S/he’s Just an Asshole

Unbelievably stupid:

The first Dallas health care worker with Ebola, Nina Pham, is in “improved condition today,” and the second Dallas health care worker with Ebola is “ill but clinically stable,” CDC Director Dr. Tom Frieden said Wednesday. Frieden said it’s still to be determined whether Pham will be transferred to another facility; Frieden earlier said the second patient will be transferred to Emory University Hospital.

Because she had helped care for Dallas Ebola patient Thomas Eric Duncan, this health care worker should not have traveled on a commercial airplane, CDC Director Tom Frieden said.

At that point, health care workers were undergoing self-monitoring. They were allowed to travel but not on a commercial plane with other people, he said.

Moving forward, the CDC will ensure that no one else in such a situation travels outside of a closed environment, he said.

If our health care professionals are this god damned stupid, there is no chance we are going to contain Ebola.

In a day and age where conscientious adults keep their kids home from school and people don’t go to work when they have a cold because they know better than to expose everyone at the school and workplace, this is just astonishing. Does this jackass really need to be told that after handling an Ebola patient, they shouldn’t be traveling on a public airline. In my mind, this nurse is just as guilty as someone who knows they have HIV running around having unprotected sex? This is a toxic cocktail of malicious ignorance, entitlement, and casual disregard for your fellow man. I don’t think we need to be restricting flights, but it should be common sense that people EXPOSED to Ebola should not be jaunting about in public.

I eagerly await the inevitable news that the person was traveling to and from a college reunion or a large family event or a football game, exposing untold thousands. Because you just KNOW they weren’t there for something important. And of course this asshole lives in Texas. Of course. FSM help us all if anyone in Florida gets Ebola, because then we are all surely screwed.

And I would wish this nurse well, but it doesn’t really matter. Should s/he recover, they will no doubt stick a fork in a socket or do something really stupid like mop naked.






250 replies
  1. 1
  2. 2
    Ben Cisco says:

    Actually, she’s in for a real bad time.

    Just think, between the GOP and our homegrown Radio/TV Rwanda, she’ll be lucky not to get hunted down and harmed.

  3. 3
    elmo says:

    Meh. Everything I’ve read about the disease says no symptoms = no transmission. The guy with a fever who lied to get to the US, yeah – he was in the wrong. But notice that there aren’t any infections from his Brussells – Dulles – Dallas flight, even though he was already symptomatic.

    Ebola is a terrible, terrible disease to be sure, but seems to me to be pretty hard to transmit until the bleed-out starts.

  4. 4

    I posted elsewhere that I laugh at people who panic over Ebola, but then I remember that this country is full of morons, and then I want to crawl into a hazmat suit and get shot into space.

  5. 5
    big ole hound says:

    Finally. The health care industry is called out for being just plain careless. Every health care worker in contact with an Ebola patient should be screened daily and log in everywhere they have been. These rules should have been in place for just this type of disease.

  6. 6
    Betty Cracker says:

    Just the other day one of the media people who was exposed (along with the TV news camera man who got Ebola) was busted for going out in public even though she was supposed to stay in her apartment. Irresponsible morons. I’m not sure what the answer is when people are too goddamned dumb to follow commonsense precautions. You hate to overreact and commandeer a gated community to install them in until they check out in 21 days, but it may come to that.

  7. 7

    Yeah, she may have been asymptomatic when she got on the plane, but she had no guarantee she wouldn’t start to feel symptoms during the flight. Pretty stupid thing to do.

  8. 8
    RaflW says:

    people don’t go to work when they have a cold because they know better

    Uh, have you been out in retail America? Or to a restaurant? Millions of Americans have no sick days, or nearly useless sick benefits.

    That said, your recent tweet was correct: the flying nurse was an asshole for refusing to follow travel protocol. Maybe they weren’t told. But for chrissake, they couldn’t figure out that there could be a risk.

    I blame Rick Perry, by the way. Just because he’s turned into the invisible jerk.

  9. 9
    Rosalita says:

    and they are flying the second nurse who has it to the CDC in Atlanta for observation. In a hazmat suit?

  10. 10

    If she wasn’t contagious who cares. I’m pretty sure she took a shower if she got barfed on

  11. 11
    Culture of Truth says:

    Calm down. We are going to contain ebola.

  12. 12
    jibeaux says:

    @Rosalita: probably chartered.

    Sheesh, the schools have 24 hour fever-free policies, gotta keep them home a day even after they’re better.

  13. 13
    Trollhattan says:

    @Betty Cracker:
    Did they ever build that Citadel winger compound in Idaho? Because I have an idea about solving two problems at once….

  14. 14
    Rosalita says:

    @jibeaux:

    @Rosalita: probably chartered.

    I’m sure, I just couldn’t resist the irony of the tweet from Tapper

  15. 15
    RaflW says:

    I’m not that concerned that the nurse actually was in a transmissible phase. But that either the no-airtravel protocol didn’t get communicated, or complied with, we’ll see, that indicates some sloppy management and/or nursing.

    Which it is sounding like Presby Hospital was engaged in.

  16. 16
    Trollhattan says:

    @Rosalita: FedEx.

  17. 17
    Gin & Tonic says:

    @Betty Cracker: Not just “one of the media people”, she’s an MD. Nancy Snyderman/Schneiderman (not sure of the spelling.) And in her nopology, read on-air, she said “a member of our team,” not “stupid me.” Fuck her with a rusty chainsaw.

  18. 18
    dr. luba says:

    @Betty Cracker:

    “You hate to overreact and commandeer a gated community to install them in until they check out in 21 days, but it may come to that.”

    This is when all those FEMA camps could really be put to good use.

  19. 19
    scav says:

    @elmo: The ones with no symptoms I’d worry far less about, although they’d probably be well advised to not go on absolute vacation . . . keep up with watching for symptoms and be near a hospital that will leap into proper action if there are any worrying on the safe side symptoms. But after exhibiting, I think the risk of infection keeps ratcheting up as it seems to mess with the body’s defenses along the way. searching for links on that last.

  20. 20
    RaflW says:

    @Trollhattan: Not quite. They probably don’t have enough marks patriots yet.

    LOCATION: We are in the process of selecting the ideal location among the beautiful mountains of Idaho in the American Redoubt.

  21. 21
  22. 22
    skerry says:

    @Betty Cracker: That person was Dr. Nancy Snyderman. She went out for take-out food while under “voluntary” 21 day quarantine. She’s a fricking MD and had to have her carry-out. She didn’t go in the restaurant, but a male companion did.

    She’s now on “mandatory” quarantine. Not sure what that means in New Jersey.

  23. 23
    Mike J says:

    @skerry:

    She’s now on “mandatory” quarantine. Not sure what that means in New Jersey.

    They’re going to cause traffic jams to make sure she can’t get into Manhattan.

  24. 24
    RaflW says:

    @scav: Just read that even before symptoms present, the virus starts shutting down the body’s production of interferon. The interferon response apparently starts before antibody production in typical viral infections.
    The loss of interferon response is said to be part of the reason Ebola is so nasty.
    Which begs the question: are interferon injections part of Ebola treatment? That said, I can’t imagine there’s enough global supply for 10,000 African cases, sadly. But for the (hopefully) 2 or so living US patients?

  25. 25
    Trollhattan says:

    @RaflW: Jesus, that’s lame. Slackers (but we knew that).

  26. 26
    Comrade Luke says:

    My college reunion is this weekend, and I have friend flying in from all parts of the country. Believe me, this has crossed my mind.

  27. 27
    peach flavored shampoo says:

    Maybe you’re being a bit too harsh. Those unfamiliar with Ebola’s residency time may assume they’re uninfected b/c they dont exhibit symptoms for days after being in contact. With the assumption they’re in the clear (b/c damn near every other virus makes its appearance known quickly), they travel. It’s quite possible this person doesn’t know the life cycle of this virus and its modus operandi.

    Proper training and education would solve this. But alas, a day late and a syringe short.

  28. 28
    Ella in New Mexico says:

    John, I respectfully want to say that you don’t know FUCK about what really happened here.

    Hold your anger on this one until the facts come in. The “CYA by Blaming the Nurse” game has been modus operandi on this Ebola case. Catch up on what these nurses were forced to deal with in caring for Duncan, what they were told, then how that changed and changed again. Like how they weren’t even given fucking SHOE COVERS until a few days in, or that the nurses caring for him also had assignments with other patients in the hospital. That happened because the hospital didn’t want to pay to have more RN’s on shift to take up the slack freeing a dedicated team to this one patient. Learn just how terrible the guidance from the CDC was through all of this. You’ll find that Texas Presbyterian management failure of leadership is ultimately to to blame here. But because there are no nurses unions at that hospital, only now are the nurses voices being heard.

    We have exactly three hospitals in the United States that are equipped to deal with Ebola. Three. The new consensus is that any future patient diagnosed with Ebola should be fucking shrink-wrapped and shipped immediately to one of those locations for treatment.

    If this RN violated orders and flew, then that’s on her. My guess is there were no such orders because the official line at TPH was “No Worries!! Just treat this like a case of C-Difficile”. Trust me, I’m a CCU RN. I’m in on a lot of the back story on this situation. ICU and Emergency Department nurses are not idiots. We are the fucking smartest, most kick-ass people in the health care system. We know more than most MD’s, and often tell THEM what to do with your ass. We would not knowingly or willingly risk a patient or other people’s lives, I promise you.

    My own ED/ ICU is totally unprepared to deal with Ebola, and yet our hospital spokespeople just gave interviews that we are fully equipped to deal with a patient should one show up. NO. WE. AREN’T. But we also have no union, and the word is that if we can be traced to any “negative commentary on electronic media or the public” in regards to the fact that we are not prepared we can and will be fired on the spot.

    Cuz money is to be made, and we must calm the fears out there by misinforming the public so we can continue to rake it in…

  29. 29
    scav says:

    @RaflW: Ah, there’s the word I was missing, I’d migrated from Interferon to, gsd help me, white blood cells. Got a link for that? Details, I do so love details. Thanks!

  30. 30
    boatboy_srq says:

    If our health care professionals are this god damned stupid, there is no chance we are going to contain Ebola.

    Healthcare professionals are among the most real-world sack-of-hammers dumb people on the planet. They’re the people who bought SUVs (because the Hummer was cheaper for the medical office to lease than the Jag and came with a “farm equipment” tax credit) then whinged about $4/gal fuel because Freedumb and DrillBabyDrill. They’re among the whingers who simultaneously insist that Gud Aul’ Ahmurrcan Ingeenyewity™ will solve all our energy problems and shriek that Obummer and Fat Al are taking away their light bulbs. They love their BlackBerries but can’t get it that the Windows2000 servers with Exchange 5.5 their practice is running can’t talk to them without lots of shoehorning (and consequent consulting charges). And you can’t talk to them about anything because MDs make them smarter than Gawd Hisself; so unless you have similar advanced indoctrination education, your opinion doesn’t count because Doctorate. Yes, especially with regard to how to behave among Real People, medical professionals are among the most bone-stupid folk on the planet.

    And I say this coming from a long line of physicians.

  31. 31
    RaflW says:

    @peach flavored shampoo: If a nurse was in close treatment of an Ebola patient that has caused a national uproar, and remains “unfamiliar with Ebola’s residency time” then they should be fired, post haste.

    For g-d’s sake, a profession isn’t very professional if the practitioners don’t bother to learn about the disease they are in direct proximity to.

  32. 32
    Botsplainer says:

    Hopefully she went to a Hometown Buffet or Golden Corral or Ryan’s Steakhouse somewhere. That would be the shizzle.

  33. 33
    RaflW says:

    @scav: Not the article I read this morning but the goooooglz provided this, which (despite being HuffPo) seemed informative.

