Ebola thread

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Diadem
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Re: Ebola thread

Postby Diadem » Wed Nov 05, 2014 11:59 am UTC

EMTP wrote:Military docs and nurses are precious scarce resources (you should hear the recruiters beg) and cannot be sent to Africa without serious problems of many kinds (imagine if 5 or ten of them didn't want to go and went to the media with that.)

You raise a lot of good points. This one requires some explanation though. Isn't it the job of the military to be sent to dangerous areas? If the US sends troops to war, the troops generally don't complain that they want to wage their war in a more peaceful area. Surely the same principle holds for army doctors?
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WibblyWobbly
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Re: Ebola thread

Postby WibblyWobbly » Wed Nov 05, 2014 1:45 pm UTC

Diadem wrote:
EMTP wrote:Military docs and nurses are precious scarce resources (you should hear the recruiters beg) and cannot be sent to Africa without serious problems of many kinds (imagine if 5 or ten of them didn't want to go and went to the media with that.)

You raise a lot of good points. This one requires some explanation though. Isn't it the job of the military to be sent to dangerous areas? If the US sends troops to war, the troops generally don't complain that they want to wage their war in a more peaceful area. Surely the same principle holds for army doctors?

Here's the way I read it:

Sure, the job of the military is to be sent to dangerous areas, but when military doctors and nurses are already difficult to recruit/retain (better money/opportunities/safety in civilian practice), you want to make sure to send them to do combat medicine first, where you can hopefully place them a little behind the front lines and have them treat the most dire cases of combat injuries. The soldiers in the front, taking the worst of the combat (unfortunately), while the docs and nurses are slightly better protected and in a better position to treat.

Ebola reverses that position, and makes doctors and nurses the front-line forces and the more likely victims of infection, while the risk to the soldiers should be minimal (build a new hospital and maintain security, but you have no need to be in close contact with patients). So you're potentially risking an already scarce and highly valuable resource (healthcare professionals for your soldiers) and potentially harming future recruitment/retention (doctors/nurses who refuse to go, trained or trainable professionals who would have joined choosing not to for fear of being sent) for a risk to your soldiers that isn't commensurate with the risk to the medics. Thus, sending medics to treat front-line Ebola cases is going to raise many eyebrows and cause a lot of difficulty. Remember, the job of a military medic is to treat their own soldiers, first and foremost. If you can do that effectively and treat others, great! But putting medics at higher-than-average risk will be seen as also putting soldiers at an even higher-than-high-average risk. And that's not going to fly without a damn good reason (I'd argue this is one, but YMMV).

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Re: Ebola thread

Postby sardia » Wed Nov 05, 2014 6:57 pm UTC

http://www.npr.org/blogs/goatsandsoda/2 ... t-millions
Studies show large problem make people depressed and hopeless. That makes you give less. Posits as to why Ebola is t being well funded.

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Re: Ebola thread

Postby addams » Thu Nov 06, 2014 5:37 am UTC

Remember, the job of a military medic is to treat their own soldiers, first and foremost. If you can do that effectively and treat others, great!

WibblyWobbly?
Where did you get that idea?
Is it in The Manual?

Do you have a source?
A long time ago, there may have been a different standard.

You give the best you have to the person God has put in your hands."

You do not look at the Uniform.
You look though it to The Man inside.

No matter what color, what language, what class, what age.
If human, we deliver the Best we have. Every time.

I know there have been a lot of changes in US Policies and Manuals.
I sort of liked that bit. Did the Pat Act reach out and touch that, too?

It took a couple of classes for some to understand it when it was right.
It would take a couple of classes for some to understand Triage based on US vs Them.

They are All out there acting like Fools.
None of them should be in danger of neglect in the hospital.

There were some Fucked Up things that happened as late as Vietnam.
We made some strict Rule changes. Has all the progress been lost?
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
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Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

morriswalters
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Re: Ebola thread

Postby morriswalters » Thu Nov 06, 2014 2:18 pm UTC

Military Docs for the most part treat whoever comes in the door to be treated. Some few died fighting the Flu in WW1. Having said that they aren't in most cases infectious disease specialists and suffer from fear just the same as you and me. But in the end they serve the Military and not the civilian population and I would hazard that they are in short supply. And I don't see the Military loaning them out. Were they to, retention would drop and intake would do even worse, or so I believe. They don't get the best as is, if what I read is in any way true.

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Re: Ebola thread

Postby addams » Thu Nov 06, 2014 6:10 pm UTC

morriswalters wrote:Military Docs for the most part treat whoever comes in the door to be treated. Some few died fighting the Flu in WW1. Having said that they aren't in most cases infectious disease specialists and suffer from fear just the same as you and me. But in the end they serve the Military and not the civilian population and I would hazard that they are in short supply. And I don't see the Military loaning them out. Were they to, retention would drop and intake would do even worse, or so I believe. They don't get the best as is, if what I read is in any way true.

