UKC

This ebola scare is getting rather scary.
http://www.huffingtonpost.co.uk/2014/10/06/ebola-uk-outbreak-_n_5937682.htm...

In reply to The Lemming:



No it isn't. If you want something to worry about, try flu.

In reply to Jonny2vests:

yeah. Flu is always lurking there like a serial killer in a badly fitting straightjacket - you never know when it's going to work loose

In reply to The Lemming:

I'm not scared. From what I can gather of the illness, there is little to be scared of. You can only catch it from people who clearly have it and if they do have it, not being around them is a good way not to get it.

Unlike flu, where it is contagious amongst people who are yet to display symptoms.

In reply to The Lemming: There's much worse than that coming!

http://www.buzzfeed.com/alanwhite/relax-this-isnt-a-real-daily-mail-front-p...

In reply to The Lemming:

Interesting article with the guy who discovered it here - http://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-outbrea...

He is more worried about it getting loose in India than Europe.

"But an outbreak in Europe or North America would quickly be brought under control. I am more worried about the many people from India who work in trade or industry in west Africa. It would only take one of them to become infected, travel to India to visit relatives during the virus's incubation period, and then, once he becomes sick, go to a public hospital there. Doctors and nurses in India, too, often don't wear protective gloves. They would immediately become infected and spread the virus."

In reply to The Lemming:

It will be here almost certainly, and guess where? Says the person who works in a SE London hospital.

Nevertheless, it's not a very infectious virus, and if it's clamped down on then it won't get a hold. One potential problem is if communities try to look after infected people at home and only go to hospital at the last minute, at which point it will probably spread through that community (the infectious stage is when patients are bleeding and vomiting). Isolated incidents we can cope with, there's two category 4 beds here in London. Once more than 2 people are infected the infection control gets slightly harder.

In reply to climbwhenready:
it'd be really scary if it were to mutate and spread like the flu.

where is the dustin hoffman then!

In reply to The Lemming:
I agree it is getting scary, there is a theory (as i understand it) that diseases generally become slightly less lethal and more transmissable as they adapt to a new host (us). The epidemic doesn't seem to be quite playing out as predicted by experts, may be due to demographic changes in africa, transmission to spanish nurse is worrying, less developed countries will suffer horribly if this runs

In reply to climbwhenready:

Isolated incidents we can cope with, there's two category 4 beds here in London. Once more than 2 people are infected the infection control gets slightly harder.

The NHS is awful with simple stuff like isolating MRSA patients, today and not 5 years ago, so how is it going to cope with Ebola when it hits our shores?

In reply to The Lemming:

I heard the head of the European Centre for Disease Control & Prevention this morning on R4 Today. I wasn't at all convinced by his statement that he was 'sure that the outbreak won't spread in Europe'. It seemed to me to be a rather misguided faith in the ability of 'western health services' to deal with cases appropriately (we have a huge 2 cat 4 beds in London? whoopdedoo). Despite the clear evidence that that isn't true (the Spanish case).

I shudder when I think how many people I meet in a day. And how many they go on to meet. And I don't have to travel very far to work and back. Imagine having to try to track down all such contacts...

Case numbers doubling every three weeks, and a 40% mortality is not good. Not good at all.

The news all seems rather Biblical at the moment. Pestilence & War, anyone?

In reply to ByEek:
Is it not like many other viral infections, such as Mumps, which is pretty easy to catch? I recently caught that off someone who was feeling somewhat unwell, but had not developed symptoms, simply by shaking hands. Mumps also has an incubation period of about 20 days.

In reply to captain paranoia:


I heard the interview and thought the same. Hope the experts are right!

In reply to captain paranoia:

He's not likely to tell everyone to shit their pants tho is he.... Honestly is probably not the best policy when it comes to Ebola in my opinion

In reply to The Lemming:

I'm about as scared of ebola as I was of SARS and bird flu.

In reply to climbwhenready:


that's me steering clear of Stafford on a Saturday night then

>Isolated incidents we can cope with, there's two category 4 beds here in London. Once more than 2 people are infected the infection control gets slightly harder.

especially given austerity cut backs

In reply to The Lemming:


But MRSA is harder because for most people its asymptomatic, and lots of people have it.

The infectious stages of Ebola are dramatic, and good hygiene will markedly reduce the risk of infection.

In reply to John Stainforth:


No. It's tempting to think of viral infections as like mumps, or chickenpox, or flu, but infectivity varies. Think of Hep C or HIV - actually quite hard to catch.

In this epidemic epola is turning out to be about 6 times less infectious than flu, or 3 times less infectious than mumps. Also, importantly, when people are infectious they are highly symptomatic and are not highly infectious during the incubation stages.

In reply to climbwhenready:


There only needs to be 4 beds, mainly because in the UK infections like this are rare. But I can guarantee that if the sh1t were to hit the fan, whole wards of special units would materialise out of no where. I am sure there are whole armies of contingency planners in the NHS who have considered this.

