AgeOfEgos wrote:

 d-usa wrote:
It seems like it might be double complicated since she didn't have EVD until after she flew.

I know with the TB guy they didn't have authority while he had TB while in the US, but once he was a TB patient that entered the US they could force him into quarantine. But he also had active disease and not a potential infection.

It should have been common sense on her part to keep of a plane, but I wonder what authority the CDC has to actually enforce it.

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html

From the language, it appears they can--but were choosing not to. It reminds me of the Dallas apartment fiasco, where the doctor in charge of monitoring other inhabitants of the complex would show up to take their temperatures--and find no one home. Right now, the CDC appears to be just reacting to situations, rather than proactively taking steps...which of course, is not something you like to see in leadership. This gave me a WTF moment;

The Centers for Disease Control and Prevention said that Vinson called the agency several times before flying, saying that she had a fever with a temperature of 99.5 degrees. But because her fever wasn't 100.4 degrees or higher, she didn't officially fall into the group of "high risk" and was allowed to fly.

If a nurse that cared for an ebola patient, that has a temperature calls the CDC several times---and doesn't fall into a 'high risk' category because according to their chart it requires a 100.4 temperature---then they need to rethink their common sense approach to this. Did she take her temperature correctly? Did she use an oral too soon after drinking water? Is a home thermometer qualified enough to cut her out from 'high risk' because of a 0.9 degree difference according to their chart? Pretty mind boggling.

The only thing I can assume, is that everyone involved in these cases that has made astoundingly stupid decisions---are too afraid of appearing as foolish or fearful. Every mistake so far could have been stopped by someone, really anyone, just stopping a moment and saying "I understand that this might be overly cautious but let's talk about this a bit because I'd rather look silly and be wrong then feel cowardly and be right".

 whembly wrote:
Did the CDC truly know that she cared for that ebola patient?

If they hadn't... then, their response made sense.

(CNN) -- A hospital official apologizes for blunders in handling Ebola.
Schools close for fear of possible exposure.
And health officials consider putting 76 hospital workers on a no-fly list after a nurse who treated an Ebola patient flew with a fever.
The director of the Centers for Disease Control and Prevention says the nurse shouldn't have been cleared to fly after reporting her fever to the agency. But she was, and now 132 other people are wondering if they may be vulnerable.
As the list of missteps grow, here's the latest on Ebola in the United States:
Hospital official: 'We are deeply sorry'
Nurse's Ohio family 'self monitoring' Texas hospital apologizes, is it enough? CDC: 'Intensively' assessing 4 workers Second Texas health care worker has Ebola Ebola patient on plane before diagnosis Ebola patient showing 'grit,' 'grace' Gupta suits up in Ebola protective gear Mayor: 'Concerned' about Ebola spreading Understanding Ebola protocols Director: Nurse's infection 'unacceptable' Dallas doctors try to calm Ebola fears Dallas nurse's friend: She's selfless This is the messy truth about Ebola
The Texas hospital where an Ebola patient died and two nurses became infected is apologizing for mistakes made when first confronted with the deadly virus.
Dr. Daniel Varga said the hospital mishandled the case of Thomas Eric Duncan, the Ebola patient who was originally sent home from Texas Health Presbyterian Hospital Dallas even after he had a fever and said he was from Liberia.
"Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes," Varga, the chief clinical officer for Texas Health Services, said in written testimony to the House Energy and Commerce Committee.
"We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry."
Days after Duncan returned to the hospital, he died from the virus.
But Varga did outline a timeline of the hospital's preparation, saying hospital staffers were given guidance on looking for Ebola symptoms several times over the summer.
He said the hospital has made several policy changes, such as updating the emergency department screening process to include a patient's travel history and increasing training for staffers.
CDC might ground Texas hospital workers
The CDC is now considering putting 76 health care workers at Texas Health Presbyterian Dallas on the Transportation Security Administration's no-fly list, an official familiar with the situation said.
The official also said the CDC is considering lowering the fever threshold that would be considered a possible sign of Ebola. The current threshold is 100.4 degrees Fahrenheit.
The idea came after news that Amber Vinson, a nurse who cared for Duncan, flew home from Cleveland to Dallas after reporting a fever.
Vinson called the CDC to report an elevated temperature of 99.5 Fahrenheit. She informed the agency that she was getting on a plane, a federal official told CNN, but she wasn't told to stay grounded.
CDC Director Tom Frieden said Vinson shouldn't have flown because she helped care for Duncan, and because another health worker who cared for him had already been diagnosed with the virus.
He said there's an "extremely low" risk to anyone else on that plane, but the agency is reaching out to everyone on the flight as part of "extra margins of safety."
Vinson, 29, is now being treated at Emory University Hospital in Atlanta, which has successfully treated two other Ebola patients and has not had any employees infected.
Staffing issues at the Texas hospital led to the decision to transfer Vinson to Emory, a federal official told CNN Chief Medical Correspondent Dr. Sanjay Gupta.
"What we're hearing is that they are worried about staffing issues and a possible walkout of nurses," the official said.
Texas Health Presbyterian Dallas is still treating Nina Pham, the first nurse who tested positive for Ebola. She also treated Duncan at the hospital.
Pham remains in good condition, officials said. It has not been determined whether she will be transferred to another facility.
Hospital employees can quarantine themselves
With two of its own nurses infected with Ebola, Texas Health Presbyterian said it will allow any concerned employee to have a hospital room.
"Texas Health Dallas is offering a room to any of our impacted employees who would like to stay here to avoid even the remote possibility of any potential exposure to family, friends and the broader public," the hospital said in a statement.
"We are doing this for our employees' peace of mind and comfort. This is not a medical recommendation. We will make available to our employees who treated Mr. Duncan a room in a separate part of the hospital throughout their monitoring period."
Several Texas and Ohio schools close
News of Vinson's travel on a Frontier Airlines plane led to school closures in two states.
In Texas, a few schools in the Belton Independent School District are closed Thursday because two students were on the same flight as Vinson from Cleveland to Dallas -- Frontier Airlines Flight 1143, the superintendent said.
And in Ohio, two schools in the Solon School District in suburban Cleveland are closed Thursday because a staffer "traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft" as Vinson, the school district said in a statement.
"Although we believe what the science community and public health officials are telling us about the low risk of possible transmission of the virus through indirect contact, we are nonetheless taking the unusual step of closing the dual school building for Thursday so that we can have the schools cleaned and disinfected," the statement said.
Frontier Airlines grounds 6 crew members
The school districts aren't the only ones concerned about Vinson's travels.
Frontier Airlines placed six crew members on paid leave for 21 days "out of an abundance of caution," CEO David Siegel wrote in a letter to employees.
The airline also removed the plane's seat covers and carpet near where the infected passenger sat, even though it had not been asked to by the CDC, Siegel said.
Hospital fires back after claims
After scathing allegations by a nurses' union, a Texas Health Presbyterian spokeswoman said some of the claims were not true.
National Nurses United, citing interviews with nurses at the hospital, said Duncan was "left for several hours, not in isolation, in an area where other patients were present" during his second visit to the hospital.
But hospital spokeswoman Candace White said Duncan "was moved directly to a private room and placed in isolation" during his second visit.
And after the union claimed "there was no one to pick up hazardous waste as it piled to the ceiling," White said the waste was "well-contained in accordance with standards, and it was located in safe and containable locations."

