybe even take on some truly progressive policies like education and tax reform, too. out to all Democrats.  Vote!  It's a two branches of government for one, 2014 election.

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Friday, October 17, 2014

Intensified U.S. airstrikes have pounded ISIL positions; but ISIS retaliation is also fierce

Just trying to imagine how ISIL, the evil Islamic State can withstand the intensity of these reported air strikes. 

Hundred of extremists have been killed in days. of raids by coalition forces, says Pentagon.

Although ISIL now claims to have 3 MIG (Soviet) jets, it would be a challenge to find someone willing to fly them. Nevertheless, we can assume that ISIL is preparing some sort of suicidal strike on the locations where the airstrikes are launched.

October 16, 2014 7:00PM ET
US pounds ISIL targets, but Kurds warn more arms needed to defend Kobane.  Hundred of extremists have been killed in days of raids by coalition forces, says Pentagon
Intensified U.S. airstrikes have pounded ISIL positions in and around the besieged Syrian border town of Kobane for a third day, with 14 raids reported in the last 24 hours alone.

The attacks on Wednesday and Thursday appear to have slowed the advance of Islamic State in Iraq and the Levant (ISIL) fighters, but "the security situation on the ground in Kobane remains tenuous," the U.S. Department of Defense said in a statement on Thursday.

Underscoring the fragile nature of Kobane’s defense, Kurdish forces called Thursday for the supply of more weapons in order to push extremists back from the vulnerable town.

The Pentagon said on Wednesday that air strikes had killed hundreds of ISIS fighters so far, though it cautioned that the town could still fall to the group, which has held onto a vast territory stretching across Iraq and Syria despite the efforts of the U.S.-led coalition.

"The more they want it, the more resources they apply to it, the more targets we have to hit," Rear Adm. John Kirby, the Pentagon press secretary said.

However, an unnamed Syrian Kurdish official told the Associated Press that his fighters needed weapons to beat ISIL on the ground, and that air strikes were not enough – something the U.S.-led coalition has always acknowledged.

On Thursday, the U.S. Central Command, which commands U.S. forces in the Middle East, said the latest attacks were designed to disrupt ISIL's reinforcement and resupply efforts and to prevent it from "massing combat power on the Kurdish-held portions of Kobane.”

Also on Thursday, the Pentagon said talks between the U.S. and Turkey on a possible Turkish role in combating ISIL went "very, very well."

Turkey, a NATO ally, has rebuffed American requests to take a more active role in the anti-ISIL coalition and relief mission in Kobane – which lies just across the Turkish border with Syria – or to allow arms to flow to the Kurdish armed group PYD.

Turkish support is complex, given that Ankara has long tolerated ISIL because it effectively countered Turkey’s main enemies in Syria — the regime of President Bashar al-Assad and the country’s Kurds, who are allied with Turkey’s own Kurdish PKK insurgency. It also fears opening up its vast border with Syria and Iraq as the frontlines against ISIL, which has a presence in Turkish cities but has mostly left the country alone.

Over one million people have fled Kobane for Turkey, including many who were refugees themselves in the Kurdish enclave.

Meanwhile on Thursday, at least 47 people were killed and more than 120 wounded in bombings and mortar strikes across Iraq that were blamed on ISIL.

Al Jazeera and wire services

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Ebola causing collateral damage especially in countries hardest hit

"People are massively dying from other diseases that are normally treatable, like malaria, or women die while giving birth because hospitals are abandoned or are full with Ebola patients. So that's a very, very destabilizing factor," he said, adding that the impact of its spread is "beyond Ebola," Peter Piot, a microbiologist and a former undersecretary general of the United Nations, "And I continue to be worried that the response to the epidemic is really running behind the virus."

Peter Piot, a member of the team that discovered the virus in 1976 in what is now the Democratic Republic of Congo, said he feared an "unimaginable catastrophe" if the virus became lodged in a mega-city such as Lagos, Nigeria.

"The three countries that are affected are being totally destabilized, not only in terms of people who are killed by Ebola -- their families, the orphans that now are coming up because the parents died -- but the economy has come to a standstill," Piot said Thursday, speaking from Oxford, England.

