Dear Colleagues: Here is the latest news from the U.S. newspapers, media, lay current affairs and science magazines and NEJM and PLoS journals, as of 8:30 pm, St. Louis time:
1. The Baltimore Sun reports that the 2 men hospitalized in Washington, D.C. yesterday do not have EBOV. One man has malaria; the other man’s illness is undisclosed.
2. The NY Times reports that Texas Presbyterian Hospital in Dallas has retracted some information given to the news media yesterday re: why the EBOV patient was discharged from their ER two days prior to hospitalization. Specifically, the hospital’s EMR was not to blame; physicians and nurses do share the same EMR.
One suggestion to avoid this preventable error in the future is to program immediate pages to ER physicians and Infection Control when certain words (say ‘Liberia’ or ‘Africa’) are entered into the EMR. (A similar system is used in Radiology at the VAH in Tampa, FL; certain words in a voice-recognition dictation system automatically page the attending physician.)
3. The NY Times reports that the U.S. does not intend to limit flights from Western Africa to the U.S. I believe this is short-sighted; a single EBOV viral particle can produce infection; RT-PCR is positive 20 hours prior to symptoms.
4. The NY Times reports that Dr. Khan did not receive ZMapp; this was the decision of the physicians caring for Dr. Khan. He died shortly thereafter. Physicians were worried about the repercussions in country of Dr. Khan’s death if they did give him ZMapp prior to his passing. The two ZMapp doses were given later to two American workers for Samaritan’s Purse
I have suggested to ‘Contact The White House’ that several immediate actions be taken. At the top of my list are: appoint a military commander as Surgeon General to take command of the public heath response to EBOV in the U.S.; ‘No landing, No docking’ federal order for planes/ships carrying passengers/crew with travel to West Africa within 21 days of flight/voyage to U.S.; daily Presidential/Surgeon General briefing to U.S. public on EBOV situation in U.S.