Second Texas health worker tests positive for Ebola

[Bosonic]

Source: BBC

A second health worker in the US state of Texas has tested positive for Ebola, health officials say.

Both health workers treated Liberian man Thomas Duncan, who died last week after becoming the first person diagnosed with Ebola in the US.

Meanwhile, the UN's Ebola mission chief says the world is falling behind in the race to contain the virus.

The World Health Organization (WHO) says 4,447 people have died from the outbreak, mainly in West Africa.


Read more: http://www.bbc.co.uk/news/world-us-canada-29628622

---

A second health care worker at Texas Health Presbyterian Hospital who provided care for Thomas Eric Duncan has tested positive for Ebola, the state Department of Health said Wednesday.

The worker reported a fever Tuesday and was immediately isolated, hospital spokeswoman Carrie Williams said.

The facility will now begin monitoring all those who had contact with the unidentified worker for signs of potential exposures.

The preliminary Ebola test was done late Tuesday at the state public health laboratory in Austin, and results received around midnight.

http://www.news4jax.com/health/nurses-slam-texas-hospital-for-no-ebola-plan/29135524

Source: NBC

A second Texas health care worker who provided care for Ebola victim Thomas Eric Duncan, has tested positive for the virus in preliminary check, officials said early Wednesday - the third known case of the disease in the United States.

The worker reported a fever Tuesday and was immediately isolated at the Texas Health Presbyterian Hospital in Dallas, state health officials said in a statement. Confirmatory testing will be carried out 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 Texas Department of State Health Services said. "The type of monitoring depends on the nature of their interactions and the potential they were exposed to the virus."

The worker was among those who took care of Thomas Eric Duncan, who died a week ago after he was diagnosed with Ebola earlier this month. The first Texas Health Presbyterian nurse to become infected, Nina Pham, said in a statement Tuesday that she was "doing well" and grateful for her care.

Read more: http://www.nbcnews.com/storyline/ebola-virus-outbreak/second-texas-health-care-worker-tests-positive-ebola-n226161

#BREAKING Second health worker in Texas tests positive for Ebola: state

https://twitter.com/AFP/status/522309589929574400

[Warpy]

1. so much for blaming the victim

They need to admit their protocols are piss poor.

They are going to have to upgrade things a lot to get nurses to work. That means full body covering, Clorox foot baths, decontamination showers.

The sad thing is that I'm not a bit surprised. Suits resisted isolating Duncan even when the house nursing supervisor insisted on it.

http://www.koat.com/health/nurses-texas-hospital-unprepared-for-ebola/29132612

[JI7]

3. you mean after they knew he had ebola ?

"Suits resisted isolating Duncan "

[still_one]

6. They knew he came from a region that had the outbreak, and he had a 103 degree temperature, but they

just gave him antibiotics and sent him home.

[still_one]

5. Damn right their protocols are piss poor. This was already predicted by the CDC so it should come

as no surprise, still it is quite unfortunate.

I suspect when removing the protection suits the decontamination procedures were flawed.

As you put it the "suits" sent him home leaves still a lot of uncertainty of what may come.

As far as "so much for blaming the victim", which victim are you referring to, Duncan? Duncan is partly to blame if the stories are accurate and he provided false information where he had been and who he had contact with before he boarded the airplane.

[Dustlawyer]

39. An adult with 103 fever should not be sent home, ever! That's what is wrong with society

today, that we allow this to go on. An adult with 103 fever is very very sick, whether it turns out to be Ebola or not. Why do we tolerate this?
The hospitals are supposed to be professional, whether he lied about being exposed to Ebola or not, given his fever he should have been admitted and treated to bring the fever down and an attempt to find out what was causing the fever should have been made. Given the news about Ebola in Africa and knowing he had recently come from there, they should have caught it, p,Ian and simple. Sadly, most hoitals in the U.S. would have done the same!

[still_one]

40. you are right

[Warpy]

48. Hospitals are run by people in suits, not doctors.

They go around telling nurses to do more with less while providing happy, peppy customer service (want an enema with that?) while denying that nurses are burning out in record time, having to take care of more and sicker people every single year.

Administration is getting in the way of patient care as they howl about costs.

Now their idiotic mania for cost containment is killing people.

[Warpy]

47. No, blaming the nurse for a "breach in protocol."

Every nurse out there knew that was bogus. Nurses are on the front line of dealing with every nasty, resistant bug out there and know how to use barrier protocols.