"People are massively dying from other diseases that are normally treatable, like malaria, or women die while giving birth because hospitals are abandoned or are full with Ebola patients. So that's a very, very destabilizing factor," he said, adding that the impact of its spread is "beyond Ebola."

Piot said that it is impossible to predict the number of cases. Asked about the WHO projections, he said: "10,000 per week, or 1,000, we don't really know."

At the moment, there are about 1,000," he said. "It's still expanding, that's for sure. And it probably will continue to grow until all the measures have been put in place in a more efficient way."

Piot's comments came on the same day as Daniel Varga, the chief clinical officer for Texas Health Services, apologized over mistakes he says were made in the care of Thomas Duncan, a Liberian national who became the first person in the United States to die from the virus. Duncan was sent home despite saying he had a fever and that he had visited West Africa.

"Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes," Varga testified to Congress. "We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry."

Writing for CNN earlier this month, Centers for Disease Control and Prevention chief Tom Frieden said one way for the United States to prevent the disease spreading in the United States is to tackle it at the source, in West Africa.

"After all is said and done here, that is the only way to truly and completely protect the health security of America -- and the world," Frieden wrote.

Beyond the impact of the Ebola virus itself, with an apparent 50 percent mortality rate among those who are infected, the collateral damage from affected health and business systems has yet to be fully realized.

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Thursday, October 16, 2014

Ebola and nurses

Nina Pham, R.N. - She is a young woman who had attended Catholic schools and who lives by the most fundamental Catholic principle, one that marks her kin in spirit with true heroes of all faiths and professions. “I want to help people,” she once explained.

Nurses earn licenses supporting their title as "Registered Nurses". One of the responsibilities of carrying the R.N. title is to protect the public from harm. Therefore, kudos to Dallas Texas nurse Briana Aguirre who alerted the nation on national news about how ill prepared Texas Health Presbyterian hospital was when Mr. Thomas Eric Duncan presented in the emergency department with symptoms and travel history consistent with Ebola.  

Mr. Duncan later died of the deadly Ebola virus, in spite of heroic efforts to save his life following the error in judgement made by Texas Presbyterian to send him home after his first visit to the emergency department, where he came presenting with a fever.  

As a result of this error, Mr. Duncan returned by ambulance to the same emergency department with even more acute symptoms and exposed dozens of people to the Ebola virus.

Texas Health Presbyterian Hospital nurse Briana Aguirre, who cared for her friend and co-worker Nina Pham after she tested positive for the Ebola virus, says she can no longer defend her hospital over how she claims it responded to the disease, after Thomas Eric Duncan arrived.

“I watched them violate basic principles of nursing," Aguirre told TODAY's Matt Lauer in an exclusive interview that aired Thursday. "I would try anything and everything to refuse to go there to be treated. I would feel at risk by going there. If I don’t actually have Ebola, I may contract it there," she said. 

Well, there you have it......Texas Presbyterian will probably never be able to overcome the stigma of being ground zero for three Ebola infections.  Mr. Duncan arrived with a high viral load of the Ebola virus in his blood.  As a result, his infection somehow passed through the barriers and protocols used by two nurses who treated him, causing them to become ill with the Ebola virus. Three patients from one hospital!  Ms. Aguirre is absolutely correct. 

Look at it this way, if Texas Presbyterian made three medical errors leading to the deaths of a trio of surgical patients, all in a cluster of less than two weeks, the Texas health department would be conducting a sentinel event survey....or should.  I'm pretty sure Texas Presbyterian hospital corridors resemble haunted tunnels where few patients and only a skeleton staff are holding operations together in the face of all this horrific Ebola news.

Meanwhile, nurses are now suffering as a result of being the caregivers for one Ebola patient. The Dailey Beast is reporting how Ebola nurses are as brave as soldiers.

The nurses fighting to contain Ebola at Texas Presbyterian have shown uncommon courage, even as their work puts them at the greatest risk for infection.

By comparing the work schedules of the two Texas nurses who have been diagnosed with Ebola, medical detectives have narrowed down when they were most likely infected.

