Doctors Without Borders at Breaking Point in Ebola Fight

The front line doctors, nurses, and other healthcare workers, are the real heroes in the fight against Ebola. It takes real bravery and dedication to go to the dangerous work day after day. I salute them all.

I hope our CDC is in close contact with DWB. In Africa, they have led the Ebola fight for years. Africa is the place this disease must be stopped. The international response must be robust. The US is now leading the way and must continue to show leadership. We need to aid Doctors Without Borders  and they need to aid us. The disease can be stopped, but will take a massive effort.

doctors and nurses
Doctors and Nurses Are Heros

By Makiko Kitamura and Naomi Kresge Oct 19, 2014 Bloomberg.

At 3:30 a.m. in the world’s biggest Ebola treatment center, Daniel Lucey found the outbreak reduced to its essentials: patients lying on mattresses on the floor and vomiting in the dark, visible only by the wavering flashlight beam of a single volunteer doctor.

“I don’t see a light at the end of the tunnel,” said Lucey, a physician and professor from Georgetown University who is halfway through a five-week tour in Liberia with Medecins Sans Frontieres, the medical charity known in English as Doctors Without Borders. “The epidemic is still getting worse,” he said by phone between shifts.

That’s an increasingly urgent challenge for MSF and the global health community. As fear spreads in the U.S. over transmission of the virus to two nurses in a modern Dallas hospital, the main fight against the outbreak is still being waged by volunteers like Lucey half a world away.MSF has been the first — and often only — line of defense against Ebola in West Africa. The group raised the alarm on March 31, months ahead of the World Health Organization. Now, after treating almost a third of the roughly 9,000 confirmed Ebola cases in Africa — and faced with a WHO warning of perhaps 10,000 new infections a week by December — MSF is reaching its limits.

Photographer: John Moore/Getty Images
A doctor outside the JFK Ebola treatment center speaks to journalists on Oct. 13, 2014… Read More
“They are at the breaking point,” said Vinh-Kim Nguyen, a professor at the School of Public Health at the University of Montreal who has volunteered for a West African tour with MSF in a few weeks. MSF has already seen 21 workers infected and 12 people die, and “there’s a sense that there’s a major wave of infections that’s about to wash everything away,” Nguyen said.

Biafra War

The story of how a relatively small, decentralized group like MSF came to lead the response to the world’s biggest outbreak of Ebola began 43 years ago in Paris. Alarmed by war and famine in the Nigerian secessionist state of Biafra, 13 doctors and journalists created an emergency medical response organization that could work around the world.

Read More: Doctors Without Borders

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Ebola Infected Nurse Traveled by Plane

Ebola Spreads in US. Plane Travel Will Suffer.

Ebola is here and it’s on the move. Passengers on a Frontier Airlines flight from Cleveland, Ohio to Dallas/Fort Worth International Airport may have been exposed to the Ebola virus. How about the workers who clean the plane? And the flight attendants and crew?  And workers at the airport? Incomplete protective protocol at the Dallas hospital may have profound consequences.

Second Texas Nurse with Ebola had Traveled by Plane


A second Texas nurse who tested positive for Ebola after caring for a patient with the virus had traveled by jetliner a day before she reported symptoms, U.S. and airline officials said on Wednesday.

The worker at Texas Health Presbyterian Hospital in Dallas had taken a Frontier Airlines flight from Cleveland, Ohio to Dallas/Fort Worth International Airport on Monday, the officials said.


The woman, identified to Reuters by her grandmother as Amber Vinson, 29, was isolated immediately after reporting a fever on Tuesday, Texas Department of State Health Services officials said. She had treated Liberian patient Thomas Eric Duncan, who died of Ebola and was the first patient diagnosed with the virus in the United States.

The circumstances under which Vinson traveled were not immediately known. But the latest revelation raised fresh questions about the handling of Duncan’s case and its aftermath by both the hospital and the U.S. Centers for Disease Control and Prevention (CDC).

At least 4,447 people have died in West Africa in the worst Ebola outbreak since the disease was identified in 1976, but cases in the United States and Europe have been limited. The virus can cause fever, bleeding, vomiting and diarrhea, and spreads through contact with bodily fluids.

“Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored,” the health department said in a statement.

During the weekend, 26-year-old nurse Nina Pham became the first person to be infected with Ebola in the United States. She had cared for Duncan during much of his 11 days in the hospital. He died in an isolation ward on Oct. 8.

The hospital said on Tuesday that Pham was “in good condition.”

News of the second nurse’s diagnosis follows criticism of the hospital’s nurses of its initial handling of the diseases, in a statement Tuesday by National Nurses United, which is both a union and a professional association for U.S. nurses.

The nurses said the hospital lacked protocols to deal with an Ebola patient, offered no advance training and provided them with insufficient gear, including non-impermeable gowns, gloves with no taping around wrists and suits that left their necks exposed.


Basic principles of infection control were violated by both the hospital’s Infectious Disease Department and CDC officials, the nurses said, with no one picking up hazardous waste “as it piled to the ceiling.”

“The nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own,” the statement said.

The hospital said in a statement it had instituted measures to create a safe working environment and it was reviewing and responding to the nurses’ criticisms.

Speaking early Wednesday on CBS “This Morning,” U.S. Health and Human Services Secretary Sylvia Burwell declined to comment on the nurses’ allegations.

Dallas Mayor Mike Rawlings said at a news conference Wednesday that the second infected nurse lived alone and had no pets.

He said local health officials moved quickly to clean affected areas and to alert her neighbors and friends. A decontamination could be seen taking place at her residence.


