September 20, 2020

Ebola: Mark Zuckerberg and crisis in Dallas

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mark-zuckerberg-facebook-112Mark Zuckerberg gave a great answer to someone on Facebook who asked why he donated $25 million to fight Ebola

By Dave Smith From Business Insider

Facebook CEO Mark Zuckerberg, along with his wife, Priscilla Chan, announced on Tuesday that they’ve committed a $25 million grant to help fight Ebola.

When a Facebook user asked why Zuckerberg would commit his money when the US has a GDP of $17 trillion, Zuckerberg offered the following response:

I think we have a responsibility to help out wherever we see a need.

One problem right now is that most people — including government leaders — don’t realize we’re at such a critical turning point. It’s easy to say Ebola is still small compared to other diseases or that it’s mostly in other countries and won’t affect us, but if we don’t get this under control soon, then it will spread and become an epidemic we have to deal with for decades to come.

Spending $25 million to help get this under control now is very little cost compared to all the lives it could save and all the billions of dollars of costs we’d have to spend fighting the disease if it spread much further.

The commenter goes on to ask the Facebook founder to “resuscitate” his Facebook group, which “used to have 470 members and 550 pics,” which just vanished one day, according to the man.

IMAGE: mark zuckerberg facebook REUTERS/Beck Diefenbach

For more on this story go to: http://www.businessinsider.com/mark-zuckerberg-on-why-he-donated-25-million-to-fight-ebola-2014-10#ixzz3GEMQ9i2x

 

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The Ebola crisis In Dallas exposes a critical gap in the US Public Health system

ap595891288214By Erin Brodwin From Business Insider

If healthcare workers had responded faster and in full force in Dallas two weeks ago, they might have prevented two healthcare workers from getting Ebola, CDC director Tom Frieden said in a call with reporters for the first time on Tuesday.

That might have happened, had there been an “Ebola czar” to spearhead efforts to contain the virus.

As it turns out, we already have one of those — it’s the Surgeon General. The position was created for the express purpose of maintaining public health by coordinating efforts between various national agencies and the states to enforce a uniform public health policy.

Unfortunately, the man Obama nominated for the job back in November never got confirmed. His nomination was blocked over controversy regarding his position on gun violence.

For now, CDC Director Tom Frieden has essentially been serving as Ebola czar, though there’s no designated person coordinating the public health efforts of the CDC and the research efforts — including experimental vaccines and treatments — of the NIH. Also missing in action, at least publicly, is Nicole Lurie, the Department of Health and Human Services’ Assistant Secretary for Preparedness and Response, and the Acting Surgeon General — Boris Lushniak.

This is what might have happened if our Surgeon General was in office.

Domestic Communicator

The Surgeon General would oversee the US Public Health Service Commissioned Corps, which include some of the people sent in to track down and contain dangerous viruses like Ebola. He or she would also work closely with US public health agencies like the NIH and the CDC to clearly communicate to the public and to healthcare workers information about new and emerging public health issues, such as Ebola. His or her role would be complex, but critical: Prepare healthcare workers to treat people with the virus while simultaneously educating the public to quell irrational fears about its spread.

Today, the ongoing situation in Texas underscores how important that kind of thoughtful, scientifically sound communication can be. So why isn’t it happening? Without a Surgeon General, relaying information about infectious disease falls on the states. This is where the CDC comes in.

ap639424113721The CDC works as a reference center for each state — it provides them with recommendations and guidelines to prepare doctors and nurses to treat patients with Ebola and contain the virus. Unfortunately, the CDC doesn’t enforce those recommendations, as Northwestern University Director of the Center for Global Health Robert Murphy told the New York Times . “It’s strictly up to the states as to whether they follow those guidelines or not,” said Murphy.

This state-by-state enforcement was a clear problem in Dallas, where despite having more than enough trained staff and equipment, healthcare workers failed to properly diagnose and treat their first Ebola patient , Thomas Eric Duncan . He died from the virus on Wednesday, Oct. 8 . This weekend, the hospital announced that a healthcare worker who treated Duncan was also sick with Ebola even though she was doing her best to follow all CDC safety precautions while caring for him.

Public misinformation about Ebola has only worsened the situation. Since Thomas Eric Duncan became the first person to be diagnosed with the virus in the US on September 30, the CDC has received more than 800 calls a day from healthcare workers who suspect a patient has Ebola. Without clear communication about what the virus looks, sounds, and feels like, it’s no surprise that most of the public — not to mention some trained doctors and nurses — think every fever, cough, or bloody nose could be Ebola.