  34. 34

    @Ella in New Mexico: I’m not going to hold off on anything. And yes, I do blame the nurse. Not nurses in general, but this particular one.

    I have spent zero days in a nursing or medical program, but I have two synapses still working, so if I were exposed to Ebola, I would not only not get on a fucking plane and go somewhere, but I would not leave my damned house. S/he handled a man who died from it. Fer fuck’s sake, what does s/he need to know not to be prancing around in public?

    You don’t need fucking protocols to have a lick of common sense. This person is an idiot and an asshole. End of story.

  35. 35
    Botsplainer says:

    @boatboy_srq:

    Healthcare professionals are among the most real-world sack-of-hammers dumb people on the planet.

    Docs are the worst investors on Earth. Shit all stupid.

    Paramedics and EMTs are great people, but generally lousy at marriage and even worse at personal finance.

    Nurses are on a whole other level of dysfunction when it comes to personal life.

  36. 36
    scav says:

    @RaflW: And I found this (!) USAToday one plus a Science Daily one so with yours, I’m off!

  37. 37
    Ruviana says:

    @Ella in New Mexico: Thank you for this. The same article that John linked to also says this:

    The Ebola virus is not contagious before symptoms set in.

    The woman “exhibited no symptoms or sign of illness while on Flight 1143, according to the crew,” Frontier Airlines said in a statement.

    This means she was not contagious, even if her interferon levels were dropping. She was not shedding virus. These kinds of assumptions are also part of what creates panic. Rather than being like an HIV positive person having unprotected sex, right now she’s like anyone. The actual analogy would by like a sick ebola patient projectile vomiting on people. Get a grip!

  38. 38
    Culture of Truth says:

    @Betty Cracker: Actually the local police department is guarding Dr Snyderman’s house to prevent her from leaving again.

  39. 39
    Betty Cracker says:

    @boatboy_srq & @Botsplainer: Christ on a Triscuit, overgeneralize much? On behalf of the smart, dedicated, competent, caring nurses and doctors I know, sod off to the both of you.

  40. 40
    Ella in New Mexico says:

    @John Cole +0: John, you simply do not know the facts. We don’t even know at what level she “provided care” which could have been completely non-contact. We don’t know what she was told she could or could not do. At this point, using your logic, every single person in that hospital should be shipped to a leper colony and placed on quarantine.

    http://www.washingtonpost.com/.....s_homepage

  41. 41
    boatboy_srq says:

    @Ella in New Mexico: Edit to my earlier rant: NURSES are whip-smart, and surviving in an ICU/ER environment takes brains: knowledge, good observation skills and quick thinking all at once. That said, nearly all the MDs I’ve met (and I’ve done my share of consulting to medical businesses of various sorts) are brilliant in their respective field, and in no other sphere whatsoever – and neither you nor I could persuade them otherwise. Snyderman is the poster child for “I’m a hospital administrator so I know all about everything: ‘scuse me while I breach protocols and do something insanely stupid because I know I’m doing the right thing.” As for your last comment (about public statements and publicity), seems there’s one more thing we can thank volk like Governor Voldemort for.

  42. 42
    Brother Dingaling says:

    people don’t go to work when they have a cold because they know better than to expose everyone

    As if not going to work is even an option for some of us. I don’t mean unpaid sick days, I mean don’t come in and you’re fired.

  43. 43
    I'mNotSureWhoIWantToBeYet says:

    @elmo: ThinkProgress said he was checked 3x in Liberia for fever (and apparently didn’t have one):

    In fact, Ebola screening is statistically even more unlikely to yield results than the fruitless SAARs screening described in the BJM article. Canada did mass fever screening for SAARs, which the U.S. is refraining from doing for Ebola. Only about 150 travelers a day will receive the screenings. The fact that Ebola has a 21-day dormancy period — more than twice than that of SAARs — also does not help. Thomas Eric Duncan, the Liberian man who died of Ebola in a Dallas hospital last week, was screened for fever three times at the Liberian airport. A fourth screening here in the U.S. would not have stopped him from entering the country.

    We really shouldn’t panic about this. Ebola is very difficult to spread without contact with bodily fluids of a (presumably severely) symptomatic patient.

    Cheers,
    Scott.

  44. 44
    Ella in New Mexico says:

    @Ruviana: Exactly. On one hand, we panic too much too soon about this damn virus, and on the other hand, especially when it comes to how we are actually caring for these patient’s, we panicked far, far too late.

    Also, the information about interferon is fascinating. Totally makes sense.

  45. 45
    Jim, Foolish Literalist says:

    @Culture of Truth: Is there a communicable stupidity virus in the CNN cafeteria?

  46. 46
    Ella in New Mexico says:

    @boatboy_srq:

    “Healthcare professionals are among the most real-world sack-of-hammers dumb people on the planet… And I say this coming from a long line of physicians.

    Which is why your nurse will save your ass from your doctor on any given day. ;-)

  47. 47

    @Ella in New Mexico:

    The second Dallas health care worker who was found to have the Ebola virus should not have boarded a commercial jet Monday, health officials say.

    Because she had helped care for Ebola patient Thomas Eric Duncan, and because another health worker who cared for Duncan had been diagnosed with Ebola, the worker was not allowed to travel on a commercial plane with other people, said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention.

    Enough excuses.

  48. 48
    WaterGirl says:

    @Ruviana: @Ella in New Mexico:

    Are people unfamiliar with the concept of “exercising an abundance of caution”?

  49. 49
    Jim, Foolish Literalist says:

    @John Cole +0: I was just going to check for a timeline wrt the other patient’s diagnosis and the second’s traveling. That is pretty bad.

  50. 50
    RaflW says:

    @Ruviana: In this circumstance it will probably all work out OK for the other pax, crew, ppl in the terminals, etc.

    But what if this nurse (or some future dunderhead) starts puking mid-flight? It appears that didn’t happen, so I’m not ringing some urgent alarm bell about this case. But being asymptomatic at 6:30am when you wake up to travel doesn’t mean you won’t be at 2pm in seat 22B at 36,000 ft.

    Hence the CDC saying “don’t travel on airplanes” if you are a healthcare worker who has been exposed. Which this nurse failed to do.

  51. 51

    @RaflW:

    I blame Rick Perry, by the way.

    I think this is the most responsible course of action.

  52. 52
    Emma says:

    Which part of “it’s not contagious until symptoms appear” did y’all miss? Honestly, the panic over this is spilling everywhere.

    I am more concerned about hospitals without proper protocols, walk-in clinics that aren’t equipped for treating the disease, and government officials running around covering their asses by handing out misinformation.

  53. 53
    Ella in New Mexico says:

    @Botsplainer:

    Hopefully she went to a Hometown Buffet or Golden Corral or Ryan’s Steakhouse somewhere. That would be the shizzle

    And hung out at the chocolate fountain, dipping and re-dipping her strawberry in the flowey deliciousness and picking it out with her just licked fingers when one fell into the bowl

  54. 54
    Gin & Tonic says:

    @Emma: NBC is reporting that she had a fever when she boarded.

  55. 55
    Belafon says:

    In a day and age where conscientious adults keep their kids home from school and people don’t go to work when they have a cold because they know better than to expose everyone at the school and workplace, this is just astonishing.

    What day and age are you referring to? The one where people don’t get paid if they take a day off, and therefore either go to work sick, or send their kids to school sick because mom and dad can’t afford to take the time off? Or those parents whose sick time is also their vacation time, and therefore can’t afford to take the time off themselves in case their kids get sick?

  56. 56
    WaterGirl says:

    @Emma: May I refer you to RalfW’s comments above:

    But what if this nurse (or some future dunderhead) starts puking mid-flight? It appears that didn’t happen, so I’m not ringing some urgent alarm bell about this case. But being asymptomatic at 6:30am when you wake up to travel doesn’t mean you won’t be at 2pm in seat 22B at 36,000 ft.

    Hence the CDC saying “don’t travel on airplanes” if you are a healthcare worker who has been exposed. Which this nurse failed to do.

    And I will repeat myself: Anyone in contact with an Ebola patient – at any stage – should be exercising an abundance of caution. There’s nothing to be lost and everything to be gained by following that approach.

  57. 57
    Culture of Truth says:

    so if I were exposed to Ebola, I would not only not get on a fucking plane and go somewhere, but I would not leave my damned house

    .

    So anyone “exosed” to ebola has to shut themselves in their home for 10 days? That’s going to make it a little tough to treat people.

  58. 58
    japa21 says:

    @Betty Cracker: You beat me to it. I do have a bias in favor of nurses, since I am about to celebrate 40 years of wedded bliss to one. But I can tell you that she is smart as a whip and as commonsensical as they come in any matters related to medicine. She worked in a family practice setting for many years and some of the docs she worked for will readily admit that she saved their asses multiple times by seeing something they didn’t.

    If this nurse had been her, there is no way she would have traveled. Hell, she probably wouldn’t even have let me give her a kiss until the incubation time was well past and she definitely wouldn’t have gotten anywhere near our children or grandchildren.

  59. 59
    Punchy says:

    You don’t need fucking protocols to have a lick of common sense. This person is an idiot and an asshole. End of story.

    And you’re just a complete dick. And ignorant of the full story, so please STFU before you make a bigger jackass of yourself.

    So all nurses who work with infectious diseases waaaay more infectious than Ebola be barred from leaving their home? Why treat Ebola any differently? It’s LESS lethal than HIV (no travel restrictions), way less communicable than the flu virus (no travel restrictions), only transmittable during times that symptoms are present (easy to know when to travel or not), and one must try damn hard to transmit it to others (not airborne).

    Cole’s new rule– all nurses working with nasty shit can never leave home. Because he’s a scared little shithead and virology is hard.

  60. 60
    LongHairedWeirdo says:

    From what I’ve heard, you’re not contagious until you’re showing symptoms – and even then, it’s not *easy* to get it. That she was on OMG AN AIRPLANE without symptoms is meaningless. It was a breach of protocol and needlessly panicking, but it wasn’t a danger.

    It was like the Oregon water folks choosing to drain a reservoir when some guy filmed himself taking a leak in it. It wasn’t done because there was a danger – it was done because there’s some tiny number of people who’d swear they tasted urine in the water, or who’d refuse to drink tap water, or, whatever.

    (And yes, I just basically said that if you thought it was stone cold stupid for Oregon water to dump the reservoir, then you’re being stone cold stupid for being pissed off that she flew if she had no symptoms.Unless you’re angry over the needless panic – in which case, show some sympathy for the guy who decided to dump the reservoir, even if you disagree with him.)

  61. 61
    kindness says:

    What is this ‘don’t go to work because they have a cold’ of which you speak John? I am unfamiliar with it. It is an alien concept here at my job and I work in a very large office.

  62. 62
    Emma says:

    @Gin & Tonic: See, that really makes a difference. The news reports I saw said she was asymptomatic.

    Still, there are infectious diseases that are way easier to get than Ebola. Plain old influenza kills more people worldwide than Ebola does. When are we going to forbid people sneezing to travel?

  63. 63
    SiubhanDuinne says:

    @Culture of Truth:

    I don’t call for gunplay, but I hope they have their tasers at the ready if she so much as sticks her big toe out the front door. What a fucking entitled arrogant twit of an idiot.

  64. 64
    Mnemosyne says:

    @Ella in New Mexico:

    We would not knowingly or willingly risk a patient or other people’s lives, I promise you.

    My friend’s husband is a cardiac ICU nurse. He also refuses to get a flu shot, because he doesn’t think it’s “necessary.” This is at a major medical center in Southern California.

    You may have a somewhat higher opinion of your fellow RNs than they always deserve.

  65. 65
    Barry says:

    @RaflW: “LOCATION: We are in the process of selecting the ideal location among the beautiful mountains of Idaho in the American Redoubt.”

