There are only 2 planes in the US with the isolation capability for the Ebola virus.

[pnwmom]

So if an Ebola patient turns up in your city, chances are he's going straight to your local hospital -- ready or not.

http://www.cidrap.umn.edu/news-perspective/2014/09/very-few-aircraft-equipped-evacuate-ebola-patients

"There are only two jets in the world with the current system, and we own both of them," said Dent Thompson, vice president of Phoenix Air, which has served as the airlift provider for the Centers for Disease Control and Prevention (CDC) for about 8 years.


Thompson said the company is working to fit one more plane with the special equipment. It includes a metal frame that holds numerous pieces of medical equipment and, inside it, a big plastic tent for the patient. Only one patient can be accommodated.

The apparatus includes an air filtration and negative-pressure system and allows for medical equipment connections such as heart and pulse oxygen monitors, according to Thompson. Medical personnel can enter the patient chamber but must first use an anteroom to don a protective suit. When they leave the chamber, they must be decontaminated in the anteroom.

After each Ebola flight, the equipment must be put through a 24-hour decontamination process that was designed by the CDC, Thompson said. The plastic liner, even though sterile by that time, is then removed and burned in a special incinerator.

SNIP

[MineralMan]

1. Did you expect a whole fleet of them?

I'm surprised there are two. We saw one of them in use already with this Ebola outbreak. How many should there be?

If someone becomes ill with Ebola, they'll be in an isolation room in their own or a nearby city. As we write, hospitals are creating protocols for potential Ebola patients. There was a news story here in the Minneapolis St. Paul area this morning about preparations to receive such patients in one of our excellent hospitals. Similar arrangements are being made in most areas, I'm sure.

[pnwmom]

2. And most local hospitals are NOT ready to receive these patients. They're particularly

not ready to handle the problem of the mountains of hazardous waste. Even Emory University's hospital wasn't -- they finally sent their waste to the CDC. But the CDC doesn't have a branch in every city.

http://www.democraticunderground.com/10025612086

[MineralMan]

3. Mountains, eh? Really?

I checked here in the Twin Cities. We have a company that specializes in incinerating biological waste from healthcare facilities. I assume they'll be the ones dealing with it here. Apparently, there's quite a business in doing that, since the local business here is a branch of a national company.

Mountains, though, may just be something of an exaggeration, don't you think? Right now, we have one patient in Texas to deal with. In a worse situation, I suppose, crematoriums could be pressed into service to incinerate the stuff. They incinerate bodies, after all. Their services could handle all such waste, if necessary. I'm sure there's one of those wherever it is that you live.

If necessary. We don't have incinerators that are certified to handle Ebola-contaminated waste because we haven't had a need for them, you see. We do have lots of incinerators that would be capable of safely doing so, though. A crematorium would be a good choice, if it were necessary, and I'm sure they'd meet the requirements.

[pnwmom]

4. Emory U was having 40 bags a day from a single Ebola patient. They were overwhelmed.

And if even that hospital was having problems, you can expect that your hospitals will, too.

http://www.reuters.com/article/2014/09/24/us-health-ebola-usa-hospitals-insight-idUSKCN0HJ0AD20140924

The issue created problems for Emory University Hospital in Atlanta, the first institution to care for Ebola patients here. As Emory was treating two U.S. missionaries who were evacuated from West Africa in August, their waste hauler, Stericycle, initially refused to handle it. Stericycle declined comment.

Ebola symptoms can include copious amounts of vomiting and diarrhoea, and nurses and doctors at Emory donned full hazmat suits to protect themselves. Bags of waste quickly began to pile up.

"At its peak, we were up to 40 bags a day of medical waste, which took a huge tax on our waste management system," Emory's Dr. Aneesh Mehta told colleagues at a medical meeting earlier this month.

Emory sent staff to Home Depot to buy as many 32-gallon rubber waste containers with lids that they could get their hands on. Emory kept the waste in a special containment area for six days until its Atlanta neighbor, the U.S. Centers for Disease Control and Prevention, helped broker an agreement with Stericycle.

SNIP

Few hospitals have the ability to autoclave medical waste from Ebola patients on site.

"For this reason, it would be very difficult for a hospital to agree to care for Ebola cases - this desperately needs a fix," said Dr Jeffrey Duchin, chair of the Infectious Diseases Society of America's Public Health Committee.

Dr. Gavin Macgregor-Skinner, an expert on public health preparedness at Pennsylvania State University, said there's "no way in the world" that U.S. hospitals are ready to treat patients with highly infectious diseases like Ebola.

[MineralMan]

6. So, Stericycle finally dealt with the waste?

Maybe they needed some direction on how to do that from the CDC. Apparently, they now have that direction and are accepting it. That's the same waste company that serves the Twin Cities, by the way. My assumption is that they now know how to deal with Ebola-contaminated waste and will be accepting it from other hospitals as well.