I never caught a single thing from a patient and I'm immunosuppressed. Barrier methods work for things that aren't as aggressively infectious as the Ebola virus. We likely did track MRSA out of the hospital and into the community, however, because hospitals were too cheap to provide us with shoe coverings.

Now they're too cheap to come up to African standards to protect their workers and that is not just shocking, it's fucking criminal.

Health care should never have been invaded by businessmen. It should always be run by medical professionals. Health care is one of those things that can't be done on the cheap. It has to be done right.

[Chemisse]

7. That is really shocking!

And inexcusable. A CDC team should have been there.

[still_one]

10. They are there now, but it was up to the hospital to contact them when Duncan showed up if they

suspected ebola. Based on the information the patient, Duncan gave them, and his symptoms, that should have been the red flag that put him into immediately isolation, and you are right the CDC should have been involved the moment the test confirmed positive or before. Not sure if the hospital requested it or the hospital thought they could handle it on their own

[Sunlei]

28. Mr Duncans family member contacted the Federal CDC first. The CDC sent the ambulance & contacted

the Texas hospital.

[still_one]

35. Then the hospital really screwed up

[LisaL]

49. That isn't accurate.

Duncan was in the hospital for the second time, when his relative called CDC thinking that the hospital was not doing enough.
He came on a regular ambulance.
Which is why that ambulance was put out of service 2 days after it took Mr. Duncan to the hospital.

[deutsey]

36. Pssst. Haven't you heard? "Government is the problem." St. Reagan

[nitpicker]

2. Only a headline yet

Reuters also has a banner headline.

[nitpicker]

4. CNN update atop nurse complaints

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html?hpt=hp_t1


CNN) -- [Breaking news update, posted at 4:57 a.m. ET]

A second health care worker at Texas Health Presbyterian Hospital who provided care for Thomas Eric Duncan has tested positive for Ebola, the state Department of Health said Wednesday.

(snip)
The preliminary Ebola test was done late Tuesday at the state public health laboratory in Austin, and results received around midnight.

A second test will be conducted by the Centers for Disease Control and Prevention in Atlanta.

[Last update posted at 12:30 a.m. ET]

Nurses' union slams Texas hospital for lack of Ebola protocol

(CNN) -- The Texas hospital where a nurse contracted Ebola while caring for a patient had guidelines that were "constantly changing" and didn't have protocols on how to deal with the deadly virus," a nurses' union claims.

"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," National Nurses United Executive Director RoseAnn DeMoro said Tuesday night. "We're deeply alarmed."

(snip)

[aceofblades]

16. The thing I don't understand is

As far as I know there were fairly clear protocols in place at emory, and along with the site in nebraska and they have successfully treated patients, and no health care workers have gotten sick(although the units and rooms are specially equipped as well). So there are a lot of questions here (at least from my point of view) What was the protocol communicated to Texas presbyterian by the CDC and was it sufficient? If the protocol was sufficient, was it taught properly to all of the staff? Who is legally responsible for doing this training, and Was there enough of it. The failure of 'typical' droplet and contact precautions from my experience is that there is still exposed skin. In the words of a spanish doctor, who worked in the affected African areas, in a piece on the huffington post,even a micron of exposed skin can be a problem. There is so much field information from health care staff in Africa that was not in usage in Texas apparently(for instance I was shocked that there was no apparently no buddy-system while caring for )

I think Frieden was incorrect to imply that 'any hospital' can care for an ebola patient safely. In theory that may be correct, but the fact of the matter is that ,presently, some hospitals have extra provided funding,facilities and training. That additional training and muscle memory can be extremely helpful in working with a virus that is as infectious as ebola. I'm shocked that the 1st patient hasn't been moved already. In africa, the MSF have transported and cared for many health-staff from other non-affiliated clinics if for no other reason than to spare the staff the additional burden to morale of potentially watching a former colleague die. In this case, in addition to that, there is still an investigation as to the procedures in place at the hospital, and so in my opinion it would be prudent to transport these patients as soon as possible before they deteriorate further.


As far as victim blaming, I would say this; there's nothing wrong with victim blaming if it is actually true. "To use a reducio ad-absurdum, if someone wantonly runs across a highway and is hit, there may be a fair amount of blame to be put on the victim depending on other circumstances. But the problem here is that Frieden, without additional public information ascribed it to a 'breach in protocol', while either not providing (or not knowing) what specifically caused it. i.e. bad communication from the CDC, bad implementation by the hospital, or simply mistake from inexperience.