 Forar wrote:
Y'know, I normally loathe Fox News, but one shining light of awesome is Shep Smith, and he recently did a brief segment on Ebola that, real talk, is one of the best I've seen.




Not that it seems to have stopped other shows on the network from going a more, ah... direct route to Scaremongerville.

An outsider question though- in a situation like that, where it is a public health issue, the check ups and so on are all paid for by the state, right? I mean, you're not going to end up with an outbreak because someone was uninsured and decided they couldn't afford to get their fever checked out?

 Da Boss wrote:
What the hell? Are you joking?

 Da Boss wrote:
What the hell? Are you joking?

 Da Boss wrote:
But then they can charge you for it afterwards, right?

Not for profit hospitals and Enron

A friend of mine just called. An employee of his required a CAT scan of her abdomen. She was charged by a local “not for profit” hospital $4400. This is $3600 more than the independent facility to which I refer patients charges. After her insurance paid $2200, she was billed $700 and the hospital wrote the rest off as a loss.

What’s my point? Just down the road, a facility with a better radiologist that would like to have more business than they have, would have done the scan for $800. The insurance company didn’t want the patient to go there. You wonder why health care is so expensive? Then there’s this other little nasty bit. If you have followed this blog you are familiar with the phrase “uncompensated care.” You can check out the details of this scam here if you are interested in knowing how the payments to hospitals are calculated. Basically, my friend’s employee as a patient was forgiven the $1500, but not as a taxpayer. This $1500 uncollected amount goes in to the “uncompensated care” pool for the purposes of the calculation that will result in a car dealer like rebate to the hospital at the end of the year’s hospital-government shell game. Actually, current year “losses” result in future increases in payment so the losses are always seen as “now” without acknowledging the future, offsetting payments. This, of course, allows the big hospitals to constantly poor mouth it, while knowing that future loot based on their reported losses is on the way courtesy of the taxpayer.

This is what I call the reverse Enron accounting method. Rather than overstate your earnings, overstate your losses. This fictitious loss translates into big bucks for our cost-shifting, price-gouging hospital friends. I couldn’t make this stuff up if I had too. Can you see from the formula above, that it is the spread between “billed” and “collected” amounts that determines the rebate? Isn’t it therefore obvious that the patient who clearly can’t pay, is the patient most likely to receive the most exhorbitant bill? This explains why the uninsured get blistered by the hospitals and see bills the giant size of which other patients never see. The hospital actually doesn’t want them to pay! The hospital also needs this red ink to maintain the fiction of their non-for-profit status.

All this said, isn’t it clear that little-to-no charitable care is rendered at all at these hospitals? They collect one way or the other.

Health care reform? Yeah, we need it. We need to get the government out of this business. The government and their crony hospital friends will bankrupt all of us if we let them.

 Da Boss wrote:
But then they can charge you for it afterwards, right?

 Da Boss wrote:
Doesn't that act as a financial disincentive to sensible behavior in a situation like this with a potential outbreak of a dangerous contagious disease?

Wow. I kinda felt dumb for asking that question because I assumed the cost would be eaten by the state in the case of people who were legitimate risks (perhaps not cranks with no contact or potential contact with the disease). Now I am just amazed that the system is as good as it is at controlling outbreaks of contagious disease!
Thanks for the links and quotes, very educational.