Sunday, 19 October 2014

Ebola update - 10/18/2014

Ebola turns Dallas hospital into a ‘Ghost Town’ – virus could destroy U.S. healthcare system

October 2014 – DALLAS – The Dallas nurses who contracted Ebola while treating a patient at Texas Health Presbyterian Hospital have been moved from the building, but patients are still steering clear of the once-bustling hospital. 

People have called to cancel outpatient procedures, and some have even opted not to go to Texas Health Presbyterian Hospital in emergency situations, ABC Dallas affiliate WFAA reports. “It feels like a ghost town,” Rachelle Cohorn, a local health care vendor who has been to the hospital recently, told WFAA. “No one is even walking around the hospital.” Texas Health Presbyterian’s average emergency room wait time had been 52 minutes, according to federal hospital data. 

But when ABC News called the hospital and asked the emergency department for the ER wait time today, the response was that there was no wait time. The hospital has also taken public relations hits on a number of fronts. It was revealed that Ebola patient Thomas Eric Duncan was initially sent home from the ER even though he told staff there that he had recently come from West Africa, the epicenter of the Ebola outbreak. And this week, another health care worker who took care Duncan criticized the hospital administration for not providing proper training and equipment to nurses caring for Duncan. The hospital still has no idea how two of its staff nurses were infected with the Ebola virus.

To weather the storm, the hospital will need to convince people that Texas Health Presbyterian is still a safe hospital, said Dr. Dan Varga, the chief clinical officer of Texas Health Resources, which owns the Dallas hospital. “I would tell this community that Presbyterian is an absolutely safe hospital to come to,” Varga told ABC News chief health and medical editor Dr. Richard Besser on Thursday. 

We’ve been in communication with our doctors that have their private offices in our professional buildings around the campus who are getting 40, 50, 60 percent cancellations just for fear of being somewhere in the geography of the hospital where Ebola is treated.” 

Texas Health Presbyterian became the first hospital in the nation to be faced with diagnosing Ebola on American soil when Duncan, a Liberian man visiting family in Dallas, went to the emergency room on Sept. 26. He was initially sent home with antibiotics, but returned two days later in an ambulance when his symptoms worsened. The hospital put Duncan in isolation. He died on Oct. 8. Two nurses contracted Ebola from Duncan, though how exactly they were exposed remains unknown. Nina Pham, 26, was diagnosed on Oct. 11, and Amber Vinson, 29, was diagnosed on Oct. 15, health officials said.

Texas Health Presbyterian cared for Pham in isolation for five days before requesting that she be moved to another facility. She was flown to an NIH facility in Bethesda, Maryland, on Oct. 16, and Vinson was flown to Emory University Hospital the day before. Varga told Congress on Oct. 16 that the hospital staff was never trained to handle a patient with Ebola. He said they received guidelines from the U.S. Centers for Disease Control and Prevention in July but never received any face-to-face training. About 70 staff members are being monitored after possible exposure to the Ebola virus. “Over the long haul is the emotional toll going to be something that leaves a mark?” Varga asked. “We have a bunch of employees on surveillance now because they had contact with Mr. Duncan, with Nina, with Amber.” Alex Normington, who works for a national firm that helps hospitals establish their reputations, told WFAA that Texas Health Presbyterian has had a “very good” reputation since it opened in 1966. “A hospital’s reputation can take years or generations to build,” Normington said. –ABC News

Healthcare system in grave peril: Decontamination protocols, the disposal of hazardous waste from the patient, unpaid medical bills, the infection of healthcare workers, potential lawsuits and on-going civil litigation exposure. This is how a level-4 pathogen like Ebola could destroy well-established U.S. hospitals across the country in the space of a few weeks. U.S. hospitals were never designed to treat such cases and U.S. healthcare professionals have no training in how to treat patients infected with level-4 pathogens. Duncan was only one case. There will be many more. It may take years for this Dallas hospital to recover from this one Ebola case – if it ever recovers at all. –Alvin Conway

Liberia thinks it needs 84,000 more body bags for the Ebola outbreak – cases likely 2.5 times higher than reported
October 2014 – LIBERIA - Earlier today, the Liberian government published a list of the supplies it has on hand to treat Ebola patients — and the supplies it thinks it will need.

The data paints a dire picture of a country bracing for an outbreak that only gets worse. The Liberian government estimates it needs an additional 84,841 body bags. It currently has 4,901 on hand. The West African country also needs more than 2 million boxes of rubber gloves and a half-million pairs of goggles and tens of thousands more pairs of rubber boot.

 Right now, it has very little of any of these. Liberia has been harder hit by the Ebola outbreak than any other country. It has so far recorded 4,076 cases and 2,316 deaths. More than half of all Ebola deaths worldwide have happened in Liberia. The country is also poor, with few resources to fight the deadly outbreak. Even before Ebola hit, Liberia had one of the world’s poorest health care systems. Liberia spends an average of $66 per person per year on health care — a mere 2 percent of the OECD average. 

Supplies matter a lot in the Ebola outbreak. Without proper protective gear, it’s easier for the disease to spread — not just in Liberia, but also outside of the country, too. If you’re looking for ways to help ease the supply shortage, consider this list of non-profits currently providing aid in West Africa in the Ebola fight.

We have no idea how bad the Ebola outbreak actually is

While official estimates suggest there are already more than 8,000 cases of Ebola this year, the real number is likely much, much higher. “Under-reporting” has been a constant feature of the world’s worst Ebola epidemic. Cases have gone missing, deaths are uncounted, and “there is widespread under-reporting of new cases,” 
warns the World Health Organization. 

