pubhealth
pubhealth:

Ebola in the U.S.—Politics and Public Health Don’t Mix
By Judy Stone
“Against stupidity, even the gods strive in vain.” — Fredirich Schiller
I’ve been glued to the Ebola news, riding the roller coaster of emotions. While  very impressed with CDC’s director, Dr. Tom Frieden’s, initial press conference (10/2/14), I became infuriated at the subsequent statements from Lisa Monaco, Homeland Security Advisor, and the tragicomedy of the Dallas hospital’s farcical response, prompting this post.
Dr. Frieden was calm, reassuring and authoritative in handling this CDC press conference. He conveyed the critical messages well, “Remember, Ebola does not spread from someone who is not infectious. It does not spread from someone who doesn’t have fever and other symptoms. It’s only someone who is sick with Ebola who can spread the disease.” And he was candid: “It is certainly possible that someone who had contact with this individual, a family member or other individual could develop Ebola in the coming weeks. But there is no doubt in my mind that we will stop it here.” He emphasized basic, proven public health strategies of careful infection control, contact tracing, and isolation.
In contrast, although she acknowledged the possibility of a secondary case, Ms. Monaco appeared less credible as she stated, “I want to emphasize that the United States is prepared to deal with this crisis both at home and in the region. Every Ebola outbreak over the past 40 years has been stopped. We know how to do this and we will do it again.”
While I agree that we have the knowledge, experience, and resources to be able to control Ebola, most of the experts are academicians or practice in relatively well-heeled ivory towers. I have practiced Infectious Diseases and Infection Control for 30+ years, primarily in a number of community hospitals, and offer a different perspective here, based on these experiences.
Administrators vs. Practitioners
Increasingly, decision makers are administrators who are disconnected from the realities of patient care. The latest fad, for example is to design hospitals to look like hotels and be “inviting” to patients, although they are very dysfunctional for delivering patient care, especially problematic in ICUs.
Similarly, when “bioterrorism preparedness” first became the rage, our hospital and health department focused on high tech units and hazmat suits while ignoring basic hygiene. I went ballistic, given that there was no soap nor any paper towels in the public school bathrooms, something the county health commissioner said was “not within their purview.” Gotta have priorities, right?
It is not all that different now. One hospital I am familiar with has Powered Air Purifying respirators (PAPRs), purchased with bioterrorism preparedness grants, but neither stethoscopes nor other dedicated equipment for isolation rooms. So nurses and docs gown up to go in the room of a patient with a “superbug” but take their stethoscopes into the room and then on to other patients, perhaps remembering to wipe it down first.
The problems with controlling Ebola cases in the United States is not that we can’t care for people well, or with good infection control. We absolutely can. But the Dallas case abundantly illustrates some of the problems in caring for anyone with a communicable illness, whether a antibiotic resistant organism (aka “superbug) like carbapenem resistant enterobacter (CRE), measles or Ebola.
(More from Scientific American)

pubhealth:

Ebola in the U.S.—Politics and Public Health Don’t Mix

By Judy Stone

“Against stupidity, even the gods strive in vain.” — Fredirich Schiller

I’ve been glued to the Ebola news, riding the roller coaster of emotions. While  very impressed with CDC’s director, Dr. Tom Frieden’s, initial press conference (10/2/14), I became infuriated at the subsequent statements from Lisa Monaco, Homeland Security Advisor, and the tragicomedy of the Dallas hospital’s farcical response, prompting this post.

Dr. Frieden was calm, reassuring and authoritative in handling this CDC press conference. He conveyed the critical messages well, “Remember, Ebola does not spread from someone who is not infectious. It does not spread from someone who doesn’t have fever and other symptoms. It’s only someone who is sick with Ebola who can spread the disease.” And he was candid: “It is certainly possible that someone who had contact with this individual, a family member or other individual could develop Ebola in the coming weeks. But there is no doubt in my mind that we will stop it here.” He emphasized basic, proven public health strategies of careful infection control, contact tracing, and isolation.

In contrast, although she acknowledged the possibility of a secondary case, Ms. Monaco appeared less credible as she stated, “I want to emphasize that the United States is prepared to deal with this crisis both at home and in the region. Every Ebola outbreak over the past 40 years has been stopped. We know how to do this and we will do it again.”

While I agree that we have the knowledge, experience, and resources to be able to control Ebola, most of the experts are academicians or practice in relatively well-heeled ivory towers. I have practiced Infectious Diseases and Infection Control for 30+ years, primarily in a number of community hospitals, and offer a different perspective here, based on these experiences.

Administrators vs. Practitioners

Increasingly, decision makers are administrators who are disconnected from the realities of patient care. The latest fad, for example is to design hospitals to look like hotels and be “inviting” to patients, although they are very dysfunctional for delivering patient care, especially problematic in ICUs.

Similarly, when “bioterrorism preparedness” first became the rage, our hospital and health department focused on high tech units and hazmat suits while ignoring basic hygiene. I went ballistic, given that there was no soap nor any paper towels in the public school bathrooms, something the county health commissioner said was “not within their purview.” Gotta have priorities, right?

It is not all that different now. One hospital I am familiar with has Powered Air Purifying respirators (PAPRs), purchased with bioterrorism preparedness grants, but neither stethoscopes nor other dedicated equipment for isolation rooms. So nurses and docs gown up to go in the room of a patient with a “superbug” but take their stethoscopes into the room and then on to other patients, perhaps remembering to wipe it down first.