There's a lot of rightful criticism for the CDC(their messaging has been terrible, and it is clear that they have not been well prepared in a logistics sense either) but what this also exposes is a long-time lack of coordination and communication, between the federal, state,local and hospital level(which has an independent legal responsibility for patient care and staff safety). There is a fair amount of public confusion (and perhaps private confusion) as to where responsibilities and legal obligations lay for advising, training, caring and monitoring. A hodgepodge of hospital regulations, local laws, state laws, federal laws, and constitutional powers. Regardless, my condolences to the current victims and their families, this is an awful situation.

[greymattermom]

22. Emory and Nebraska are designated BSL-4 facilities

Ebola is a BSL-4 level pathogen. There are only 4 facilities in the country where staff are trained to deal with BSL-4 pathogens.

[boomer55]

8. From the local news in Dallas

On the day that Duncan was admitted to the hospital with possible Ebola symptoms, he was "left for several hours, not in isolation, in an area where other patients were present," union co-president Deborah Burger said.

[jtuck004]

9. Given that he was left in with other patients, as well as others he may have come in contact

with, as well as others those health care workers may have come into contact with, I wonder where the next one is?

Makes ISIS, and terrorists in general, seem awfully small, next to this itty, bitty, deadly-as-hell virus.

[still_one]

12. The health care workers are at the greatest risk since they are dealing with his bodily fluids.

Patients in a waiting room are most unlikely to come in contact with his bodily fluids. The ones giving direct care to him are the most concern, as well as his family members who he came home to after he was released.

[Heywood J]

31. Then there's the small matter of pressure-washing the sidewalk...

I wonder what happened with those people.

[still_one]

34. That was at his residence after he threw up.

[xxqqqzme]

52. Pressure washed with what?

How was the washing liquid contained?



Has anyone on faux called for the Texas borders to be sealed yet?

[jtuck004]

38. I'm sure that will comfort people who are sneezed on. While those workers are at

greatest risk, it doesn't mean others are at no risk. And they are at greater risk when the information the person gives you is ignored and the person sent home with some antibiotics, typical treatment when they are black and or poor, vs people in communities where people have more money, or are white. Which then puts people who aren't health care workers at greater risk.

That racism, btw, flips that whole "who is at most risk" thing on its head. Because then we are no longer dealing with probabilities, but ineptitude sand hatred.

[WhiteAndNerdy]

11. Beat me to it!

I was just coming here to post this.

[tomm2thumbs]

13. hopefully this will create a sense of urgency on the 'best procedures' to protect healthcare workers

the costs of not doing it right are too high

'Duncan's lab samples were sent through the usual hospital tube system “without being specifically sealed and hand-delivered. The result is that the entire tube system … was potentially contaminated,” they said.'

'“There was no advanced preparedness on what to do with the patient. There was no protocol. There was no system. The nurses were asked to call the infectious disease department” if they had questions, but that department didn't have answers either, the statement said. So nurses were essentially left to figure things out on their own as they dealt with “copious amounts” of highly contagious bodily fluids from the dying Duncan while they wore gloves with no wrist tape, flimsy gowns that did not cover their necks, and no surgical booties, the statement alleged.

“Hospital officials allowed nurses who interacted with Mr. Duncan to then continue normal patient-care duties,” potentially exposing others, it said.'


http://www.latimes.com/nation/la-na-ebola-dallas-20141014-story.html


*if you can't read the story from the link, search 'Nurses at Dallas hospital describe poor safety measures with Ebola victim' in Google and click through that link to read.

[Earth_First]

17. Just absolutely asinine...

“Hospital officials allowed nurses who interacted with Mr. Duncan to then continue normal patient-care duties,” potentially exposing others, it said.' 

The medical staff that was charged with the care of Duncan should have been given strict isolation orders to handle this patient and this patient ONLY.

Not only during his care, but immediately following the 21-day incubation period.

I know that this creates a host of staffing issues in an industry that is heavily understaffed, however this is an unprecedented situation with grave consequences.

A protocol directive needs to be implemented that specifically states that any team that has access from day one is specifically charged with the SINGLE patients' care and barred from normal daily routines until an isolation period expires before returning to daily healthcare delivery routine.

Immediately.

[tomm2thumbs]

18. agreed

there needs to be much better protocols

[suffragette]

42. Agree. And I bet that "allowed" actually meant 'had to' continue working normal case load

Also, if this is an example of lack of training and provision of adequate protective equipment to medical personnel, I keep wondering about training and equipment for those who do clean up.
With the emphasis on profit and keeping wages low, they probably had minimal ,if any.

