Topic: WE'RE STUFFED!!!

[Nichi]

It's also speculated that in the end, it will be considered "airborne".

Call me paranoid on any of these points, no matter, but I think it's time to adopt a "germophobe's" stance, on just about everything.

[runningstream]

yes i appreciate that you guys can follow the details

i am interested in whats going on

my view is pretty far back most of the time

distant

and then action upon the general feeling of things

actually at one point a whole life can seem to make sense in the light

of the current position

i feel these things are escalating or deteriorating "generally"

that just makes me go back to the earth

economically i imagine the "whole" picture becomes tied together

and later human nature takes the stage

unfortunately i have lost much faith in that

despite trying to effect things for a long time

many would just give up on a better nature

[Nichi]

A second nurse comes down with it in Texas.

Dallas Nurses Accuse Hospital of Sloppy Ebola Protocols

Oct 15, 2014, 4:46 AM ET

Co-workers of a Dallas nurse who contracted Ebola from a sick patient say they worked for days without proper protective gear and that the hospital’s Ebola protocols and procedures were unclear and inadequate, leaving workers and hospital systems prone to contamination, according to a statement by the largest U.S. nurses’ union.

The statement, which was provided by National Nurses United on behalf of several registered nurses at Texas Health Presbyterian Hospital, details hospital procedures after Thomas Eric Duncan arrived at the hospital. The nurses are not represented by the union, and the group declined to reveal the nurses’ identities.

Duncan was diagnosed with Ebola Sept. 30 and died Oct. 8. Nina Pham, one of about 70 staff members who cared for Duncan, was diagnosed Sunday with the virus. Pham’s colleagues say the hospital was ill-equipped to handle the situation.

“No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training,” the statement reads.

Duncan was left in a nonquarantined zone for several hours, and a nurse supervisor faced resistance from hospital authorities after demanding that Duncan be moved to an isolation unit, according to the union’s statement. Additionally, Duncan’s lab specimens were sent through the hospital’s tube system, potentially contaminating the system, the nurses said.

Co-workers of a Dallas nurse who contracted Ebola from a sick patient say they worked for days without proper protective gear and that the hospital’s Ebola protocols and procedures were unclear and inadequate, leaving workers and hospital systems prone to contamination, according to a statement by the largest U.S. nurses’ union.

The statement, which was provided by National Nurses United on behalf of several registered nurses at Texas Health Presbyterian Hospital, details hospital procedures after Thomas Eric Duncan arrived at the hospital. The nurses are not represented by the union, and the group declined to reveal the nurses’ identities.

Duncan was diagnosed with Ebola Sept. 30 and died Oct. 8. Nina Pham, one of about 70 staff members who cared for Duncan, was diagnosed Sunday with the virus. Pham’s colleagues say the hospital was ill-equipped to handle the situation.

“No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training,” the statement reads.

Duncan was left in a nonquarantined zone for several hours, and a nurse supervisor faced resistance from hospital authorities after demanding that Duncan be moved to an isolation unit, according to the union’s statement. Additionally, Duncan’s lab specimens were sent through the hospital’s tube system, potentially contaminating the system, the nurses said.

Nurses who interacted with Duncan were given the option of wearing special N95 masks, but some supervisors said the masks were not necessary, the nurses said, according to the statement.

“For their necks, nurses had to use medical tape, that is not impermeable and has permeable seams, to wrap around their necks in order to protect themselves, and had to put on the tape and take it off on their own,” the statement reads.

“Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids.”

A hospital spokesman did not respond to specific claims by the nurses but said the hospital has not received similar complaints.

"Patient and employee safety is our greatest priority and we take compliance very seriously," hospital spokesman Wendell Watson said in a statement. "We have numerous measures in place to provide a safe working environment, including mandatory annual training and a 24/7 hotline and other mechanisms that allow for anonymous reporting.

"Our nursing staff is committed to providing quality, compassionate care, as we have always known, and as the world has seen firsthand in recent days. We will continue to review and respond to any concerns raised by our nurses and all employees."

