Ebola on US shores

[Forever_frost]

http://www.washingtonexaminer.com/article/2555075/

Travelers from Ebola-stricken countries face new restrictions
By Susan Ferrechio | October 21, 2014 | 12:38 pm

Travelers arriving from three Ebola-afflicted countries in Africa will have to land in one of five airports equipped with special screening measures for the disease, the Department of Homeland Security announced Tuesday.

The DHS labeled the move a travel restriction, though it does not go as far as banning arrivals from those nations, which has been called for by many Republican lawmakers and some Democrats.

“We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly,” Johnson said.

About 94 percent of travelers from Liberia, Sierra Leone and Guinea, where Ebola is rampant, land at one of the five airports.

The latest restriction, which begins tomorrow, would require the remaining six percent of travelers to land at those airports.
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The move comes amid criticism that the original screening plan left open the possibility that an Ebola-infected traveler could still gain entry into the United States.

Thomas Eric Duncan, who died of Ebola, came to the United States on a flight that landed at the Dallas/Ft. Worth International Airport, which is not on the list of five airports with extra screening.

The DHS last week put special passenger screening in place for West African arrivals at Dulles International Airport outside Washington, D.C., Chicago’s O’Hare Airport, Hartsfield–Jackson Atlanta International Airport, Newark Liberty International Airport in New Jersey and John F. Kennedy International Airport in New York.

Republicans say the latest DHS move is not enough and are insisting on an outright ban of travel from the afflicted countries.

“The administration must do more to protect Americans,” House Judiciary Committee Chairman Bob Goodlatte, R-Va., said. “Obama administration officials openly admit that these enhanced screening measures would have never detected the disease in Thomas Eric Duncan, a non-U.S. citizen, who later infected two American nurses in Dallas.”

Democratic lawmakers praised the latest DHS plan.

“The Department of Homeland Security’s policy to funnel all passengers arriving from Ebola hotspots to one of these five equipped airports is a good and effective step towards tightening the net and further protecting our citizens,” Sen. Charles Schumer, D-N.Y., said.

[Jewrrick]

This seems like a good compromise between an outright ban and nothing. I would like to know what the "special screening measures" are and how effective they really are.

[Sean88gt]

He is pro-panic, with a slight conservative lean.

I agree. I also can't stand him. I think he's just scrambling to get his time slot back from the gash that ousted him.

[BoostedD1]

http://boston.cbslocal.com/2014/10/03/nbc-news-cameraman-from-providence-diagnosed-with-ebola/

Providence, Rhode Island... another person has been diagnosed with Ebola.


Ashoka Mukpo, 33, was on a freelance assignment for the network in Monrovia, reporting on the Ebola outbreak.

His father, Dr. Mitchell Levy, said Mukpo will be transported to the isolation unit at the Nebraska Medical Center in Omaha Sunday, the same facility where Holden*Dr. Rick Sacra*was treated for Ebola last month.

According to NBC, Mukpo started showing symptoms on Wednesday, when he ran a fever and began feeling tired and achy. He was tested for the virus Thursday and it came back positive just under 12 hours later, the network*reported on its website*Friday.

The other four members of the NBC News team are feeling well and not showing symptoms of the Ebola virus, according to the network.

Mukpo is the fifth American infected with Ebola. *He is currently being treated*at the Doctors Without Borders Clinic in Monrovia.

His mother, Diana Mukpo, told WBZ-TV Chris McKinnon Friday her son is “very, very frightened, But his spirits are relatively good.”

“We intend to go wherever he ends up,” she said.

Diana Mukpo (WBZ-TV)

Mukpo*said her son’s virus is in the “early stages” and she is optimistic he will be cured.

Ashoka told his mother he has an idea of how he may have contracted Ebola.

“At one point he was trying to help decontaminate a car. He had most of the protective gear on, but he thinks something might have splashed on his body at that point. That’s one possibility, but really, one doesn’t know fully,” Diana said.

Ashoka has been working in Liberia for the past three years, NBC said, adding that the freelancer had just been hired by the network on Tuesday.

He came home to Providence during the summer, but his mother said he went back to Liberia because of the “incredible impact of the Ebola situation.”

“He felt it was very important to go back and document the impact that this is having, socially and health-wise and financially,” Diana told WBZ.

“He called me the night before he was leaving,” she said. *“I was really distraught.”

“Ashoka is very smart, he’s very passionate and he’s very committed and there was no way to change his mind.”