    Because nothing says ‘amber waves of grain’ like ‘Northern Rocky Mountains’.

    ISTR reading that this was definitely a con (a *lot* of money has been collected on down payments), but I wonder if the marks ever thought about how to actually survive in the mountains?

  66. 66
    AnonPhenom says:

    Does this jackass really need to be told…

    Telling people what to do won’t do shit. Take a second and remind yourself that all of us, even the smartest among us, are just hairless apes a few tens of thousands of years removed from being chased on the African plains. Hell, we’re as best only 500 years removed from thinking that evil spirits caused illness. By nature our habits are built on fear and repetition. Everyone involved in providing direct healthcare services will be developing a brand new set of habits from this moment forward. Just like they did in the 80s because of AIDS. Will there be Darwin Award winners? Sure. But we’ll get it right and in a suprisingly short amount of time. Just breath.

  67. 67
    RaflW says:

    Holy shit, the Presby Hospital folks sound like utter idiots. Deadly dangerous utter idiots.

    The 3-day window of Sept. 28-30 is now being targeted by investigators for the Centers for Disease Control and Prevention as the key time during which health care workers may have been exposed to the deadly virus by Duncan, who died Oct. 8 from the disease.

    Duncan was suspected of having Ebola when he was admitted to a hospital isolation unit Sept. 28, and he developed projectile vomiting and explosive diarrhea later that day, according to medical records his family turned over to The Associated Press.

    But workers at Texas Health Presbyterian Hospital Dallas did not abandon their gowns and scrubs for hazmat suits until tests came back positive for Ebola about 2 p.m. on Sept. 30, according to details of the records released by AP.

  68. 68
    Ella in New Mexico says:

    @John Cole +0:

    John, like I said, they are using the “First, blame the nurse. Then tell the truth later” as modus operandi for this case. That’s what they did when they said Duncan came into the ED, and we later found out it was erroneous. That’s what they did when little Nina Pham got sick–“breach of protocol” they said. Follow the time line, and you’ll see that the HOSPITAL gave direction and provided resources that were wrong, not Pham breaking protocol.

    That plus the fact that YOU ARE NOT SUPPOSED TO BE CONTAGIOUS WHEN YOU HAVE NO SYMPTOMS. You monitor your fever because an elevation in temp precedes by a significant time-frame when you are actually contagious. You are supposed to then get yourself to a medical provider and isolated. Not before.

    Seriously, we don’t have all the information here, and given their track record, I’m withholding judgement until I do. No matter what, if you only knew what it was like to be on the front lines caring for critically ill people in today’s profit-driven hospital environment, the kinds of pressure your administration places on you, you’d be aghast. You should be in this nurses corner, not turning her into a scapegoat. The CDC is doing a good enough job of it.

  69. 69
    boatboy_srq says:

    @Betty Cracker: When you explain to your 40th MD that his ten-year-old laptop can’t talk to his shiny new smartphone because the systems aren’t compatible, and that his staff’s fifteen-year-old desktops certainly can’t, and watch him/her plugging it in, fuming at it, and demanding his office manager try as well, while you’re on your way out of that office (just like the 39 before him/her did), and you can still say that, I’ll be happy to go away.

    “Medical professional equals blockhead” is too general: I’ll admit that is too broad. But physician as a career does attract more than its share of people who are neither real-world high functioning nor remotely cognizant that they aren’t real-world high functioning. My clients, my GPs (with only one exception and I miss her terribly), my specialists and my many former clients were all alike in this: talented in their field and requiring multiple professionals to fill the gaps in their talents (accountants, payroll (separate from accounting),housekeepers, nannies, relationship counselors, personal shoppers, and IT professionals (for office and for home – and not infrequently different ones for each because Neither Knows What S/He’s Doing)).

  70. 70
    Ella in New Mexico says:

    @RaflW: THEY WERE TOLD THAT THE PPE THEY HAD WAS ALL THEY NEEDED.

    My own hospital was telling us that up to yesterday. We’re not buying it.

  71. 71

    @Trollhattan: They better hurry before the Ebola gets there.

  72. 72
  73. 73
    Valdivia says:

    that hospital was totally negligent in how they treated Duncan and their staff after he was admitted.

    http://thescoopblog.dallasnews.....2773012ff1

  74. 74
    catclub says:

    Speaking of weapons of mass destruction:

    This is a big deal:
    http://www.nytimes.com/interac.....&_r=0

    Chemical weapons found in post Saddam Iraq? Check? Made by Saddam’s 1999 re-armament efforts?
    Nope. 1985 and helped by Western industrial powers – US, Germany, Spain.

    And covered up since 2004.

  75. 75
    Face says:

    Duncan was suspected of having Ebola eating at Denny’s when he was admitted to a hospital isolation unit Sept. 28, and he developed projectile vomiting and explosive diarrhea later that day

    Fixed for ya.

  76. 76
    Culture of Truth says:

    At every Dallas press conference they mention their reliance on prayer. It’s not totally comforting.

  77. 77
    Pogonip says:

    @Culture of Truth: How? As stated before, millions of people can’t stay home if they’re sick.

  78. 78
    RaflW says:

    @WaterGirl:

    There’s nothing to be lost and everything to be gained by following that approach.

    Well, now, the nurse probably had a nonrefundable ticket. That’s hundreds of dollars that would have been thrown away, just at the risk of inconveniencing the traveling public.

    And by inconveniencing, I mean there will now be a whole bunch of people on 21 day monitoring, several of whom will probably be in freakout mode. And who, one hopes, won’t get on another plane. And one dearly hopes, will stay healthy.

  79. 79
    gvg says:

    Many people have jobs where they get fired for calling in. Others get yelled at for coming in while sick. There is no consistancy, you have to learn the new corperate culture when you start a job and it can change over time because of the actual people you work with’s opinion on what is proper. Some people think you are rude and inconsiderate to infect other people and others think you are a whining pansy if you ever take a sick day.
    Nurses and doctors in my limited experience are expected to come into work almost no matter what. Hospital management has been cutting back on the numbers of nurses per patient for decades, to the point Nurses are overworked and burn out faster causing more shortages etc.
    I think I would wait a little in case there are more facts just because the hyper fear is stupider than usual on this story and it may be nothing like it sounds like. Or even flat out didn’t happen.
    Nurses may have been briefed across the country on how to take care of Ebola patients but I doubt they have been briefed on how not to do something that sounds scary to a hysterical public getting it’s news from non scientific journalists and a bunch of lie prone attention seeking pundits who don’t really have any incentive to say anything except fear. It’s a completely different skill set. I bet they didn’t teach that in Nursing school.

  80. 80
    feebog says:

    Thanks for the link John. The last couple sentences from the clip lead me to believe that there may have been confusion, or even misinformation regarding travel transmitted to the health care workers involved. As Ella pointed out, we don’t know specifically what these folks were told, or even if they all received the same information. They were not forbidden to travel, only not on commercial airlines? It was ok for them to go shopping, to the movies, to a restaurant or other crowed place, but not travel on a commercial airliner. Does that make any sense? Before we condemn this individual, I’d like to know all the facts. Given the hospital’s poor performance so far, I think placing blame here is premature.

  81. 81
    Heliopause says:

    In a day and age where conscientious adults keep their kids home from school and people don’t go to work when they have a cold because they know better than to expose everyone at the school and workplace

    BWAHAHAHAHAHAHAHAHAHAHAHAHA!!!!!!!! OMG!!! BWAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA…

    [gasping for air] Oh my goodness gracious, you should take this routine on the road! It’s hilarious!

  82. 82
    Ella in New Mexico says:

    @Mnemosyne:yes, BUT, in all hospitals, if you refuse or cannot take a flu shot you must wear a face mask the entire flu season. I have two co-workers who are allergic and must do so.

  83. 83
    catclub says:

    @🚸 Martin: me too.

    Plus, hospitals trying to dump patients without visible insurance coverage was what got Duncan not admitted the first time.

  84. 84
    Gin & Tonic says:

    @feebog:

    Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, told reporters that the nurse had a temperature of 99.5 degrees before she got on the plane on Monday.

  85. 85
    RaflW says:

    @Ella in New Mexico: Told by who? Is this what the CDC and/or NIH told Presby management?

    If you mean that the hospital told the workers their scrubs and masks were sufficient, then the responsibility goes up the ladder, of course.

    But we need to know what and when the hospital’s medical leadership was told about protective protocol. Are there links?

  86. 86
    hoodie says:

    One problem with coming down hard on nurses or other caregivers that fuck up like this is that it is probably hard enough to get people to care for Ebola patients and this won’t make it any easier. We also don’t know exactly what she was told, e.g., if the travel ban was effectively communicated to her. From the other ineptness exhibited by Texas Pres, they may have fucked that up too by telling her to check out a webinar or something equally lame. The bigger problem is that we’ve neglected public health for so long because of free market fetishism and the need to spend money on such necessities as the Iraq Adventure. We’ve turned healthcare into a free for all that tends to make docs and hospital administrators into money-grubbing “entrepeneurs” instead of key players in the public health infrastructure. My mom was OR nurse and supervisor for 45 years and was glad to retire when she saw everything heading in this direction in the 1980s.

  87. 87
    Mnemosyne says:

    Commenter Pongo has a good comment about this in the Uncle Joe thread — here’s a link.

    The whole comment:

    Worth pointing out that patients sent to Atlanta and Nebraska have not spread the disease, presumably because they were cared for by adequately trained and outfitted healthcare workers. This is more a failure of the Texas healthcare system, Texas Presbyterian Hospital and the Texas Dept of Health, than an indictment of American medicine. It does demonstrate that one weak link has the potential to overwhelm the entire disorganized ‘system’ we have for providing care, though. How unfortunate that Duncan sought help from a weak link hospital in a weak link state.

    Just read the complaint filed by the Dallas Nurses Union regarding how Texas Presbyterian mismanaged this situation and put the nurses at risk. If their complaints turn out to be real, it is astounding for the sheer idiocy of hospital leadership. The nurse supervisor had to demand isolation for Duncan and fight the hospital administration for it. In the hours that took, Duncan was left in an unsecured area of the hospital. Nurses who cared for him had to cover their necks and other exposed areas with medical tape (not an effective barrier) because they did not have the right gowns.They had to remove the exposed tape themselves, risking infection. Linens and soiled materials were left in piles on the ground. These are not Ebola-specific issues.If true, this hospital is in violation of very basic infection control standards.

    I know there is no appeasing the blame Obama crowd and the CDC should not have assumed the Dallas folks were up to the task of containment and should have taken over like the jack-booted thugs they are accused of being, but I think it is important to point out that Texas is the only site in the US treating Ebola patients that has had an issue with transmission. It is the Texas Dept of Health that apparently bungled quarantining individuals who had been in contact with Duncan and allowed a sick nurse to board a commercial airliner. It is a Texas issue, not a national issue. Texas dropped the ball. Sadly their failure has the potential to amplify transmission now, but the response from the rest of the country has been effective and we need to keep that in mind.

    Also good to remember that this ‘epidemic’ has still only affected two people in the US. Two. Not 2,000, not 200,000. Two. Everyone else being treated here brought the infection with them from somewhere else. Yes, it’s scary, but we have really gone around the bend on this and it is time to bring some sanity back to the discussion.

  88. 88
    Marc says:

    @Ella in New Mexico:

    This disease became an out–of-control epidemic in west africa. If the nurse had gotten sick on the plane she could have been the root cause of a national pandemic, with vectors all over the country. That’s a hell of a consequence, and it’s not as if she didn’t know what the stakes could be.

  89. 89
    Face says:

    I’m supposed to get on a plane in 10 days. I’m actually a little worried that I’ll inadvertently sneeze during the flight and be met by Hazzys upon unloading and placed in 3 week quarantine. My only hope is that my whiteness and lack of African dialects saves my ass from such a punishment.