Nina Pham and Amber Joy Vinson were both treating Thomas Duncan during the days between his Sept. 28 admission to the Texas Health Presbyterian Hospital and the subsequent confirmation that he did indeed have Ebola.

And, according to an anonymous statement apparently issued by some of their co-workers, this was the same period of time before the hospital instituted adequate precautions.

“Our investigations increasingly suggest that the first several days before the patient was diagnosed, appear to be the highest risk period,” says Dr. Thomas Freidan, director of the federal Centers for Disease Control and Prevention. “That was the 28th, 29th, and 30th. These two health-care workers both worked on those days and both had extensive contact with the patient when the patient had extensive production of body fluids because of vomiting and diarrhea.”

But that is still only supposition. What is uncontestable is that 26-year-old Pham and 29-year-old Vinson and all the other nurses who treated Duncan were uncommonly brave.

As an Ebola patient slips from bad to worse to dire, he can expel as many as two and a half gallons of effluvia a day. A single drop of his blood can hold nearly a half billion viral particles, some 50,000 times more than with untreated HIV—math that makes Ebola at this stage so much more contagious.

Yet the nurses kept giving their all to save Duncan, fighting to keep their patient hydrated as he geysered it back out as hyper-hazardous waste.

They did so knowing that each time they inserted a needle or cleaned him or simply adjusted him in the bed they risked sharing his fate. His very skin would have had high levels of Ebola.

The specter of this virus fills some of our most stalwart souls with unreasoning dread even when it is no immediate threat. Soldiers of the 101st Airborne at Fort Campbell, Kentucky, who have faced IEDs in Afghanistan and Iraq, say they are more apprehensive about being deployed to Liberia. This, despite assurances that they will not be in contact with Ebola victims and therefore run minimal risk of infection. They can only be grateful to be equipped and trained with full body hazmat suits complete with hooded face masks.

Too bad the courageous nurses in Texas were not similarly trained and equipped before Liberia and Ebola came to them in the person of Duncan. They did the best they were able to do with what they had and what they knew as this Texas hospital was suddenly on the frontline of the war against Ebola.

The threat of this virus to the general public may have been exaggerated. But the dangers faced by those who work with its victims has not been fully appreciated even by some hospital administrators. Nobody is more heroic than Ebola nurses; not soldiers, not cops, not firefighters.

And none of the nurses was more meticulous or caring than 26-year-old Pham. She once told a friend that she asks herself a question when treating a patient.

“What would I do if this was my mom, dad, or grandparent?”

Not even the most careful care could stop the virus and all the nurses’ efforts ended in Duncan suffering a harrowing death. The nurses were then left to worry if they had themselves become infected. They were told to continue to monitor themselves for symptoms and take their temperature twice a day for 21 days.

On Oct. 10, two days after Duncan’s death, Pham saw that she had a low-grade fever. She immediately drove herself to the hospital, placing nobody at risk.

By several accounts, Pham remained her usual buoyant self as she began her own struggle with Ebola in the same facility where her patient had just died. She is a young woman who had attended Catholic schools and who lives by the most fundamental Catholic principle, one that marks her kin in spirit with true heroes of all faiths and professions.

“I want to help people,” she once explained.

She now issued a public statement, but she did not join the complaints about the hospital that other nurses had lodged anonymously.

“I’m doing well and want to thank everyone for their kind wishes and prayers,” she said. “I am blessed by the support of family and friends and am blessed to be cared for by the best team of doctors and nurses in the world.”

Everybody was hoping that she was not just in a stage during the first few days when some Ebola patients seem hardly ill, but then suddenly crash. She received a transfusion as well as a dash of hope from Dr. Kent Brantly, an Ebola survivor who had himself received a transfusion from a teenage survivor when he was battling the virus in Liberia.

The continuing mystery was how the meticulous and careful Pham had become infected. The CDC initially suggested that she had somehow broken protocol, but quickly reconsidered when it became clear that an appropriate protocol had not been established at the outset. There was also the question of inadequate protective gear and insufficient instruction.

But there was still no clear answer as to exactly how Pham had gotten ill. And this meant that the nurses who now cared for her had no way of being sure they were safe. They still did not hesitate to do all they could. And the CDC team that arrived to ensure they were properly trained and equipped found them in no need of moxie and dedication.

