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What did the cdc director wore versus what he recommended be worn by workers...

Posted on 10/17/14 at 11:27 am
Posted by thetempleowl
dallas, tx
Member since Jul 2008
14811 posts
Posted on 10/17/14 at 11:27 am
This is director of cdc and his protective gear getting disinfected...



This is MSF disinfection and seeing their PPE...



This is cdc recommendation...



I want every paper to freaking carry this. I want the presby administrators who actually agreed to these recommendations to be ridiculed.

Lets actually put all of them who put our healthcare workers in harms way on a plane to liberia where they can treat ebola patients in the PPE they recommended.

This would be comical if it wasn't true.
Posted by Vegas Bengal
Member since Feb 2008
26344 posts
Posted on 10/17/14 at 11:29 am to
You're linking general PPE instructions for infectious diseases on how to put the PPE on properly, not what the recommendations are for Ebola.

That's here:

quote:

The U.S. Centers for Disease Control and Prevention recommends health care workers treating Ebola patients adhere to the agency's Recommended Standard, Contact and Droplet Precautions, he explained. This ensemble includes two layers of gloves, a liquid-impervious surgical gown and boots, hair covering, mask and face shield. In most instances, the CDC recommends health care workers replace the basic surgical mask with a more protective N95 particulate respirator. This disposable filter forms a tight-fitting shield over the nose and mouth, and screens out 95 percent of airborne pathogen particles that are greater than 0.3 microns in size.
Posted by TK421
Baton Rouge
Member since Oct 2011
10411 posts
Posted on 10/17/14 at 11:29 am to
quote:

I want the presby administrators who actually agreed to these recommendations to be ridiculed.


I don't think criticism of the hospital administrators is warranted at this point. The CDC exists to assist hospitals in these cases and they had no reason to doubt the recommendations given to them.
Posted by Meauxjeaux
98836 posts including my alters
Member since Jun 2005
39856 posts
Posted on 10/17/14 at 11:30 am to
quote:

cdc director


Always good at the top.
Posted by Vegas Bengal
Member since Feb 2008
26344 posts
Posted on 10/17/14 at 11:31 am to
Read your own link. It says the type of PPE will vary and the procedure may vary based on the type of PPE.
Posted by thetempleowl
dallas, tx
Member since Jul 2008
14811 posts
Posted on 10/17/14 at 11:38 am to
quote:

The U.S. Centers for Disease Control and Prevention recommends health care workers treating Ebola patients adhere to the agency's Recommended Standard, Contact and Droplet Precautions, he explained. This ensemble includes two layers of gloves, a liquid-impervious surgical gown and boots, hair covering, mask and face shield. In most instances, the CDC recommends health care workers replace the basic surgical mask with a more protective N95 particulate respirator. This disposable filter forms a tight-fitting shield over the nose and mouth, and screens out 95 percent of airborne pathogen particles that are greater than 0.3 microns in size.


The devil is in the details.

They are saying exposed skin is ok. You wear hair covering, face shield and gown. What you need is gown, boots, gloves, n95, and hood.

That hood and goggles are the important thing.

That hood not being needed to be worn allows active virus to sit on you a while where it is infectious.

When dealing with a ebola patient when he is most infectious, this is what is needed.

When taking care of someone who is asymptomatic and not shedding much then perhaps you could get by with the cdcs recs.

This really is stupid VB. Look at what he wore and read what is recommended.

The hood makes a huge difference.

Posted by Vegas Bengal
Member since Feb 2008
26344 posts
Posted on 10/17/14 at 11:46 am to
You're saying what it says. It says boots, liquid impervious boots and gown, respirator, hair covering, two level gloves. It says face covering in addition to the mask and you have the respirator. Read.

If any skin is exposed it's no more harmful for transmission than the PPE because if it's transferred one way it can be transferred the other (meaning someone touching a droplet and then his/her eye or mouth) it won't penetrate the slight bit of neck that may be exposed.

