Ebola and fragility

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Chad
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Re: Ebola and fragility

Post by Chad »

jennypenny wrote:
I don't know whether to laugh or cry at these pictures.
How can you be that stupid?

jacob
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Re: Ebola and fragility

Post by jacob »

Zero Hedge is definitely the place to be if you want the latest in US ebola. I dug into that powerwasher story a bit. It just may have been that the powerwashing was done AFTER the CDC cleaned the vomit up. I find it more disturbing that the CDC actually couldn't get in to clean it up before acquiring the proper local permits(*). That the apartment wasn't cleaned up until today. That a quarantine was "broken" because the monitees didn't have food: "well, I guess you can go and buy some then", said the authorities. That the hospital didn't have a proper way of disposing of the mountains of biohazardous thrash isolation generates [in these days of disposable everything]. Apparently it was stockpiled locally until it could be boiled at the local CDC building.

As for rolling up the sleeves on a hazmat suit... All the techmology in the world and all the 30 minute webinars followed by a 10 question multiple choice on whether or not to eat the yellow snow won't make up for the lack of brains or experience. You can find pictures from West Africa too where medical personal aren't wearing gloves or masks. In this case it just might be because they don't have any.

(*) Just how many cell phone zombies walked through that pile of vomit before it was cleaned up?

So lets just say that things aren't running smoothly just yet. More interestingly, now every instance of early symptoms combined with international travel is treated seriously. Flu season is coming up. I wonder which insurance will be billed for a full stay in the isolation ward. Knowing that I wonder how many people will go if they know they're risking a serious case of drive-by-doctoring.

In other news, I saw the first person wearing a surgical mask on the subway today.

theanimal
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Re: Ebola and fragility

Post by theanimal »

So what's the best strategy to prepare, right now, for a worst case scenario? Stock up on extra water, food and sanitation supplies (masks, gloves etc.)?

jacob
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Re: Ebola and fragility

Post by jacob »

@theanimal - Don't get sneezed on. Wash you hands a lot---whenever you touch something that has been touched by others. Don't touch your face!! (Stay away from people) In case a quarantine is enacted (unlikely) be sure that you can at least adhere to it longer than your neighbor.

For a worst case scenario (unlikely), get as far away from interacting with other people [and the things they touch] as possible.

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jennypenny
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Re: Ebola and fragility

Post by jennypenny »

@theanimal--Always wear glasses (I use sunglasses) to remind yourself not to touch your eyes. As soon as it's cold enough, wear gloves and get a balaclava that can hide a mask underneath it or use a scarf. I always read a book or magazine while I'm standing in public places as a kind of shield for my face (I bring my own--don't touch public magazines). Avoid touching as much as possible with bare hands including doorknobs, railings, elevator buttons, etc., even carry your own pen so you don't have to touch someone else's. Keep wounds covered. Don't bring anything into your house without spraying it with disinfectant first. Wash your hands as soon as you get home. Take off your shoes and wear slippers inside. Leave coats and such in one place, and don't take anything you carry around outside of the house into your bedroom or kitchen. Don't sit on your bed in clothing you've worn outside.

Pronoid
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Re: Ebola and fragility

Post by Pronoid »

I live in a tiny studio apartment right outside NYC. All the precautions listed would be extremely difficult to follow all the time. I'm counting on being that random guy who happens to be immune to it like Matt Damon from the movie Contagion. I take Vit C and Zinc everyday to help not get sick in general. Better double the dose to be safe :D

theanimal
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Re: Ebola and fragility

Post by theanimal »

Jacob and Jennypenny- Thanks

My biggest concern right now is that my dad works in Dallas 2-3 days every week. So he is flying in and out, staying in a hotel etc. I've tried to talk to him about not going there for a while but that's unlikely to happen since he's unconcerned since there's only one documented case and he's the CEO. I don't live with him but usually see him every couple weeks. Another issue is that one of my brothers is in high school, so if it arrives it could spread quickly.

