Dear Colleagues: Today is Sunday in the U.S. and news media and journals and magazines ‘take a break’ on Sunday. American football dominates the air time and radio time, delaying or cancelling the daily evening news shows on CBS, NBC, and ABC. Here is today’s EBOV news:
l. The Week, November 21st issue, reports on Page 11 about ‘Surviving Ebola’. Important statements include: Emory hospital overcame its EBOV-contaminated waste problem by installing an industrial-size autoclave, which uses pressure and 275 degree F. heat to sterilize any kind of material. Dr. Strada, founder of the non-profit group called Emergency says: ‘For a 100 bed EBOV hospital you need 100 nurses and 10-15 doctors.’ Dr. Paul Farmer, founder of Partners in Health, says what is needed now in West Africa to fight EBOV are the 4 ‘S’s’: Staff, stuff, space, systems. Understaffing is a great problem; only 22% of the planned 4,707 treatment center beds for EBOV have retained staffing.
2. NY Times reported at 1:16 p.m. today that the condition of Dr. Salia has been downgraded from ‘critical’ to ‘extremely critical’. The patient first experienced symptoms on November 6th so today is Day #10 of his course. Normally, adequate treatment must be delivered by Day #5 of symptoms to have a successful outcome. I could not find on-line details of his treatment in hospital in Sierra Leone prior to his air evacuation to Nebraska.
3, Reuters reports today that the U.N. has cancelled its contract with the non-EBOV treatment center named the Pasteur Clinic in Mali to treat U.N. workers. This clinic did not make the diagnosis of EBOV in the iman who later died of the disease. The clinic reports that the patient had no fever on presentation. But 12% of EBOV patients do not present with fever as a symptom. Note that the CDC report on EBOV in HCW in Liberia from June-August, 2014, found that 64% of EBOV in HCW occurred in non-EBOV treatment centers. See this CDC report at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm63e1114a3.htm?s_cid=mm63e1114a3_x