If it will sit on your skin it will sit on whatever PPE you're wearing.

The cartoon is NOT what they recommend. Read your own link. That's the procedure to out on PPE. Not a specific PPE
This post was edited on 10/17/14 at 11:52 am
Posted by thetempleowl
dallas, tx
Member since Jul 2008
14811 posts
Posted on 10/17/14 at 12:15 pm to
quote:

You're saying what it says. It says boots, liquid impervious boots and gown, respirator, hair covering, two level gloves. It says face covering in addition to the mask and you have the respirator. Read.

If any skin is exposed it's no more harmful for transmission than the PPE because if it's transferred one way it can be transferred the other (meaning someone touching a droplet and then his/her eye or mouth) it won't penetrate the slight bit of neck that may be exposed.

If it will sit on your skin it will sit on whatever PPE you're wearing.

The cartoon is NOT what they recommend. Read your own link. That's the procedure to out on PPE. Not a specific PPE



Jesus you are dense.

I know it won't penetrate the skin. But the virus will still be active on the skin.

And that is correct, if will also sit on PPE that you are wearing.

Of course.

That is what I am saying and I hate to say idiot, but idiot.

You take off your PPE and the virus goes with it.

You have exposed neck, and get viral particles on it, you take off ppe, and you still have active viral particles. You go off and do your thing. Fifteen minutes later, you rub your neck and then rub your face and bam, you are infected.

And this is a deadly virus. This is not something to be fooling around with.

Do you see how freaking MSF deals with this thing? Do you see exposed neck? Everything that can get covered with viral particles is covered. Everything is sprayed with chlorinated spray to inactivate virus.

That is a huge thing and that is my freaking point. Stop harping on the freaking picture. Add a freaking hair thing and you have their recommendation leaving lots of skin exposed.

And I am sorry, that virus is active and can be carried. You actually don't need to immerse your head in vomit to catch it. You get coughed on and it gets on your exposed neck. You take off your PPE, hair gear, gloves and follow everything well. You walk around for a few minutes rub your neck. You walk a bit and then your eye gets itchy and you rub your eye. Do you see the problem?

Do you know what the CDC says?

Ebola can remain active for up to six days under perfect conditions.

Normally it is probably a couple of hours.

Do, you get saliva on your neck when close when patient coughs, that stuff will remain active for a couple of hours.

That means that person is now infectious for a couple of hours. He or she walks out and someone gives them a neck rub because they were stressed and bam, them could get it.

Do you know how often you touch your face a day without knowing it?

Please, please, please read what I am saying and understand. I understand that the freaking picture is not exactly what they recommended, but it really is very freaking close.

And the exposed skin thing which you gloss over is freaking huge. Do you see what people who actually deal with the virus are wearing and doing? They deal with it on a daily basis.

The deal simply is this. If it was the flu, sure. Chances are you will be fine. You don't want to get sick, but its not that big of a deal.

Ebola is a big deal.

Posted by thetempleowl
dallas, tx
Member since Jul 2008
14811 posts
Posted on 10/17/14 at 12:32 pm to
By the way...

quote:

"There is concern among health care providers about whether or not this particular ensemble is sufficient in protecting them against Ebola exposure," said Reilly as he demonstrated the "donning and doffing" procedures for standard PPE with his colleague, Jared Shapiro. "One of the limitations is some skin exposure -- back of his neck, collar of his shirt, hair -- potential routes of splash or inadvertent aerosolization of infectious material could come in contact with him."

This is why Ebola clinics in West Africa and high-containment medical facilities such as Emory University Hospital in Atlanta -- where two American missionaries were successfully treated for Ebola and where Texas nurse Amber Vinson was transferred on Thursday -- have opted for what Reilly calls "enhanced precautions for high-risk health care workers."


That is the magical difference. No skin exposed.
Posted by Homesick Tiger
Greenbrier, AR
Member since Nov 2006
54202 posts
Posted on 10/17/14 at 12:54 pm to
quote:

But the virus will still be active on the skin.


