Saturday, November 29, 2014

Why No One Wants To Play With The Ebola Kids

Apparently the Washington Post was able to sneak out an Ebola story when Ebola Czar Klain was busy in the men's room:
(WaPo) - U.S. officials trying to set up a network of hospitals in this country to care for Ebola patients are running into reluctance from facilities worried about steep costs, unwanted attention and the possibility of scaring away other patients.
“They’re saying, ‘Look, we might be willing to do this, but we don’t want to be called an Ebola hospital. We don’t want people to be cancelling appointments left and right,’ ” said Michael Bell, director of laboratory safety at the Centers for Disease Control and Prevention. 
The handful of U.S. hospitals that have treated Ebola patients have discovered that doing so can be costly, requiring around-the-clock care involving scores of nurses and other health workers. That would be a big challenge for many hospitals, where staffing is often stretched thin.
TL;DR Highlights:
* No one with any sense wants to play with Ebola

* Remember that when you hear about a hospital that does.

* Since Thomas Duncan's diagnosis, the CDC has barely managed to visit 1 hospital per day to evaluate as potential Ebola treatment destinations. (We won't ask WTF they were doing for the last 40 years since Ebola was discovered.)

* "Airport screening" is touted as having prevented outbreaks so far; in reality, they haven't successfully screened out anyone here, as evidenced by all the US Ebola cases to date.

* THP-Dallas was gutted by the consequences of treating Duncan.

* The cost to each dedicated facility, like Emory and U NE, for treating a single Ebola patient, is between $600K-$900K PER PATIENT.

* TWO MONTHS INTO THIS, most hospitals STILL have no idea how to deal with the basics, like training employees, segregating potentially infected persons, or how to deal with the mountains of medical HAZMAT waste generated by even a single patient.

* At this point, hospitals and private insurers (if there are any) will have to eat the costs of treating an Ebola patient, and any opportunity costs of closing departments or the entire facility. There is ZERO financial incentive to do that, and most hospitals nationwide struggle to break even or stay in-budget year to year - particularly the teaching facilities that the CDC would like to use for this, who tend to serve the poorest strata of patients, on city and county budgets already being raped by the long-term recession and staggering unemployment.


  1. Last line in the quoted article: "That would be a big challenge for many hospitals, where staffing is often stretched thin."

    That's proven to be an insurmountable challenge for the Omaha specialist hospital as I highlighted in a previous comment. They're only willing to treat 2 patients at a time, despite having a total of 10 isolation beds. Now, they're using 2 of those rooms for donning and doffing PPE and 1 for a lab, but their stated requirement of 5 medical workers per 12 hour shift, plus supporting staff, equaling 40 to 60 per patient, evidently means they can't take care of any more than 2 at a time and those diverted rooms are therefore surplus to needs.

    I also note the Montana specialist hospital is not volunteering for any cases, it's just Omaha, Emory, which only has 3 beds, and the NIH, with only 7 (from memory).

    Even in the very best, most focused, many cases treated without a single healthcare worker getting infected locations, it's a very, very intense disease to treat at normal, 1st World standards. As you keep saying, that's not going to happen if we get a lot of cases, which I suspect won't happen, or happen for long, i.e. after our first really bad experience we'll close down our borders/implement the old fashioned and currently Politically Incorrect public health measures like quarantine that we know work to keep the caseload manageable.

  2. St. Patrick's in MT has been expressly restricted from taking any Ebola cases, in order to preserve the space for its intended purpose: treating those infected at the nearby BL4 lab, or any of the other ones in the country.

    They didn't bow out, they were volun-told by Uncle they would not be taking any repatriated Ebola cases, period.

    So yeah, max, there are maybe 8 available beds for this, which is why the CDC "suddenly" realized that might not cut it if we get , say, 9 cases(!).
    Federal geniuses, no question.