  90. 90

    @feebog:

    The last couple sentences from the clip lead me to believe that there may have been confusion, or even misinformation regarding travel transmitted to the health care workers involved.

    Agreed. Considering how thoroughly fucked the hospital’s protocols were regarding treating Duncan, why is anyone giving them the benefit of the doubt that they told their staff the correct information about quarantine and monitoring?

  91. 91
    Mnemosyne says:

    @Ella in New Mexico:

    Sadly, they don’t seem to enforce that at his hospital, so he goes both maskless and flu-shot-less. It’s a really sucky thing for him to do, but none of us have been able to talk sense into him. And he’s an RN, fer chrissakes, not a frickin’ candy striper.

  92. 92
    Ella in New Mexico says:

    @Mnemosyne: Ok, then HE’S definitely an asshole. ;-)

  93. 93

    @dr. luba: There’s gated communities all over the US, just rent a home or buy one on short sale and move the patients right in.

  94. 94
    Punchy says:

    @Gin & Tonic: That’s not a “fever” by any stretch. I can get to 100F by doing cardio in a hot gym. No way alarm bells should go off for someone’s temp less than 100F. A complete nothingburger.

  95. 95
    Valdivia says:

    @RaflW:

    cdc has very specific protocols which were shared with the hospital. seems from what has come out today they did not follow, even when it was suspected but not confirmed.

  96. 96
    catclub says:

    @boatboy_srq:

    medical professionals are among the most bone-stupid folk on the planet.

    So, Ron and Rand Paul, plus that Broun guy.

  97. 97
    Elie says:

    @elmo:

    Mr Duncan was asymptomatic for several days after his arrival, as well as during his flight here from Brussels.

    So far none of the people who had contact with him up until he became symptomatic in DALLAS (not the airplane), have symptoms, thanks be

    Infectivity seems to be correlated (as the experts have been TRYING to tell us), with exposure to acutely ill patients, increasing in likelihood the sicker they are. That is because by the last phases of the disease, the virus is literally everywhere in the sick person and replicating without any restriction from the body’s immune system which is now overwhelmed by the disease.

  98. 98
    boatboy_srq says:

    @Ella in New Mexico: And don’t I just know it.

  99. 99
    Ella in New Mexico says:

    @Mnemosyne: This is excellent. Thank you for sharing it. It sounds like what I deal with everyday, and that’s just fighting for my “just critically ill” patients.

    Medicine should not have any profit motive whatsoever. It’s at the root of all evil in healthcare.

  100. 100
    boatboy_srq says:

    @catclub: Don’t forget to add Frist to that list.

  101. 101
    RaflW says:

    @Mnemosyne (and Pongo): I’ve joked before that Perry needs to be held accountable.

    No more joking. The Texas Department of Health appears to have a lot to answer for. I just wonder if the media has the gumption to do the damn asking.

  102. 102
    Mnemosyne says:

    @Punchy:

    No way alarm bells should go off for someone’s temp less than 100F.

    Under normal circumstances, sure. But for someone who is aware that she’s been exposed to Ebola and cautioned that she needs to closely monitor her temperature, alarm bells sure as hell should be going off loud and clear with even a small change like that.

  103. 103
    Valdivia says:

    @Mnemosyne: thanks for reposting that. and amen.

  104. 104
    Ella in New Mexico says:

    @Punchy: Thank you!!! :-)

  105. 105
  106. 106
    Betty Cracker says:

    @feebog: Good points.

  107. 107
    FormerSwingVoter says:

    Am I the only one who thinks ebola isn’t a big deal? I mean, three people have gotten it, and it’s only transmitted through bodily fluids. If it were anywhere near as bad as people are talking about, half of Africa would be dead.

  108. 108
    Elie says:

    @boatboy_srq:

    I am sorry that is what you think. It is untrue and not helpful right now. They are no more stupid than many other professions, though like every other profession, there are plenty of morons and knuckleheads.

    I have admired the professionalism of the CDC ers and NIH staff as well as many epidemiologists and other infectious disease medical docs interviewed. I have been less impressd with the nursing leaders who seem whiny and too finger pointy rather than demonstrating confidence in their expertise.

    I agree with John however, that this was an extraordinarily stupid individual and I am glad she is being shipped out to Emory since it seems they have a real problem with the quality of the nursing staff (or at least that is a question), for this hospital..

    But please don’t insult lots of really good people doing really necessary and good work here and all over the world. It just makes YOU look – well – stupid.

  109. 109
    Calouste says:

    @Botsplainer: What about pharmacists?

  110. 110
    Violet says:

    Apparently she was going to Cleveland to see her fiance and plan her wedding.

  111. 111
    RaflW says:

    @Ella in New Mexico:

    Medicine should not have any profit motive whatsoever. It’s at the root of all evil in healthcare.

    +1

    Or +1 million, if I could.

  112. 112
    Gin & Tonic says:

    @Punchy: I don’t know about you, but my temperature rises during the day. 99.5 at 6:00 pm means a lot less than 99.5 at 6:00 am. And if I’ve been treating somebody who just died from Ebola, and know that one of my co-workers has been diagnosed positive two days ago, then any elevation early in the morning should catch my attention.

  113. 113
    Mnemosyne says:

    @feebog:

    Actually, I can see why there would be a travel ban but not a ban on doing things locally — the fear could be that the person would get sick while out of the area and possibly end up at a hospital that would not be prepared for an Ebola patient. If someone started running a fever while out shopping at the local mall, they could just take themselves back to Dallas Presbyterian for treatment.

    But I also suspect that the “do’s and don’ts” probably were not well-communicated since it sounds like nothing is well-communicated at that hospital.

  114. 114
    Valdivia says:

    @Violet:

    they better get him quarantined right away.

  115. 115
    Elie says:

    @Culture of Truth:

    Amen!

    We are going to contain Ebola here – but it won’t stay contained here or anywhere unless we get down to cases in Africa. For.Real.

  116. 116
    Ella in New Mexico says:

    @Elie:

    I have admired the professionalism of the CDC ers and NIH staff as well as many epidemiologists and other infectious disease medical docs interviewed. I have been less impressd with the nursing leaders who seem whiny and too finger pointy rather than demonstrating confidence in their expertise.

    Seriously? The CDC and it’s “professionals” are why we are having this fucking problem at Texas Pres. Yes, they do look nice in their office attire during their remote interviews where they seem so calm and level headed, as compared to the “whiny” nurses who point fingers at their administrators who at first wouldn’t allow them to have isolation rooms and proper attire while they cleaned up Duncan’s PROJECTILE VOMIT AND EXPLOSIVE DIARRHEA.

    Man, I’m so sorry, let me apologize for my fellow nurses who “get whiny” instead of feeling confident we won’t catch Ebola in that environment.

    But I will say this, our own Infectious Disease MD told us the other day that if an Ebola patient presented at my ED, we pretty much all will catch it given our current resources and protocols.

    So I respect HIM.

  117. 117
    Anoniminous says:

    @Ella in New Mexico:

    Medicine should not have any profit motive whatsoever. It’s at the root of all evil in healthcare.

    This. This. A thousand times this.

  118. 118
    RaflW says:

    @FormerSwingVoter: We’re only in the early stages of the disease in Africa. Will half the continent die? Doubtful. But hundreds of thousands might. That is a significant human tragedy. Some of the more sobering projections go over 1 million infected.

  119. 119
    Botsplainer says:

    Disclaimer – this guy is an acquaintance of my past.

    He’s also pretty goddamned douche-y.

    http://www.mediaite.com/tv/exe.....l-failure/

    Dr. Daniel Varga, chief clinical officer for Texas Health Resources, defended Texas Health Presbyterian Hospital at a press conference Wednesday morning after news that a second health worker had contracted ebola from patient Thomas Eric Duncan, who passed away last week. The second case intensified criticism of the hospital, especially after a statement from a nurses association accusing the hospital of lacking proper protocols.

    “We’re a hospital that serves this community incredibly well and we have for nearly a half century,” Vargas said. “We’re a hospital that may have done some things different with the benefit of what we know today. But make no mistake, no one wants to get this right more than our hospital, the first to diagnose and treat this insidious disease that has now attacked of two our own.”

    Translation: “Delta has a long tradition of service to its members and the community at large. Please quit bitching me out. This job was supposed to be about me being a ‘hands-off’ administrator while collecting a fat paycheck and being a front line investor in all the equipment and allied health subcontracting enterprises. It wasn’t supposed to be like this – I would buy a few powerpoints and video presentations, preferably with affiliated enterprises, and the magic of tort-reformed, unregulated Texas was supposed to take care of the wrinkles.”

    One reporter asked whether the second case represented a “systematic, institutional problem” at the hospital.

    “I don’t think we have a systematic institutional problem,” Vargas said. “The case of this patient here again shows that the ability to intake those folks, get them into isolation and manage them has been very effective. But we’re looking at every element of our personal protective equipment and infection control inside the hospitals.”

    Translation: “I don’t know about you, Greg, but I am not going to sit here and let you bad mouth the United States of America!”

    “We don’t have an answer for this right now, but we’re looking at every possible angle around this,” he concluded.

    Translation: “I can tell you about the magic of tort reform and revenue maximization, but as to infection control, I got nothin’. Maybe my replacement will come up with something.”

  120. 120
    aimai says:

    @Ella in New Mexico: I agree with this. Nurses are the bottom of the heap, just above orderlies, in the hospital system. Not only are they not trusted with lots of information they have zero power. You don’t know what these nurses were told, when, and how by the hospitals but you ought to assume that the hospitals lied to the nurses about protocol in order to get them to do the work more cheaply than would have been possible following a rigorous protocol. And no doubt the hospitals aren’t paying the nurses to be in quarantine either. We have an ad hoc, for profit, health care system which nickles and dimes its patients and staff to death in the first place. You have to assume that they fucked over quarantine protocol with the nurses because it would have cost a lot of money to train, equip, and quarantine the nurses and probably would have prevented the nurses from working the other jobs they have to hold down to make a living wage. Did you know that health care workers–including doctors and nurses–don’t always have health insurance themselves? Their employers care about them just.that.much.

  121. 121
    Botsplainer says:

    @RaflW:

    We’re only in the early stages of the disease in Africa. Will half the continent die?

    No, but if it gets to India, things could get dicey.

  122. 122
    CONGRATULATIONS! says:

    You all feeling confident this’ll stay under control? I got one hyphenated word for you: anti-vaxxers.

    Nobody is sticking to the protocol and that is not a situation the CDC ever planned for, or even thought could happen (which makes them pretty much as stupid as the idiots getting on planes after being exposed to ebola).

    The one guy who pretty much war-gamed this scenario accurately turns out to be Stephen King, and that didn’t end so well for just about everyone.

  123. 123
    lou` says:

    The nurse should have stayed home. She just moved to Texas from Ohio and I’m sure her family is still there and that’s why she felt compelled to fly up there.

    That said, the fault for her getting sick in the first place seems to fall clearly in the lap of Texas Presbyterian. I think it also illustrates the pitfalls of “right to work” states where employees fear to speak out. The nursing union has been forceful on this issue, conveying the anonymous complaints of the hospital’s nurses, and good on them for highlighting the incompetency of the hospital administration.

    Here’s a key quote from Al Jazeera America/Associated Press:

    The Texas Health Presbyterian nurses are not represented by the NNU or any other union. DeMoro and Burger said the nurses claimed they had been warned by the hospital not to speak to the media or they would be fired.

  124. 124
    scav says:

    @Ella in New Mexico: Scuse me, I think it’s the local TXPres admins and bean-counters and suit-withholders that deserve your ire, not the cdc and nih crowd.

  125. 125
    RaflW says:

    @Mnemosyne:

    If someone started running a fever while out shopping at the local mall, they could just take themselves back to Dallas Presbyterian for treatment.

