Monday, September 15, 2014

Things That Make you Go "Hmmmmmmm"

Totally aside from the march of Ebola unchecked or even constructively hindered by anything done so far, as documented multiple places, a couple of things we know, and a couple of more things I'd like to:

FACT: We were told that Nancy Writebol and Dr. Brantley were infected with Ebola.
FACT: Both were medically evacuated to Emory U. Hospital for treatment.
FACT: Beating the not inconsiderable odds, they both survived, and have been discharged as EVD infection-free.
FACT: Discounting WHO's cooked numbers, if you look at the number of cases and the number of deaths, the rough number of deaths now for any point in time, is the same as the number of cases 21 days prior to now (the incubation period of Ebola) if you multiply that number by 90% (the standard prior Ebola max death rate).

Conclusions:
> This strain of Ebola is behaving exactly as every other strain did with regard to speed of progression, and fatality.
> The spread is different, precisely because it got out of the boonies, and into large urban populations, which it's never done before.
> If Writebol and Brantley were truly infected with Ebola, the safest place for them right now is working with the sick in West Africa, because they're both presumably bulletproof as far as Ebola virus is concerned. For life.
> Their combined survival, assuming both had Ebola, is a 1% absolute likelihood on a probability scale. (10% of 10% = 1%).
> If they didn't have Ebola, their dual survival in a BL4 hospital ICU under round-the-clock medical care and observation is a 99.9999999% certainty.

But:
FACT: Neither of them is in West Africa now, despite being so dedicated prior that they were willing to work among a deadly pestilence with sub-par protective gear, and even none, to bring what help they could, and ease suffering; not particularly bright, but on a moral level if not an intelligence one, commendable.

FACT: Either they had Ebola, or they didn't.
FACT: They either knew the truth of their status, or they didn't.

Tinfoil fringe decision matrix in line with the known facts:

If they were infected with Ebola, why aren't they back in action on the ground?
They could now go there without any protective gear, and give unprotected mouth-to-mouth, with no further risk of contracting Ebola. (They wouldn't do it because of any number of other infection risks, but it makes the greater point.)
Since they aren't back nor champing to try to get back, either their prior commitment is suspect, or their immunity is, and they know the truth of both those things at this point.

If they didn't have Ebola, either they knew that, or they didn't. Either way, the CDC knows the truth.
If they didn't have Ebola, why say they did?

If they didn't have Ebola and knew that, why consent to be evacuated and held for treatment?

I could spin any number of wild suppositions. I won't because that's what Daily Kos and Facebook is for.
But all I know at this point is that the undisputable facts don't add up.
2 + 2 = 9 and 11/3rds.
And it's nagging the hell out of me.

When I couple that lack of coherence of what we know with what we've been told and what we may reasonably and logically assume, with CDC today issuing a "Prepare to Shit Kittens" Warning Order to every hospital in the US, I'm even less comforted.

Thursday, September 4, 2014

EBOLA: Why You Need To Wake The Eff Up

In case my last missive on the subject didn't get your attention, here's another crosspost.
Just a little more sunshine for your fund of How Bad It Really Is:

CHARLOTTE, N.C. (AP)

The hospital in Liberia where three American aid workers got sick with Ebola has been overwhelmed by a surge in patients and doesn't have enough hazard suits and other supplies to keep doctors and nurses safe, a missionary couple told The Associated Press on Wednesday.

The latest infection -- of Rick Sacra, a doctor who wasn't even working in the hospital's Ebola unit -- shows just how critical protective gear is to containing the deadly epidemic, and how charities alone can't handle the response, they said.

About 250 staffers at the hospital use thousands of disposable protective suits each week, but that's not enough to fully protect the doctors and nurses who must screen people entering the emergency room or treat patients outside the 50-bed Ebola isolation unit, they said.

"We don't have enough personal protective safety equipment to adequately be able to safely diagnose if a patient has Ebola. So they are putting themselves at risk," David Writebol said.

Sacra, 51, a doctor from suburban Boston who spent 15 years working at the hospital, felt compelled to return despite these challenges. As soon as he heard that Dr. Kent Brantly and Nancy Writebol were sick, Sacra called and said "I'm ready to go," SIM President Bruce Johnson said.

Sacra's job was to deliver babies and care for patients who were not infected with Ebola. He helped write the protocols for handling Ebola, his brother Doug said, and he followed all the protections, said Will Elthick, the group's operations director in Liberia.

But Sacra got infected nonetheless by the virus that has killed more than 1,900 people and sickened 3,500 in five West African nations.

The disease is spreading faster than the response for lack of protective gear and caregivers, said Tom Kenyon of the U.S. Centers for Disease Control and Prevention. At least $600 million is urgently needed to provide these tools and extra hazard pay so that more doctors and nurses are willing to risk their lives, the World Health Organization said Wednesday.

Health care workers at other West African hospitals have gone on strike demanding more protections, the Writebols said.

"They see colleagues who have fallen. They don't want that to happen to them. But they are saying, 'I can't go to work safely until there is personal protective equipment available -- the right gear, the right procedures in place. And then, if they don't go to work, are they going to get paid?" David Writebol said.

The Writebols left Charlotte for Africa several years ago; David helped with the hospital's technology while Nancy helped dress and disinfect people entering and leaving the Ebola unit at ELWA, which stands for Eternal Love Winning Africa.

Liberians were already struggling to survive when they got there, but with Ebola it's chaos — the number of patients is surging, finding food and supplies is more costly, schools are closed and people with common injuries or even mothers in childbirth can't get care.