 The problems encountered at the Dallas hospital are reflective of training and equipment insufficiencies at hospitals across the country, Deborah Burger, co-president of National Nurses United, told ABC News.

“What concerns me is that this validated what our systems say all over the country throughout the last two months, that hospitals are not prepared to take care of Ebola patients,” she said. “It is disturbing to have all of our concerns validated in one hospital.”

The criticisms follow a Tuesday admission by Thomas Frieden, the Centers for Disease Control and Prevention director, who said he regrets not sending a larger team of experts to Texas when Duncan was first diagnosed with Ebola.

The CDC could have sent a "more robust management team and been more hands on from day one," Frieden said. "Looking back, we say we should have put an even larger team on the ground immediately."

Ebola has killed more than 4,000 people, mostly in the West African countries of Liberia, Sierra Leone and Guinea, according to recent figures by the World Health Organization.
http://abcnews.go.com/Health/dallas-nurses-hospital-sloppy-ebola-protocols-union/story?id=26205956

[Michael]

Right, sounds like a real shambles. Then the second nurse took a commercial flight. This is not looking pretty.

[Nichi]

Right, sounds like a real shambles. Then the second nurse took a commercial flight. This is not looking pretty.

The incompetence is shocking, between that hospital's blunders and then the CDC allowing the nurse to fly..

I don't want to believe that the hospital-incompetence is nation-wide, but maybe it is. I just know that the hospitals in which I trained and worked were absolute sticklers for procedure and protocol, and always feared their yearly investigations/audits by the Joint Commission of Hospitals and OSHA (can't remember now what OSHA stood for.) I'm quite certain that the errors portrayed in the article above would have compelled JCAH to shut us down. Now I don't know if that's just "Virginia" or if times have changed with the economy. When I was in for the appendectomy, I observed some (surprising!) conditions and actions that were less than sterile.

They all better begin to implement the old ways fast, however. There's a hell of a lot at stake. Every hospital in this country needs to be cracking the whip, getting the appropriate supplies in and educating their people. If the staff needs their pay doubled, then double their pay. This is crisis time. I just don't get how all of this has slipped in through the back doors.

(If that Dallas hospital and the CDC don't get their arses sued, I'll be stymied.)

[Nichi]

National Nurses United write Obama:

The National Voice for Direct-Care RNs

President Barack Obama
The White House
Washington D.C.
1600 Pennsylvania Avenue
Via Electronic Mail
October 15, 2014

On behalf of registered nurses and other health care workers across
the United States we understand that the only way to adequately
confront Ebola crisis, that the World Health Organization has
termed the most significant health crisis in modern history, is for
the President to invoke his executive authority to mandate uniform,
national standards and protocols that all hospitals must follow to
safely protect patients, all healthcare workers, and the public.
Every healthcare employer must be directed to follow the
Precautionary Principle and institute the following:
•
Optimal personal protective equipment for Ebola that meets
the highest standards used by the University of Nebraska
Medical Center
•
Full-body hazmat suits that meet the American Society
for Testing and Materials (ASTM) F1670 standard for blood
penetration, the ASTM F1671 standard for viral penetration,
and that leave no skin exposed or unprotected and National
Institute for Occupational Safety and Health-approved
powered air purifying respirators with an assigned protection
factor of at least 50 — or a higher standard as appropriate.
•
There shall be at least two direct care registered nurses caring
for each Ebola patient with additional RNs assigned as needed
based on the direct care RN’s professional judgment with no
additional patient care assignments.
•
There will be continuous interactive training with the RNs
who are exposed to patients. There will also be continuous
updated training and education for all RNs that is responsive
to the changing nature of disease.  This would entail
continuous interactive training and expertise from facilities
where state of the art disease containment is occurring.

•
If the Employer has a program with standards that exceed
those used by the University of Nebraska Medical Center, the
higher standard shall be used.

The Ebola pandemic and the exposure of health care workers to
the virus represent a clear and present danger to public health.
We know that without these mandates to health care facilities
we are putting registered nurses, physicians and other healthcare
workers at extreme risk. They are our first line of defense. We
would not send soldiers to the battlefield without armor and
weapons.