    I’d drive myself all the way to f’n Atlanta before I’d pop over to Presbyterian, unless they’ve gotten a serious dose of figure-it-out.

  126. 126
    shelley says:

    John, you’re missing the point. The important thing is, how can we find a way to blame this on Obama?

  127. 127
    Anoniminous says:

    @FormerSwingVoter:

    I agree it’s not a Big Deal, granted one proviso: stopping Ebola from becoming endemic in Africa. That is a Big Deal.

  128. 128
    Comrade Mary says:

    @Elie: Nigeria is just about there. They really deserve a hell of a lot of praise for making this happen.

  129. 129
    Botsplainer says:

    @Calouste:

    What about pharmacists?

    Only pharmacist I ever knew was my shithead brother-in-law’s first wife. She got away while the getting was good, so that counts her as smart in my book.

    I gotta say, she was really nice to look at. I found myself missing that.

  130. 130
    Elie says:

    @FormerSwingVoter:

    You said if it is as bad, half of Africa would be dead…

    Seriously, the spread in Africa is very very serious and has implications for us here…there may be as many as a million infected people in Africa by next spring. That will make it go seriously global and the density alone will make it much more difficult to contain… so why we should stay cool, we have to focus on what seriously needs to be done.

  131. 131

    @Gin & Tonic: Well that’s not looking good. I take back what I said earlier, this was a big fuckup

  132. 132
    RaflW says:

    @Botsplainer: Things are pretty damn dicey in at least three African countries. Yes, transmission to India opens a huge new avenue of risk.

    But what is happening in Africa right now needs high impact attention right now. That was my point.

  133. 133
    Leah says:

    @elmo:

    We don’t know that Eric Thomas Duncan lied to get to Dallas; he wasn’t symptomatic and he probably didn’t know he was infected, plus we know that he had other reasons for coming to Dallas, i.e. a reunion with family members including a son, although almost all we know about him is subject to error, being mostly media gossip.
    Duncan’s nephew has an op ed that states Duncan didn’t know he was infected with ebola,and that he denied to the nephew that the incident with the pregnant woman vomiting ever happened. Mr. Duncan paid a terrible price for contacting a disease over which he had no personal control; I think we should try and be respectful of his memory.

  134. 134
    JPL says:

    There should be notification for anyone being monitored to not take public transportation under threat of house arrest.

  135. 135
    watcher says:

    There is an amazing lack of common sense here. Perhaps she should run for public office.

  136. 136
    LongHairedWeirdo says:

    (Updated) – saw a note that she had a fever on the flight – at this point, strike my previous comment. She should have known better and should be in serious professional trouble over this. We trust health care professionals to understand actual *risks*. And she should have understand that as soon as she showed symptoms, she presented a danger to others.

  137. 137
    Ella in New Mexico says:

    @aimai: You nailed it. Totally.

  138. 138
    Ripley says:

    Am I the only one who thinks ebola isn’t a big deal?

    On this thread you apparently are. Today, we’re trusting the journalism skills of CNN & NBC in support of Cole’s recessive Republican tendency to punch down, hard.

    Do check back tomorrow though.

  139. 139
    RaflW says:

    Yeah, that Presby Hospital exec is a classic corporate hack.

    The statement described a hospital with no clear rules on how to handle Ebola patients, despite months of alerts from the Centers for Disease Control and Prevention in Atlanta about the possibility of Ebola coming to the United States.

    [emphasis added to highlight profiteering incompetence]

  140. 140
    kc says:

    I thought we weren’t supposed to flip out about Ebola.

    I guess that’s changed?

  141. 141
    Elie says:

    @Ella in New Mexico:

    Chill, sister. I’m a nurse..

    I am not saying that the hospital should not be confronted with bad practices, but surely there must be a way of doing it without making everyone else feel that nurses don’t know what they are doing. Seriously. Is that ok for you?

    I recognize that the CDC senior level folks we see on tv are not delivering direct care, but you would be mighty wrong in characterizing them as sitting on their asses. You are also completely underestimating the hands on work done by the epi team at the CDC who are there on site now. We can agree and the CDC admitted that they should have been there from the outset. They are hardworking AND know what they are about. Many are clinicians and veteran Ebola fighters with experience in Africa. That is what they do for a living. I think they agree with you and must have seen something to make them transfer this patient to Emory…

    Stop screaming. I read perfectly well

  142. 142
    kc says:

    In a day and age where conscientious adults keep their kids home from school and people don’t go to work when they have a cold because they know better than to expose everyone at the school and workplace

    What color is the sky in your world? Too many people don’t get sick days. They go to work and cough and sneeze all over the place.

  143. 143
    Ella in New Mexico says:

    @Leah: I so agree with you. I feel so much empathy for that poor guy. He was a human being stricken by what he was fully aware of was a horrific, terrifying and lethal disease he did not choose to acquire. I can’t imagine his suffering. I only hope he had some hope, at least knew he was cared about by his nurses until he slipped into unconsciousness.

  144. 144
    peach flavored shampoo says:

    @Botsplainer: I see one infected person in the middle of this potential vector bomb and realize that, yeah, having this move to India could be Game Over, Turn Out the Lights for many, many, many millions.

  145. 145
    kc says:

    @boatboy_srq:

    Healthcare professionals are among the most real-world sack-of-hammers dumb people on the planet. They’re the people who bought SUVs (because the Hummer was cheaper for the medical office to lease than the Jag and came with a “farm equipment” tax credit)

    I think the politicians who created that tax credit are hella dumber than the MD’s and insurance salesment who took advantage of it.

  146. 146
    Xenos says:

    @Botsplainer: Ever handle a Dr v Dr divorce? Holy shit, it is the worst.

    Especially with a special needs child and dueling teams of expert witnesses, all treated with contempt because they are not real doctors. It is enough to make you wonder if we would all be better off dying rather having to deal with such people.

  147. 147
    Elie says:

    @aimai:

    I am sure I don’t know about every hospital and health system, but I think you need to provide more facts that just your say so that many docs and nurses don’t have health insurance coverage themselves.

    I also do not agree with you perspective of nurses being the bottom of the heap. From where are you getting that perspective? Sure, we work hard and aren’t paid on the scale of docs, but I always thought of myself and my colleagues with respect and admiration. I have always felt we were admired and that we had prestige within our practice. No, we didnt always win the power wars against the administration and docs, but we are respected and counted on by our team and our patients.

  148. 148
    Ella in New Mexico says:

    @Elie: Awesome! Nothing personal, I’m just frustrated with all the nurse blaming here and elsewhere, forgive me. I’m going to look at puppy videos shortly, then go to the gym. :-)

    So as a nurse surely you must know what it’s like to function in a hospital environment today. We have NO voices in most places. They are maxing out staffing ratios and cutting CNA’s and other support staff to absurd levels while piling on top of us more and more documentation and compliance demands, all at the same time they expect perfection in patient care. And always with the unspoken threat that if you complain too much, you could be fired.

    Meanwhile, we STILL are the one thing that can be the difference in your postitive recovery, in preventing medical errors, and in teaching you how not to come back. THAT’s the only reason most of us stay.

    So look, I get it. There are smart people out there. But it’s all great to be cool, calm and collected in the Ivory Tower of the CDC when you don’t literally provide bedside care in a less than supportive environment.

  149. 149
    RaflW says:

    @kc:

    I thought we weren’t supposed to flip out about Ebola.
    I guess that’s changed?

    Well, Cole is famous for his flip-outs.

    But seriously, while I think the risks of widespread Ebola in the US are extremely remote, I also think we need to be paying close attention to what we’re learning from the whole Dallas mess.

    That’s not, to me, flipping out, though I admit that upthread, I was hard on the flying nurse. Her action does matter and does need to be criticised, whether the fault lies with the nurse, with the hospital admin, or the DCD/NIH, or a mix of those root causes.

    Because the way we keep the disease from being a serious problem is with effective, rapid and full containment. As I also said upthread, it’s doubtful she was actively infectious. But her decisionmaking was indicative of either 1) isolated bad decisionmaking, in which case healthworkers need to wake up and learn from her story or 2) (more likely) hospital administrations are not treating the Ebola risk with seriousness, at least in some regions. In that case, the federal gubmit has to step in forcefully. Which it sounds like they are doing.

    (Sorry Rick Perry, but your TX Dept of Health at least appears to be asleep at the switch. Accountability, how does it work?)

  150. 150
    The Dangerman says:

    @Botsplainer:

    Hopefully she went to a Hometown Buffet or Golden Corral….

    Or a cas1no where she was handling lots of chips?

    I just heard she had a low grade fever when she boarded the plane; I’m surprised she is capable of breathing because this is well beyond stupid.

  151. 151
    boatboy_srq says:

    @Elie: Except we’re not talking here about CDC, NIH, Medecins Sans Frontieres or any other body where exceptionalism is expected – and respected. We’re talking about an ordinary hospital in the US healthcare system, and how it’s fallen flat on its face for inadequate procedures and for recurring failures to adhere even to them, flying in the face of good medical practice and common sense. All of this from one of the epicenters of the “We’ve Got The Best Healthcare In The World” ranting. If there had been a single instance of a shortcoming there might be reason to believe that such respect were merited: instead we’re seeing a pattern develop where rules either don’t apply to the rulemakers or are silly nuisances that get in the way of daily habits. This is not encouraging, either in terms of the hospital staff’s ability to handle crisis situations or their ability to function effectively in their daily lives.

  152. 152
    scav says:

    @RaflW: Yep, pay close attention, analyze, and learn: post España, post TX, and still keeping up with the various African experiences. A few things right at the top of the Morbidity and Mortality Weekly Report (MMWR) page today. Also agree that TX has not covered itself in glory yet again.

  153. 153
    jehrler says:

    @Punchy:

    No, but one who has been exposed in a Hospital where a protocol error or mishandling occurred to a disease that has a long dormant period but, when it strikes, results in voluminous amounts of highly infectious fluids (the virus load per CC is off the charts compared to other diseases) that can either a) be vomited upon or near other passengers or b) expelled into a common restroom or a passenger seat and has an 80% fatality rate is something very, very different.

  154. 154
    boatboy_srq says:

    @kc: Agreed. But if you’re going to make the conscious decision to drive a gas hog then don’t expect sympathy when you complain how expensive it has become to fill the tank, and don’t demand increased domestic oil production a/k/a DrillBabyDrill just because you’re feeling the pinch at the gas pump.

  155. 155
    Goblue72 says:

    @Mnemosyne: bingo. Cole has gone full metal melodrama. Seriously. People need to chill the eff out.

    We have 2 whole infections in the entire U.S. and zero deaths. More than 2 people died in this country from drunk drivers by the time Cole finished his first cup of coffee.

  156. 156
    Botsplainer says:

    @Xenos:

    Ever handle a Dr v Dr divorce? Holy shit, it is the worst.

    Especially with a special needs child and dueling teams of expert witnesses, all treated with contempt because they are not real doctors. It is enough to make you wonder if we would all be better off dying rather having to deal with such people.

    Picked one up 10 years post decree, special needs child and everything. They were still going at it like they’d just separated.

    It was so acrimonious that the court appointed a parenting coordinator to help them facilitate the minutiae across the parenting divide on all three children, but rather than smoothing the troubled waters, he saw a profit opportunity. Pre-me, he had them sign an agreement that every communication from the other parent would be answered in 72 hours, and that he be copied on each.

    Ex-husband communicated with my client at least 6 times a day – my girl had a $14,000.00 bill outstanding to the coordinator all by herself when I came in. I told her to cut out the coordinator, and it still took me 18 months to turn that nonsense off. The primary problem was that he communicated more about those kids than do fathers in intact families; he’d call in the morning to make sure they were up, he’d call three or four times in the afternoon about homework. My solution (which worked) was to tell her to stop answering, and to pick up calls every other day, the agreed order be damned – theory being that it was so stupid that the judge wouldn’t even dream of contempting her on it.

