tag:blogger.com,1999:blog-8939666320943790100.post3384558804457143531..comments2024-02-11T01:14:21.904-08:00Comments on SURVIVING IN ARGENTINA: U.S. Hospitals Prepared for Ebola?FerFALhttp://www.blogger.com/profile/07578136334334588454noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-8939666320943790100.post-77791609532012737362014-10-26T16:48:25.641-07:002014-10-26T16:48:25.641-07:00Not sure if anyone will see this here in the comme...Not sure if anyone will see this here in the comments. I sent the original email in this article. So the next day after the events of this email, I think word got a round, and a bunch of hospitals had hasty information sessions. Word gets around pretty quickly in the healthcare world, particularly about screw-ups.<br /><br />So that same next day, we had an announcement that they were having a disaster drill. I was in an office with my boss. So I didn't see what was supposed to be happening. I asked someone afterwards, and they said it was an earthquake drill. I thought they were joking. But I asked around, and even after not knowing what to do with a potential ebola patient, they really honest-to-god decided they would be better doing an earthquake drill in the NE USA.<br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8939666320943790100.post-43904095109028590972014-10-21T06:33:08.829-07:002014-10-21T06:33:08.829-07:00An Update: The 2008 MSF manual I mentioned in an ...An Update: The 2008 MSF manual I mentioned in an earlier post above was a summary , albeit <br />a book size summary. The full, detailed MSF manual for Ebola, dated 2007 and titled "Ebola & Marburg Outbreak Control Guidance Manual, Version 2.0"<br />is here:<br />http://www.medbox.org/ebola-toolbox/ebola-marburg-outbreak-control-guidance-manual/preview?q=<br /><br />The full manual has MSF's detailed equipment list, why they chose the equipment they<br />did (e.g, that the coveralls or gown has to be waterproof) and the specific models they chose. However, I don't see some of the models they mention --e.g, the <br />TopGuard Tyvek-ProTech overalls --currently being sold in the USA. MSF appears to get a lot<br />of their stuff in Europe and the overalls may be sold there. Alternatively, they may have<br />been what's currently called Tychem.<br /><br />The orange duckbill respirator seen in photos of their African personnel may be the <br />"Kimberly-Clark Professional Fluid Shield 46767 PFR95 N95 Orange Regular Particulate Filter <br />Respirator and Surgical Mask Fluid Protection, Safety Seal Film- pouch style".<br /><br />Note that MSF says NOT to use a respirator with an external valve. Unfortunately, that<br />means the respirator will soon become clogged with exhaled water vapor. I seen reports<br />that MSF doctors can only work about 45 minutes -1 hour in their gear before they have to leave Ebola patients and remove it. <br /><br />Which means an ENORMOUS logistics requirement since part of<br />the gear is then burned and has to be replaced with another set. <br /><br />From the photo I provided in the previous post, The reuseable items<br />(soaked in bleach water and air dried ) appear to be the goggles,heavy rubber gloves (doctors<br />use disposable surgical gloves), high rubber boots (in case dress-like gowns worn vice overalls),<br />and plastic aprons. <br />Don Williamsnoreply@blogger.comtag:blogger.com,1999:blog-8939666320943790100.post-75504420305952718852014-10-17T19:40:02.424-07:002014-10-17T19:40:02.424-07:00I have also been looking into the details of Pers...<br />I have also been looking into the details of Personal Protective<br />Equipment recommended by WHO, CDC and Doctors without Borders (MSF).<br /><br />For what it is worth, what I found is as follows:<br /><br />1) Paul Roddy, Independent Consultant in Barcelona, issued a call for an updated Ebola manual in Viruses (Sept 30, 2014). Google "A Call to Action to Enhance Filovirus Disease Outbreak Preparedness <br />and Response"<br /><br />2) Roddy cited several existing manuals:<br />a) Esther Sterk (MSF)'s 2008 manual "Filovirus Haemorrhagic Fever Guidelines", which I linked to in the previous post.<br />b) WHO's August 2014 "Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola" at <br />http://www.who.int/csr/resources/ who-ipc-guidance-ebolafinal-09082014.pdf <br />CDC also issued isolation guidelines --including PPE recommendations -- in 2007.