In conclusion, not one more patient, nurse, or healthcare
worker should be put at risk due to a lack of health care facility
preparedness. The United States should be setting the example on
how to contain and eradicate the Ebola virus.
Nothing short of your mandate, that optimal safety standards
apply, will be acceptable to the nurses of this nation.

Sincerely,
RoseAnn DeMoro
Executive Director
National Nurses United
Cc: National Nurses United Executive Committee
http://msnbcmedia.msn.com/i/MSNBC/Sections/NEWS/NNUObama.pdf

Hope it gets his attention and he acts.

[erik]

A few comments from medics and researchers of this corner of the planet:

1) "For God's sake, Google "Ebola" and you'll learn all you need to know!"
2) "How exactly could any remotely sensible/educated medical professional be unaware that Ebola is a class 4 pathogene (no cure) It kills! Protocols??? Lack of information???"

It sounds so utterly outrageous. You have somebody with a very lethal disease (no direct cure, no vaccine) in your hospital, in your ward, in the bed next to you. What does it take to draw some elementary conclusions and take some elementary steps? Where's the common sense and initiative of people? Why do people expect somebody to come and do thinking for them?

[Nichi]

Hospitals live on 'protocols' - it's the way of the medical profession.  I agree with what you say, Juhani, but clearly, we can't rely on the 'common sense' of the next guy. And while that senselessness might be amusing sometimes, this time it's perilous.

For example, in the Dallas Presbyterian hospital, there is a room with 'red bags' (where toxic medical waste is disposed) piled to the ceiling. The hospital can't get anyone to remove them, according to something I read earlier. I could understand anyone's skepticism about that facility now - be it patient or staff. But something needs to happen of a tyrannical sort, obviously.

I don't know the civic order of things here, but the way I see it, someone better take charge now.  I don't know who the appropriate person/agency is to do so, but I think it would behoove them to figure it out right away. 'Disaster' was declared in Dallas, which supposedly will enable them to call in a more structured response.  Whatever works!

Rumors are abundant and one needs to take everything with a grain of salt, but I did read a rumor that Obama kissed and hugged a healthcare worker involved with the caretaking of ebola very recently. He explained that he was trying to show support. I don't know if this story is true, but I wouldn't be extremely surprised by it, since he and his family took a dip in the poisoned Gulf of Mexico to show his 'lack of fear'. In short, where is common sense?

Then, you have the faction who doesn't want to cause panic, really mincing words and shuttling them to some cloud of uncertainty. If the public's head is spinning, it's no wonder.

[Michael]

Airline shares will plummet again.

[Michael]

I am impressed with the defenders of Kobane. A tough lot of fighters if there every was! With only the guns and ammunition they had at the beginning of the siege. Why no one could resupply them is a mystery to me - I know the Turks won't and the Iraqi Kurds have tried unsuccessfully, but why doesn't the US coalition drop supplies from the air?

How long can they hold out, and how many fighters does ISIL have to throw at this battle? With a third of the town held by ISIL, I expect they are committed now as much as the Kurds. An incredible battle. The Turks have damaged their relations with the Kurds forever from this by now - they will regret it. But old attitudes die hard, we are watching across the globe, how so many are fixed in the past, and can't reposition themselves for the future to their own survival benefit, like Electricity and Coal companies.

[erik]

I am impressed with the defenders of Kobane. A tough lot of fighters if there every was! With only the guns and ammunition they had at the beginning of the siege. Why no one could resupply them is a mystery to me - I know the Turks won't and the Iraqi Kurds have tried unsuccessfully, but why doesn't the US coalition drop supplies from the air?

How long can they hold out, and how many fighters does ISIL have to throw at this battle? With a third of the town held by ISIL, I expect they are committed now as much as the Kurds. An incredible battle. The Turks have damaged their relations with the Kurds forever from this by now - they will regret it. But old attitudes die hard, we are watching across the globe, how so many are fixed in the past, and can't reposition themselves for the future to their own survival benefit, like Electricity and Coal companies.

