generalspeaking

Mea Culpa

"[Mr. Duncan] met several of the criteria of the Ebola algorithm."
"We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry. Despite our best intentions, and a highly skilled medical team, we made mistakes."
Dr. Daniel Varga, chief clinical officer, Texas state health resources

"People's lives are at stake and the response so far has been unacceptable. People are scared. We need all hands on deck. We need a strategy."
"None of us can understand how a nurse who treated an Ebola-infected patient, and who herself had developed a fever, was permitted to board a commercial airline and fly across the country."
American Congressman Fred Upton, Congressional hearing

"We remain confident that Ebola is not a significant public health threat to the United States. We know Ebola can be stopped with rapid diagnosis, appropriate triage and meticulous infection-control practices in American hospitals."
Dr. Thomas Frieden, director, Centers for Disease Control and Prevention

"I can no longer defend my hospital at all. I'm embarrassed for my hospital. I watched them violate basic principles of nursing care, of medical care." 
"Our infectious disease department was contacted to ask 'What is our protocol?' And their answer was, 'We don't know'."
"There were no special precautions, no special gear. We did not know what to do with his lab specimens."
"I threw a fit. I couldn't believe in the second week of an Ebola crisis the only gear they were offering us allowed our necks to be uncovered."
"There was no one to pick up the garbage for two days. It was literally piled to the ceiling. The garbage room was full."
Briana Aguirre, nurse, Texas Health Presbyterian Hospital

A general view of Texas Health Presbyterian Hospital is seen where Ebola patient Thomas Eric Duncan is said to have died on October 8, 2014 in Dallas, Texas. The patient who had traveled from Liberia to Dallas 10 days ago was the first person Ebola that had been diagnosed outside of West Africa. (Joe Raedle/Getty Images)

While the United States rode to the rescue, along with other nations' health authorities, responding to the plight of the three West African countries most heavily impacted with the onset and growing threat of the Ebola virus with the message coming through of American competence and the huge unlikelihood of Western countries having at any time any difficulty suppressing the spread of such a virus given their hygiene practices and modern technology, all of a sudden Ebola is grinning its deaths-head from a Texas hospital.

Greater routine hygiene and access to all the benefits of modern medical technology aside, a litany of failures went to demonstrate how ignorance and unpreparedness has an international mien. When Liberian Thomas Duncan first appeared at the emergency ward of Texas Health Presbyterian Hospital on October 8 only to be turned away and told to rest and given antibiotics, that was the first blip in the system. And there were more, much more, telling a tale of profound ineptness and medically unsound practise, to come.

That first no-clue inkling could be swept under the carpet of never-happened at the time. Not so when two nurses at the hospital who had helped in his eventual care, Nina Pham and Amber Vinson contracted the virus with its deadly 80% mortality rate. With the added news that Miss Vinson had been given permission by CDC officials to board a commercial flight despite an elevated temperature, and while in the incubation period that required sequestration, public anxiety and White House fury was raised to an incandescent level.

When one of the Texas hospital's nurses tearfully spoke before the Congressional committee conducting hearings into the state of Ebola preparedness or lack of, in the United States, her testimony was shocking in its revelations of slovenly medical procedure. She incredulously described "chaos" at the hospital treating Mr. Duncan, staff completely ignorant of how they might go about conducting themselves in view of the diagnosis of Ebola.

The hazmat suits issued had large neck gaps, even while materials used in the treatment of Ebola patients were left to moulder in hospital corridors for days at a time shedding still-viable contagion. Suspected Ebola patients were wheeled about the hospital with no care to protection while doctors were informed it was perfectly acceptable to move from room to room without disinfecting. On Mr. Duncan's arrival in an ambulance he was placed in an area with other patients.

The nurse who was tasked to look after Mr. Duncan was simultaneously looking after three other patients. So much for undivided attention and scrupulous care not to re-infect. Three hours elapsed before the CDC was contacted. When her friend and colleague Ms. Pham became ill, Ms. Aguirre was tasked with treating her. She was informed by hospital officials to fix the gap between the hazmat suit given her and her neck with the use of tape.

In its defence the Texas hospital said: "The assertions do not reflect actual facts learned from the medical record and interactions with clinical caregivers. Our hospital followed the CDC guidelines and sought additional guidance and clarity."

If so, and if it can thus be proven to be so, Ms. Aguirre could be offered a consulting job with a horror production agency.

Labels: Disease, Medicine, United States

posted by Pieface @ Saturday, October 18, 2014