[In_The_Wind]

26. omg

The facts are shocking.

[deutsey]

37. Ebola isn't what's going to wipe us out

Greed, stupidity, and ignorance will.

[Ex Lurker]

14. I was talking to a medical person today. He was expecting this

but wasn't too worried about it as long as it stays at this level. He said the thing to watch out for is if a person presents whose contacts can't be directly traced back to someone who's been in an affected country. That would mean it's broken out into the general population. And especially watch out if it gets into a "marginal" population-homeless, street people, drug abusers, indigents-they will likely not seek immediate treatment when they start feeling poorly. Thus you'd have the scenario of people collapsing on the street and spreading it randomly. That would make it very difficult to eradicate.

[leftynyc]

27. I've been terribly worried

about undocumented workers. They don't have insurance and are already likely to live in the shadows. I'm not sure how likely it is they would head to a hospital for what's been described as flu like symptoms.

[greymattermom]

15. BSL-4

There are only 4 BSL-4 level facilities in the country, where people are trained to handle patients with a BSL-4 level virus, like Ebola. None of them are in Texas. You haven't seen staff infections from Emory or Nebraska. If that happens, the problem is super serious. in the meantime, more of these facilities need to be set up asap.

[littlemissmartypants]

19. Gee thanks, Rick Perry, Tex as.

Where are all of the "doctors" you had in the legislature last summer, when you were laying down the law on women's health and their bodies?

Science and medicine: more fun than the law, but not as safe as a pony, necessary for reality.

Your fantasy Texas may secede but not for the reasons you once thought. Good luck with that.

~ Lmsp

[Iamthetruth]

33. Really?

I can't stand Perry and his bible thumping ways but somehow you find a way to blame him for this. Sorry, my blame goes to the man that lied to get to Texas and is responsible for brining this disease to the US.

[Vinca]

20. Now can we all agree it's the protocol?????

[Recursion]

21. Why?

Not sure why we would all agree it's the protocol rather than it's underfunded hospitals trying to hire staff on the cheap.

[Vinca]

23. It's not the level of pay that's the issue, it's the steps followed . . .

especially when removing tainted protective gear. Not saying nurses aren't paid appropriately, but I doubt any of them sign up having had zero training and hoping to be infected.

[deurbano]

41. "Texas Ebola Cases Prompt CDC to Adopt Stricter Guidelines"

It seems you are right. CDC protocol is being updated, but may not go far enough. (Still not as strict as the Doctors Without Borders protocol... and that organization just had several of its own health workers infected if I am remembering correctly....)

http://www.bloomberg.com/news/2014-10-15/texas-ebola-cases-prompt-cdc-to-adopt-stricter-guidelines.html

"Texas Ebola Cases Prompt CDC to Adopt Stricter Guidelines"
By Makiko Kitamura Oct 15, 2014 5:51 AM PT

<< The spread of Ebola in a Texas hospital is exposing inadequate protection measures for nurses and doctors, spurring U.S. officials to adopt more stringent guidelines. The new advice still falls short of what the aid group with the most Ebola experience advises.

The U.S. Centers for Disease Control and Prevention yesterday disclosed measures designed to better protect health workers that more closely resemble protocol used by Doctors Without Borders on the frontlines of the outbreak in West Africa. Workers at Texas Health Presbyterian Hospital in Dallas must now wear hoods that cover their necks and wash their hands in a specific sequence when they remove protective gear, the CDC said in a statement....

...The aid group Doctors Without Borders has always required gear that doesn’t expose any area of skin as well as hand-washing in between removal of each item of protective equipment for workers dealing with Ebola patients.

Even with the recent revisions, the CDC guidelines aren’t stringent enough, according to MacIntyre.

The updated advice suggests the second glove can be removed by hooking a bare finger under it, risking contact with a potentially contaminated surface, and doesn’t mention protective boots at all, she said. Doctors Without Borders requires two pairs of gloves, while the CDC only mentions one.>>

[pnwmom]

44. The protocol allowed staff to care for both Duncan and other patients.

This never should have happened.

[LisaL]

50. And apparently staff flew all over the country.

At least one staff, who is sick with Ebola now.
Did these people understand they were not supposed to fly?

[KittyWampus]

51. You are wrong. It was the ADMISTRATORS/MANAGEMENT who allowed staff to care

for both Duncan and other patients.

