Evening Ebola Update Tues 10/14: Standardize HCW PPEs/10,000 cases/wk by Dec./? Length of incub.   Leave a comment

10/14/14

Dear Colleagues:

1.  NY Times reports that the Sudanese lab technician, Mr. Basheer, who became infected with EBOV in West Africa and was flown to a Leipzig hospital for treatment, has died.  Mr. Basheer was in charge of waste disposal at his treatment center.  His own waste products are being disinfected by a ‘machine’ and then incinerated in Leipzig.

2.  NY Times reports that 16 EBOV patients have/are being treated outside of West Africa.  Six patients have recovered; 6 patients are being treated; 4 patients have died.

3.  NY Times reports that Dr. Bruce Aylvard, assistant DG of WHO, said today there will be 10,000 new cases of EBOV per week by December.  Currently, there are 1000 new cases of EBOV per week.  We are entering the steep portion of the exponential spread of EBOV curve.

4.  PLoS Current Outbreaks published a new article today by C. Hass, Ph.D., Professor of Environmental Engineering at Drexel University, which questions 21 days as the upper limit of the EBOV incubation period.  Prof. Haas reports that the WHO Response Team’s determination of 21 days is at the 95th percentile of the incubation range.  So that 2-12% of EBOV patients could exceed that incubation period.  See: http://currents.plos.org/outbreaks/article/on-the-quarantine-period-for-ebola-virus/ for the entire article on the incubation period for EBOV.

5. Dr. Fauci and Dr. Collins at CDC and NIH issued an update today on the status of testing of vaccines for safety and activity against EBOV.  See: http://directorsblog.nih.gov/2014/10/14/nih-ebola-update-working-toward-treatments-and-vaccines/

6.  I emailed Secretary Burwell at HHS to recommend she advise the President to mandate standardized PPEs for health care workers involved in treatment of EBOV patients.  Dr. Atul Gawande has shown the benefits of ‘checklists’ in preventing peri-operative and post-operative surgical infections.  Standardized is another word for checklists.  I recommended Alpha Pro Tech full body suits and MaxAir 800 Series PAPRs, which were used at Emory University by Dr. Ribner’s team to protect HCW from EBOV infection.

7.  If you are interested in learning more about why human errors are made in crisis situations, I recommend a seminal article by Dr. Richard Gunderman titled ‘Why Planes Crash: Lessons for Radiology’, which is mandatory reading at Wharton School of Business.  See: https://col128.mail.live.com/?page=Compose&cmid=mgJkk1pQlU5BGVydidZ19Fxg2&cacc=3 for the Abstract of this article.

Corrections:  In last evening’s blog I spelled Prof. Racaniello’s name incorrectly, and I gave the impression that his blogs are from PLoS.  That is not true; both his blogs are entirely his own.

RGL, MD

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Posted October 15, 2014 by levittrg in Ebola

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