PREVENTING, CONTAINING AND TREATING EBOLA
Two of the three actions in the title of this blog are indeed “rocket science”, very hard to do technically. But the third element, containing the “bug” of Ebola is NOT a medical mandate, alone, nor does it take a “rocket scientist” to figure out what to do. I would add the Federal Government and the Center for Disease Control, CDC will flop around forever trying to provide “procedures” to do so, contain Ebola once it gets “out” which has already happened in America, but not yet Joplin.
What it will take is absolutely firm and effective local leadership wherever the disease is found, period. Isolate, contain the people and materials with the disease, or even might have been infected by the disease, until it can be proven beyond a doubt they do not have the “bug” inside or “on” them, each and every one of them and everything they touch.
Doing just that, isolating and containing both people and materials that “might have” the disease of Ebola takes command and control, of people and materials. That is not a medical challenge alone. It is a challenge for leaders to command and control anyone that has come into contact with that invisible, until it is too late, disease, for now at least.
I am in no way a medical expert, a doctor or anyone that knows much at all about disease and how to prevent it or treat it. Medical experts are the only ones that can develop a vaccine or treat infected people. As well medical experts are the only ones to develop tests to find the disease in people before they present, physically, with the disease in terms of temperature, vomiting, etc. There “should be” a blood test or “something” to detect the presence of Ebola in a body or on an object, before the bad stuff starts presenting. But that seems to take time as well to develop such tests. Go to work CDC and do that if you please.
So why do I try to write with any confidence on containing a “bug”? I submit that I did exactly that for 35 years, rather intensely. Except containing bad stuff and resolving issues when it was accidently released to the public environment was limited to radioactive materials, not “bugs”. But believe you me the risk to the public of release of radioactive material can approach the dangers of releasing Ebola into America, which has now happened.
As a nuclear trained naval officer and later an executive in charge of a very large and dangerous radioactive facility, I ran countless “drills”, table top exercises, manned up emergency action centers, even coordinated things with local police and fire fighters and hospitals during simulated accidents. Thankfully I never had to do it “for real” as I never was around a major nuclear release. But if such had happened, I was trained myself and trained many others to deal with it, correctly.
If someone gets a microscopic “bug”, Ebola, inside themselves today they are likely to die so far. Get an invisible and very hard to detect microgram of plutonium in your lungs and you are likely to die, in about 25 years from lung cancer. So containing just plutonium, all 57 tons of it in nuclear materials and facilities was very much part of my job a few years ago. And I did that in the same way I would do it if I heard of an Ebola case in Freeman Hospital, if I was in a position of leadership in Joplin, government leadership, like a Mayor or City Manager. A rapid and effective response to contain further spread of the disease outside of that hospital would be MY job, at least in my mind. And I would not bother calling the CDC to ask how to do that and wait for an answer!!
I offer just two examples, both of which require the same action in terms of containment.
Say a large truck carrying highly dangerous “plutonium” crashes on I44, in Joplin. OR a stranger is walking down I44, sick as a dog, vomiting, etc. Both “accidents” MUST be contained, right where they are found, immediately and effectively with NO mistakes allowed, period. I only address “the man” one individual found that might have the disease of Ebola from here on in.
“Wrap him up”, completely by emergency responders arriving on the scene. Rubber sheets, poly bags over his arms and legs, blankets, anything available to prevent the further spread of the virus, possible spread of the virus. Be conservative to be safe. Isolate that area around him, make it a big area to be safe and do not allow ANYONE to enter that area, no mistakes, after initial emergency responders arrive to care for the man. And of course they must be assumed to be fully contaminated as well, whether they are or not to be determined elsewhere and much later. Contain such responders at the scene until……
Transport the man to a local medical facility, one ready to receive an Ebola patient. Do we have ANY such facilities right now in Joplin, a hospital ready and willing to receive an Ebola patient? If not, why not and it is something to do now to be ready, if…… Or we can wait to actually find an Ebola infected person and then call for help from the CDC, right?
The ambulance and medical responders transporting the man to the medical facility must also be assumed to be contaminated with the “bug” until PROVEN otherwise. Same applies to every nurse, hospital worker or doctor that comes anywhere close to that man. Any material, stretchers, rags, towels, rubber sheets, etc. must also be treated as very deadly stuff, period.