“They’re all tired. They’re stressed because they all think ‘Maybe I’m the next one,’” Dr. Pierre Rollin of the CDC told a Dallas TV station. “But they’re all willing to work. They’re all volunteers. They’re not forced to come to help; they want to do it.”

The weekend following Duncan’s death, Vinson visited her mother and her fiancé in Ohio to plan her wedding. She took her temperature on Monday and noted it was slightly elevated to 99.5, just under the threshold for worry.

She went ahead and flew on Frontier Flight 1143 from Cleveland back to Dallas. The CDC would later suggest that she should not have boarded a commercial plane at all until 21 days past her last exposure to Duncan. But she reportedly called the CDC before she flew and was given an OK because the fever so close to normal and she posed no threat unless she was showing symptoms. And it should not be forgotten that the CDC had vetted a video message by President Obama last week that a person “cannot get Ebola through casual contact like sitting next to someone on a bus.”

On Tuesday, Vinson saw that her temperature had risen above 100. She was soon after at the hospital with Pham. Dallas County Judge Clay Jackson praised Vinson’s “grit, grace, and determination.”

“Like Nina Pham, she is a heroic person—a person who has dedicated her life to helping others,” he told a press conference.

The CDC reported that even though the risk was minimal for those who had been aboard the plane with Vinson, it was tracking down the passengers and crew out of an abundance of caution.

“We think there is an extremely low likelihood that anyone who traveled on this plane would have been exposed, but we’re putting into place extra margins of safety and that’s why we’re contacting everyone who was on that flight,” Frieden said.

Pham remained at the Texas hospital as preparations were made to transfer Vinson to Emory Hospital in Georgia, which has a highly regarded infectious-disease facility that successfully treated Brantly.

Vinson was rolled out in a wheelchair wearing a full body hazmat suit. Such gear might have protected her from being infected in the first place during those initial days when she and Pham and the others selflessly fought to save Duncan.

Now Pham and Vinson have Ebola and are in the care of nurses as brave as themselves.

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American women must be diligent about how Republicans respond to our health issues

Wisconsin Governor Scott Walker (R) is dodging questions about women's health. 

He's a conservative Republican who has traditionally walked the GOP party line about issues related to women's health. In other words, in the past, Walker has been a rabid pro-life supporter without regard for how a woman's health might be adversely impacted.

Now, the Huffington Post is reporting about Walker's side dance around this important women's issue. Women cannot allow the Governor to remain reticent. 

Huffington reports:

Wisconsin Gov. Scott Walker (R) has made it clear in the past that he believes abortion should be illegal, even in cases of rape and incest. But now that Walker is neck-and-neck in the polls against pro-choice Democrat Mary Burke, he is dodging questions on abortion and trying to change the subject.

In my opinion, all politicians seeking state or federal offices should answer a simple two questions survey about women's health: (a) Do you believe a woman should be in charge of her own body's health care? yes or no; and (2) Do women have the right to control their reproductive rights? yes or no.  Simple. No ambiguity.  

Now, reverse the gender. Let's propose for candidates seeking state or national office to answer two like minded questions about men. (a) Do you believe a man should be in charge of his own body's health care? yes or no; and (b) Do you believe men should have access to sexual performance stimulants like Viagra?  yes or no.

These two simple questions, directed to all high minded politicians seeking state or national offices, would quite likely erase these ridiculous personal health care issues from any political party's platform. In a nutshell, the answers are self explanatory  and have no business in any political campaign.

Nevertheless, women voters can't just take our health care rights for granted.  

All women should demand the right to be in control of our bodies and our health care.  Period!  

Politicians who act like they have the rights to fool around with women's health should be removed from office. In fact, I'm ready to propose an Equal Rights Amendment about women's health. Along with the Constitutional rights to free speech, freedom of religious beliefs and a free press, should be added the freedom of women to be in control of our own bodies. If such an amendment passed, politicians like Scott Walker, who have flip flopped about a woman's right to access health care, could be prosecuted for breaking federal law.

