anyone catch the 60 minutes piece?

http://www.cbsnews.c.....ic-duncan/

from forbes

60 Minutes on Sunday told the story of a hospital tackling Ebola. A story of brave nurses and determined administrators. A story of heroes, frankly.

It was the story of Texas Health Presbyterian Hospital in Dallas — the hospital that treated the first patientdiagnosed with Ebola in the United States. A hospital that’s been widely criticized, since Texas Health nursesNina Pham and Amber Vinson also got sick with Ebola.

You may think you know the details of what happened in Dallas. But 60 Minutes asks you to think again.

60 Minutes correspondent Scott Pelley sat down with four of the nurses who treated Thomas Duncan, the initial Ebola patient.

Here’s what we learned.

1. Whether intentionally or not, Duncan misled authorities about his exposure to Ebola.

When Duncan first presented to the hospital on September 25, he didn’t specify that he’d come from Liberia or even West Africa — the center of the Ebola outbreak.

Duncan only said he’d returned from “Africa,” which could’ve meant one of dozens of nations, most of them far from the Ebola outbreak. Perhaps the nurses could’ve pressed him further. But with Duncan’s symptoms not that severe yet, and with no real reason to think he had Ebola, they sent him home.

After Duncan was re-admitted to the hospital three days later, significantly sicker, the hospital suspected Ebola might be the cause. But even then, Duncan wasn’t wholly honest. He said he hadn’t been exposed to anyone who was sick from Ebola, even though later reports revealed that Duncan had bravely helped carry an Ebola-infected woman to a local hospital in Liberia.

Duncan also told a nurse that he’d buried his daughter who died in childbirth — but he said that she hadn’t died from Ebola. Duncan later denied the story to federal officials.

2. The hospital was unprepared, partly because the nation wasn’t ready.

Public health officials have said this repeatedly: Nearly any hospital would’ve faced challenges if an Ebola patient unexpectedly walked through their doors. Texas Health was reportedly in the middle of Ebola training when Duncan showed up.

(“There had to be a first hospital, and unfortunately for Texas Presbyterian, it was them,” said Dr. Sean P. Elliott, medical director of infection prevention at the University of Arizona Health Network, told the New York Times.)

One enormous challenge, the nurses told 60 Minutes, was that protections to treat Ebola patients were initially unclear. For instance, when the nurses first treated Duncan on September 28, they were wearing gowns, masks, gloves, and face shields.

That’s seemingly plenty of protection…but it still left their necks exposed. And that could be a fatal mistake when treating an Ebola patient. It’s probably the reason why nurses Pham and Vinson got sick.

This lack of sufficient protection has been widely reported, and blamed on the hospital. But the nurses say they looked up protocols from the CDC, and as of late September, that’s what the CDC recommended.

Scott Pelley: So the CDC protocols that you would’ve looked up the day he came into the emergency department was in your estimation deficient?

All four nurses: Yes.

Within 48 hours, Texas Health Presbyterian Hospital moved to equip its staff with suits that didn’t expose any skin — three weeks before the CDC made that policy their new national standard.

3. The Ebola patient presented unprecedented challenges.

After the hospital confirmed that Duncan had Ebola, administrators had to make crucial, rapid decisions. First, they emptied the entire 24-bed medical intensive care unit to focus just on Duncan.

They also told staff that they had an Ebola patient, and they gave them the option to opt out. As a result, every staff member involved in Duncan’s care ended up being a volunteer — from doctors to nurses to housekeepers.

Still, treating Duncan was unlike anything the care team had done before. Nurses worked two at a time, for two-hour shifts, wearing full-body protections that left them soaked in sweat under the suit.

Duncan’s vomit and diarrhea also presented logistical challenges; it was all hazardous waste, because anything with Duncan’s bodily fluids could infect someone else. And he was producing an unbelievable amount of it.

“I’ve been in health care for nearly 20 years,” ICU nurse John Mulligan told 60 Minutes, “and I’ve never emptied as much trash as just from the waste of his constant diarrhea.”

4. The nurses are still reeling from the experience.

The nurses who treated Duncan remain nervous. At least a few of them are still self-monitoring, because they were exposed to Nina Pham or Amber Vinson and they’re still within the 21 days window for infection.

One nurse said he’s been having repeated nightmares of his coworkers getting infected and dying from Ebola.

But they’re also traumatized by the experience of treating Duncan — watching the patient slip away, despite everything they did to try and save him. Duncan remains the only U.S. patient to die from Ebola.

“It was the worst day of my life,” Mulligan told 60 Minutes. “This man that we cared for, that fought just as hard with us, lost his fight. And his family couldn’t be there.”