  157. 157
    Joel says:

    Considering that we still have massive reservoirs of infleunza cycling in- and out- of our very poorly regulated agricultural sector, I’m wondering if we’re worrying about the wrong problem.

  158. 158
    CONGRATULATIONS! says:

    Mr. Duncan paid a terrible price for contacting a disease over which he had no personal control; I think we should try and be respectful of his memory.

    @Leah: He had nothing but personal control over it.

    Fuck that guy.

  159. 159
    am says:

    So, without having read the preceding messages and slightly off topic, is anyone else seeing really alarming behavior from the the fringe conservatives?

    I think there is a perfect storm of
    * a black president of the opposing party
    * an epidemic in Africa of a hemorrhagic fever
    * a midterm election
    * fashionable end-of-the-world/zombie tv shows
    * an enabling, even encouraging, epistemic closure around them

    And honestly it’s a little disconcerting. There are a bunch of hateful, well-armed people out there that are pant-shitting scared of something that is not a huge event. I really think there are some people out there that have pretty much lost their minds from being constantly terrorized by the sources of news to which they expose themselves.

  160. 160
    Emma says:

    @Joel: Yep. As I mentioned above, influenza will kill more people than Ebola. But it’s not as sexy a disease, I suppose.

  161. 161
    jehrler says:

    @Ella in New Mexico:

    That seems awfully strange when Doctors without Borders and other organizations have been able to contain previous infection incidents, even in 3rd world Africa.

    If anything, it sounds like you and your hospital are the ones in panic mode. Even now in West Africa where the infrastructure is terrible, it is rare for foreign health care workers to come down with the disease. They have buckets with bleach water for goodness sake.

    Yes, for an initial outbreak out of the blue, yeah, I wouldn’t be surprised that there would be a lot of trouble, but given the weeks that this has been out there and previous containment success, it is pretty shocking that your facility lacks confidence in its ability or preparedness.

  162. 162
    CONGRATULATIONS! says:

    Considering that we still have massive reservoirs of infleunza cycling in- and out- of our very poorly regulated agricultural sector, I’m wondering if we’re worrying about the wrong problem.

    @Joel: Yes and no. Your problem is far more serious than Ebola will ever likely be; however, both point to the absolute inability of the United States to deal with outbreaks of infectious diseases of any type.

    Not to mention the utterly appalling lack of cleanliness, infection control, and antiseptic procedures in every hospital in this country, as proven time and time again by the simple and verifiable fact that the place you are most likely to get an infection of any kind is in a hospital.

  163. 163
    West of the Cascades says:

    Not to dive into the blame-the-nurse or blame-Cole themes here, but the fact that there seemed to be so much confusion about the protocols at the hospital do underscore how funding cuts to the CDC and NIH make it harder for there to be a strong, concerted, consistent response to situations like these.

    The great new Agenda Project Action Fund ad with all of the Republicans saying “cut” and ending with “Republican cuts kill” is so completely and irrefutably true. https://www.youtube.com/watch?v=c3D0DxjgPB0 if you haven’t seen it.

  164. 164
    Heliopause says:

    This might be a good time to point out that many times more Africans are going to die of Malaria and AIDS this year than ebola. Never mind Americans, talking Africans.

  165. 165

    Apparently some of the non-union nurses at Texas Health Presbyterian contacted the national union with concerns. They did not go public themselves because, it appears, they are afraid of management retaliation.

    “The protocols that should have been in place in Dallas were not in place, and that those protocols are not in place anywhere in the United States as far as we can tell,” National Nurses United Executive Director RoseAnn DeMoro said Tuesday night. “We’re deeply alarmed.”—http://www.wxii12.com/health/nurses-texas-hospital-unprepared-for-ebola/29137122

    If this is how we react to a deadly disease without an airborne transmission path, what are we going to do with something that can be transmitted by air?

  166. 166
    JPL says:

    No one is blaming all nurses and no one should interpret it that way. The CDC said that protocols were not followed and guess what, they weren’t. It wasn’t the nurses fault, it was the hospitals.
    As far as getting on a plane after being exposed to ebola, with a fever, is unfair to the other passengers.

  167. 167
    RAM says:

    Oddly enough, we might have been better able to have handled the spread of Ebola 60 or 70 years ago when it was not at all uncommon to see houses slapped with big red “Quarantine!” signs. In our town, the last quarantine for scarlet fever was in 1950, but there were further quarantines for polio and other diseases right up through the late 1950s. Not sure under what laws quarantines were applied back then or why quarantine has not been immediately revived to handle anyone who has come in contact with Ebola, but it sounds to me like it’s an old idea who’s time has come again.

  168. 168
    JPL says:

    @JPL: Also, I didn’t mean to indicate, that I think most of the passengers are at risk since it is not an airborne virus.

  169. 169
    Loneoak says:

    @Ella in New Mexico:

    Just wanted to second Ella here. My wife works in a major urban ER and the exact same thing has happened here: they have zero training to handle ebola patients and their hospital admins did an interview outside of the hospital lying about it. Their only preparation is an ‘ebola cart’ with some ppe’s and a written checklist about how to put them on and take them off (which is much harder to do right than you imagine).

    These are people who are putting their lives on the line in conditions of institutional neglect. And you expect them to halt their lives because their corporate betters are greedy, incompetent fucks who won’t spend money on preparation and training? That deserves a hardy fuck you, too, buddy.

  170. 170
    Mnemosyne says:

    @Loneoak:

    And you expect them to halt their lives because their corporate betters are greedy, incompetent fucks who won’t spend money on preparation and training?

    In the case of the nurse who got on the plane, she needed to halt her life to save her own life. The person who was primarily put at risk was herself, and secondarily her fiancé. Frankly, the other travelers that day were at very low risk compared to her family and friends.

    That’s what’s so horrific about Ebola and I think is one of the reasons it’s captured people’s imaginations: even more than a “normal” infectious disease, you’re likely to put the lives of your family, friends, and caregivers at high risk. And if your nurses don’t have the right equipment or don’t know how to use that equipment properly or have even one slip-up of a needle stick or touching their eye or nose, they are at far higher risk of catching it than a random person an Ebola patient passes on the street.

  171. 171
    Mike J says:

    @JPL:

    As far as getting on a plane after being exposed to ebola, with a fever, is unfair to the other passengers.

    I have no desire to blame nurses, but I have to blame the individual who got on the plane.

  172. 172
    Mandalay says:

    @West of the Cascades:

    The great new Agenda Project Action Fund ad with all of the Republicans saying “cut” and ending with “Republican cuts kill” is so completely and irrefutably true.

    The Washington Post begs to differ, and I’m inclined to agree with them to some extent.

    To directly quote Dr. Fauci, Director of NIAID, from the ad:
    – “Our budget has been flat since 2003…”
    – “the right cross was the sequestration…”
    You should blame Democrats as well as Republicans on those points. Democrats could have done something about that Budget when they controlled both houses of Congress, and sequestration was a bipartisan measure.

    A much better and more honest ad would have been clips of Democrats demanding bigger budgets for outfits like the CDC and the NIH…if any such clips exist.

  173. 173
    jehrler says:

    @Mnemosyne:

    I think you hit the nail on the head for why this is such a more concerning disease than flu, etc.

    Now, as my father remembered, the Spanish Flu of 1918 was also something that generated panic because it was EXACTLY those young vital people who had strong immune systems who were the ones dying from the flu. Yes you had the old and the young cases too, but the fact that it would strike with such vigor those who were so vigorous meant that caregivers (professional or home) were also at heightened risk.

  174. 174
    Mnemosyne says:

    @Mandalay:

    Yes, because in a hotly contested midterm election where Democrats are in danger of losing control of the Senate, the best possible electoral strategy is to say that Democrats are equally to blame. This strategy will be especially effective since Republicans have been running around claiming that Obama is deliberately trying to infect Americans with Ebola.

    What other brilliant electoral strategies do you have in mind, Mark Penn?

  175. 175
    InternetDragons says:

    Sorry, but there is just no excuse for getting on a plane with a fever when you know you are within the window of infection after exposure to a serious and transmissible illness. She DOES carry some responsibility, though I wouldn’t be too hasty to point fingers at her or at the CDC.

    The real issue is that when protocols are in place, clearly communicated, and enforced, they do at least a decent job of addressing the places where human stupidity, obliviousness, or ignorance could otherwise create risks. And as annoyed as I am at that nurse, it’s far more concerning that protocols didn’t seem to be in place.

    I work in public health. Started in front-line care and worked my way up to a level where I have more than a passing acquaintance with CDC/WHO. While there’s no reason to panic, I can say that far too many things about the way Ebola is being addressed are giving me little tweaks of anxiety based on what I SO clearly remember about the early years of the HIV epidemic and how badly it was fumbled. We’ll likely be OK this time – though some of you are far too casually asserting that the virus is only transmissible during acute symptoms. You’re certain about that? Really? I’d love to see your sources.

    But either way, there are other viruses out there. And we’re not ready.

  176. 176
    Jebediah, RBG says:

    @Ella in New Mexico:

    Medicine should not have any profit motive whatsoever. It’s at the root of all evil in healthcare.

    That we allow it at all is one of the things that boggles my mind the most….

  177. 177
    Botsplainer says:

    Ron Fucking Fournier never stops trolling.

    http://www.nationaljournal.com.....o-20141015

    Should the president go to ground zero? It’s one thing to tell Americans they’re safe. It’s another to show it. What message would Obama send by visiting federal, state, and local health care officials in Dallas? I care. We’re on top of this. You’ll be OK. In addition, Obama could personally thank first-responders on the nation’s behalf, which can’t be done enough. I asked a White House official about this idea. He laughed. “We don’t do grandstanding,” he said. “It would be a circus.” Still, he didn’t rule it out.

  178. 178
    Elie says:

    @boatboy_srq:

    That may be true — but these are human systems run by humans. Clearly, some institutions and individual professionals perform better than others but how would YOU communicate expectations if you are a lead agency such as the CDC or NIH?
    Would you say”Hey, we think that x numbers of our hospitals will do fine but x of you are fuck ups and we won’t know who you are until you fuck up” ? Nope — you have to assume people and systems will perform until they don’t. Then you have to dispassionately focus on a) collecting information on what was done and by who to 2) figure out how to change and improve the process. There is not a priori way to single out which institution is going to fail — especially in a “rare event” situation. And even poor performers can be missed by being lucky in some way.

    High risk care and situations have to be handled calmly and systematically by the leaders of the relevant organizations and professionals. The team in the middle have to stay calm and focus and keep their wits about them to have a chance to get on top of things.

    There is absolutely NO VALUE in disparaging ANY of the professionals who are trying to get on top of what is happening to improve things. You have no call to do that. Their job is difficult because of the nature of the challenge. We have to focus on getting things improved and keeping everyone’s morale as high as possible so we can do what is needed with our heads straight.

  179. 179
    Ella in New Mexico says:

    @jehrler: I don’t think you or many people understand just how different Ebola is from almost any other infectious disease we deal with in the average community hospital today.

    We are prepared for stuff that’s hard to transmit and/or relatively easy to contain. That is not the case with Ebola. Seriously, I’d take the damn MSF designed Clorox water buckets over what my hospital expects us to use, over what Texas Pres made those RN’s use until they were told it was inadequate by CDC.

  180. 180
    jehrler says:

    @Botsplainer:

    Hey Ron, why not ask where Rick Perry is at this point in the situation? Oh, right, Europe.

  181. 181
    Botsplainer says:

    @Ella in New Mexico:

    Ella, wouldn’t MRSA control protocols work pretty well to scrub down an Ebola environment?