Ebola has "overwhelmed the supply chain," David Writebol said. "They can't get equipment in because there aren't any regular flights coming in. Same thing with aid workers from the international community. There are only a limited number of seats available to come into Liberia. ... That's one of the biggest problems -- getting medicine, protective gear and supplies for health care workers who are there."

Nancy Writebol said people who showed up at the emergency room with symptoms were ushered into triage. But health workers were sometimes exposed as they screened patients who may not have known or advertised that they were carrying the virus.

And sometimes, the sick would leave before finding out if they had Ebola. "Those are the people you really worry about going back into the community, because if they are sick with Ebola, it will ultimately spread," she said.

Sacra immediately got tested for Ebola after coming down with a temperature, and like his colleagues, went into isolation to avoid spreading the virus, his brother Doug Sacra told the AP.
Some other doctors haven't been so rigorous.

The WHO announced today that a doctor in southern Nigeria was exposed by a man who evaded surveillance efforts, and then in turn exposed dozens of others by continuing to treat patients after he became ill. Before he died, his family and church members laid their hands on his body in a healing ritual.

Now his widow and sister are sick and about 60 others in the city of Port Harcourt are under surveillance, the agency said.

Sacra, who left his family at home for this latest trip to Africa, was in good spirits Wednesday and able to send emails, Elthick said. That could mean he's physically well enough to be evacuated.
His wife, Debbie, said in a statement that she's focusing on her husband, but she said "Rick would want me to urge you to remember that there are many people in Liberia who are suffering in this epidemic and others who are not receiving standard health care because clinics and hospitals have been forced to close.

"West Africa is on the verge of a humanitarian crisis, and the world needs to respond compassionately and generously," she said.

It's not clear where Sacra would be treated in the U.S. Experts say any fully-equipped hospital that follows safety protocols could prevent an American outbreak while caring for an Ebola patient. But there are four high-level isolation units designed especially to handle dreaded infectious diseases.

The largest is at the Nebraska Medical Center in Omaha, which was told to prepare to receive a patient, but they were told the same thing before Brantly and Writebol were evacuated instead to Emory University Hospital in Atlanta, medical center spokesman Taylor Wilson said Wednesday.
 The other two units are National Institutes of Health facilities in Maryland and Montana.

So to recap:

* one facility, with but a modest patient capacity, goes through "thousands" of those suits weekly
* the hospitals are out of the suits, routinely, to provide basic protection in order to limit the further spread of the disease and keep staff alive
* the staff at those hospitals are bright enough to say "F--k no!" when asked to work without the suits
* the do-gooders coming in from outside the countries affected aren't quite that bright
* some staff members, after becoming infected, are becoming Typhoid Marys and actually propagating the spread themselves by wanton indifference to reality
* patients leave before diagnosis and quarantine, guaranteeing further spread indefinitely
* there are a total of four facilities in the entire US capable of properly handling Ebola patients without spreading the disease and making it worse

Which I've far from vaguely hinted at for a few weeks now, despite the "it can't happen here" BS being spewed from the White House, CDC, WHO, and every media jackass in creation.

(BTW, nota bene that the NSC adviser for this crisis, Gayle Smith, is precisely such a medically ignorant media jackass, and Special Adviser To The President, and who has noted that contrary to the requests from actual doctors from Medicins Sans Frontieres, who've been on the scene, and requested bio-incident response teams, Ms. Smith's extensive experience from a lifetime background of journalism school, reporting from African hotels, and poverty pimping on Africa through successive Democrat administrations and multinational boards and such, has led to the recommendation that we ignore the requests of medical professionals, and not risk testing our capabilities by sending our people to the hot zone, but rather just send them more boxes of those disposable suits. Either because our precautions are suspected of being ineffective as well, or because she knows we'll be needing those teams in NYC and Atlanta all too soon, and helping to guarantee that reality by waiting to face the problem until it walks onto our own front porch.
TOP.
MEN.

(I can count on the fingers of my third hand the number of times, when some serious question arose, anyone intelligent replied, "Quick, let's get a news reporter to tell us what's really happening."
But the current administration actually puts them in charge of that. What could possibly go wrong?)

But hey, cheer up:
New numbers  are up, as of September 3rd:

3500+ cases, 1900+ deaths

Note the official transition to the "plus" sign, to scientifically indicate "we have no fucking idea anymore", along with the notably sharper-than-expected upward trend of both categories since the tally on 8/26/2014. It's transitioning from an upward curve to a more vertical spike.

If this still isn't on your dashboard of things to consider yet, the next step is when lights start flashing on the instrument panel, and strange noises and smoke begin to emanate from under the hood.

"Farewell and adieu to you fair Spanish ladies..."

Wednesday, August 20, 2014

Z

Z is for "Zebras"
which we've quite often hunted
on request of new residents
'til their ardor is blunted.

Tuesday, August 19, 2014

Y

"Y" is for Yankauer
a tool without flaw,
and the one thing we'd want
to stick into your maw.

Monday, August 18, 2014

X

"X" is for Xerox,
our favorite play,
when we copy your chart
to make you go away.

Sunday, August 17, 2014

W

"W" is for Who? What? and
When? Where? and Why?
But it can't quite encompass
why you thought you could fly.

Saturday, August 16, 2014

V

"V"'s for Vag Valley
and the pelvic beds' curse
where we feel for the patients
But so glad we're the nurse.

Friday, August 15, 2014

U

"Universal Precautions"
has become rather moot.
On reflection we'd prefer
to don a spacesuit.

Thursday, August 14, 2014

T

"T" is for Triage
where we're s'posed to sort.
If we really did that we'd
push most out the port.

Wednesday, August 13, 2014

S

"S" is for Sandwich
which we're out of, of course.
Did we mention the hospital
makes them from horse?