“I was the last one to leave the room. And I held him in my arms. He was alone.”

http://www.forbes.co.....-revealed/

the most hated woman in Maine right now

FORT KENT, Maine —Kaci Hickox, the nurse who had been held in quarantine in New Jersey after returning from treating Ebola patients in West Africa, was in Fort Kent Wednesday morning.

Hickox spoke to "Good Morning America" and said she is symptom-free and has been symptom-free since returning from Africa.

She told "Good Morning America" she will take the state of Maine to court if officials try to enforce  the state's "voluntary" quarantine on health care workers who've treated Ebola patients.

Hickox's lawyer said there is no medical reason to quarantine her.

On Tuesday, Maine Department of Health and Human Services Commissioner Mary Mayhew spoke in Bangor about additional steps to make sure people with a higher risk of Ebola do not make contact with the public.

They included voluntary, in-home quarantine for anyone who had direct contact with an Ebola patient.

Hickox said she does plan to return to Africa to treat Ebola patients.

Mayhew did not talk about Hickox or any of the specifics of her condition.

Hickox had been quarantined in New Jersey after being in Africa while working for the nonprofit Doctors Without Borders. She had planned to stay with her boyfriend in Fort Kent, but no information was available on Tuesday about her whereabouts.

Mayhew said that DHHS and the Maine Center for Disease Control and Prevention did daily post-arrival monitoring of travelers who came to Maine from an Ebola-affected country. She also outlined what she meant about a quarantine.

"I want to be sure everyone understands what quarantine means in this case. Stating it plainly, what we are asking for is that individuals who had direct contact with Ebola patients stay in their home and avoid public contact until the 21 days for potential incubation has passed," Mayhew said in a release.

Freeport police Lt. Susan Nourse told WMTW News 8 on Tuesday that her supervisor was contacted on Monday that Hickox was staying overnight in town.

Freeport residents were not troubled by the possible visit.

"I know the incubation period is 21 days, so people just need to be smart about whether or not they go out and about and travel around other people," said Eric Bell.

"It doesn't bother me at all.  I mean she is just a woman who is trying to survive just like anybody else," Deshon Gaither said.

The University of Maine at Fort Kent said her partner, nursing student Ted Wilbur, has opted to take a break from campus to be with her. His off-campus home showed no sign of activity Tuesday.

UMFK officials said they have also been in contact with the Maine CDC and have offered to allow Wilbur to stay on campus the next three weeks.

UMFK said in a statement on Tuesday, "(We are) in constant communication with Ted Wilbur, and there is no definitive decision on where he will reside right now, however he has told UMFK officials that he will not be in class or on campus."

http://www.wmtw.com/.....e/29379150

Attorneys for a nurse released from isolation in New Jersey after returning to the U.S. from West Africa say she will not comply with Maine health officials’ requirements that she remain under quarantine at home for 21 days.

Kaci Hickox, who treated Ebola patients in Sierra Leone and shows no symptoms of the virus, agreed to refrain from going out in public for two days, said Steven Hyman of the New York law firm McLaughlin & Stern. She traveled to Maine on Monday by private car after her release from New Jersey, where she was isolated against her will in a tent outside University Hospital in Newark after she flew into New York on Friday.

“She doesn’t want to agree to continue to be confined to a residence beyond the two days,” Hyman said.

Maine health officials have said they expect Hickox to agree to be quarantined at her home until 21 days have passed since her last potential exposure to the virus. Twenty-one days is the maximum incubation period for the Ebola virus.

Local officials in Fort Kent, where Hickox lives with her boyfriend, said Tuesday that she was not heading back to town right away. On Tuesday morning, vehicles from about a dozen national and state media outlets lined the road near the house in town, though no one appeared to be home.

Early Tuesday evening, Maine Department of Health and Human Services Commissioner Mary Mayhew noted at a hastily called news conference that the state has the authority to seek a court order to compel quarantine for individuals deemed a public health risk.

She did not address Hickox’s case directly, saying the state has not filed a court order.

Another attorney representing Hickox, New York civil rights lawyer Norman Siegel, said she would contest any potential court order requiring her quarantine at home.

“The conditions that the state of Maine is now requiring Kaci to comply with are unconstitutional and illegal and there is no justification for the state of Maine to infringe on her liberty,” he said.

Hickox will abide by daily monitoring, as recommended the by updated guidelinesreleased Monday by the federal Centers for Disease Control and Prevention, Hyman said. She has been in regular contact with state health officials, Siegel said.