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Governor Rick Perry is not responding to the Dallas health response to Ebola outbreak

Given the extraordinary media attention justifiably being swarmed on Dallas and the Texas Health Presbyterian hospital's admitted wrong response to the city's Ebola outbreak, it seems odd not to be hearing from the state's Governor Rick Perry. It just seems like the governor's leadership should offer condolences to the victims of this horrible Ebola outbreak in Dallas and provide support for Texans in the form of assurance about the state's public health response to the situation. Instead, the situation of "horribles" is  floundering from bad to worse and the end is not yet in sight.  

In another 21 days, the longest incubation period of the Ebola virus, the nation will either have an end to the outbreaks of person to person spread of the disease or not. Hopefully, the second American nurse, who inappropriately traveled with a fever after she cared for the now deceased Mr. Duncan, the Liberian man who died from the virus at Texas Health Presbyterian, has  not infected any others.  Nevertheless, the chances of others becoming ill with Ebola, as a result of the Texas Health Presbyterian blunders, including not monitoring the nurse who wrongfully traveled, raises the risk of more infections.

News media aren't asking for a statement from Governor Rick Perry. Yet, when Hispanic innocent children from Central America were detained in Texas, the governor was front and center with criticism about the state's border security. Now, the governor is apparently speechless about a deadly infection brought to Dallas from a visitor who should have been screened for the Ebola virus when he presented with a fever at Texas Presbyterian. Instead, the patient was sent home, where his illness exacerbated, and he exposed countless others to the virus now causing panic about who is at risk for being the next victim. 

This Ebola outbreak in Dallas didn't arise from immigrant refugee children who  were fleeing from horrific violence, but from one person who entered the US with a passport.

Now, spokespersons from Texas Presbyterian are showing some remorseful leadership by taking responsibility for the error compounded by not monitoring a nurse who cared for Mr. Duncan.
CNN -- A hospital official apologizes for blunders in handling Ebola. Schools close for fear of possible exposure. And health officials consider putting 76 hospital workers on a no-fly list after an infected nurse flew on a plane with a fever.

The Texas hospital where an Ebola patient died and two nurses became infected is apologizing for mistakes made when first confronted with the deadly virus.

Dr. Daniel Varga said the hospital mishandled the case of Thomas Eric Duncan, the Ebola patient who was originally sent home from Texas Presbyterian Health Dallas hospital even after he had a fever and said he was from Liberia.

It's obvious, based upon Governor Perry's reticence about the error now drawing media attention, that he wants nothing to do with this terrible problem.  Maybe Governor Perry should go back to the script, when he blundered so badly in one of his "wanna be" presidential debates. Remember when Governor Perry forgot what federal agency he'd abolish when asked the question during a 2011 presidential debate?  He admitted to an "ooops" moment at the time. Well, seems to  me, the governor's "ooops" has become more than a moment long, now extended to the lack of response to the overwhelming Ebola concerns now permeating the nation.  

Where is Governor Perry? His leadership gaffs are inexcusable.

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Tuesday, October 14, 2014

Medical workers infected by Ebola virus are infection control experts!

I'm a registered nurse who is well aware of how to implement infection control procedures. Although I've certainly never cared for a person infected with the deadly Ebola virus, I have cared for people who've had syphilis, tuberculosis, HIV/AIDS, hepatitis and pneumonia to name a few infectious diseases. I don't know of any health care workers, nurses or physicians who've been infected with these infections by caring for a person who carries the vector of the illnesses. To imagine care givers who obviously use their infection control training to care for Ebola victims, but then become ill with the virus, is simply unfathomable.

Now a United Nations German medical care giver has died from Ebola he contracted while working in Liberia.

Something is obviously extremely strange about how Ebola is transmitted. Although the Centers for Disease Control (CDC) assures the public that the Ebola virus can only be transmitted by direct contact with the bodily fluids of a person who is exhibiting symptoms of the disease, the virus is sneaking through infection control processes and protective clothing. Obviously, the virus must be a micro "nano" size viral organism to get through these barriers and to evade the infection control process. Undoubtedly, a cure for this disease must be discovered and soon. Blood plasma obtained from people who have survived the disease are being used to bolster the immune systems of some victims, but this intervention won't be a permanent cure. Eventually, the antibodies in the blood of survivors will become less effective over time.  