Ashoka Mukpo. (Facebook Photo)

On*his Facebook page, Mukpo wrote this about his experiences from Monrovia on September 18:

man oh man i have seen some bad things in the last two weeks of my life. how unpredictable and fraught with danger life can be. how in some parts of the world, basic levels of help and assistance that we take for granted completely don’t exist for many people. the raw coldness of deprivation and the potential for true darkness that exists in the human experience. i hope that humanity can figure out how we can take care of each other and our world. simple, soft aspiration for all my brothers and sisters on this earth who suffer the elements and the cold. may we all be free, loved, and tended to…

NBC will fly its team back on a private charter flight and they will be placed under quarantine in the United States for 21 days.

Diana Mukpo said the U.S. State Department has been very helpful, compassionate and accessible in helping them get her son back to the U.S. for treatment.

“Sunday feels like an awfully long way away,” she said.

WBZ NewsRadio 1030’s Mark Katic reports

[Forever_frost]

I'm sorry, if I am tasked with decontaminating a car where there's been ebola, I have 10 gallons of gasoline, a 25 pound bottle of propane, a pound of tannerite and a 37mm flare.

[DON SVO]

I'm sorry, if I am tasked with decontaminating a car where there's been ebola, I have 10 gallons of gasoline, a 25 pound bottle of propane, a pound of tannerite and a 37mm flare.

It's a win-win for you Frost.

That guy wanted a story: he got it... And Ebola. You would have had the glee of burning it to the ground.

On that note... What would an Ebola-riddled Toyota Tercel bring at auction?

[John -- '02 HAWK]

http://boston.cbslocal.com/2014/10/0...ed-with-ebola/

Providence, Rhode Island... another person has been diagnosed with Ebola.

Ashoka Mukpo, 33, was on a freelance assignment for the network in Monrovia, reporting on the Ebola outbreak.

um thats old news, he was declared ebola free three days ago, and is going home today or tomorrow

http://www.nbcnews.com/storyline/ebola-virus-outbreak/nbc-news-freelancer-ashoka-mukpo-declared-free-ebola-n231061

[BoostedD1]

Well that's good news... it seems to be winding down I hope.

[Forever_frost]

It's a win-win for you Frost.

That guy wanted a story: he got it... And Ebola. You would have had the glee of burning it to the ground.

On that note... What would an Ebola-riddled Toyota Tercel bring at auction?

Most things tend to equal win/win if you change how you view things. I mean, with all the random bullshit in my life, they tend to work out so ebola and a car? Charity explosion with the trigger pull going to the highest bidder

[Forever_frost]

http://www.reuters.com/article/2014/10/22/us-health-ebola-usa-interventions-idUSKCN0IB2OM20141022

(Reuters) - The Ebola crisis is forcing the American healthcare system to consider the previously unthinkable: withholding some medical interventions because they are too dangerous to doctors and nurses and unlikely to help a patient.

U.S. hospitals have over the years come under criticism for undertaking measures that prolong dying rather than improve patients' quality of life.

But the care of the first Ebola patient diagnosed in the United States, who received dialysis and intubation and infected two nurses caring for him, is spurring hospitals and medical associations to develop the first guidelines for what can reasonably be done and what should be withheld.

Officials from at least three hospital systems interviewed by Reuters said they were considering whether to withhold individual procedures or leave it up to individual doctors to determine whether an intervention would be performed.

Ethics experts say they are also fielding more calls from doctors asking what their professional obligations are to patients if healthcare workers could be at risk.

U.S. health officials meanwhile are trying to establish a network of about 20 hospitals nationwide that would be fully equipped to handle all aspects of Ebola care.

Their concern is that poorly trained or poorly equipped hospitals that perform invasive procedures will expose staff to bodily fluids of a patient when they are most infectious. The U.S. Centers for Disease Control and Prevention is working with kidney specialists on clinical guidelines for delivering dialysis to Ebola patients. The recommendations could come as early as this week.

The possibility of withholding care represents a departure from the "do everything" philosophy in most American hospitals and a return to a view that held sway a century ago, when doctors were at greater risk of becoming infected by treating dying patients.

"This is another example of how this 21st century viral threat has pulled us back into the 19th century," said medical historian Dr. Howard Markel of the University of Michigan.

Some ethicists and physicians take issue with the shift.

