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#271943 - 09/30/14 06:07 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Arney]
AKSAR Offline
Old Hand

Registered: 08/31/11
Posts: 1162
Loc: Alaska
Originally Posted By: Arney
Originally Posted By: wildman800
A "possible" Ebola case has been isolated in Dallas, Tx according to news via radio.

They seem very hush-hush about this potential case. Can't find any specifics, like was this a businessperson who was in the region? Another aid worker who became infected with the Ebola response? A foreign visitor?

I doubt the fact that they are hush hush means anything much. Because of the Health Information Privacy rules in HIPAA, hospitals and other medical providers are generally prohibited from releasing much of anything specific in any medical case. Unless the patient specifically signs a release, they can't give out much information.
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-Dorothy, in The Wizard of Oz

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#271944 - 09/30/14 06:32 PM Re: EBOV versus Pandemic Flu Preparedness [Re: AKSAR]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
Originally Posted By: AKSAR

I doubt the fact that they are hush hush means anything much. Because of the Health Information Privacy rules in HIPAA, hospitals and other medical providers are generally prohibited from releasing much of anything specific in any medical case. Unless the patient specifically signs a release, they can't give out much information.


Whatever else may be going on, the effect of HIPPA is exactly as AKSAR describes it, and even extends to prohibit the release of medical information about a spouse to their own spouse! We (DW and I) have run into this problem on several occasions. Please make sure you read, understand (if you don't, ask) all the forms you sign at the Doctor's office and hospital: you must specifically authorize info to be released to your significant other. The "default" is no information to anyone.
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#271947 - 09/30/14 09:32 PM Re: EBOV versus Pandemic Flu Preparedness [Re: wildman800]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
CDC confirms Ebola diagnosis for this person in Texas. He became symptomatic several days after returning from West Africa.

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#271948 - 09/30/14 09:38 PM Re: EBOV versus Pandemic Flu Preparedness [Re: bws48]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
True, HIPAA comes into play. Although the public certainly knew a lot about most of the people flown back to the US, even before they even arrived, like Dr. Kent Brantly and Nancy Writebol. Did they consent to updating the public on their condition? I don't know.

Then again, there's also little known about the "other" US case--the person admitted to the NIH facility in Bethesda. So, the information flow can be inconsistent.

From what's been released recently, this new Dallas case appears to be a Texas resident.

Edit: On the drive home, the radio said the patient is from Liberia, not Texas, and came to the States to visit relatives. The report also said he was not in contact with many people after he arrived.


Edited by Arney (10/01/14 02:19 AM)
Edit Reason: Add new info

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#271951 - 10/01/14 04:41 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Arney]
bws48 Offline
Old Hand

Registered: 08/18/07
Posts: 831
Loc: Anne Arundel County, Maryland
I heard a report that the 3 EMTs who transported him to the hospital are now required to stay at home for 21 days and "self Monitor" for any symptoms. Apparently this is the protocol if you "may" have been exposed.

I trust the EMTs to be responsible enough to actually comply and stay at home.

The thing that scares me is that if this protocol has to be implemented on a "large" number of people, I doubt that we can rely on individual compliance. It seems reasonable that some form of confinement may be necessary. That prospect opens up a whole set of other questions and problems that I don't think we are ready for.
_________________________
"Better is the enemy of good enough."

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#271952 - 10/01/14 06:01 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Meadowlark]
wildman800 Offline
Carpal Tunnel

Registered: 11/09/06
Posts: 2818
Loc: La-USA
Forced Quarantine Detention was approved via Executive Order last August.
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#271953 - 10/01/14 06:08 PM Re: EBOV versus Pandemic Flu Preparedness [Re: bws48]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Another worrisome aspect of this Dallas case is that this gentleman actually went to the same hosptial two days earlier because he felt ill, but they didn't ask about his recent travel history and sent him home with a prescription for antibiotics. Only two days later did he deteroriate to the point to require an ambulance to take him back to the same hospital.

Fortunately, he stayed home during those two days when he was symptomatic and presumably infectious so his contact with the public was minimized. Still, whoever was caring for him is presumably at high risk.

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#271954 - 10/01/14 07:10 PM Re: EBOV versus Pandemic Flu Preparedness [Re: wildman800]
AKSAR Offline
Old Hand

Registered: 08/31/11
Posts: 1162
Loc: Alaska
Originally Posted By: wildman800
Forced Quarantine Detention was approved via Executive Order last August.

Forced Quarantine Detention has been on the books for many years. Federal law allows quarantine to prevent entry of infectious diseases into the US, and to prevent the spread across state lines. The last large scale Federal use of quarantine was for Spanish Flu in 1918. See the CDC page on Legal Authorities for Isolation and Quarantine .

Diseases must be added by executive order to the list for which quarantine is authorized. The executive order you are probably thinking of actually added pandemic influenza to the list. Viral hemorrhagic fevers (such as Ebola) had been on the list since 1983. See Q & A on the Executive Order.

States can use quarantine to prevent the spread of disease within their borders. Most states already have such laws on the books. See State Quarantine and Isolation Statutes. For example, see Texas.



Edited by AKSAR (10/01/14 07:14 PM)
_________________________
"Toto, I've a feeling we're not in Kansas any more."
-Dorothy, in The Wizard of Oz

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#271955 - 10/01/14 07:43 PM Re: EBOV versus Pandemic Flu Preparedness [Re: wildman800]
MartinFocazio Offline

Pooh-Bah

Registered: 01/21/03
Posts: 2153
Loc: Bucks County PA
[quote=wildman800]Forced Quarantine Detention was approved via Executive

The only source I can find for this is this:

http://www.whitehouse.gov/the-press-offi...icable-diseases

It was last July, is this the one you were referring to?



Edited by MartinFocazio (10/01/14 07:45 PM)

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#271956 - 10/01/14 07:54 PM Re: EBOV versus Pandemic Flu Preparedness [Re: Arney]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Turns out that the hospital was told at the first visit that this man had just arrived from Liberia when they asked for a SSN. Despite all the heightened awareness of Ebola, no one thought it might be Ebola in a guy who just got off a plane from Liberia?

And this isn't a dinky little community hospital. This hospital has a Level One trauma center and is in the heart of a major US city that receives many international flights from all over the world.

News is now reporting a second possible case, presumably one of his caregivers. And news is also reporting that he had contact with at least five school age children.

The Dallas case is noteworthy because it gives us an idea of what future domestic responses will look like in the days and weeks ahead.

There does not seem to be any plans to transfer this person to any of the special biocontaiment units that other Ebola patients have been admitted to, so perhaps future domestic cases will also be handled close to where they are diagnosed. I guess that probably puts more burden on hospitals in cities with populations from Ebola-stricken countries since those cities are the most likely to be where future cases are diagnosed.

I already posted an article that mentions that the disposal of Ebola-exposed medical waste is very difficult or even impossible for US hospitals under current regulations, even at the CDC's special unit that cared for Dr Kent Brantly. I have not seen any news since then that this problem has been remedied or clarified at the regulatory level. I'm curious how Texas Health Presbyterian Hospital deals with this issue.


From here and here.


Edited by Arney (10/01/14 09:08 PM)
Edit Reason: Added content

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