The New York Times reported: “The Ebola outbreak in West Africa is so out of control that governments there have revived a disease-fighting tactic not used in nearly a century: the “cordon sanitaire,” in which a line is drawn around the infected area and no one is allowed out.
Cordons, common in the medieval era of the Black Death, have not been seen since the border between Poland and Russia was closed in 1918 to stop typhus from spreading west. They have the potential to become brutal and inhumane. Centuries ago, in their most extreme form, everyone within the boundaries was left to die or survive, until the outbreak ended.
New Jersey Spotlight reported: “Worldwide alarm over the West African Ebola virus outbreak has highlighted the fact that such infectious diseases are spreading due to increased travel.
And that globalization of viruses has led New Jersey health officials to take precautions against tropical diseases, including testing for a pair of mosquito-borne viruses.
They’re also alerting healthcare providers to the symptoms of Ebola, which led to one state resident being isolated for part of last week until it was determined that the person wasn’t exposed to Ebola.
The New York Times reported: “Erica J. Sison has dealt with sick and dead dogs and cats, 40 dead lab rats in bags, trophy animals, cooked monkey meat on sticks, human skulls from Indonesia and a live Asian bat that flew out of an airplane cargo hold.
Now she is poised for Ebola, and has seen three false alarms in the last two weeks.
Ms. Sison, the quarantine officer in charge at Newark Liberty International Airport, is on the front lines of a complex system developed to protect United States borders from a “Contagion”-like invasion of rare foreign diseases. It is, she says, a bit anxiety provoking.
“We use a scoring system that predicts the likelihood of survival,” said Dr. Hassan Khouli, chief of the critical care section and chair of the ethics committee at Mount Sinai Roosevelt in New York City. Khouli serves on the state’s task force that is updating the guideline to include children. “The ethical principle driving this is to save the most lives.”
“Faster care hasn’t cut heart attack deaths in hospitals.”
A USA Today article noted “The Medicare metric for timely heart attack treatment is … “door-to-balloon” time — the time between when a heart attack patient arrives in the ER and when the balloon angiography begins — researchers found that the percentage of heart attack patients who die while in the hospital, about 5%, hasn’t changed.”
“Irreversible damage from a heart attack can begin in 30 minutes. Most tissue death occurs in the first two to three hours…” “A new study suggests that speeding up hospital care isn’t enough to save lives … A better predictor of survival might be ‘symptom to balloon time’…”
Personally I want to have an ongoing relationship with a primary care physician. I want a physician who knows me!
A New York Times article focused on the rapid growth “walk-in” clinics, often open 24/7, staffed by either a physician or nurse practitioner.
A recent Time article noted: “…National Institutes of Health immunologist Dr. Anthony Fauci told CBS This Morning that his research team is working on a vaccine to prevent Ebola, which is completely effective in monkeys, and will be tested in humans in September. And he’s not the only one developing a treatment for the deadly disease. The question is: Should experimental treatments be rushed into practice, given the breadth of this outbreak?”
A New York Daily News article noted: “In the age of modern medicine, scientists are feverishly working to find a cure for the deadly Ebola virus, which can kill up to 90% of those it infects. But the disease is a tricky one, able to outsmart its host and entrench itself quickly.”
“When you’re infected with a virus, your cells sense the presence of an infection and respond by making a variety of proteins designed to stop the virus from replicating,” said Dr. Christopher Basler, a microbiology professor at Icahn School of Medicine at Mount Sinai. “Ebola has mechanisms that disable these innate immune responses.”
A CBS News story noted: “A manual published in 2007 by the CDC, “Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings,” outlines protocols that should be adhered when caring for patients with Ebola.”
“The report recommends health care workers wear single gloves for routine care and double gloves during surgery and other invasive procedures that could potentially pose risk for blood exposure. It’s also highly recommended that anyone in contact with an Ebola patient wears eye protection, such as goggles or a face shield, since the disease is easily contracted with fluid contact to the mucous membrane such as the tissue of the eyes. Additionally, health care workers should wear fluid-resistant gowns.”
Are physicians practicing defensive medicine or are we demanding unnecessary test?
The CBS News report noted “Among the reasons these tests are not recommended is that they can often find some abnormality, which although benign, could lead to further unnecessary tests and treatment…” “In 1 to 3 percent of people you will find something on the MRI, whether it be a tumor or blood vessel malformation. You don’t want to find something you weren’t looking for. It can be anxiety provoking…”