In reply to The Lemming:

You're out of date.

"Based on results from a selection of hospitals across England, the report indicates that there have been large reductions in both MRSA and C. difficile rates since the last survey was conducted in 2006. C. difficile infections fell from 2% of patients becoming infected in 2006 to 0.4% in the 2012 report. MRSA fell even more sharply, from 1.8% of patients affected to less than 0.1%."

The NHS has learnt how to manage basic infection control issues precisely because of things like MRSA and C Dificile and these diseases are significantly harder to control than Ebola.

Fundamentally, the Huffington Post is talking about one case appearing (a la Texas) appearing in the UK, not an actual outbreak.

Having seen India's hospitals, the article linked above makes a fair point, an outbreak there would be disastrous.

In reply to ByEek:

What about staff? If you join the army, the possibility of getting killed or injured is what you sign up for. Medical staff in general don't expect this as part of their jobs. As demonstrated in Spain, however, treating Ebola patients is highly risky and may result in dying. Will there be sufficient staff willing to risk their lives to control an outbreak?

In reply to ByEek:
I am sure there are whole armies of contingency planners in the NHS who have considered this.

I suspect so, I think we've also got a fair few other hospitals that can provide a high degree of isolation suitable for dealing with cases like ebola; I'm pretty sure Southampton General has expertise in dealing with highly infectious patients and that is before you look at facilities like Porton Down.

It is also worth noting that while we may not have a huge number of high isolation beds we do have a lot of companies that manufacture the equipment required to build them. I was looking at buying a flexible isolator fairly recently and you can get hold of customised enclosures pretty quickly.

In reply to Reach>Talent:

yeah some of the inflatable stuff - derby door etc, is pretty cool.

In reply to MG:
As demonstrated in Spain, however, treating Ebola patients is highly risky and may result in dying. Will there be sufficient staff willing to risk their lives to control an outbreak?

Without knowing the details of the Spanish case I can't comment on specifics but dealing with highly infectious diseases and dangerous substances isn't actually that difficult: You have procedures and you follow them obsessively. While handling a live patient is obviously more difficult than handling small samples in a lab the basic principles are the same. A properly set up isolation unit should be a very safe place, I've spent many happy hours working in environments where a thin bit of plastic separated me form a rather unpleasant demise. Treating people with HIV/AIDS may result in you dying, working on an emergency response team may result in you dying but following procedures carefully means the rate of occupational deaths are very low.

In reply to Reach>Talent:

I think what would happen is people would make "Ebola containment" solutions that are cheaper and easier to install than full Cat 4 stuff. Since it doesn't spread by aerosol (we think) a full negative pressure system is probably overkill.

I think the Royal Free have the only Cat 4 beds in the country, I don't think there's any at Southampton - that said, most generals should be able to find a way to cope. There's also a story in the papers this morning that equipment will be distributed from the Royal Free to key hospitals in the event of them getting an Ebola-infected patient.

In reply to Reach>Talent:


It'd be interesting to know if any breach of procedure is identified in the Spanish case - that seems by far the most likely cause of the infection.

In reply to Carolyn:

Like most situations it depends how well the personnel are trained and how motivated / tired they are. Sweating your nuts off in CBRN gear for hours and your buddy doesn't notice you raise your hand or your arm to wipe sweat from your eye as you disrobe. Easy to under stand how it happens as the 10% fatality demographic of african medical staff working with Ebola attests. You think NHS staff are drilled in this stuff to he hazmat ninjas, think again.

D

In reply to Dauphin:




I totally agree NHS Health Workers of all grades are woefully poor at even the simple stuff like hand hygiene let alone anything a little more serious.

In reply to The Lemming:
Where is your evidence for this bold claim, as I cited above, MRSA rates in NHS hospitals in England and Wales have dropped from from 1.8% (2006) of patients affected to less than 0.1% (2012).

Given that, unlike Ebola, MRSA can spread (a) when the patient is asymptomatic (b) is harder to kill than Ebola when outside the body and (c) is an airborne pathogen I think this points to rather good infection control in the NHS.

In reply to climbwhenready:

Thank for enlightening me. I am pretty ignorant about medical things.

In reply to The Lemming:

Maybe somebody could develop an App to stop it's spread.

In reply to The Pylon King:

Revised estimated ETA weeks/days rather than months?

D

In reply to Dauphin:

That was going to be the title of the OP but people would have accused me of scare mongering.

In reply to Dauphin:


Revised on what basis?

Of course it could already be here but if you're alluding to the airport screening that's little more than theatrical arse covering, being seen to be doing something so blame can be deflected later.

jk

In reply to Jonny2vests:

I understand the virus is more fragile and not as easily transmitted than flu, nonetheless it has infected healthcare workers in first world countries despite full PPE, and has a much higher mortality rate. Western governments have been way, way too complacent about this.