I think if it ends up coming to the Chicago area, I'll head up to northern Wisconsin for a while.

Edit: Wow, the planes that Duncan was on are still being/have been used. It seems like there is a lot of oversight and a general lackadaisical attitude with this issue so far in the US. http://abc7chicago.com/news/united-plan ... th/333049/

Riggerjack
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Re: Ebola and fragility

Post by Riggerjack »

So, lemme get this straight. Duncan went to the ER, with Ebola symptoms, and was sent home, and the 18 people being monitored include kids and paramedics.

Um, what about the ER patients and staff from the first visit!?! Hello, symptomatic, and in public closed spaces!

And this is why I avoid news.

susswein
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Re: Ebola and fragility

Post by susswein »

Assuming your house/apartment has it's own water heater, water is probably the LEAST useful item to stock up on in your emergency supplies. Water heater tanks typically hold 40-80 gallons of water which can easily be accessed in an emergency. Yes, the water that initially comes out via the drain spigot at the bottom will look rusty and gross, but it's totally potable.

prosaic
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Re: Ebola and fragility

Post by prosaic »

Toilet tank is good for a few gallons, too.

Also, make sure any hand sanitizer you buy and use is 70% alcohol or higher. Most commercial brands are 63%.

Have a well-stocked first aid kit, because we still have injuries and falls and whatnot at home, even in self-imposed quarantine. Anything that helps prevent a trip to an ER is crucial.

Chad
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Re: Ebola and fragility

Post by Chad »

Just keep a couple bottles of grain alcohol handy. Way higher than 70%. Plus, if it's the end of the world you can have one last party.

workathome
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Re: Ebola and fragility

Post by workathome »

I only drink 200 proof.

jacob
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Re: Ebola and fragility

Post by jacob »

http://online.wsj.com/articles/spain-st ... 1412678870

Spain joins the club after a nurse contracts the disease from a patient.

"She then took time off to take an exam, with the aim of upgrading her temporary contract to a permanent one, but followed the required precautions as soon as she noticed a mild fever, her colleagues said. She checked in with medical staff at a different Madrid hospital but was sent home because her fever didn’t exceed 101.48 degrees Fahrenheit, the temperature that would set in motion the protocol to test for Ebola, said Elvira González, head of Spain’s Nursing Aides Union.

The infected worker then checked in with her primary health care physician, who gave her Paracetamol, a common pain reliever, to treat her fever. Then she summoned an ambulance to her home, but her fever still wasn’t high enough. “She went to these health professionals basically giving them a pre-diagnosis,” and alerting them that she had worked with an Ebola patient, Ms. González said.

She also had spots on her skin, Ms. González said. A rash is a symptom of Ebola, according to the WHO.

As the fever persisted, her colleagues said, the infected woman started sleeping in a separate bedroom and using a different bathroom from those of her husband. She was finally hospitalized and tested after her fever spiked."

Substituting "procedures" for critical thinking or even plain thinking seems to be the primary problem with first world health care systems where apparently no action will be taken without Form 27b-6. There's a little too much faith that "we're invincible due to our advanced techmology and 'first class' hospitals". Ironically, the first point of failure in this case was a substandard hazmat suit.

Spartan_Warrior
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Re: Ebola and fragility

Post by Spartan_Warrior »

Substituting "procedures" for critical thinking or even plain thinking seems to be the primary problem with first world health care systems where apparently no action will be taken without Form 27b-6. There's a little too much faith that "we're invincible due to our advanced techmology and 'first class' hospitals".
Yeah, I must admit, although I am in favor of the U.S. moving toward more nationalized health care, this is one aspect that worries me. Not that our system is much better, obviously, but bureaucracies LIVE to substitute critical thinking with procedures and forms.

(I hope this doesn't start a political tangent. I'm just saying.)

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Re: Ebola and fragility

Post by jacob »

I think we've just demonstrated (with one data point in each place) that both "advanced" systems are equally incompetent when it comes to diagnosis, relying on procedures rather than [not even] uncommon sense. Hopefully, these first failures will be relatively cheap "tuition".