U.S. CDC Director Tom Frieden called for isolation of people at the highest risk for Ebola infection but said most medical workers returning from the three African nations at the center of the epidemic — Sierra Leone, Liberia and Guinea — would require daily monitoring without isolation.

The new guidelines recommend considering isolation only for individuals exposed to Ebola who show symptoms. Those with no signs of illness should be monitored for 21 days after the last potential exposure, with symptom-free individuals at the highest risk subject to “restricted movement within the community” and no travel on public transportation, according to the guidelines.

The federal CDC’s guidelines serve only as recommendations. States have leeway to develop their own protocols.

Both of Hickox’s attorneys declined to comment on where she was staying, who she was with or her travel plans, saying only that she had arranged housing in Maine.

“She understands the nature of the disease, she treated it,” Hyman said. “She understands the nature of the risk.”

Hickox’s boyfriend, Ted Wilbur, a University of Maine at Fort Kent nursing student, plans to join her and will not return to campus for the next 21 days, according to Raymond Phinney, associate dean of student life and development at the university.

Mayhew reinforced the state’s intent to prevent people who have been exposed to Ebola from contact with others during the news conference at the department’s offices in Bangor late Tuesday afternoon.

“The way that goes right now is that anybody who remains at home with an individual that is placed at risk, who’s had exposure, if that patient does become symptomatic, all family members must agree to go into quarantine for a 21-day period,” Mayhew said.

She acknowledged that the state’s protocols “may go slightly beyond the federal guidelines,” but described them as a common-sense approach to guard against a public health crisis.

“As we’ve indicated, the intent is to minimize public contact if they have family members who have become exposed to them and they later develop symptoms, those individuals would be subject to the 21-day quarantine.”

“If they had visitors, those visitors would be subject to the quarantine if the individual under quarantine develops symptoms,” Mayhew said.

Though they declined to get into specifics on Tuesday, officials from the Maine Department of Health and Human Services provided an update on the state’s efforts to prevent the spread of Ebola to Maine.

Federal health officials have said the risk of an outbreak in the U.S. is very low. Contracting Ebola requires direct contact with the bodily fluids of someone who is both infected and exhibiting symptoms. The virus is not spread through the air.

State health officials do have some mechanisms for handling situations in which individuals refuse to comply with quarantines and other safeguards.

“We will proceed with a court order to seek legal authority as provided under Maine law,” Mayhew said. “We expected that the Maine attorney general’s office will represent the Department of Health and Human Services in this avenue of pursuing a court order,” she said, later, adding, “No court order has been filed at this time.”

Asked if there were any plans to take such an action, Mayhew said, “We are evaluating appropriate steps to ensure that our protocol is complied with and if necessary, will be enforced.”

Also during the Bangor news conference, Maine CDC Director Dr. Sheila Pinette described how people who come to Maine from places in which Ebola is present.

“We have an active monitoring program for low-risk patients, where with active monitoring there’s a phone call that is between the epidemiologist and the individual on a twice-a-day basis. For direct active monitoring we do have the epidemiologist go to the home to speak to the individual, assess the individual’s status and observe the patient taking the temperature, looking at the temperature and then recording that. So we are in continuous contact.

“And I do want to comment a little bit on the science here,” Pinette said, referring to reports that the nurse had not tested positive for Ebola.

“The problem we’re faced with here is that this is a blood-borne pathogen,” Pinette said. “We don’t know a lot about this virus but we do know from the experiences learned in Texas that they had some equivocal tests within the first 72 hours of testing their health care workers and we need to go based on the facts.

“The fact of the matter is that it has a 21-day incubation period. This individual was tested within the first 24 to 48 hours and the federal CDC was in agreement with retesting the patient should she develop symptomatology,” she said, adding, “But they wanted to wait 72 hours and they wanted to continue to keep the individual under 21-day incubation period for monitoring because as the viral load increases, that is how you can develop a positive Ebola test.

“So we believe that she may have been tested too early and therefore that is the reason why we continue to monitor this individual. So I have to say, in my own clinical opinion, to protect the health and safety of even one Mainer, it is extremely important for us to be very, very cautious,” Pinette said.

In a Monday editorial, the New England Journal of Medicine criticized mandatory quarantines for health care workers returning from West Africa, imposed in states including New York and New Jersey.

“This approach … is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal,” the editorial said. “The governors’ action is like driving a carpet tack with a sledgehammer: it gets the job done but overall is more destructive than beneficial.”

http://bangordailyne.....ref=latest

yeah, it's pretty much all over the news up here and people are non to happy with the way she is handling this