  182. 182
    jehrler says:

    @Ella in New Mexico:

    I understand it is very difficult, I really do, it just seems like the materials and protocols for successful isolation have existed for decades now. Yes, not in the US, but certainly with US based organizations.

    It is the claim that it is beyond the ken of many modern US facilities to be ready that is so hard to fathom.

    Maybe the idea of having regional centers for infectious treatment (beyond just the 4 isolation ones already prepared) would be something that is worth insurers, health systems and government taking a really, really hard look at. Having practice drills etc. for ebola or whatever new contagion presents itself in the future.

  183. 183
    Ella in New Mexico says:

    @Botsplainer: Not in the least. No where NEAR enough. Sorry. :-(

  184. 184
    Ella in New Mexico says:

    @jehrler: Yes, but those materials are overkill for almost all typical hospital infectious disease situations. So no hospital will ever have all that stuff on hand because they are also insanely expensive. They’ll invest in another MRI machine because THAT will rake in the revenue bucks. Super duper isolation equipment won’t.

    And yes, I really do think we should consider regional specialty centers for all kinds of higher acuity medical issues, especially for stuff like this. But again, I think the profit motive means every community hospital would have to give up a share of the pie on things like open heart surgeries. So they wouldn’t like the idea.

  185. 185
    Ella in New Mexico says:

    @Elie:

    There is absolutely NO VALUE in disparaging ANY of the professionals who are trying to get on top of what is happening to improve things. You have no call to do that. Their job is difficult because of the nature of the challenge. We have to focus on getting things improved and keeping everyone’s morale as high as possible so we can do what is needed with our heads straight

    I agree with you when clearly, they have decent and noble motives and are genuinely trying to do the very best and right thing.

    It’s when they’re not doing that that I must disparage them.

  186. 186
    kc says:

    How does everyone know what this lady’s exact temperature was when she boarded the plane?

  187. 187
    Gex says:

    @peach flavored shampoo: One of these quarantine busting/traveling idiots was a nurse, the other an MD.Are we really supposed to just say, aw shucks, whoocoodanode???

    If you can’t get those people to be informed and do the right thing, we may as well forget about fighting this thing. I mean, do we expect the general public to do better than we expect trained health care professionals?

  188. 188
    Rick Astley says:

    Long time lurker here-

    Um mopping naked is stupid? I didn’t get that memo.

  189. 189
    Mnemosyne says:

    @Ella in New Mexico:

    Actually, you don’t need super duper isolation equipment, but you do need a door that closes, with a private bathroom, and someone stationed outside to prevent people from wandering in. You need lots and lots of disposables, and incinerators to burn them up once they’re used, and people to do the incinerating. You need at least two people for every shift of assisting that patient, and they have to be dedicated to that patient or patients — they can’t do any other patient care in that shift.

    Essentially, you need all of the current basic universal precautions turned up a notch or two, but what you need most is additional people to take care of the extra work of training, supervision, patient care, sanitation, etc. And that’s what hospital administrators don’t want to spend the money on. Frankly, it sound like a lot of places don’t even have basic universal precautions in place.

  190. 190
    InternetDragons says:

    Let’s see how the Texas hospital spins this article written by the newphew of the patient who died there:

    http://www.dallasnews.com/opin.....w-says.ece

  191. 191
    Mike J says:

    @Rick Astley:

    Um mopping naked is stupid? I didn’t get that memo.

    John Cole has a tale in which he swears he was completely innocently mopping while naked and he just happened to slip. Which is why we bring it up so often.

  192. 192
    Betty Cracker says:

    @Mnemosyne: You seem to be instructing a highly trained, experienced medical professional about what isolation equipment is required to contain an Ebola outbreak. What are your qualifications? Of course, this is the Internet, so maybe she’s really a Piggly-Wiggly bagger and you’re actually head of the CDC. But your comment made me go WTF…

  193. 193
    Elie says:

    @Ella in New Mexico:

    Just wording but its not that you want to disparage them. That implies negative labeling. People tend not to listen or learn as well when they are disparaged. We aim for data and information driven constructive criticism… information that gives them what they need to know to improve something — not belittles them or yells for yelling’s sake. I am sure you like to improve your practice in that way also. I know that I do. No one wants to be a fuck up, Ella. Everyone wants to do “right” and be good at what they do and help our patients. Dark criticism has limited utility for that..

  194. 194
    Violet says:

    @kc: The news just reported her temperature was 99.5 when she boarded the plane to return to Dallas on Monday. I don’t know how they know but that’s what they said. Seems pretty specific.

  195. 195
    Ella in New Mexico says:

    @Mnemosyne: Yep. Well, maybe a little super duper for Ebola, though. It IS frigging Ebola, after all. (we all joke about MRSA and that we all have it anyway so why do we put people who carry it in their nostrils under contact precautions by saying “like, it’s NOT frigging Ebola!!)

    I would definitely want the Tyvek suits with total leg/body/head and neck coverage and/or sealed head coverings. It’s not like you’re just standing next to the guy–as his nurse or CNA, you’re on top of him all day, cleaning the mess and doing all his care. That stuff flies all over the place–normal “universal precautions” gear does NOT expect that kind of contact with this kind of contagiousness and lethality. I have no idea how they cleaned, but there is no way the way OUR hospital cleans its rooms that would be good enough for Ebola.

    I simply cannot believe that Texas Pres did some of the things it did. Why on heaven’s earth they would cut a single corner in caring for Thomas Duncan? Seriously, the Charge Nurse had to argue and argue to get an isolation room for the guy!!! The nurses and other staff were told they didn’t need protective shoe covers and that they were being hysterical. They couldn’t find a way to limit the number of staff in actual contact with the guy–they had to give them other patient’s to care for??? They let docs and administrators and everyone else traipse in and out of the isolation area with no real infection control—-Simple stuff!!!

  196. 196
    RaflW says:

    @Botsplainer: Ugh.

    Let’s make a deal, Mr. Fournier: Rick Perry, Greg Abbott, Barack Obama as well as David Lakey and Vivek Murthy meet, and after a “constructive conversation,” hold a joint presser on the lawn of Presbyterian Hospital.

    Otherwise, fuck off, you trolling prick.

  197. 197
    Mnemosyne says:

    @Betty Cracker:

    I’m going by published CDC guidelines. From what Ella has been saying here, it doesn’t sound like she thinks there’s a problem with the CDC’s guidelines in and of themselves, it sounds like her hospital is in no way prepared to properly implement the CDC’s guidelines:

    The recommendations in the manual make use of common, low-cost supplies, such as household bleach, water, cotton cloth, and plastic sheeting. Step-by-step instructions for implementing the recommendations are presented along with instructional aids for easy reference in health centers.

    If you read the stories from Nigeria, they’ve been able to successfully control their outbreak by following guidelines very similar to the ones provided by the CDC. The guidelines are fairly simple, and they work, but the question is whether or not US hospitals are willing and able to implement them.

  198. 198
    CONGRATULATIONS! says:

    You seem to be instructing a highly trained, experienced medical professional about what isolation equipment is required to contain an Ebola outbreak. What are your qualifications?

    @Betty Cracker: Mnemo is a lawyer.

    OF COURSE.

  199. 199
    Howard Beale IV says:

    @Ella in New Mexico:

    But we also have no union, and the word is that if we can be traced to any “negative commentary on electronic media or the public” in regards to the fact that we are not prepared we can and will be fired on the spot.

    That’s why there’s SecureDrop.

  200. 200
    Ella in New Mexico says:

    @Elie: Oh, but I DO want to disparage people who do what the Texas Pres administrators do–they forced, (under implication that should they complain too much, they would be fired) frontline nurses to ignore their own common sense concerns and risk their lives to do unsafe things just to save their OWN asses. That’s not the same as what you’re talking about, where people are genuinely and with no malice trying to do the right thing.

  201. 201
    Mnemosyne says:

    @Ella in New Mexico:

    I think we’re on the same page. :-) Like I said, it’s not really a question of whether or not the US has the knowledge to safely take care of Ebola patients — when those two patients were initially brought to the CDC for care, no one at the CDC got sick. The question is whether or not hospital administrators are willing to do what it takes (i.e. spend the money on training and equipment) to safely take care of Ebola patients. Sadly, right now I think the answer is probably “no.”

  202. 202
    Mnemosyne says:

    @CONGRATULATIONS!:

    Actually, I’m a secretary. But I can read and understand things.

  203. 203
    Howard Beale IV says:

    @Culture of Truth: I hope they have shoot to kill orders.

  204. 204
    Bobby Thomson says:

    For the love of FSM, Cole, chill the fuck out and stop watching cable news. You have to touch precious bodily fluids to get this.

  205. 205
    Omnes Omnibus says:

    @CONGRATULATIONS!: No, Mnemo is NOT a lawyer. Or so she frequently states. I, however, am one and since I know fuck all about the disease and the precautions needed to prevent it, I am staying the hell out of the discussion. Douchebag.

  206. 206
    Tripod says:

    Maybe the ticket was non-refundable.

  207. 207
    Howard Beale IV says:

    @Face: All jet aircraft recirculate the air inside the cabin. The last jet that didn’t was the 727.

  208. 208
    Elie says:

    @jehrler:

    Bingo

    People however want to have quality outcomes without updating and upgrading their skills with a lot of practice and self scrutiny on their own practice.

    Part of my stint was in the OR and the nurses are pretty pointed in their observations about any breach in technique.

    In this case, it seems reasonably clear that there were several possible issues about this hospital environment in indeed to some possible personal practice issues that need to be addressed. Again, without hysteria and coldly, methodically. Some of this assessment by the CDC seems to have already ocurred, hence, the second case is being moved offsite. Makes sense. They (the CDC), did not have to disaparage or disgrace the hospital or its professional staff to take care of business. They just made plans for the transfer and I assume will calmly deal with other issues at the hospital related to their processes or procedures outside of the public eye for now. Again, the goal is to fix things calmly and get the hospital to improve things so it can handle situations.

    While I am not totally against some sort of regional “expert hospitals”, I think that all hospitals should have the capability to handle and isolate as well as safely try to stabilize patients… you never know what is going to come through your doors and as many have seen with the recent enterovirus outbreak, “shit happens” and bugs can change or impact in unexpected ways. They don’t have to be exotic species from other places but our own varieties from many of our home grown resistant strains. And let me tell you , a few of them are at the edge of having any antibiotic that will work on them (tuberculosis). So everyone calm down and hitch up their pants and do what needs to be done to better improve what we do on the front lines without making the learning a negative blame focused shit storm.

  209. 209
    scav says:

    It’s really Nigeria that convinces me we should be able to handle things here. They (Nigeria) should have a fairly decent base of trained staff –maybe unusually so (there are at least a solid generation or more of Nigerians educated in the UK and elsewhere — that pulse of oil money helped) plus the more usual mix of other local medical individuals and the external medical groups, one of which retooled from polio to Ebola when needed. Their physical equipment is a mixed bag (so again probably comparable to the US, moreso on the low end), but they seemed to have the brains and the discipline to use it effectively. So, are we as good as Nigeria?

  210. 210
  211. 211
    Howard Beale IV says:

    @scav: Let’s see how well we contain our ebola outbreak first. Then we can compare.

  212. 212
    g says:

    @Comrade Luke:

    My college reunion is this weekend, and I have friend flying in from all parts of the country. Believe me, this has crossed my mind.

    You should be fine as long as you don’t exchange any bodily fluids.

  213. 213
    Ella in New Mexico says:

    @Elie: :-)

  214. 214
    Elie says:

    @scav:

    Yep. EXACTLY.

    We need to calm down and assess what is needed and then do what needs to be done without melodrama and with people taking responsibility for their practice and professionalism. We can do this. Really. Maybe we keep the specialized hospital idea, but I am not 100% convinced that we need to… We need to stop screaming and get everyone focused and ready to meet this. We can.

