UO

tinyhumantoe · October 2014

Hyaline said:

tinyhumantoe said:

I actually have a UO! The Ebola situation is very, very scary. Somewhere in between the manufactured media panic, and the now "Ebola is NBD" posts that are circulating.

It is a huge deal, but not in a freak-out-in-my-daily-routine-we're-all-going-to-die kind of way. It's a virus that transfers like the flu, but has a very high fatality rate - which is absolutely terrifying. If you think 'western medical care' eliminates the fatality rate, you're wrong bro. Right now the only people that need to be taking panic-induced actions are state health officials to provide proper training to at-risk employees, proper quarantine areas, PPE, facilities with negative air pressure rooms, and proper trash decon and transport to incineration (each patient generates 40 bags of trash a day, filled with bodily fluids which are infectious). Anyway............ I digress.

To nitpick, not quite like the flu--flu can survive much longer dry surfaces, and you need direct contact with a bodily fluid to transmit ebola (suspended air particles don't count). But yeah, you can get it from someone sneezing a loogie in your mouth, so comparison is fair if imprecise

My major issue with what's going on now actually isn't about ebola--it's that if some of these snafus happened with a virus that actually DID spread quickly, we'd be effed.

I think the bloopers we're seeing with nurses getting sick and potentially contagious people allowed to fly indicate that we are really not ready for an actual disease disaster.

Ok, I read this again and I have additional comments. I think it is irresponsible to imply:

(1) that direct contact with a bodily fluid is difficult - and would require someone sneezing a loogie into your mouth, you licking someone's sweaty forehead, or drinking their urine to transfer the virus. It is simply not true. Where are people getting this information? I almost think that people trying to disseminate the unnecessary public panic caused by the media are going to do more harm than the media did in the first place!

Viruses that can be transferred by common bodily fluids (blood, urine, saliva, SWEAT, etc.), by ingestion or inhalation, directly or by mutual surface contact, are absolutely effective at infecting the population. People get viruses all the time without ever a wet sneeze to the face, a loogie in the mouth, or a major makeout session with an infected individual. I think it's HIV you mean to feel comfortable with, not Ebola. It is truly irresponsible to make people feel like they have to lick a snot rocket to contract a virus. Think of all the shit you touch all day. Why do people think ebola does not transfer via contaminated surfaces?

(2) that ebola isn't the concern here. This IS the virus that spreads quickly. With western healthcare, we're speculating a minimum 30% fatality rate with maximum care. The actions taken between now and when more people start trickling in will determine if we are effed or not.

I seriously have an equally hard time being around people who are freaking the fuck out and those who are minimizing the situation with misinformation and bogus anecdotes. The panic isn't good for anyone, but it's a serious situation. Let me put it this way........ the people who know this virus are in OH FUCK mode, and working around the clock.

Holly_1007 · October 2014

Woah THT

tinyhumantoe · October 2014

Yah, sorry. I should probably step away from the computer.

Hyaline · October 2014

tinyhumantoe said:

Hyaline said:

tinyhumantoe said:

I actually have a UO! The Ebola situation is very, very scary. Somewhere in between the manufactured media panic, and the now "Ebola is NBD" posts that are circulating.

It is a huge deal, but not in a freak-out-in-my-daily-routine-we're-all-going-to-die kind of way. It's a virus that transfers like the flu, but has a very high fatality rate - which is absolutely terrifying. If you think 'western medical care' eliminates the fatality rate, you're wrong bro. Right now the only people that need to be taking panic-induced actions are state health officials to provide proper training to at-risk employees, proper quarantine areas, PPE, facilities with negative air pressure rooms, and proper trash decon and transport to incineration (each patient generates 40 bags of trash a day, filled with bodily fluids which are infectious). Anyway............ I digress.

To nitpick, not quite like the flu--flu can survive much longer dry surfaces, and you need direct contact with a bodily fluid to transmit ebola (suspended air particles don't count). But yeah, you can get it from someone sneezing a loogie in your mouth, so comparison is fair if imprecise

My major issue with what's going on now actually isn't about ebola--it's that if some of these snafus happened with a virus that actually DID spread quickly, we'd be effed.

I think the bloopers we're seeing with nurses getting sick and potentially contagious people allowed to fly indicate that we are really not ready for an actual disease disaster.

Well, technically each individual flu strain behaves differently than each other, including surface survival time and average titre required to infect. But I stand behind my statement that this virus can behave like the flu via droplets, which can directly infect a new host or leave infectious residue on surfaces or other fomites, but there is also a high probability of viable droplet nuclei, which is why this virus should be treated like an airborne pathogen by those in contact with known or suspect cases.

The cities that don't already have centralized biocontainment laboratories outfitted for patient care are getting them now. They are completely biosealed. We've always done research with Ebola in the US (a few select BSL4 labs) and a slew of other gnarly pathogens, but a live infected patient is an entirely different situation than controlled in vivo laboratory work.