And one cracked fingernail cuticle would be all it takes.

If I'm wrong someone please explain why it wouldn't.
Posted by WeeWee
Member since Aug 2012
40090 posts
Posted on 10/17/14 at 12:58 pm to
quote:

And one cracked fingernail cuticle would be all it takes.


it would take more than a cracked finger nail cuticle but an open cut like a paper cut that drew blood maybe
Posted by Homesick Tiger
Greenbrier, AR
Member since Nov 2006
54202 posts
Posted on 10/17/14 at 1:01 pm to
quote:

it would take more than a cracked finger nail cuticle


Proof or opinion? I'm looking at two right now that are fresh and red. You really don't think that is not an active wound?
Posted by CptBengal
BR Baby
Member since Dec 2007
71661 posts
Posted on 10/17/14 at 1:03 pm to
quote:

it would take more than a cracked finger nail cuticle but an open cut like a paper cut that drew blood maybe



you can inhale aerosolized particles and become infected - CIDRAP
Posted by WeeWee
Member since Aug 2012
40090 posts
Posted on 10/17/14 at 1:43 pm to
quote:

you can inhale aerosolized particles and become infected - CIDRAP


from your article in the last thread.
quote:

here is also some experimental evidence that Ebola and other filoviruses can be transmitted by the aerosol route. Jaax et al24 reported the unexpected death of two rhesus monkeys housed approximately 3 meters from monkeys infected with Ebola virus, concluding that respiratory or eye exposure to aerosols was the only possible explanation.

quote:

Zaire Ebola viruses have also been transmitted in the absence of direct contact among pigs25 and from pigs to non-human primates,26 which experienced lung involvement in infection. Persons with no known direct contact with Ebola virus disease patients or their bodily fluids have become infected.12

quote:

Direct injection and exposure via a skin break or mucous membranes are the most efficient ways for Ebola to transmit. It may be that inhalation is a less efficient route of transmission for Ebola and other filoviruses, as lung involvement has not been reported in all non-human primate studies of Ebola aerosol infectivity.27 However, the respiratory and gastrointestinal systems are not complete barriers to Ebola virus. Experimental studies have demonstrated that it is possible to infect non-human primates and other mammals with filovirus aerosols.25

okay that was from a 1996 study. Here is a 2012 study
quote:

Here we show ZEBOV transmission from pigs to cynomolgus macaques without direct contact. Interestingly, transmission between macaques in similar housing conditions was never observed.

quote:

We have also never observed transmission of EBOV from infected to naive macaques, including in an experiment employing the same cage setting as in the current study, where three NHPs intramuscularly inoculated with EBOV did not transmit the virus to one naive NHP for 28 days, the duration of the protocol.

quote:

During another study, three EBOV infected NHPs cohabiting with 10 naive NHPs in adjacent cage systems did not transmit the virus to naive animals for 28 days

quote:

t is of interest, that the first macaques to become infected were housed in cages located directly within the main airflow to the air exhaust system. The experimental setting of the present study could not quantify the relative contribution of aerosol, small and large droplets in the air, and droplets landing inside the NHP cages (fomites) to EBOV transmission between pigs and macaques. These parameters will need to be investigated using an experimental approach specifically designed to address this question.

quote:

The present study provides evidence that infected pigs can efficiently transmit ZEBOV to NHPs in conditions resembling farm setting.

LINK
The study I cited used the study that the article that you cited as a reference and further classified that aerosol transmission was not seen from NHP to NHP but was seen from pig to NHP. It is also a mute point because what the CIDRAP recommended in your article in the other thread as VB and I pointed out the CDC as changed the recommendations this week and according to CIDRAP TPH used that kind of respirator.
Posted by WeeWee
Member since Aug 2012
40090 posts
Posted on 10/17/14 at 1:45 pm to
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