Chad
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Re: Ebola and fragility

Post by Chad »

jacob wrote: Substituting "procedures" for critical thinking or even plain thinking seems to be the primary problem with first world health care systems where apparently no action will be taken without Form 27b-6. There's a little too much faith that "we're invincible due to our advanced techmology and 'first class' hospitals". Ironically, the first point of failure in this case was a substandard hazmat suit.
I would bet they didn't even follow procedure.

http://www.amazon.com/Checklist-Manifes ... +checklist

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Re: Ebola and fragility

Post by jacob »

Yes and NO! Problems appear when checklists substitute for insight. In this case the patient was sent home because her temperature wasn't high enough despite showing all the other symptoms. This is a case of a "decision tree" going wrong. Checklists are good for predictable systems like launching aircrafts. Not good for things like diseases.

A good way to think about these failures is in terms of type I and type II failures. Type I is "finding ebola when there isn't ebola". Avoiding those is the overly cautious approach. Type II is "not finding ebola when the is in fact ebola". Avoiding those is the overly pessimistic approach.

In this case avoiding Type II errors seems to override avoiding Type I. Unfortunately this requires people [at all levels] to think independently rather than follow procedures. This is probably too much to ask...

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Ego
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Re: Ebola and fragility

Post by Ego »

............

Chad
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Re: Ebola and fragility

Post by Chad »

jacob wrote:Yes and NO! Problems appear when checklists substitute for insight. In this case the patient was sent home because her temperature wasn't high enough despite showing all the other symptoms. This is a case of a "decision tree" going wrong. Checklists are good for predictable systems like launching aircrafts. Not good for things like diseases.

A good way to think about these failures is in terms of type I and type II failures. Type I is "finding ebola when there isn't ebola". Avoiding those is the overly cautious approach. Type II is "not finding ebola when the is in fact ebola". Avoiding those is the overly pessimistic approach.

In this case avoiding Type II errors seems to override avoiding Type I. Unfortunately this requires people [at all levels] to think independently rather than follow procedures. This is probably too much to ask...
I think you are asking too much of most people. They just aren't able to do this. Checklists are necessary even if they fail some times. The difficult part is having checklists, while still allowing independent thought.

Maybe if we changed our education system there would be more people capable of independent thought. Though, I think most jobs would have to be re-imagined too, as many times the drudgery of the job kills the independent thought.

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jennypenny
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Re: Ebola and fragility

Post by jennypenny »

jacob wrote:I think we've just demonstrated (with one data point in each place) that both "advanced" systems are equally incompetent when it comes to diagnosis, relying on procedures rather than [not even] uncommon sense. Hopefully, these first failures will be relatively cheap "tuition".
The constant counterargument to a large ebola outbreak is our "advanced health care system." Yes, we do a better job with quarantine and a much better job with treating symptoms to avoid secondary problems. OTOH, there is currently no way to prevent or treat or inoculate against ebola. When it comes to ebola, we're not 'advanced' at all.

Chad wrote:Maybe if we changed our education system there would be more people capable of independent thought.
What we should change is "health" education. The bulk of it is sex education, which has its place, but should be taught along with healthier lifestyle choices and preventing non-STD infectious diseases since they are the biggest cause of death and disability. It's kinda sad that most kids know more about preventing herpes than they do about preventing staph infections or type II diabetes.

Despite how advanced our system is and how predictable the annual flu season is, 30-40K people still die in the US every year from complications related to influenza. That's approximately the same number of deaths as from breast cancer, yet which gets more public attention? More people die from MRSA and related staph infections than from AIDS in the US each year, but how many people are educated in preventing MRSA infections compared with preventing HIV infections?


I'm not saying we should reduce education efforts for breast cancer and HIV/AIDS prevention. I'm just pointing out that our advanced health care system is only selectively 'advanced' and health education is uneven and woefully inadequate.

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