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re: Serious Ebola Transmission Question for OT Medical Experts

Posted on 10/3/14 at 5:53 pm to
Posted by Hopeful Doc
Member since Sep 2010
15004 posts
Posted on 10/3/14 at 5:53 pm to
quote:

If American bat species were to come into contact with Ebola, and if a particular American bat species were to become a carrier, that would be the worse scenario for the Western Hemisphere...right?



Bat bites are fairly rare in the US. It wouldn't be all that bad.

quote:

If or when that happens, there would be no stopping the occasional Ebola flair up in the US. Our new way of life would be to live with Ebola, much like we have come to live with the AIDS crisis.



Let's assume that it does become rampant with an epidemic that lasts 6 months. Local authorities and national government will step in and control the bat population and possibly quarantines on the cities involved. Further, the more people that get the virus, the more survivors, and the more of a chance to study the virus and come up with an attempt at vaccination.


Two very similar diseases have carriers in the US and, before modern medicine and widespread transfer of disease, were highly fatal and simply rampant. They were malaria- essentially eradicated in the US despite having the proper carrier mosquito still present in much of the South, and the Flu, which thanks to modern droplet precautions, vaccination, and novel antivirals is not nearly as frequently the cause of death of people in the US as it used to be.


quote:

If I'm right, why the hell is the US taking unnecessary risks in bringing Ebola patients to this country?


Bringing patients in an isolation plane in an isolation suit to an isolation ward doesn't pose a risk to the US native bat population becoming carriers of the disease. Person to person spread is the big fear. It's also not going to happen, given the restrictions at the facilities taking care of these patients.

quote:

Why can't we setup a temporary isolation and care unit in Africa that is up to American standards?

To ask this is to misunderstand how much better care, hospitals, staff, and medicines in the USA are. We can't build a world-class hospital there, staff it, and transport competent nurses and doctors trained to monitor ICU patients. That's not feasible for an outbreak period. It's a potential long-term goal, given that the majority of pandemics arise from places with poor medical care, but Africa is a very large continent, and to assume that a single major center staffed there would do any good is probably naive. A temporary hospital like you're mentioning fails to realize that the centers in the US that have accepted Ebola patients have wards literally built to stop airborn (not that this is airborn) spread of wildly contagious diseases quite safely and easily. They're so far beyond anything that could be built in short time, given unlimited money, over there that it's not even a short-term consideration.

That aside, the main thing these patients would be offered is 1:1 nursing care, central lines, aggresive IV fluids, possibly steroids, likely pressors. The equipment and the "know how" just aren't available widely in places over there. The WHO and Doctors Without Borders, and to some extent medical missionaries, essentially all live by the motto of "do more with less" and aren't prepared to deliver such a high level of care.


Lastly, and this is meant in no way to be condescending,- I mention that because tone is impossible to convey in black and white- these people know a lot more about medicine, infectious disease, and epi/pandemics than you or the average Joe Blow. Let's trust our highly educated medical community for OK'ing the treatment of these people. It would be highly unethical for them to pose a threat to Global or National Health, and they don't feel they're doing so. And if you're in the crowd that is distrusting of the ethical mindset of groups like the CDC and the Infectious Disease department at Emory (who brought the doctor and nurse volunteers back to the country a few weeks/months back), remember how bad this would look if it backfired. They're not taking a risk they don't assume/believe is very safe. The backlash would be people calling for their heads.
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