Residents at The Bend East in the Village apartment complex were awoken early Wednesday by text messages from property managers saying a neighbor had tested positive for Ebola, and pamphlets had been stuffed beneath doors and left under doormats, said a resident, who asked not to be named.

Other residents were concerned enough that they were limiting time spent outdoors.

“Everybody thinks this won’t happen because we are in the United States. But it is happening,” said Esmeralda Lazalde, who lives about a mile from where the first nurse who contracted Ebola resides.

Texas Health Presbyterian Hospital is doing everything it can to contain the virus, said Dr. Daniel Varga of Texas Health Resources, which owns the hospital. “I don’t think we have a systematic institutional problem,” he said at a news conference on Wednesday.

At the same briefing, Dallas County Judge Clay Jenkins, the county’s chief political officer, said authorities were anticipating additional possible Ebola cases.

“We are preparing contingencies for more, and that is a very real possibility,” Jenkins said.

The CDC said in a statement that it was performing confirmation testing of Texas’ preliminary tests on the new patient.

CDC Director Dr. Thomas Frieden said Tuesday the agency was establishing a rapid-response team to help hospitals “hands on, within hours” whenever there is a confirmed case of Ebola.

Frieden has come under pressure over the response and preparedness for Ebola, but White House spokesman Josh Earnest said U.S. President Barack Obama was confident of Frieden’s ability to lead the public health effort.

Read More: Texas Nurse

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Nurse’s Union Criticize Safety as Ebola Spreads

The Texas Health Presbyterian Hospital in Dallas, Texas, says they’re following procedures established by the CDC. The CDC says procedures to contain Ebola are adequate. Clearly, the news that a second health worker at the hospital has been infected with Ebola indicates procedures should be reviewed. Perhaps the protocol is flawed.

Within days, additional health workers will likely be reported as infected. The CDC needs to get help from Doctors Without Borders. For years, DWB has been treating Ebola patients in Africa. Not one of their health workers has been infected.

Second Health Worker Has Ebola as Nurses Criticize Safety

By Caroline Chen, Darrell Preston and Romy Varghese

A second health-care worker in Texas tested positive after caring for an Ebola patient, opening new questions about oversight lapses by federal officials and spurring a nurses’ group to criticize safety precautions used within the hospital.

A Centers for Disease Control and Prevention team that responded within a day after Thomas Eric Duncan was admitted to Texas Health Presbyterian Hospital was focused on contact tracing and did not care for the patient, said Dave Daigle, a CDC spokesman, in a telephone interview.

Laboratory examination of Ebola.

At the time, National Nurse’s United, a labor union, said the hospital left Duncan for hours in an area with other patients, supplied safety suits with exposed necks, forcing nurses to use medical tape to cover their skin, played down the need for more protective face masks, and sent Duncan’s lab specimens through the system without being specially sealed.

“The clinical care was done by the hospital’s clinical care team,” Daigle said. “We did consult with the team and the hospitals” but did not provide direct care.

Texas officials didn’t comment on the nurses’ complaints during a morning conference call. The focus for health officials in Dallas is now toward the future, said Judge Clay Jenkins, the county’s chief executive, during the call. The county is preparing contingencies for more cases, he said.

“It will get worse before it gets better, but it will get better,” added Dallas Mayor Mike Rawlings at the briefing.

Immediately Isolated

The worker at Texas Health Presbyterian Hospital reported a fever yesterday and was immediately isolated at the hospital, the Texas Department of State Health Services said in a statement today. The preliminary Ebola test was run late yesterday at the state public health laboratory in Austin, and results were received at about midnight.

This is the second health-care worker infected with Ebola while caring for Duncan, a Liberian visitor to the U.S. who died at the hospital last week. Asked at the briefing about the hospital’s performance, Daniel Varga, the chief clinical officer for the hospital group, said “I don’t think we have a systemic institutional problem.”

’’No one wants to get this right more than we do,’’ Varga said.

The nurses’ union said the information about hospital safety lapses came from “registered nurses” at the hospital “who have familiarity with what occurred at the hospital.” The Dallas nurses chose to remain anonymous “out of fear of retaliation,” the union said in a statement.

Contacts Identified

Health officials have interviewed the latest patient “to quickly identify any contacts or potential exposures, and those people will be monitored,” the Texas health department said. The type of monitoring depends on the nature of their interactions and the potential that they were exposed to the virus, according to the statement.

“An additional health-care worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimize the risk to health-care workers and the patient,” the CDC said in a statement today. “The CDC and the Texas Department of State Health Services remain confident that wider spread in the community can be prevented with proper public health measures.”

The new case is the third known instance of Ebola transmission outside of Africa, where the worst-ever outbreak is raging in Sierra Leone, Guinea and Liberia. A nurse who treated Duncan, Nina Pham, has contracted Ebola, as has Teresa Romero, a Spanish nursing assistant who cared for two infected missionaries evacuated to Madrid for treatment.

Airline Screening

The infections outside Africa have spurred the U.S. and U.K. to begin screening some airline passengers on arrival in the past few days.

“It’s really concerning that health workers wearing full personal protective equipment have developed Ebola,” said Raina MacIntyre, a professor of infectious diseases epidemiology at the University of New South Wales in Sydney.

“The initial response of the authorities has been to blame the nurse, that they made a mistake in the donning and doffing of equipment or made some mistake in the protocol” she said. “But it’s also possible that the guidelines aren’t adequate.”

Surgical masks may also be inadequate, and respirators that provide more protection should also be considered, she said.

Read More: Ebola in Texas

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