It hurts me to even think about this. I keep telling myself, "Don't be panicky guy, it'll be okay", but we have simply run out of time for under reaction. On a day when Liberia said it will need 80,000 body bags and 1 million protective suits we are clearly light years away from "Overreacting". We don't need to panic and run in the streets, we need however to treat this as the crisis it is. Keep this in mind:
An epidemic is by definition a situation where an infectious disease is passed on from the infected to someone else at a rate of MORE than 1 to 1. Every other detail is meaningless. A traveler who flew into one of the great cities in the Greatest Nation On Earth proceeded to get sick. Using good judgement he quickly went to a big city hospital Emergency Room. He got the best treatment we should expect on this big Earth and so far he has infected two people. Yes, many mistakes clearly were made but mistakes have to be factored in to any situations of this scale. Should we expect a better outcome for those traveling to Kinshasa or Khartoum?
This is not your father's Ebola. It used to burn threw its victims quickly and only direct contact with blood, feces etc transferred the disease. In two decades Ebola rarely, if ever, killed a nurse or doctor following protocol. We now have about a hundred known fatalities of health workers thus far and the number has climbed by two already here in the US of A. Clearly we have to throw away the old trope "only direct contact with bodily fluids". This strain may have figured a way to survive outside the warm body of a host. Maybe aerisolized mucus from sneezing has evolved to the point it can live for an extra couple minutes clinging to the glove of a nurse. Who knows, what counts is the fact that old containment measures aren't working and we are looking at a disease with a >50% mortality rate spreading exponentially.
My daughter is flying in one month to Dallas. Both my kids have asthma and I could not comprehend living without either of them nor my wife. None of us want to survive or die in a next Plague. Apart from a vaccine (which may be too late already) there are three elements necessary to contain this outbreak.
Pay patients to seek care.
People in low income nations need to be offered a payment to come seeking help. There will be those who fake symptoms but this is a disease that is frankly, inimitable. Payments need to go directly to patients AFTER they have recovered and only if they recover to dissuade people from infecting others to benefit. Yes, it will encourage fire starters but this disease is too deadly to expect a significant % of self-infectors. $200 would be a great incentive for a sick person to show up at a triage center. Once triaged as an Ebola candidate, they would then be placed in a treatment center. This is the easy part.
Patients must care for themselves.
Please keep in mind I am not suggesting abandoning the sick to death colonies, rather designing systems that can be rapidly scaled which reduce the contact of health providers with the infected as much as possible. The more able bodied must help those who can't help themselves. Those who have recovered must remain as caregivers until they are 100% clear. As horrific as this prospect may sound, events on the ground may make it's implementation mandatory sooner than we can imagine.
MONROVIA (Reuters) - Healthcare unions in Liberia called off a strike on Wednesday over pay and working conditions for medical staff tackling an epidemic of the deadly Ebola virus.
These unions called off the strike because their own members couldn't stomach the action for more than a day. However, conditions and patient pressures aren't going to get better for these workers who increasingly are seeing coworkers getting sick and dying.
The World Health Organization (WHO) said on Tuesday the epidemic was continuing to spread in the three worst-hit nations and there could be between 5,000 and 10,000 new cases a week by early December.
Most first world health professionals do not have the skill set to capably work in the makeshift super-quarantines that will be set up on soccer fields and in cane fields. We cannot let families tend to those who are ill or this epidemic will burn until there is no targets left to infect. The common cold does this every year, killing thousands despite a statistical mortality rate of 0%. The WHO needs to figure out how to ship in mega facilities that can provide comfort, sanitation and sustenance for a population that will be caring for itself.
Allow unfettered drug trials
Common HIV drugs that would be available on a large scale immediately have been claimed to have success with 13 of 15 patients.
Dr. Logan's recovery rate has been impressive as he cautions that his method only works if the patients turn themselves in on time. "When the patients come early, and they are put on this medication, they recover within three to five days. This medication is not specifically for HIV/AIDS, I want this to be clear, but an Anti Retrovirus agent that is used to treat other virus illnesses like hepatitis 'B'. It is one of those medications that are combined with two or three other medications to treat HIV/AIDS, so it should not really be called an HIV/AIDS drugs," He says.
Why would be bad to offer it to a hundred volunteers and see what happens? The one thing we know is their will be no shortage of volunteers because the alternative is likely death. Many possible treatments like ZMapp and TKM-Ebola are promising but need to be vetted much faster than the one year at best timetable they are looking at.
As much as we all are hoping a cure will be found soon, we were all hoping the same thing about AIDS in 1985. Wish in one hand, shit in the other... isn't that the saying.
Regardless of the results, getting patients into care is essential and we have to accept that this will be a Herculean effort of a scale we have never seen. Systems need developed yesterday to allow self care. Oh, and yes, it will have to be the same here.
I really hope someone on this site will tell me, "Hey, you're an idiot and here's why!"
I just don't see it. Sorry.