International Liaison

Four people in the US, including an NBC videographer and two Dallas healthcare workers, remain ill with Ebola. In Spain, a nurse in Madrid who contracted the virus has worsened.

Yet the brunt of Ebola’s damage continues to be felt in West Africa, where more than 4,000 have died and more than 8,000 are sick with the virus. While the CDC and the WHO could likely have contained the outbreak early on had they acted in full force when Ebola first emerged, both agencies are now simply struggling to keep up with the virus as the number of infected in West Africa doubles every 30 days.

In all seven countries where Ebola cases have been reported, the health agencies are following the same protocol they’ve been using for every former Ebola outbreak: contract tracing. The procedure involves tracking down every person who’s come into contact with an infected person so the outbreak can’t continue to spread unchecked. In West Africa, however, it may be too late for the procedure to work. With so many sick — and so many being turned away from hospitals to die at home and pass the virus to family — the total number of infected people could climb to 1.4 million by the end of January.

If the Surgeon General led communication between the CDC and the WHO, that person could not only coordinate efforts to send aid to the most affected countries in West Africa, but could also implement airport health screenings and spearhead hospital trainings.

Many of the airport screeners who were dispatched at five US airports last week are supervised by members of the US Public Health Service, the Surgeon General’s boots on the ground. In 2003, after meeting with health professionals in California who proposed implementing airport screenings to battle the SARS outbreak (a much less deadly virus than Ebola), then Surgeon General Richard Carmona decided to give an official go-ahead to the procedure. The same year, the Surgeon General identified several infectious disease quarantine sites where SARS could be contained.

Why We Have A Surgeon General

Our most recent Surgeon General, Regina Benjamin, says the job serves the critical function of digesting all of the information about a particular public health scenario, such as Ebola, and telling the public what they need to know to stay safe.

The position was initially created in 1798, when President John Adams created the Marine Hospital Service. That group’s lead doctor was called the Surgeon General. Years later, the MHS became the US Public Health Service, and the Surgeon General began to take on health issues related to immigration, national safety, smoking, and many other public health issues.

Since then, the position has been significantly weakened. In the midst of what is perceived to be a massive public health crisis, however, a Surgeon General could serve a critical role. “Not having [this person] right now, you don’t have that face and that person that the American people can identify with as their doctor who’s looking out for them on a large scale,” said Benjamin.

IMAGES:

AP / Pablo Martinez Monsivais President Barack Obama pauses while speaking at the Global Health Security Agenda Summit on the White House complex in Washington. The president said that in an interconnected world, outbreaks of deadly viruses like Ebola have the potential to affect every nation.

AP Photo/Charles Dharapak Dr. Vivek Murthy, President Obama’s Surgeon General nominee, prepares to testify before the Senate Health, Education, Labor, and Pensions Committee.

For more on this story go to: http://www.businessinsider.com/no-surgeon-general-during-ebola-in-us-2014-10#ixzz3GEN2fWH1

CDC: U.S. health worker with Ebola should not have flown on commercial jet

By Josh Levs and Holly Yan, CNN

(CNN) — 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.

The worker had a temperature of 99.5 Fahrenheit (37.5 Celsius) before she boarded her flight, he added.

Health care workers who had been exposed to Duncan were undergoing self-monitoring. They were allowed to travel but not on a commercial plane with other people, Frieden said.

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

The worker is Amber Vinson, 29, a nurse at Texas Health Presbyterian Hospital in Dallas. She was confirmed to have Ebola overnight.

Now, she will be transferred from the Dallas hospital to Emory University Hospital in Atlanta, which has successfully treated two other patients. It is now treating a third: a male health care worker who was infected in Sierra Leone.

Vinson is “ill but clinically stable,” Frieden said.

The first Dallas health care worker with Ebola, Nina Pham, is in “improved condition,” Frieden said. It has not been determined whether she will be transferred to another facility.

Both Dallas health workers had “extensive contact” with Duncan on September 28-30, when he had “extensive production of body fluids” such as vomit and diarrhea, Frieden told reporters in a conference call.

DC wants to interview passengers

The risk of exposure to the passengers who were on the plane with Vinson is low, since she did not yet have symptoms, health officials said Wednesday. The Ebola virus is not contagious before symptoms set in.

Still, the CDC wants to interview all 132 passengers who were on the plane with her.

“Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13,” the CDC said in a statement. The flight landed Monday at 8:16 p.m. CT.