[pnwmom]

60. What did I say that was wrong? The CDC allowed the hospital to develop

some of its own protocols and that's what its protocol allowed.

[harun]

43. Blaming protocol is just leaderships way of covering

Their own ass and blaming the workers.

[truebrit71]

45. ^^This^^

x100000000

[Vinca]

46. I stand corrected on my original post. After listening to more reports today,

apparently the hospital had no protocol in place. "Best health care in the world." Uh huh. My ass.

[littlemissmartypants]

53. Exactly!!! eom

[ReRe]

24. If anyone's to blame...

... look no further than the Hospital itself. Not the staff. Not the patient. Not the CDC. It's all due to the bottom line. Expenses RISE exponentially, just like the disease itself, when caring for an ebola patient. Hospitals don't like that extra cost and they make the staff cut corners and make do with what they are given to protect themselves from the virus.

It's best what the CDC says it's going to do, i.e. send special units to hospitals that are not equipped to handle this deadly communicable virus. Head-to-toe plastic bunny suits are absolutely required, as opposed to paper isolation suits that are commonly found in hospitals. Looks like Dallas IS the flash point, since now a 2nd healthcare worker has come down with a fever.

[littlemissmartypants]

54. Cost over care.

For profit hospitals, healthcare and ilk MUST END.

Outcomes are essential and empathy should be demanded when caring for the sick and disturbed.

We deserve universal health care now!

Caregivers will stand on the right side of history here, the Boardroom CEO'S are the real disease and propagating the arena of deaths.

Nurses are more valuable than scientists. They should be treated with the dignity and respect that they are required to give their patients, nothing less.

Many thanks to all of you who are caregivers. Rise Up!

Love, Peace and the Righteous Fight.

~ Lmsp 🙌

[ReRe]

55. I don't know who that Nurse was...

... who Chris Hayes just had on, but I agree with everything she said. (Find the interview at about 15-25 mins into the show if you catch the overnight repeat.) Nurses are speaking out. Loudly. Amy Goodman devoted a good bit of her show today (10-15-14) on the nurse's views.
http://www.DemocracyNow.org

[littlemissmartypants]

56. Suddenly it is relevant

To be a caregiver and to be a woman.
Some ills are spread through the stink in the aire.

Women are coming.
Quote me.
Take it to the bank.
#FJL

ReRe, I believe and you are so right. Thank you for the recommendation, love.


Peace and the Righteous Fight!
~ littlemissmartypants 🙅

[Psephos]

58. Yes, if only this had occurred in a hospital meeting VA standards of excellence. n/t

[littlemissmartypants]

59. Rapier sharp, Psephos. Indeed. nt

[Sancho]

25. Several comments...

First: Join a union! If not for the nurses union much of the conditions in this Texas hospital would be hidden. They have been saying from the beginning (before some of the secondary infections) that training and equipment was not up to par. Employers will not protect you from dangerous conditions so you have to depend on professional organizations.

Second: It seems from the ER mistakes at the beginning (antibiotics for a virus, leaving patients for hours in the lobby, record mistakes, possible discrimination for lack of insurance, no diagnosis) all indicate a hospital run for profit, not for quality.

Third: The Texas public health system is completely unprepared if you think about all the craziness over the family apartment, cops entering unprotected, no clean up, and lawyers making health decisions. Just like Florida's state government: cheap and proud of it!

Fourth: Instead of CNN giving advice and the CDC offering excuses - everyone on DU needs to call their Senator right now and demand that that a Surgeon General is confirmed NOW! Not because the SG will change the protocol, but because this is a national/international problem and it needs a single point of information and leadership to coordinate such diverse agencies as the airlines, CDC, hospitals, and politicians.

[Hubert Flottz]

29. Wasn't that the one who hung out at...

the George W Bush Library?(heard through the grapevine)

Edit * This disaster in the making, will illustrate to the evil world, that the USA is a sitting duck for a biological weapons attack. We had better get our act together and fund a better system and better research. The GOP playing politics and cutting corners, in order to continue to reward the wealthy, is the culprit, IMHO.

[cosmicone]

30. This is not a joking matter ... someone's life is at stake. n/t

[Hubert Flottz]

32. Thank you for your concern.

Better to laugh than to cry, about the bad things, over which I have no control.

[littlemissmartypants]

57. Texas Instruments has more stringent

Cleanliness requirements for the chips they manufacture than Texas has for its citizens.

Thanks, Rick Perry.

I stand with Wendy.
#FJL


🙅lmsp