  215. 215

    @Bobby Thomson: I’m not freaking out. I’m just astonished at the stupidity of this woman. She was exposed to a very contagious disease, told not to do certain things, and then fucking went ahead and did it anyway. She’s an asshole.

    And for some reason or another, this thread was derailed into a discussion of how nurses are picked on or we are all going to die.

  216. 216
    Omnes Omnibus says:

    @John Cole +0:

    She was … told not to do certain things

    The article you linked does not say that. It says that the CDC says she should never have been on the plane, but unless I missed something, it does not say that she was told not to do it.

  217. 217
    Howard Beale IV says:

    Auntie Beeb has you covered.

    Especially when it comes to how fast the panic is spreading: http://www.bbc.com/news/blogs-trending-29618224

  218. 218
    Craig says:

    I eagerly await the lunatic right-wing calls for stopping all travel from Texas. Seal the border to keep us all safe! Maybe there would be a quick Senate confirmation if the Prez appointed Republican Todd Kincannon as Ebola Czar so he could keep us all safe by napalming Dallas.

    Or maybe those folks think that virii need a more measured response when they infect an area with a lot of white folk who vote….

  219. 219
    Interrobang says:

    Given the number of antivaccine nurses or nurses heavily into woo I’ve encountered, I’m not optimistic about frontline health care, to be honest, and I’m in Canada.

    My doctor’s clinic always puts up a thing in the waiting list saying their staff is 100% vaxed for flu, which is a good thing at least.

  220. 220
    Elie says:

    @John Cole +0:

    That is because we went from your labeling the nurse’s behavior to labeling the CDC, NIH, the Dallas hospital and every point in between….Its all about negative judgement than what to do to fix anything..The hysteria started with you, unfortunately

  221. 221
    Bobby Thomson says:

    @John Cole +0: it’s not very contagious. You really have to try to get it. Again, stop watching cable news and stop contributing to hysteria.

  222. 222
    Mnemosyne says:

    @Howard Beale IV:

    Auntie did manage to make me feel better — the nurse didn’t fall ill until after she returned from her plane trip:

    When Ms Vinson returned from Ohio on Monday evening, she was not showing symptoms of the disease, the crew has told CDC investigators.

    Health experts say people who are not showing symptoms are not contagious.

    They also have a helpful “How Not To Catch Ebola” article.

  223. 223
    kc says:

    @John Cole +0:

    @Bobby Thomson: I’m not freaking out. I’m just astonished at the stupidity of this woman. She was exposed to a very contagious disease, told not to do certain things

    Where are you getting the information that she was told not to fly? I haven’t seen that reported anywhere, including the article you linked to.

  224. 224
    kc says:

    @John Cole +0:

    @Bobby Thomson: I’m not freaking out

    It was just a little ragegasm!

  225. 225
  226. 226
    Mnemosyne says:

    Also, I hope this bit from the BBC story will make Ella and Elie feel a little more confident — the CDC will step in if a hospital screws up:

    The CDC has appointed a “site manager” in Dallas to standardise the protective equipment and supervise the method of putting it off and on.

  227. 227
    Elie says:

    @Mnemosyne:

    Thanks!

    I suspect that the CDC may have weighed in on other decisions as well.

  228. 228
    kc says:

    @Omnes Omnibus:

    If I had said it first, you would have disagreed.

    I’m KIDDING!! :)

  229. 229
    kc says:

    Ahem (courtesy of JPL in the gamer thread above)

  230. 230
    Omnes Omnibus says:

    @kc:

    CBS News Medical Correspondent Dr. John LaPook reports that Vinson called the CDC several times before boarding the plane concerned about her fever.

    “This nurse, Nurse Vinson, did in fact call the CDC several times before taking that flight and said she has a temperature, a fever of 99.5, and the person at the CDC looked at a chart and because her temperature wasn’t 100.4 or higher she didn’t officially fall into the category of high risk.”

    Relevant passage quoted.

    Cole, is she still an asshole?

  231. 231
    Howard Beale IV says:

    @Botsplainer: Translation: We don’t know what the fuck we’re doing.

  232. 232
    Howard Beale IV says:

    @Omnes Omnibus: Yes, for the simple reason she knew she was dealing with an ebola patient.

  233. 233
    jharp says:

    “In a day and age where conscientious adults keep their kids home from school and people don’t go to work when they have a cold because they know better than to expose everyone at the school and workplace”

    Not where I live. Indiana.

    With no paid sick days most can’t afford to stay home.

  234. 234
    Omnes Omnibus says:

    @Howard Beale IV: I tend to think that if the CDC says it’s okay, one should be able to rely on it. Then again, I am not an expert.

  235. 235
    Elie says:

    @Howard Beale IV:

    what he was saying is that there is no reason to think we can’t or to default to a “we can’t do this” perspective.. just no reason for that

  236. 236
    Howard Beale IV says:

    @Elie: The calendar is the final arbiter as to who has done the better job when it comes to containment from start to finish.

  237. 237

    @Omnes Omnibus: Yes. From the original post:

    Does this jackass really need to be told that after handling an Ebola patient, they shouldn’t be traveling on a public airline?”

    Common sense would tell you that if you were exposed to the Ebola patient who died, and exposed at the point where he was most infectious, you should not be running around the country. Even if you aren’t showing symptoms.

    And you can’t have it both ways, people. The nurses don’t get to scream that the hospital and the CDC dropped the ball and that you weren’t protected enough and then act shocked that one of you contracted it. If you honestly feel that the hospital dropped the ball and these nurses were not adequately trained or safeguarded, and I most assuredly do think that is the case, then you should at least be smart enough to lay low for a while because there is a good chance you might have contracted it.

    Regardless, I know what my family and friends and fiance would say if I told them I had been working with the Ebola patient who had died and that I don’t think the hospital and CDC did enough to protect me and oh, by the way, I’m coming for a visit in a couple days. It would start with “THE FUCK YOU WILL!”

    There is plenty of blame to spread around here, and I maintain the nurse is still an asshole.

  238. 238
    Omnes Omnibus says:

    @John Cole +0: Fair enough. I just think that if one checked with the CDC (and was honest with them) and the CDC said that one was okay to board a plane, one would be justified in relying on that okay. Your mileage obviously varies.

  239. 239
    Gopher2b says:

    @Ella in New Mexico:

    My Nurse Practioner wife was irate when she heard what this nurse did. She treated literally the only person in the USwith Ebola, got on a plane to plan her wedding. Got FEVERISH and then got back on a plane. Stupid, arupid, stupid. As my wife said best: nurses want to be treated like the professionals they are and that (sometimes) means making personal sacrifices.

  240. 240
    GHayduke (formerly lojasmo) says:

    100,000 amercans die each year due to medical mistakes.

    As I said before, if my colleagues cared for an ebola patient, it would certainly thin the herd where I work.

    Pathetic.

  241. 241
    Mandalay says:

    @John Cole +0:

    Regardless, I know what my family and friends and fiance would say if I told them I had been working with the Ebola patient who had died and that I don’t think the hospital and CDC did enough to protect me and oh, by the way, I’m coming for a visit in a couple days. It would start with “THE FUCK YOU WILL!”

    This x 1000. I can’t think of anyone I know well who wouldn’t give the same response to me if I were in the situation you describe.

    I see an interesting phenomenon going on here….folks who post here a lot, and probably spend a lot on time on the Internet, are losing their grip on common sense and reality. They are unearthing links that support their views, (and probably ignoring others that don’t), when they should be ignoring the internet completely for a while, and just engaging in the thought experiment you described.

  242. 242
    satby says:

    A trained nurse should know her own body and regular base temp. If she called the CDC to check “her slightly elevated temperature” then she had reason to suspect she was infected and becoming sick. Multiple times calling? She’s a nut and an asshole who put people at risk.

    My friend just got out of an overnight stay at a hospital in Morris,IL. Little country hospital. She told me the nurses there were “worried sick” about Ebola. I pointed out that as trained professionals, they of all people should know they face no risk at all without caring for an actual Ebola patient. But I was furious that the people responsible for being knowledgeable about a topical disease like this would publicly exhibit such ignorance to patients.

  243. 243
    Ella in New Mexico says:

    @John Cole +0:

    She was told no worries, she could fly. Stop expecting people to be a combination of Einstein and Mother Teresa and life gets much, much easier.

    Seriously, one of the BESTEST things about being an RN is that you pull your three 13-hour shifts in which you go balls to the wall and then you get your four days off the first of which you waste drinking coffee, taking the doggie for a walk, eating cold pizza and and surfing the internet on your computer in your jammies, just sucking up all that has happened in the world while you’ve been away. I SOOO fucking love my days off. :-)

    What I learned today:

    1. almost everything I thought when I woke up this morning and read the news and commented on at the beginning of this thread is true. And yet this is a dynamic story in which details are changing hourly.

    2. I totally agree that I would never, ever have gone anywhere if I was still in a 21 day (or more!!! Now according to researchhttp://www.sciencedaily.com/releases/2014/10/141015112323.htm) period after taking care of a deceased Ebola patient. Of course I’m 52 and more than half my life is behind me and I sincerely would not have believed what I was told by those managers or the CDC that it was perfectly fine to fly. Or anything else I was told because I tend to challenge authority.

    3. We need unions in this country. More than ever. Because expecting a single 24 or 28 year-old nurse to stand up to the kinds of pressures and mind fucks I see applied everyday in hospitals to nurses who even squeak in resistance to unsafe staffing demands is absurd.

    4. Speaking up DOES help: My and my co-worker’s posting and re-posting of these stories these past two days has led to change at my own hospital, which has picked up on our concerns and is currently taking them seriously. Trainings are being scheduled, gear is being purchased, and they are actively working with the CDC now–when they simply were not yesterday.

  244. 244
    Anne Laurie says:

    @Ella in New Mexico:

    3. We need unions in this country. More than ever. Because expecting a single 24 or 28 year-old nurse to stand up to the kinds of pressures and mind fucks I see applied everyday in hospitals to nurses who even squeak in resistance to unsafe staffing demands is absurd.

    4. Speaking up DOES help: My and my co-worker’s posting and re-posting of these stories these past two days has led to change at my own hospital, which has picked up on our concerns and is currently taking them seriously. Trainings are being scheduled, gear is being purchased, and they are actively working with the CDC now–when they simply were not yesterday.

    3. Abso-farkin-lutely!

    4. Thank you for the good news!

  245. 245
    Anne Laurie says:

    @John Cole +0:

    Regardless, I know what my family and friends and fiance would say if I told them I had been working with the Ebola patient who had died and that I don’t think the hospital and CDC did enough to protect me and oh, by the way, I’m coming for a visit in a couple days. It would start with “THE FUCK YOU WILL!”

    Easy shot, John — I’m told some people’s relatives aren’t actually looking for an excuse to keep them at a safe distance!

  246. 246
    Omnes Omnibus says:

    @Anne Laurie: Burn.

  247. 247
    Richard briggs says:

    @Gin & Tonic:

    Gotta agree with you re Dr. Snyderman’s general level of douchery. She first got on my radar when she was disgusted, disgusted I say, that Ryan O’Neal had the bad tatse to show up on TV with a bandaid on his nose.

  248. 248
    Jill says:

    John, April Vinson is the one who flew after exposure, not Nina Pham.

  249. 249
    Jebediah, RBG says:

    @John Cole +0:

    Regardless, I know what my family and friends and fiance would say if I told them I had been working with the Ebola patient who had died

    Cole has a fiance!? When did this happen?

  250. 250
    Luke says:

    This is a really disgusting post and I can’t believe you haven’t deleted it yet. The nurse is not to blame in this situation.

Comments are closed.