I don't have any concerns in my day to day life. I am washing my hands better and I quit biting my nails, because I was just begging for the flu with poor sanitation habits. I'm not panicked, but I am just saying that all of these articles stating that Ebola itself is not so bad are completely wrong. It is really bad. The only part I can get on board with is that there is no reason for mass panic from the public - it isn't endemic here and we have the capability to keep it that way, but Ebola itself is fucking nasty and has the potential to be really fucking nasty if precautions aren't taken. People shouldn't panic, but the state authorities should get a fucking move on some proper management facilities, PPE, and training (and they are). I don't think people understand what a hemorrhagic fever is.... it's a hazardous situation for healthcare workers. There is shit and vomit and blood everywhere. A lot more potential for droplet/droplet nuclei transfer/projection than the common flu. Wet droplets are significantly more difficult to penetrate decontaminate than dry surfaces - there are a lot of hospitals that are using the wrong disinfectants.

Just saying, technically, the CDC claims you cannot be infected from airborne droplets from sneezing, coughing, etc. They may or may not be correct, but that is the information being disseminated. You can't, per the CDC, catch Ebola from someone sneezing next to you on the train as you can with flu or cold. So the news stories using that claim as "Ebola isn't as bad as..." because it is harder to spread are not using faulty logic PER THE INFORMATION AVAILABLE.

I understand what hemorrhaegic disease is--and I know it certainly makes it quite easy to differentiate between someone with allergies and someone in the throes of Ebola. One ought to know if one is at risk (unlike bumping into Coughy McSneezeface who doesn't cover his mouth on the bus) and knowing helps immensely with containing that risk.

We are also missing a very important point that our sanitation infrastructure is far more sound than in the countries Ebola is currently at true outbreak status in. The risks to our healthcare workers working with Ebola patients are real, but we don't have raw sewage transmitting the disease door to door, either. (Launch on giant tirade that if people actually gave a shit, that might be what they'd be interested in assisting developing countries with instead of getting all OMG because there's a case or two of Ebola in the US.)

My point is that we should have plans and facilities in place even if Ebola is not a direct threat, because something, someday, most likely will be.

And damn, sorry my loogie joke was taken the wrong way. Chill a little. I'm not trying to minimize the risks, but it is NOT irresponsible to imply that for an AVERAGE person (NOT a healthcare worker), contact with the bodily fluid of an infected person is not going to be terribly easy. It's not contagious (per the CDC) during incubation. One must be exhibiting symptoms. And as you said, this is hemorrhaegic fever. It's hard to miss, especially as anyone exposed ought to know at this point.

jenndub · October 2014

Ebola scares me. So does the enterovirus and whooping cough. And after a visit with my friend's daughter at the children's hospital, I have an irrational fear that one of my kids will get cancer and die. Life got 1,000% scarier when I became a mom.

jenndub · October 2014

If you touch my newborn's face, I hate you. Especially if we just met. And especially if you invite me to your church two minutes after we met, which is one minute after you touched my new baby's face. And called her Lemon. I'm looking at you, new dance mom.

melody921 · October 2014

jenndub said:

If you touch my newborn's face, I hate you. Especially if we just met. And especially if you invite me to your church two minutes after we met, which is one minute after you touched my new baby's face. And called her Lemon. I'm looking at you, new dance mom.

OMG, I would cut her.

tinyhumantoe · October 2014

The CDC absolutely does not say that you cannot be infected by "airborne droplets," they say that the virus is not one of airborne particulate. Tricky wording there, folks.

Airborne droplets are bodily fluids that could result in "direct contact with bodily fluids," and per biosafety procedures any pathogen transmitted by general bodily fluids should be treated as an airborne particulate due to infectious airborne droplets (as documented in the BMBL, the acid test resource for the biological safety industry). There is a limited reach of airborne droplets, depending on the size, so if you're in the row behind an infected individual who happens to sneeze, your risk is extremely low.

However if that infected person right next to you sneezes and their saliva lands on your cracker, or on your tray that you later set your papercut finger on, ...or they hand their cup to pass over to the trash with their sweaty hand, or they touched your seat rest with their sneeze hand while going to their window seat......then you bite your nails, itch your eyeball, fix your contact, pick your nose, or eat some peanuts............... Whammo. Or if ol sneezehand fondles the Sky Mall catalog on the previous flight..... this virus survives on surfaces for many hours (CDC site says 7, but I was at Emory yesterday and they stated 9.5 in one trial of this actual strain). So a profusely sweaty dude who is wiping his brow the whole flight and putting his tray table up, arm rest down, etc, could contaminate the armrest or other common surfaces - door handles, doors, sink knobs that you touch after you've washed your hands, etc. We would be in big trouble if this virus gained some footing here... right now there's no need to be alarmed because it's not in the general population.

Many people have interpreted that Q&A on the CDC website to mean they won't get it from a sneezy rowmate. The probability of transfer is lower than chicken pox, which is airborne particulate and can travel 33 feet via coughs or sneezing, but droplets still do travel 3.4 feet. Could be worse, but not good. Chickenpox doesn't have a 30% fatality rate and most folks have the measles vaccination, so I would say that "non-airborne" Ebola is worse than our local airborne pathogens.