Nothing ever gets anticipated fully until there is a need. When the situation arises, decisions on what to do are made, and then disseminated to other areas. Ebola, like other viral diseases, can be dealt with as far as waste is concerned. Normal procedures for contaminated medical waste work just fine. Autoclaving and incineration are the usual methods. Bleach solutions are adequate for cleaning surfaces, apparently, base on my research.

So, Atlanta has solve the dilemma, once it had the dilemma. It took a little time to come up with a protocol. Now that protocol exists and will be promulgated to other areas.

I'm sorry, but you're expecting everything to be figured out prior to the need. That never happens. The waste was collected and stored in a containment area until the protocol existed. Now, it has been handled properly. Now we know how to handle that waste. Those protocols will be refined and updated over time, too.

It's not like in West Africa, where decontamination of waste is done by pouring gasoline on it and setting it on fire. We have much better methods here, but protocols have to be in place for companies like Stericycle to accept the waste.

Real situations require real solutions. That takes time. Now the protocols exist.

[pnwmom]

7. The protocols have NOT been developed. They hope to announce some in a few days.

They should have been ready long ago.


http://www.abreakingnews.com/health/us-nears-solution-for-safe-disposal-of-ebola-medical-waste-h238641.html

The United States is days away from settling the critical question of how hospitals should handle and dispose of medical waste from Ebola patients, a government official said on Wednesday.

Experts have warned that conflicting U.S. regulations over how such waste should be transported could make it very difficult for U.S. hospitals to safely care for patients with Ebola, a messy disease that causes diarrhea, vomiting and in some cases, bleeding from the eyes and ears.


Safely handling such waste presents a dual challenge for regulators, who want to both prevent the accidental spread of the deadly disease and avert any deliberate attempts to use it as a bioweapon.

Most U.S. hospitals are not equipped with incinerators or large sterilizers called autoclaves that could accommodate the large amounts of soiled linens, contaminated syringes and virus-spattered protective gear generated from the care of an Ebola patient, said Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America's Public Health Committee.

SNIP

[MineralMan]

9. OK, I'm done here.

I'm out of these scare threads from now on.

[pnwmom]

11. Yeah, because it's too hard to actually read an article. You'd rather just spout off

.http://www.reuters.com/article/2014/09/24/us-health-ebola-usa-hospitals-insight-idUSKCN0HJ0AD20140924

[MineralMan]

12. Your article is from last week. Time has passed.

Life isn't static, and articles from September 24 are not current. This is an evolving situation. You need to keep up.

[pnwmom]

15. Yes, time has passed. Where are the national protocols? This article is from 12 hours ago.

And it's still saying that we're days away from telling hospitals how to deal with the waste.

http://www.reuters.com/article/2014/10/02/us-health-ebola-waste-idUSKCN0HR07T20141002

(Reuters) - The United States is days away from settling the critical question of how hospitals should handle and dispose of medical waste from Ebola patients, a government official said on Wednesday.

Experts have warned that conflicting U.S. regulations over how such waste should be transported could make it very difficult for U.S. hospitals to safely care for patients with Ebola, a messy disease that causes diarrhea, vomiting and in some cases, bleeding from the eyes and ears.

Safely handling such waste presents a dual challenge for regulators, who want to both prevent the accidental spread of the deadly disease and avert any deliberate attempts to use it as a bioweapon.

Most U.S. hospitals are not equipped with incinerators or large sterilizers called autoclaves that could accommodate the large amounts of soiled linens, contaminated syringes and virus-spattered protective gear generated from the care of an Ebola patient, said Dr. Jeffrey Duchin, chair of the Infectious Diseases Society of America's Public Health Committee.

SNIP

[MineralMan]

16. Are you sure they don't?

Where did you learn that no protocols have been developed?

I have no idea, really. If they have not yet been developed, they are under development. We have one patient. That's all.

Arm-waving isn't going to create any protocols. That's up to the CDC, EPA and other government agencies. I'm not involved in any of them. I'm also not that concerned that such protocols will not be ready before they are needed. In the meantime, such waste will have to be stored, I suppose.

Your apparent panic is not appropriate to the situation, I think.

Now, once and for all, I'm out of these threads. Like everyone else, I'm watching the situation as best I can. At this point, I have no additional information and no particular way to alter what is going on, so I'll be watching and turning my attention to other issues for the time being.

[pnwmom]

18. According to this Reuter's report as of 12 hours ago, they hadn't. n/t

[riverwalker]

27. Twin Cities has largest Liberian population

outside of Africa, 30,000 live here. They travel back and forth frequently. Does my large Twin City area metro hospital ask about travel on our admission checklist? Nope. Have we been educated, and trained to deal with potential Ebola patients? Nope. What I know of Ebola is from the Internet. We ready? Nope.


U.S. Ebola case has local West African community reaching out

http://www.startribune.com/lifestyle/health/277781221.html

[joeglow3]

19. I am glad our hospital in Omaha is ready

[pnwmom]

21. How do you know they are? How will they be handling the hazardous waste? n/t

[joeglow3]

22. They already handled an Ebola patient a few weeks ago

[joeglow3]

28. They are sending a second patient here.

[pnwmom]

29. Then I know where you are and that's a great place for an Ebola patient to be.

But most hospitals don't have the set-up you have there. They don't even have incinerators large enough to handle the typical amount of waste from an Ebola patient.