In reply to The Lemming:

The upcoming zombie apocalypse beckons does anyone have a AK47 and a shed load of 7.62 for sale?

In reply to Phoebus:



I understand he works in the NHS, something to do with ambulances.

In reply to Dauphin:



I suppose the fear of catching it might help to keep people focussed?

Nobody on here really knows...

In reply to Timmd:

If this is meant to a refutation of my point (by way of strengthening his) then it's a fallacy to refer to someone's standing as a proxy for a good argument.

Also, so? If I want to know about the spread of a disease I'll ask a epidemiologist, of if I want to know about the performance of the NHS, a statistician, not a clinician.

Of course, if you're just mentioning this in passing then ignore me entirely.

In reply to Murko Fuzz:


Yes but look at the numbers dying and that are likely to die compared to flu or many other diseases like Malaria. It's a zit on a mosquitoes little toe.

In reply to Jonny2vests:

I don't think we can be quite so complacent yet. Although the numbers infected so far are trivial compared with flu and malaria, the numbers globally are showing an exponential growth, which means that the disease is not yet under control. Of course, and hopefully, that could change in the next few weeks.

In reply to John Stainforth:

There does seem a lot of complacency about this. I see now a third western health worker is infected, which suggest it is rather harder to prevent infection than we have been led to believe.

I suppose a good plague would solve the house price problem.

In reply to Phoebus:


I was. ()

In reply to MG:

seemingly all the Western infections have been due to protocol lapses. I was chatting to a high level Spanish doctor who advises government (its part of my job) and he was saying that the healthworker that got infected in Spain was because they were not properly trained up and made an error leading to them being exposed.

In reply to lynda:


That's no doubt true, but given the cases in Spain and the US it would suggest that the protocols aren't particularly robust at present. All industries love to present lovingly crafted protocols to their various regulatory bodies, but these are often poorly implemented at a working level, as that's the difficult and unglamorous bit that managers don't like to be involved in.

In reply to Ridge:

agreed. I think the protocols are robust, but are not necessarily followed to the letter. But it can be changed through education (and bashing heads against a brick wall) as proven in the UK where MRSA cases in hospitals have reduced significantly by actually getting health workers to wash their hands.

In reply to lynda:

It seems a bit odd that healthworkers treating the first case of Ebola in their country would not be trained and/or follow any protocol to the letter ?

In reply to Jim Hamilton:
More details coming from Texas suggest the whole things was handled poorly with little preparation and amply scope for infection. I can't see that hospital (or the Spanish one) are atypical. It looks like we can expect at least one infection per infection with current methods assuming staff continue to be willing to come close to Ebola patients. All a bit concerning.

In reply to Jim Hamilton:

unfortunately it's not that odd at all.

In reply to The Lemming:

I thought it had already arrived!
http://www.bbc.co.uk/news/health-29045908

In reply to John Simpson:

A collection of poor quality vinyl albums does the trick, so I am told

In reply to Jim Hamilton:

There has been aletter sent to all the NHS Trusts with guidance on exactly how staff should put on and off their PPE along with a lot of detail on how clinical waste which may be contaminated with the Ebola virus should be handled.

I guess it's up to the indivudual trusts to make sure this is escalated to all staff and up to staff to read and follow it.....

In reply to Uluru:

A letter means sweet f.a.

It requires planning ,resouces, education, training, drills. Its not SARS ffs, its a level four pathogen with the potential to cause Armageddon. Let's get this right. Or not.

D

In reply to lynda:


How long has that taken? 15-20 years, threats of punitive action to trusts that don't comply and I'm guessing plenty of massaging of stats.

MRSA hardly significant at all outside specific healthcare circumstances. Guidelines for isolation change and are broken all the time - net effect close to zero.

D

In reply to Dauphin:
Obama cacking himself in the press conference being shown on the BBC. Anyone care to guess why the CDC evac crew taking the nurse to a tooled up and prepared biological containment facility are all biohazard suited up yet their advice on front line health worker PPE didn't stand first contact?

D

In reply to Dauphin:

The letter specifies that all training drills etc will be carried out. Also all LRF's are to carry out traiing and exercising. It's up to people whether they follow it or not.

By the way I don't work for for these organisations so am not defending them just pointing out facts

In reply to Uluru:


I have to take issue with 'it's up to people whether they follow it or not '.

It's up to the Trust or whatever to ensure that appropriate training, provision of equipment, reinforcement (i.e. Bollocking/sacking if needed) and constant revision of the protocols are carried out.

Not the standard pretty PowerPoint presentation to the exec and much self congratulation by management. (Followed a few months later by a press conference where the phrases 'transparency' and 'lessons will be learned' are repeated like a mantra)...