Because the world has almost no experience treating Ebola patients in state-of-the-art facilities rather than the rudimentary ones in Africa, there are no reliable data on when someone truly is beyond help, whether dialysis can make the difference between life and death, or even whether cardiopulmonary resuscitation (CPR) can be done safely with proper protective equipment and protocols.

Such procedures "may have diminishing effectiveness as the severity of the disease increases, but we simply have no data on that," said Dr. G. Kevin Donovan, director of the bioethics center at Georgetown University.

Donovan said he had received inquiries from fellow physicians about whether hospitals should draw up lists of procedures that would not be performed on an Ebola patient. "To have a blanket refusal to offer these procedures is not ethically acceptable,” he said he told the doctors.

NEW GUIDELINES

Nevertheless, discussions about adopting policies to withhold care in Ebola cases are under way at places like Geisinger Health System, which operates hospitals in Pennsylvania, and Intermountain Healthcare, which runs facilities in Utah, according to their spokesmen.

Dr Nancy Kass, a bioethicist at Johns Hopkins Bloomberg School of Public Health, said healthcare workers should not hesitate to perform a medically necessary procedure so long as they have robust personal protective gear.

So far, only two U.S. hospitals have used kidney dialysis: Texas Health Presbyterian Dallas, which treated Liberian patient Thomas Duncan and where two nurses became infected, and Emory University Hospital in Atlanta, which has treated four Ebola patients at its biocontainment unit without any healthcare workers becoming infected.

Although it is not yet clear how the Dallas nurses became infected, health officials have questioned both the lack of adequate training in the use of protective gear and the decision to perform invasive procedures.

The American Society of Nephrology and CDC are now working on new dialysis guidelines for Ebola patients, whose kidneys often fail. In some cases, dialysis can help a patient get through the worst of the illness until their own immune system can fend off the virus.

Nephrologist Dr. Harold Franch said the new guidelines will consider both whether the procedure is medically necessary and whether the hospital can do it safely.

"Most academic medical centers and many good private tertiary care hospitals will be able to do this," he said. Yet he thinks many hospitals may not offer the service, since “it takes a lot of money and time to train people.”



TREAT, OR FLEE?

Throughout the history of medicine some doctors have declined to treat infectious patients or fled epidemics, said Michigan's Markel. Greek physician and philosopher Galen fled Rome during the bubonic plague 1,800 years ago, doctors deserted European cities stricken by the Black Death of the Middle Ages, and some health workers refused to treat HIV/AIDS patients in the 1980s.

"The idea that a doctor would stick to his post to the last during an epidemic, that's not part of the Hippocratic Oath," Markel said. "If you feel your life is at risk you don't have to stay and provide care."

At University of Chicago Medicine, questions of taking last-ditch measures were discussed early in the hospital's Ebola planning, said Dr. Emily Landon, a bioethicist and epidemiologist.

Decisions about offering services such as dialysis or inserting a breathing tube are made in advance by the hospital's care team in consultation with patients. But if a doctor on the team feels in the moment that she cannot provide the service, another may step in and do the procedure.

Landon views dialysis as a "no brainer" for Ebola patients, and believes the risks are fairly low to the well-trained nursing staff who have volunteered for the hospital's isolation ward.

But putting in a breathing tube and putting them on a ventilator is more controversial.

"We have very little experience with that except for Mr Duncan, who didn't do well," she said. The hospital plans to consult with patients before the need arises and plans to insert a breathing tube at the earliest sign that it might be needed.

CPR, which is performed when a patient's breathing or heart stops, also poses risks. It can involve chest compressions, inserting breathing tubes and other invasive procedures.

If a patient goes into cardiac or respiratory arrest, a team would have to don protective gear. Rushing could leave them without proper protection, but a delay could make the procedure ineffective.

That represents too great a risk for caregivers for what could be "a futile act," said Dr. Joseph Fins, chief of medical ethics at Weill Cornell Medical College in New York City.

(Editing by Michele Gershberg and Ross Colvin)

[ceyko]

I don't blame the workers for not wanting to be involved. What sucks is there is so much money flowing in the "healthcare system" that a lot of places could easily be equiped.

Just no profit in it.

[Ruffdaddy]

Ebolanado in NYC!!!!!

[slow99]

Ebolanado in NYC!!!!!

And LAKE pops another 25% today on the news!!

[line-em-up]

The Giants took it back to NY from Dallas. Now the libs in Dallas can laugh back at the libs in NY like they were laughing at Dallas last week.

[Mike]

I wonder if Seb is still hiding off the grid?