I doubt Kurds are quite on their own now. They have IS almost pushed out of Kobane and they just could not manage it on their own - Kurds are brave fighters, but they lacked the necessary kill power.

There is information on the web that says the US and PYD (the Democratic Union Party in charge of Syrian Kurds and connected to the PKK) had negotiations somewhere outside Syria and Kurdistan. If true, we might be witnessing a military solutin akin to what CIA used in Afghanistan in 2001.

In essence, it involves US spotters and controllers of the close air support on the ground and USAF in the air. It means that Kurds protect with everything they have a small number of the US SOF/intel guys who use lasers to light up the IS targets on the ground for smart weapons dropped from the above. It is an utterly deadly combination that can explain how exactly Kurds managed to turn it around. The chances are that CIA, Saudis or soembody else are also supplying weapons to Kurds.

[Michael]

What you say Juhani, may well be true, yet I have not seen it said from any reporting source, or from any Kurdish source. I have been thinking the same thing for some time now, and I can only assume it is correct - there must be some US spotters on the ground, and they surely must have received supplies somehow. How else were they able to turn around this situation? They say they are coordinating the US planes themselves, but how they could learn that from scratch, and so effectively, is unbelievable. And they say they still use their original stash of weapons and ammunition, but that also seems unlikely.

Anyway, whichever way they have pulled this off so far, it is major psychological lift for the Kurds and blow for ISIL. Can't help thinking, temporary psychological is all it will be.

[erik]

What you say Juhani, may well be true, yet I have not seen it said from any reporting source, or from any Kurdish source. I have been thinking the same thing for some time now, and I can only assume it is correct - there must be some US spotters on the ground, and they surely must have received supplies somehow. How else were they able to turn around this situation? They say they are coordinating the US planes themselves, but how they could learn that from scratch, and so effectively, is unbelievable. And they say they still use their original stash of weapons and ammunition, but that also seems unlikely.

Anyway, whichever way they have pulled this off so far, it is major psychological lift for the Kurds and blow for ISIL. Can't help thinking, temporary psychological is all it will be.

If US has the will, it could help strengthen Kurds to the extent they could fight IS to a stalemate.

I saw some BBC footage of air strikes in Kobane where the air-launched weapons seemed to land on specific targets within the city. Great precision and selectivity. It is implausible that previously untrained Kurds could coordinate close air support this way. Completely implausible.

Yet IS is not sitting still: Saddam's pilots are training IS to use military aircraft. Three of them are claimed to be operational already.
Saddam's pilots are training IS to use military aircraft. Three of them are claimed to be operational already.

[Michael]

Kobane: if the US weren't dropping supplies to the Kurds in Kobane, then they are now - apparently Turkey finally agreed, or not - it's happening.

Turkey also has allowed the Iraqi Kurds to reinforce Kobane Kurds through Turkey. I bet they won't allow PKK to help from their mountain hideouts.

Meanwhile, it looks all down hill in Iraq. I just can't see the new government getting this together in time, or ever. The consequence is frightening. Will Iran intervene, and will that draw in Saudi?

[erik]

Turks are as consistent as ever:
19 October 2014 Turkey opposes transfer of US arms to Kurds fighting Islamic State
20 October 2014 Turkey to Let Iraqi Kurds Cross to Syria to Fight ISIS

I'd say Iran's invasion depends on how successful are Sunnis/IS in pushing to Shia area in Iraq. So far IS has been gaining ground in Sunni area or Sunni-dominated area. IS have managed to kill a few Shia leaders - like a boss of Badr militia. However, to the extent I remember, Shia order of battle during the US stay in Iraq, there used to be 3-4 seriously strong, well-equipped, organised and disciplined formations. Iran supplied them with weapons like explosively formed penetrators and quite advanced sensors that could destroy even tanks. So the south eastern part of Iraq should not be a done deal.

Yet, we are already talking about a serious prospect of partition of Iraq.