The problems with controlling Ebola cases in the United States is not that we can’t care for people well, or with good infection control. We absolutely can. But the Dallas case abundantly illustrates some of the problems in caring for anyone with a communicable illness, whether a antibiotic resistant organism (aka “superbug) like carbapenem resistant enterobacter (CRE), measles or Ebola.

(More from Scientific American)

15 Things You Shouldn’t Believe About Africa - Global Citizen
I remember traveling to Uganda with both ignorance and openness. To change means dealing with your own prejudices before appreciating the truth. And, to be honest, I had some of these prejudices. But after living in Kampala (my favorite place in the world, second only to San Francisco) and building relationships with people I think of as family, I wish every day to be back in Uganda, a place I think of as home.
Picture from me. 

15 Things You Shouldn’t Believe About Africa - Global Citizen

I remember traveling to Uganda with both ignorance and openness. To change means dealing with your own prejudices before appreciating the truth. And, to be honest, I had some of these prejudices. But after living in Kampala (my favorite place in the world, second only to San Francisco) and building relationships with people I think of as family, I wish every day to be back in Uganda, a place I think of as home.

Picture from me. 

This Week in Virology (TWiV) 305: Rhymes with shinola 

Vincent, Alan, and Kathy continue their coverage of the Ebola virus outbreak in West Africa, with a discussion of case fatality ratio, reproductive index, a conspiracy 

If you don’t already listen to TWiV you really should. It’s awesome (especially for science and health nerds like me). 

nprglobalhealth
nprglobalhealth:

Raya The Muppet Talks About Poop And Is Proud Of It
Why did the superhero go to the toilet?
"Because it was her duty!" Raya exclaims as she throws her head back laughing.
Six-year-old Raya is not shy at all — especially when it comes to talking about poop. 
That’s because Raya is the sanitation Muppet. She’s one of the newest additions to the Sesame Street family, introduced back in March as part of the Sesame Workshop’s “Cleaner, Healthier, Happier" campaign. She’s got aqua green skin, big pearl eyes and an orange button nose. And her mission is to teach kids how to pee and poop in a sanitary manner.
We caught up with Raya in New York last week when she appeared at the annual Global Citizen Fesitval.
Editor’s note: The interview has been edited so it isn’t too poopy.
Have you ever forgotten to wash your hands after using the toilet?
Never! I travel with my own soap, and I’ll sing a little song to myself as I’m washing my hands. I know here, a lot of people use the alphabet and just sing, A-B-C-D-E-F-G, and while you’re doing that, you have to make sure you wash between the fingers and the tops of your hands and the bottoms of your hands and everything in between. And you don’t finish washing until you get to Z.
Some people have trouble talking openly about poop. How did you get over your shyness?
Let’s face it, we all got to go, right? So why make a taboo about it? You should be able to just talk about it. I use a toilet and I’m proud of it! And just call it what it is. Where I come from, a lot of kids poop out in the open because they don’t have much of a choice. [Editor’s note: Despite our reporter’s grilling, Raya would not reveal her birthplace, although she did say she’s from somewhere “far away.”]
Read the rest of our interview and listen to a clip of Raya.
Photo: Raya might tickle Elmo with toilet paper if he doesn’t use it properly. (John Barrett/Courtesy of Sesame Workshop)

Yes!!! Poop!!!

nprglobalhealth:

Raya The Muppet Talks About Poop And Is Proud Of It

Why did the superhero go to the toilet?

"Because it was her duty!" Raya exclaims as she throws her head back laughing.

Six-year-old Raya is not shy at all — especially when it comes to talking about poop. 

That’s because Raya is the sanitation Muppet. She’s one of the newest additions to the Sesame Street family, introduced back in March as part of the Sesame Workshop’s “Cleaner, Healthier, Happier" campaign. She’s got aqua green skin, big pearl eyes and an orange button nose. And her mission is to teach kids how to pee and poop in a sanitary manner.

We caught up with Raya in New York last week when she appeared at the annual Global Citizen Fesitval.

Editor’s note: The interview has been edited so it isn’t too poopy.

Have you ever forgotten to wash your hands after using the toilet?

Never! I travel with my own soap, and I’ll sing a little song to myself as I’m washing my hands. I know here, a lot of people use the alphabet and just sing, A-B-C-D-E-F-G, and while you’re doing that, you have to make sure you wash between the fingers and the tops of your hands and the bottoms of your hands and everything in between. And you don’t finish washing until you get to Z.

Some people have trouble talking openly about poop. How did you get over your shyness?

Let’s face it, we all got to go, right? So why make a taboo about it? You should be able to just talk about it. I use a toilet and I’m proud of it! And just call it what it is. Where I come from, a lot of kids poop out in the open because they don’t have much of a choice. [Editor’s note: Despite our reporter’s grilling, Raya would not reveal her birthplace, although she did say she’s from somewhere “far away.”]

Read the rest of our interview and listen to a clip of Raya.

Photo: Raya might tickle Elmo with toilet paper if he doesn’t use it properly. (John Barrett/Courtesy of Sesame Workshop)

Yes!!! Poop!!!