German hospital: UN worker dies of Ebola: The Washington Post

 October 14 at 6:04 AM

BERLIN — A United Nations medical worker who was infected with Ebola in Liberia has died despite “intensive medical procedures,” a German hospital said Tuesday.

The St. Georg hospital in Leipzig said the 56-year-old man, whose name has not been released, died overnight of the infection. It released no further details and did not answer telephone calls.

The man tested positive for Ebola on Oct. 6, prompting Liberia’s UN peacekeeping mission to place 41 staff members who had possibly been in contact with him under “close medical observation.”

He arrived in Leipzig for treatment on Oct. 9. The hospital’s chief executive, Dr. Iris Minde, said at the time that there was no risk of infection for other patients, relatives, visitors or the public.

The man was kept in a secure isolation ward specially equipped with negative pressure rooms that are hermetically sealed and can only be accessed through a number of airlocks. All air and fluids are filtered and all equipment is decontaminated after use, Minde said.

The Ebola patient was the third to be flown to Germany for treatment.

The first, a Senegalese man infected with Ebola while working for the World Health Organization in Sierra Leone was brought to a Hamburg hospital in late August for treatment. The man was released Oct. 3 after recovering and returned to his home country, the hospital said.

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Ebola predictions for viral epidemic are ominous

Ebola is a global disease because everyone is now at risk for contracting the virus. Epidemiologists know, from studying the history of viral pandemics, that viral infectious organisms are difficult to destroy. Finding a cure for the Ebola virus will require a much better understanding about how the virus grows. Studies are desperately needed to better understand why some people who are infected survive, while others die (about a 50 percent mortality rate), and how to create a drug to treat the disease. At this point, this urgency must happen soon, because the World Health Organization (WHO) is reporting ominous predictions about how rapidly Ebola is spreading in Africa. Predictions about 10,000 new infections a week clearly translates into Ebola becoming a world wide pandemic. Obviously, money is badly needed to respond to the growing Ebola crises. Unfortunately, government corruption is rampant in many of Africa's developing nations. Bribery has taken advantage of the money earmarked to fight the spread of the virus. This corruption must be identified and brought to swift justice with strict penalties.

CNN- There could be up to 10,000 new Ebola cases per week in Guinea, Liberia and Sierra Leone by the end of this year as the outbreak spreads, the World Health Organization warned Tuesday.

"It is impossible to look into a glass ball and say, 'we (will) have this many or that many,' but we anticipate the number of cases per week at that time, it's going to be somewhere between 5,000 and 10,000 a week," WHO Assistant Director-General Dr. Bruce Aylward told reporters. "You know, it could be higher, it could be lower but its gonna be somewhere in that ballpark."

Compare those December projections to the latest figures. As of Tuesday morning, there were a total of 8,914 Ebola cases and 4,447 deaths reported to the WHO, Aylward said.

In other words, things could get worse before they get better. Aylward told reporters that in 90 days, officials have a goal they're aiming for: They want to see the number of cases dropping from week to week.

To start to decrease the rate of infection, the WHO says it hopes to isolate 70% of Ebola patients and have 70% of Ebola victim burials performed safely by December 1. Getting responders, facilities and plans in place to meet the goal will be very difficult, Aylward said.

Missing the goal will mean that more people will die than should have and that even more resources will be needed because the infection rate will continue to climb, he said.

Infected Spanish nurse's assistant improves

Health authorities in Spain said that a nurse's assistant who is the first person to contract Ebola in Europe in the current outbreak is still in serious condition but doing better.

And even as Teresa Romero Ramos lies in a hospital bed, she's doing everything she can to take care of doctors, nurses and herself, said Dr. Marta Arsuaga, who is helping treat her.

"She is helping us to treat her. ... She was where I am now, so she knows what I have to do," Arsuaga said.

The case of Romero, like that of a nurse infected in Texas, has raised serious questions about how equipped hospitals are to cope with the Ebola outbreak.