The WHO has continually said that even its current dire numbers don’t reflect the full reality. The estimated 8,000-plus Ebola cases in West Africa could just be the tip of the iceberg. 

To get to this point, Dr. David Fisman, an infectious disease modeler working on Ebola, summed up: “A person needs to have recognized symptoms, seek care, be correctly diagnosed, get lab testing — if they’re going to be a confirmed case — have the clerical and bureaucratic apparatus actually transmit that information to the people doing гsurveillance. 

At each step along the way the case can fall out of the pool of ‘counteds.” There’s no way to know how vastly under-reported this epidemic is, but there are estimates being floated around. Comparing surveillance figures with actual hospital beds dedicated to Ebola care in West Africa, the Centers for Disease Control and Prevention suggested that under-reporting could be happening at a rate of 2.5. 

This means that every one case reported equals 2.5 on the ground. If true, today’s 8,000 Ebola cases could actually look more like 20,000. –Vox


World fears mount that Ebola battle being lost in West Africa

October 2014 – HEALTH – The World Bank warned Friday the fight to stop Ebola was being lost, as the UN pleaded for more money to combat the escalating epidemic and global travel fears mounted. 

As the death toll from the world’s worst-ever outbreak of the virus shot past 4,500, a glimmer of hope came from Senegal, which was declared Ebola-free by the World Health Organization. 

The United States, meanwhile, named an “Ebola czar” to coordinate its response, after criticism of how a Texas hospital handled a Liberian victim, with two nurses who treated him now infected. And a researcher at British pharmaceuticals giant GlaxoSmithKline said a vaccine may not be ready for commercial use until late 2016. 

“We are losing the battle,” World Bank chief Jim Yong Kim warned, blaming a lack of international solidarity in efforts to stem the epidemic. “Certain countries are only worried about their own borders,” he told reporters in Paris. 

As of October 14, 4,555 people have died from Ebola out of a total of 9,216 cases registered in seven countries, the WHO says. Most of the dead are in three West African nations at the centre of the outbreak: Guinea, Liberia and Sierra Leone. 

Experts warn that the infection rate could hit 10,000 a week by early December.

The United Nations has warned that it has received less than 40 percent of the nearly $1 billion it asked for to fight Ebola. So far, just $377 million has come in, and another $217 million has been pledged, the UN Office for the Coordination of Humanitarian Affairs (OCHA) said. “But that’s not money in the bank,” OCHA spokesman Jens Laerke told reporters in Geneva. 

And a UN trust fund for Ebola has just $100,000, despite $20 million in pledges—a situation UN Secretary General Ban Ki-moon said had left the world body with a “very serious problem. We need to turn pledges into action. We need more doctors, nurses, equipment, treatment centers and medical evacuation capacities,” he said. 

Despite enhanced health checks at airports in several countries, fears mounted, and Air France flight attendants called for an end to flights to Guinea, one of the three hardest-hit nations in West Africa. The daily Air France Paris-Conakry flight “carries a serious risk of spreading the epidemic, particularly in our country,” read a statement from the two unions of flight crew and commercial staff. 

British Big Pharma warns Ebola vaccine will come ‘too late’ to halt spread

October 2014 – AFRICA One of the world’s biggest pharmaceutical companies says a vaccine to tackle Ebola will “come too late” to curb the current epidemic, as the UK and other European countries begin screening passengers for the virus at international airports. 

GlaxoSmithKline (GSK), a British multinational that produces pharmaceuticals, biologics and vaccines, said a working vaccine would not be readily available until late 2015, by which time the epidemic may have spread far beyond West Africa. The statement follows warnings from the United Nations and World Health Organization (WHO) that there could soon be more than 10,000 new cases of Ebola per week if the spread of the disease is not curbed quickly.

 “We either stop Ebola now or we face an entirely unprecedented situation for which we do not have a plan,” said the UN’s Deputy Ebola Coordinator Anthony Banbury on Wednesday. 

“The WHO advises within 60 days we must ensure 70 percent of infected people are in a care facility and 70 percent of burials are done without causing further infection,” he dded.

Earlier this week, British Prime Minister David Cameron signed off on deploying 750 troops to Sierra Leone to help set up medical treatment centers and to the assist staff on the ground to contain the virus. 

He also urged the international community to dedicate more resources to the relief effort in West Africa, after UN Secretary- General Ban Ki-moon criticized leaders for paying a mere $100,000 into a $1 billion UN trust fund to fight the virus. 

“This is the biggest health problem facing our world in a generation. It’s very likely to affect a number of the countries that are here today,” Cameron said at the EU-Asia summit in Milan on Thursday. “Britain in my view has been leading the way. The action we’re taking in Sierra Leone, where we are committing well over £100 million, 750 troops, we are going to be training 800 members of health staff in Sierra Leone, providing 700 beds.” 

He also said the international community should “look at their responsibilities and their resources” to ensure the disease did not spread to Europe. Professor Hill, who is currently developing an Ebola vaccine, hit out at drug companies including GSK, Sanofi, Merck and Pfizer in September, arguing a vaccine wasn’t developed because there was “no business case” for it. 

“The problem with that is, even if you’ve got a way of making a vaccine, unless there’s a big market, it’s not worth the while of a mega-company,” Hill told the Independent. –RT

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