Where does one throw away a dirty towel, today in Joplin that might have Ebola on it? Once that waste is thrown into a “can” a properly labeled and sealed “can” how is that “can” disposed and where and when? If those answers are not clear right now, well should they be well understood, by every emergency responder or health care worker or ambulance attendant or citizen trying to “help” a very sick man, NOW, not just when it happens?
Of course when one sick man with a life threatening disease arrives accidentally in Joplin care MUST be provided in such an emergency. Of course such care should only be provided by trained and responsible personnel as well. Training however is only half the demand. Responsibility, at the individual level, is an absolute MUST, when dealing with “bugs or plutonium”. Not only must one be trained to put on the right protection, they must actually do exactly that, every time they don the hazmat suits, every time, no mistakes allow or ……. They must all take off such suits in a highly controlled manner and dispose of the waste strictly and very carefully, all of it.
That my readers is very hard to do for anyone, do everything right as if your life depends on it. In the case of Ebola or “plutonium” such is exactly the case and everyone involved, tired, overworked, or not, must do so, all the time, or …… Now go train everyone to do that, all the time. Impossible I say.
So independent monitoring, people that sit back and watch, people that KNOW what to do but only observe others doing it are very important to such emergencies. And they must have the authority to STOP potentially unsafe actions WHEN they happen, not hours after a torn glove is found and everyone says “opps”.
Now do you understand why I consider such emergency actions to first be a matter of command and control? Sure training helps but I submit that if a given emergency responder in Joplin today knows how to respond and contain a radioactive spill on I44 they can effectively respond, in an emergency, to that sick man proposed herein. A firefighter with a mask and full fire protection clothing will be as safe dealing with Ebola, for a while, as he would be responding to a radioactive spill. Sure extract measures once the emergency is contained would be required for Ebola, medical measures, but that is not the initial need to respond to the first emergency.
One last point for this situation, a person is found in Joplin with Ebola. This is where command and control of the finest sort, and toughest sort I would add, is critical and potentially highly unpopular. People would be outraged to do what I suggest.
Anyone within “breathing” distance or certainly anyone that comes into contact with an Ebola patient without full and effective protective clothing, must be medially isolated and contained , period until it is PROVEN they do not have the disease. No contact with anyone other than trained and protected medical personnel for as long as it takes to PROVE they are not sick with Ebola. Just how do we do that, Mr. CDC? You should be the expert to offer such advice. Wait at least 21 days, in isolation, is all I know to do, for now, to be SURE and thus safe.
Every emergency responder initially arriving on the scene without full hazmat protection must be so isolated. Every ambulance and people in every ambulance must be isolated. Every nurse, health care provider, doctor, citizen sitting in an emergency room, etc. that comes within such “distance” of an Ebola patient must be isolated, for as long as it takes, period. Unprotected trash haulers, etc. fall into that category as well, and the people operating the incinerator, etc., or God forbid the trash dump!!!
As for traveling, going home to family, going shopping, are you kidding me. Would you do THAT, to your family, other travelers, or the general public with which you mixed, until you were sure, no guessing allowed, that you were not contaminated?
Sure that is very conservative, inconvenient, makes people mad, etc. But I assert it is the only way to be safe, as anyone can be safe so far, from further spread of a very deadly and not yet well understood disease.
Can you imagine a public figure, a mayor or city manager or even hospital president ORDERING such actions? I can’t yet. But by God if I was “in charge” that is exactly what I would so “order” and put cops on the street to ensure compliance, total compliance, mobs in protest be damned in such a case.
Will our President so order, or our Governor, or the Director of the CDC? Not a chance or a snowballs chance in hell. Is such command and control needed however, for now, with Ebola? I’ll let you decide.
As for our current emergency responders, hospitals, even schools, are they now ready and willing to do what it takes IF Ebola shows up in Joplin, an unlikely but possible event. I submit they will not be so ready, today, unless they at least consider what I have written herein and then do as they deem best after being exposed at least to what I think must be done, if……
Everyone in America wants to be safe from Ebola. But is everyone in America ready and willing to do what it takes to achieve such safety? Asking, demanding just the government fix it won’t work, now that the stuff is here, which should not have happened in the first place but is now beside the point.