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

Vinson flew from Dallas-Fort Worth to Cleveland a week ago, on October 8, said Toinette Parrilla, director of the Cleveland Department of Public Health.

Frontier Airlines, however, said she traveled to Ohio on October 10 — and specifically asked people who may have been on a flight on that date to contact the CDC at 1-800-CDC-INFO (1-800-232-4636).

The CDC, in a joint news release with Frontier, said it wanted to speak only with passengers on the October 13 flight. The CDC later confirmed to CNN that it is “only interested” in the passengers on Flight 1143.

The October 13 flight was cleaned thoroughly after it landed, “per our normal procedures which is consistent with CDC guidelines,” the airline said. After the airline was informed of the Ebola patient, the plane was removed from service.

After going through decontamination, the plane was going back into service on Wednesday, Ricky Smith, Cleveland’s Director of Port Control, said at a news conference. Both the CDC and the airline were comfortable that it was safe to resume operations, he said.

In a sign of growing concerns about Ebola, President Barack Obama canceled trips to New Jersey and Connecticut on Wednesday to convene a meeting at the White House of Cabinet agencies coordinating the government’s response to the outbreak.

Hospital denies ‘institutional problem’

Vinson, who lives alone, is in isolation at Texas Health Presbyterian Hospital.

The news that she contracted Ebola cast further doubt on the hospital’s ability to handle the virus and protect employees.

It’s the same hospital that initially sent Duncan home, even though he had a fever and had traveled from West Africa. By the time he returned to the hospital, his symptoms had worsened. He died while being treated by medical staff, including the two women who have contracted the disease.

“I don’t think we have a systematic institutional problem,” Dr. Daniel Varga, chief clinical officer of Texas Health Resources, told reporters, facing questions about the hospital’s actions.

Medical staff “may have done some things differently with the benefit of what we know today,” he said, adding, “no one wants to get this right more than our hospital.”

People in the Vinson’s office building were informed when officials went door to door, and also through early morning reverse 911 calls, officials said.

The health care worker had no pets, authorities said.

More than 120 being monitored

Seventy-five health care workers in Dallas are being monitored for any Ebola symptoms, Varga said.

Separately, Dallas County Judge Clay Jenkins, who is overseeing the response efforts, said 48 other people in the community still are being monitored after having contact with Duncan, who was Dallas’ first Ebola patient. Those 48 are asymptomatic, and Sunday will mark the end of the window in which they could get sick.

The second worker reported a fever Tuesday and was immediately isolated, health department spokeswoman Carrie Williams said. The virus is not contagious before there are symptoms.

A preliminary Ebola test was done late Tuesday at the state public health laboratory in Austin, and the results came back around midnight. A second test will be conducted by the Centers for Disease Control and Prevention in Atlanta.

Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored,” the health department said.

The worker’s apartment and car will be cleaned Wednesday, Dallas Mayor Mike Rawlings said.

Official: Duncan should have been moved

An official close to the situation says that in hindsight, Duncan should have been transferred immediately to either Emory University Hospital in Atlanta or Nebraska Medical Center in Omaha.

Those hospitals are among only four in the country that have biocontainment units and have been preparing for years to treat a highly infectious disease like Ebola.

“If we knew then what we know now about this hospital’s ability to safely care for these patients, then we would have transferred him to Emory or Nebraska,” the official told CNN senior medical correspondent Elizabeth Cohen.

“I think there are hospitals that are more than ready, but I think there are some that are not.”

Troubling allegations

Also Tuesday, National Nurses United made troubling allegations about the hospital, claiming “guidelines were constantly changing” and “there were no protocols” about how to deal with the deadly virus.”

“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,” NNU Executive Director RoseAnn DeMoro said. “We’re deeply alarmed.”

Nurses were told to wrap their necks with medical tape when equipment left their necks exposed; they felt unsupported and unprepared, and they received no hands-on training, union co-president Deborah Burger said.

A Texas Health Presbyterian spokesman did not respond to the specific allegations but said patient and employee safety is the hospital’s top priority.

Global epidemic

While the Texas hospital deals with its third Ebola patient, the situation in West Africa is getting increasingly dire.

A total of 4,493 people are confirmed to have died from Ebola this year, from Guinea, Liberia, Nigeria, Senegal, Sierra Leone, Spain and the United States, the World Health Organization said Wednesday.

There could be 10,000 new Ebola cases per week in Sierra Leone, Liberia and Guinea by the end of this year as the outbreak spreads, the WHO warned Tuesday.

For more on this story and video go to: http://edition.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html

 

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