Romero is stable but remains in serious condition, Antonio Andreu, director of the Carlos III Hospital in Madrid, said at a news conference.

There is a slight improvement in her clinical state, which gives hope to the health care workers treating her, he said.

Andreu insisted that Spain's health care professionals have the situation under control.

Earlier, a source at Carlos III Hospital, where she is being treated, told CNN that Romero is producing antibodies to fight Ebola.

The news came hours after a German hospital said a United Nations medical worker who was infected with Ebola while working in Liberia had died. (note- high risk for medical workers!)

Besides treating Romero, Spanish authorities are monitoring 81 potential Ebola cases -- 15 in hospitals and 66 at home, according to the Spanish Ministry of Health.

None of the 81 people is showing symptoms of Ebola, the ministry said.

Andreu said it was possible that more Ebola patients would come to Spain and that the health care system needs to be prepared.

"Until we start to diminish the outbreak, we have to contemplate the possibilities of imported cases. And for that, our health care system has to be perfectly prepared," he said.

More training will be given to health care workers and new guidelines will be prepared, he said.

"Ebola is not a problem of Spain. It is not a problem of the United States. It's a global problem," he added.

German isolation ward

The 56-year-old man who died in Germany was Sudanese, a spokesman for St. Georg hospital in Leipzig said. He was being treated in a secure isolation ward there.

After the man's death, Germany is treating only one other Ebola patient, said hospital spokesman Constantin Sauff. 
The other patient is being treated in Frankfurt, he said. Another patient who was being treated in Hamburg has been discharged from a hospital after recovering, Sauff said.

A nurse in Dallas was this week confirmed as the first to have contracted the virus in the United States. The nurse, Nina Pham, had cared for Liberian national Thomas Eric Duncan, who contracted Ebola in Liberia and died of the illness at a hospital.

"I'm doing well and want to thank everyone for their kind wishes and prayers," Pham said Tuesday, according to Texas Health Presbyterian Hospital in Dallas, where she is being treated. "I am blessed by the support of family and friends and am blessed to be cared for by the best team of doctors and nurses in the world."

Liberia is one of the countries worst affected by the deadly virus, along with Sierra Leone and Guinea. The World Health Organization estimates that more than 4,400 people have died from confirmed or suspected cases of the virus.

Hospital, protective gear training criticized

The European Centre for Disease Prevention and Control said Monday that the Madrid hospital treating Romero doesn't meet all the standards set for centers capable of Ebola care. And in a scathing letter, Javier Limon, Romero's husband, said she received only 30 minutes of training in putting on protective gear and called for the resignation of Madrid's regional health minister over how the case has been handled. Romero helped care for one of two Spanish missionaries who were brought back to Madrid for treatment after being infected with the virus in West Africa. Both men died of the illness. A spokesman for a special committee created in Spain to keep people informed about Ebola told CNN that Spain will have a contagious diseases reference center in each of its regions. 

Police, firefighters and ambulance personnel, as well as hospital staff, will be trained to deal with Ebola cases.

CNN's Laura Perez Maestro reported from Madrid, while Laura Smith-Spark wrote and reported from London and Catherine E. Shoichet wrote and reported from Atlanta. CNN's Alexander Felton, Claudia Otto, Elwyn Lopez and Jason Hanna contributed to this report.

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Monday, October 13, 2014

Ebola Map - West African countries are the ground zero points for the deadly virus where it must be eradicated

Pink on the West Africa map indicates a few Ebola cases confirmed; darker colors are 300 or more confirmed cases and deep rose is high number of confirmed virus infected patients. The problem with this map is that the numbers of reported confirmed cases aren't completely accurate......the actual numbers are higher than what's reported. Developing countries do not have access to accurate data collection processes, and the numbers are corrupted by skewed or biased public officials.

Ebola news is consuming our attention. One mortality and another infection is now reported in Texas. But, thousands are infected in Western Africa with a rate of 50 percent mortality associated with those who are infected with the virus.