Early symptoms, which are outside of the non-contagious incubation period, are hardly noticeable. The first symptom is a mild fever, then typical flu-like symptoms that most people I know would go to work with. Later they escalate to symptoms shared with other mild diseases, and then the severe characteristics of the disease emerge. Of course someone in the later stages will look like shit and as they are on their death bed..... would only have contact their caretaker. Those in the early stages would be the danger.

p.s. people need to sneeze in to their arms, not hands, and the risk would be decreased

tinyhumantoe · October 2014

And I guess I should say that I have zero concern about any of this stuff as far as my personal safety goes as I am in my town. I'll exercise just a tad more caution with hand washing/nail biting/eating/etc. when I'm traveling by plane through an international hub because it's probably smart to do anyway. I'll be at the medical school where the deceased patient was cared for next week and I'll try not to be stupid with touching stuff and touching my mouth, but I'm not really concerned. I wouldn't be concerned if I was a resident in Dallas, I believe that infection has been contained.

So, I'm not personally afraid... but the health officials need to prepare just in case and give people on the front lines (TSA peeps, international flight attendants, and medical professionals) more training. I hope it never becomes a problem, it probably won't.

eta: clarity.

hmp1 · October 2014

I scrolled through most of the ebola talk in this thread. But now that I have 2 degree separation from people on an actual 21 day quarantine (thanks to the flying nurse) I don't side eye the doomsday hoarders as much. I thought about having more food around just in case (not worried about ebola but just in case for anything). I know I won't actually do anything though.

Hyaline · October 2014

tinyhumantoe said:

And I guess I should say that I have zero concern about any of this stuff as far as my personal safety goes as I am in my town. I'll exercise just a tad more caution with hand washing/nail biting/eating/etc. when I'm traveling by plane through an international hub because it's probably smart to do anyway. I'll be at the medical school where the deceased patient was cared for next week and I'll try not to be stupid with touching stuff and touching my mouth, but I'm not really concerned. I wouldn't be concerned if I was a resident in Dallas, I believe that infection has been contained.

So, I'm not personally afraid... but the health officials need to prepare just in case and give people on the front lines (TSA peeps, international flight attendants, and medical professionals) more training. I hope it never becomes a problem, it probably won't.

eta: clarity.

This is pretty much what I've been trying to say...

It's not a disease that should be difficult to contain. That's what the anti-doomsdayers are, to my view, trying to say. There is no reason for this disease to spread.

Hyaline · October 2014

tinyhumantoe said:

The CDC absolutely does not say that you cannot be infected by "airborne droplets," they say that the virus is not one of airborne particulate. Tricky wording there, folks.

Airborne droplets are bodily fluids that could result in "direct contact with bodily fluids," and per biosafety procedures any pathogen transmitted by general bodily fluids should be treated as an airborne particulate due to infectious airborne droplets (as documented in the BMBL, the acid test resource for the biological safety industry). There is a limited reach of airborne droplets, depending on the size, so if you're in the row behind an infected individual who happens to sneeze, your risk is extremely low.

However if that infected person right next to you sneezes and their saliva lands on your cracker, or on your tray that you later set your papercut finger on, ...or they hand their cup to pass over to the trash with their sweaty hand, or they touched your seat rest with their sneeze hand while going to their window seat......then you bite your nails, itch your eyeball, fix your contact, pick your nose, or eat some peanuts............... Whammo. Or if ol sneezehand fondles the Sky Mall catalog on the previous flight..... this virus survives on surfaces for many hours (CDC site says 7, but I was at Emory yesterday and they stated 9.5 in one trial of this actual strain). So a profusely sweaty dude who is wiping his brow the whole flight and putting his tray table up, arm rest down, etc, could contaminate the armrest or other common surfaces - door handles, doors, sink knobs that you touch after you've washed your hands, etc. We would be in big trouble if this virus gained some footing here... right now there's no need to be alarmed because it's not in the general population.

Many people have interpreted that Q&A on the CDC website to mean they won't get it from a sneezy rowmate. The probability of transfer is lower than chicken pox, which is airborne particulate and can travel 33 feet via coughs or sneezing, but droplets still do travel 3.4 feet. Could be worse, but not good. Chickenpox doesn't have a 30% fatality rate and most folks have the measles vaccination, so I would say that "non-airborne" Ebola is worse than our local airborne pathogens.

Early symptoms, which are outside of the non-contagious incubation period, are hardly noticeable. The first symptom is a mild fever, then typical flu-like symptoms that most people I know would go to work with. Later they escalate to symptoms shared with other mild diseases, and then the severe characteristics of the disease emerge. Of course someone in the later stages will look like shit and as they are on their death bed..... would only have contact their caretaker. Those in the early stages would be the danger.

p.s. people need to sneeze in to their arms, not hands, and the risk would be decreased

Yes, but AT THIS POINT anyone in contact with an infected Ebola patient KNOWS they've been in contact, so even that initial fever is something to be concerned with. As the nurse who flew knew--she checked with the CDC before flying because she knew this.

Again, because of all the knowns and the ability to control for them, this disease should not spread. It doesn't concern me like a disease that DOES spread during incubation would for that reason.

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