Thoughts on Ebola

Working at the hospital and on the ambulance, it has been heavy duty Ebola lately. Memos, flyers, posters, policies, and lots of questions. I have written power points, given talks and had many conversations on Ebola. Every day I read the CDC site for updates, which are numerous. I have even, along with two of my daughters, played an Ebola patient in a hospital drill.

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Ebola hasn’t been with us long, but already I am hearing a lot of people have Ebola fatigue. While the actual number of cases in the US is likely to remain small – at least in the near term — I don’t think we have heard anywhere near the last of Ebola.

Ebola is like a serial killer assassin who we believe is coming here to do some killing. We are not certain his target, but we believe, based on his rap sheet, he will most likely come after health care workers. We have set up roadblocks at airports, the most likely place Ebola is going to enter the country. We are quarantining people who are coming in from West Africa. In some states like Connecticut, we are quarantining people even if they are symptom-free, just to make certain Ebola is not hiding out in them. And, thankfully, we are hopefully training all of our responders in the proper use of PPE, and letting them practice in case Ebola shows up in our town and we show up on his scene.

Ebola is a tricky microbe. While he has us all busy up here in the US of A battening down the hatches to keep us all safe, he is doing his really nasty work down in West Africa. We can take all the safeguards we want up here, but unless we can stop Ebola in West Africa, we are going to be dealing with Ebola for a long time. Sure we can limit his damage and contain him in each isolated case that comes to America, but there will be more and more cases here unless we kick his ass in Africa and drive him back into the bats in the jungle from which he likely came.

Think about this. With, at the time only 2,000 cases of Ebola in West Africa, Ebola sent two exports out -— one to Spain and one to Texas. (Imagine if the guy in Texas went to a bar instead of a hospital, and there he got drunk, vomited, stumbled, hit his head, died and then someone lifted his wallet before calling EMS). The cases are increasing exponentially in Africa. People are dying in the streets and in crowded apartments. There are not nearly enough isolation centers to contain all the patients. The CDC has predicted there could be 1.4 million cases by January. 1.4 million. Wow. That’s some heavy duty suffering. And for those who care only about this country, how many of those cases will be exported here? Imagine even if they don’t get to the US right away, what if they get to India or China, countries that may not be able to contain Ebola like we can? More cases, more exports here. More chance we are in his reach. Millions dead and Worldwide Ebola’s red laser on our foreheads the next time we walk into an unknown.

Those of you who have seen the movie World War Z may recall a scene where Brad Pitt and his family are eating breakfast in their home while on the small TV Zombies are eating everyone in sight. Think Ebola. I say load up the transport planes with building materials, IV fluids and PPE gear. Recruit doctors and nurses and paramedics and EMTs and send them in with combat pay. Here’s a real chance to be a hero, to make a difference. You can go from being Meat in the Seat up here to Ebola Killer. You think you’re an inner-city bad ass with a bullet-proof vest and an ET tube? Imagine yourself with a blue hood and cape on the continent where we all came from. Fighting for the future of civilization. Beat Ebola down in his own hood.

Isolate those with symptoms, give them the best care and most compassion we can, and trace their contacts. Isolate, treat, and trace on and on until there are no new cases – at least until the next time Ebola spills over from the jungle to people. Just as Ebola did last December to a 2 year old village boy. One two year old boy in December. 10,000 Ebola cases today. 10,000 is no easy task, but if we don’t act now, there will be 100,000, then a million. The math won’t be working in our favor.

Tired of asking patients if they have traveled to West Africa? What question will be asking a year from now? It depends on how and where we respond today.

5 Comments

  • tom combs says:

    Best effort is to quarantine/contain in W. Africa. Flight restrict all wanting to leave until 21 day safe or otherwise proven to be zero risk. It’s in everyone’s best interest. Here is a radio interview I gave 10/13. Unfortunately the situation is essentially unchanged.
    Thanks and be safe! I appreciate what you do.
    http://www.rmapublicity.com/images/stories/Audio/Nerve%20Damage%20-%20Wall%20Street%20Journal%20Tji%20Morning%20-%20October%2013,%202014.mp3

    • Kent says:

      We are only talking about one airline and two weekly flights to Monrovia and Senagal because the plane lands in Dakkar. I can tell as I have been in both of these airports that prior to entry your temp is taken and a chlorine hand wash is required, this is also repeated before boarding. Again look at the flu death numbers in the US alone, why do we not quaranteen flu patients? The US is home to one a the greatest flu pandemics in history where millions died

  • RJ in florida says:

    this appears to becomming political. The lack of an african quarantine is because if the government orders it, the airlines can go back to the government for lost revinue when its over. If they do it on their own its a business descision and have to eat the loss. The appomtment of a non doctor as the emola czar is a mistake. There need to be a better preperation for the people who will be encountering the victims FIRST meaning EMS. We are getting some training but it appears that the hospitals are getting the lion share

  • Kent says:

    Every year 37000 people in the US die of the flu, for which we have a vaccine and OTC meds. 10000 Ebola cases and we loose our minds…why? Is this the CNN effect, whipping up hysteria ? Why do we not sequestering those with the flu? Quarantine is not the answer for non symptomatic people , they are not even a patient, early treatment is the key, as I write this I am on the front line in Monrovia, talks with other health care workers echo the same feelings… Don’t turn your back and abandon us because of fear anf hysteria

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