To rid the world of Ebola requires eliminating the source of the virus and the method of transmission where it is endemic, in Africa. Only two people, so far, have presented with Ebola in Texas. One of the two is 26-year-old Nina Pham, a caregiver of Mr. Duncan's, who died from the virus infection at Presbyterian Hospital in Dallas. Obviously, the fiscal toll of the two Dallas illnesses are taking a huge toll on the community. Someone is paying for the decontamination of the contaminated isolation areas, the incineration of the equipment used to treat the Ebola patients, not to mention the lost revenues associated with diversions of patients away from Texas Presbyterian, until the Ebola risk is eliminated. Resources used to prevent Ebola from spreading in Dallas are necessary but disproportionate to the small numbers who are at risk for becoming sick with the virus.

To prevent further exacerbation of Ebola in Texas or elsewhere, the source of the virus must, obviously, be eliminated. Unfortunately, destroying the source of Ebola is difficult because it's not clear where the virus originated. If the DNA of the virus can be identified, it will help to locate the source and destroy its growth.

Destroying Ebola in Africa by eradicating any potential for transmission of the virus will be millions of dollars cheaper than trying to prevent a few people in Texas from becoming ill. Nevertheless, Texas must do whatever it takes to prevent Ebola from spreading, while the world must provide the resources to stop the virus from infecting any more people in Africa.  And soon.


Sunday, October 12, 2014

Ebola is dangerously infectious - appears resistant to infection control puts caregivers at risk

Health care workers are especially well trained about how to practice infection control protocols. Consequently, it's very alarming to learn today, October 12, about a nurse at Texas Presbyterian in Dallas, who tested positive for the dangerous Ebola virus infection, after having cared for Mr. Thomas Eric Duncan who died from the disease last week.  

As a nurse myself, I suspect the Ebola virus is more virulent than the Centers for Disease Control (CDC) or any other infectious disease experts understand.  

Unfortunately, the nurse who now has the Ebola diagnosis was wearing protective gear throughout her time caring for the deceased Mr. Duncan because he had already been diagnosed.

The nurse was involved in Duncan's second visit to the hospital, when he was admitted for treatment, and was wearing protective gear as prescribed by the CDC: gown, gloves, mask and shield.

The nurse had "extensive contact" on "multiple occasions" with Duncan, Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention in Atlanta, said Sunday.

Therefore, "At some point, there was a breach in protocol, and that breach in protocol resulted in this infection," he said at a news conference Sunday.

A "close contact" who knew the nurse has been "proactively" placed in isolation, reports CNN.

The hazardous materials unit of the Dallas Fire Department has cleaned up and decontaminated the public areas of her apartment complex, Mayor Mike Rawlings said. Police are keeping people out of the area and are talking to residents nearby.

Although the experts who are evaluating this most recent Ebola exposure are seeking a breech of protocol as a cause, the fact remains that the caregivers are contracting the disease, in spite of using infection control procedures. Physicians and nurses are contracting the Ebola virus infection, when we know how to implement isolation and infection control procedures. 

In my opinion, there must be some kind of poorly understood virulence associated with transmitting Ebola. 

Perhaps any exposure at all to the bodily fluids of an infected Ebola patient puts a person at high risk, more so than touching alone. This means, being exposed to an infected person's sweat, sneezing, urine, blood, semen, saliva or any product associated with these fluids. Evidently, dumping a patient's urine, starting an IV or even giving a bed bath must create a very high risk of exposure, regardless of the infection control precautions taken to prevent the spread of the disease.

If caregivers are at risk while caring for Ebola patients, there's no doubt about how the disease will spread. Family members will try to fill the caregivers' gap and they will undoubtedly become ill doing so....and so forth.  Therefore, the only way I can foresee for stopping the  spread of Ebola is to isolate the patients as quickly as possible and minimize any exposure to the bodily fluids of the person who is ill. This means, don't draw blood or dump urine unless it's absolutely vital to do so. Urine can be dumped once very  24 hours rather than every 8 -10 and blood doesn't need to be drawn at all. Meanwhile, it's essential to develop a vaccine to prevent the future outbreaks of this lethal Ebola virus.  

Public health money, of course, is needed to stop Ebola from becoming a pandemic. Also, government corruption in African nations contributed to this now out of control outbreak. 

Of course, my dear readers, money and competent government control of the problem are the subjects of other blogs.....

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