<br /><br />3) Roddy suggested that WHO , MSF and CDC should develop an updated, joint set of guidelines. He indicated that MSF has not updated the 2008 manual. Even so,<br />the 2008 MSF Guidelines seem superior (in my opinion) to WHO and CDC's 2014 guidelines -- e.g, in calling for a covering for the head. <br /><br />CDC's site indicates they recently (2 days ago) started<br />working with MSF to use MSF's African experience to update their (CDC's) isolation guidelines/ advice on Personal Protection Equipment,etc. E.g to add double gloves, hood to cover the head and neck,etc.<br /><br />4) A study of photos of MSF workers in Africa indicates MSF has added some additional items to their guidelines. For one thing, they use what appears to be<br />N95 respirators of the duckbill form. But they also put a surgical mask over top of the duckbill respirator with a slit to expose the very end of the duckbill to the air. <br /><br />http://images.nationalgeographic.com/wpf/media-live/photos/000/832/cache/ebol...<br /><br />My speculation (and that is all this is) is that the mask covers most of the respirator to prevent the surface of the respirator from becoming contaminated --<br />for fear that the virus can penetrate a N95 respirator as the respirator becomes soggy with water vapor exhaled by the worker. Another possible reason is that the surgical mask is put over the respirator to cover any skin exposed at the edge of the respirator.<br /><br />Also the outer gloves appear taped to the coveralls.<br /><br />5) Some US makers of protective coveralls (Lakeland, Dupont) have noted sales in support of the<br />Ebola relief effort and have noted US standards for such use -- that the coverall must be impervious to blood borne pathogens and include such features as taped (vice merely sewn) seams. <br /><br />The technical standards cited are<br />the USA ASTM F1671 and European EN 14126. I have also seen some<br />discussions arguing that Tychem is better than Tyvek. There is also the question of whether a particular model can be reused by soaking in bleach water versus<br />disposable models that must be burned.<br /><br />6) Also, the MSF workers appear to be using various models of goggles with indirect venting and anti-fog lenses made by UVEX. The low-cost A610S model appears to be used by the rank and file workers in Africa while the <br />doctors appear to use more expensive models. Models with foam rubber edging appear to be avoided --probably can't be sterilized in bleach water.<br /><br />7) I would appreciate it if someone more knowledgable could provide better info.<br /><br />8) I think survivalists would be better served by looking at rubber PPE that can be washed in bleach water and reused vice stocking bales of Tyvek disposable coveralls/booties, etc that have to be burned after a single use.<br /><br />http://si.wsj.net/public/resources/images/WO-AT183_EBOLA2_G_20140728184636.jpg Don Williamsnoreply@blogger.comtag:blogger.com,1999:blog-8939666320943790100.post-8876519450867078292014-10-17T09:23:16.721-07:002014-10-17T09:23:16.721-07:00THANK YOU!
You are the voice of sanity, Ferfal. T...THANK YOU!<br /><br />You are the voice of sanity, Ferfal. TERRIFIC background info for those of use who don't understand medicine or viruses. Your site is fantastic and your info is FIRST CLASS. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-8939666320943790100.post-20493183751529594382014-10-16T22:25:09.698-07:002014-10-16T22:25:09.698-07:00Ebola doesn't need to (and probably won't)...Ebola doesn't need to (and probably won't) become officially airborn. The virus is incredibly dangerous in its current form. Because people are most infectious toward the end and after death, the people most likely to catch the disease are healthcare workers and those who dispose of bodies. <br /><br />The virus really goes after the healthcare system, taking out the most useful resource for fighting back. When you are afraid to go to the hospital because that's the center of the outbreak, commerce and distribution of needed supplies may break down as well. Many people in Africa are dying of hunger because no one is bringing food in to some districts and it's dangerous to leave home.<br /><br />Considering how poorly the CDC is doing, I don't think the US can handle 50-100 outbreaks before the medical system is overwhelmed.<br /><br />The best chance we (and Africa) have is that a vaccine or treatment is developed quickly. Anonymousnoreply@blogger.com