[joeglow3]

31. I agree. Scary to think what would happen if frequency increases.

Not many places are equipped to deal with this. Hope we don't have to see that.

[Johonny]

14. We got 1 patient for 2 planes so I think we're good

[Warren Stupidity]

5. I'm hiding under my desk right now.

I'm washing my hands continuously and spraying Lysol on everything. Please let me know when the crisis is over.

[MineralMan]

8. Good move. Keep it up. You might want to duct tape

some Visqueen on your windows and doors, too. You can never be too careful. Stock up on chlorine bleach too. 500 gallons would be a good start, and you can pick up a sprayer, too, while you're out getting the bleach. I'd get on that right away...

[LondonReign2]

10. Lordy

For your own peace of mind you really need to back away from the Ebola-is-gonna-kill-us-all posts

[FSogol]

13. Game over man, Game over!

[Cali_Democrat]

17. Are you trying to create a panic?

Calm down!!

[pnwmom]

20. I think the CDC and the hospitals need to be much more on top of this than they have been.

How many screw-ups have we seen so far?

The hospital team wasn't told that Duncan had been exposed to Ebola.

After he was finally admitted to the hospital -- vomiting -- his ambulance and crew remained in circulation for two days.

They didn't have his apartment immediately cleaned.

They first let the four children go back to school.

Then they asked the family to stay inside -- but there were multiple violations of the request, so now they're in official quarantine with a guard at the door.

They are confining the family in an apartment that hasn't been cleaned, surrounded by plastic bags with his things. Reportedly, his dirty sheets are still on the bed.

As of this morning, they still hadn't cleaned the apartment parking lot where he'd been vomiting.

The CDC still hasn't informed hospitals on how they're supposed to deal with the hazardous waste, since regular garbage haulers are prevented by law from taking it, and most hospitals don't have the capability to burn it.

[Puzzledtraveller]

23. My sister is a RN at Kosair Pediatric Hospital in Louisville.

She just posted on FB about two suspected patients in Kentucky.

[pnwmom]

24. At least there is a high "index of suspicion" now.

So hopefully no one else will slip through the cracks, like Duncan the first time around.

[Puzzledtraveller]

25. good point

I will explain that to my wife also. She has been really worried, to the point she made herself sick today. We had a baby girl in April, our first and she has been really sensitive to events since our daughter was born. We had a shooting at one of our schools two days ago and that really rattled her as she is a elementary school teacher. I have been telling her to be aware of the existence of the threat but not to dwell on it, and stay away from all the FB links to ebola stories and of course cable news.

[pnwmom]

26. The other thing you can tell her

is it sounds like Kentucky is handling this much better than Texas. They already had two suspected cases that apparently weren't Ebola, but they treated them as if they were, isolating the patients till proven safe.

(By the way, I can imagine how your new-mother-wife must feel. Shortly after 911, I remember thinking how scary it must be for pregnant women and new mothers, to bring a child into such a tumultuous world. Then when you add fears of Ebola or terrorism on top of hormones -- your wife is going through a lot. Hang in there.)

http://www.kentucky.com/2014/10/01/3458051_fayette-county-health-officials.html?rh=1

In the past five months, Fayette County health officials have quarantined two patients who had traveled to or from Liberia after they showed symptoms similar to those of Ebola.

Ebola has ravaged Liberia, in West Africa, since March. Neither Kentucky patient had the virus, but the cases show that the system of detection, isolation and investigation in place in Kentucky worked as it should, said Dr. Rice Leach, Fayette County health commissioner.

In each Kentucky case a doctor, after questioning a patient about travel and symptoms, alerted infectious disease specialists at the Lexington-Fayette County Health Department.

The patients were then quarantined at University of Kentucky Chandler Medical Center. At the same time, public health workers started tracing the patient's steps to look for possible points of spreading the illness.

"We have practiced the public health response," Leach said. "We put them in isolation in the hospital until we could prove it was something else."


SNIP

[lonestarnot]

30. So, I find it disturbing that on a suspicion someone can be held to find out if they have it. 21

days is the incubation isn't it? That could screw with alot of things if someone just decided they wanted to screw with someone else. And what does Africa do with its dead victims. Is cremation required? Think we will require it here?

[pnwmom]

32. Part of the reason the disease has spread so quickly in Africa is because of unsanitary

burial practices, involving family members preparing the bodies.

I don't know whether any area has begun to require cremation, but it would make sense.

[uppityperson]

33. That is one of the problems, why it is spreading. Traditionally people get buried, but a dead body

someone who died from ebola is extremely hazardous and more contagious than when they were first ill. They are trying to burn the bodies but people are resistant, leading them to sneak bodies out to bury and expose themselves during the process, leading to more infected people.

Short answer, yes. Cremation is the way to destroy the virus.

[lonestarnot]

34. Cremation seems cleaner to me in any case of death, no matter the cause. That is what I have

decided I want done with my carcass.