I'm not sure if your post is stumbling Off Topic or Not.
I am certain mine is.

Where is the Real Interesting Show?
It's in our heads, I suppose.

Some of the Stuff that runs Screaming Naked though my head is as funny as the Cultural Memes I make it from.

We all have The Sets and The Actors in our heads.
We arrange and rearrange them on a Whim triggered by Wild Guesses from the Internet.

The Waking NightMare in my head in response to your response.
Spoiler:
I read some of the Ebolia Thread.
I read some of a Multi-Cultural Thread.

They crashed together, somehow and I laughed.
What is funny about that?

The US is Not Multi-Cultural.
The US is Stricly Mono-Cultural.
Yet; The US is Wildly Multi-Racial.

Funny, yet?
Someone wrote, "The US Military Medical Units have a Mission.”

To care for our Own.

If there is something left over we, might, shower it onto The Others.

I know, most of the time,
Ethnicity can be determined by a bunch of purely physical attributes.
Still....Is it funny or horrible?

Shades of That Book and Movie with the Helpless Guy in a Military Hospital bed.
Loads of movies like that?

This guy watched,
while The Nurse unhooked his Urinary Catheter and Replaced the IV with it.
It's something a drugged and traumatized person might dream.

The tubes don't fit.
The reason the tubes don't fit, is so we don't make those kinds of mistakes.
Maybe. If a mistake is easy to make, we'll make a lot of it.

Keep mistakes hard.
What's funny about that?

Well...If we are Only treating American Active Duty Military....
It makes me think of a Movie named, "Born in East LA."

I only watched clips.
Some of it was so funny.

Now; Extrapolate.
Some Guy from Bismarck, North Dakota.

He has been mistaken for Mexican off and on all of his life.
He wakes up one day, to find he is Iraqi. Poor Baby.

'Born in East LA', Ya Say?
What part of Bagdad is East LA?
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

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Re: Ebola thread

Postby addams » Fri Nov 07, 2014 3:54 pm UTC

On a more serious note.
The bbc often writes clearly,
without writing down to us.

http://www.bbc.com/news/health-29613902
I think it says, "We can Do very little, until the Lab Rats have done their jobs."

They expect to hand over 20,000 viles of what May Be an effective vaccine by 1/1 2015.
The Russians have a nearly identical time line.

Personally, I'm rooting for Both Teams.
I'd take both vaccines.

I am the only person in the world that gets in the vaccine line, Twice.
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

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Re: Ebola thread

Postby Angua » Wed Nov 12, 2014 7:43 am UTC

http://www.bbc.co.uk/news/world-africa-30015329

Mali has had a nurse die, but otherwise seems to have it's outbreak under control.
'Look, sir, I know Angua. She's not the useless type. She doesn't stand there and scream helplessly. She makes other people do that.'
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Re: Ebola thread

Postby EMTP » Thu Nov 13, 2014 1:15 am UTC

morriswalters wrote:Military Docs for the most part treat whoever comes in the door to be treated. Some few died fighting the Flu in WW1. Having said that they aren't in most cases infectious disease specialists and suffer from fear just the same as you and me. But in the end they serve the Military and not the civilian population and I would hazard that they are in short supply. And I don't see the Military loaning them out. Were they to, retention would drop and intake would do even worse, or so I believe. They don't get the best as is, if what I read is in any way true.


That hasn't been my experience. A number of my colleagues in residency made military commitments which they are serving out now (and got their tuition paid thereby) and they are fine doctors.

Trauma surgeons (which are what an active combat zone mostly needs) frequently volunteered for service in Iraq -- in addition to the financial benefits, they also got continuing education in major trauma far in excess of what the most violent inner city could supply. Many of them did research and advanced trauma care (and their careers) in the process. I've seen some of them at work in the trauma bay -- while trauma surgeons are known for their, ahem, demanding personalities, there no question that there's a level of mastery and fearlessness that they came back with.

If you are looking at a full-on military career as a physician, there is certainly a financial hit you are going to take there, and it's likely not going to have the prestige of an academic appointment. Hence the constant recruitment drive. But I would not say that the physicians who make that choice are in general sub-par.

As I said above, I think it would be politically very sticky to use military doctors and nurses to fight Ebola. I have no doubt that they could do it and do it well, and that the vast majority would do so professionally and without whining about it. But the toxicity of our political culture at the present moment is such that the inevitable minority of complainers would star in a 24/7 merry-go-round of cable news, op-eds, and congressional hearings. "Obama sent us to die for the sake of random African foreigners" would I imagine be the gist of it. But of course I'm only speculating.
"Reasonable – that is, human – men will always be capable of compromise, but men who have dehumanized themselves by becoming the blind worshipers of an idea or an ideal are fanatics whose devotion to abstractions makes them the enemies of life."
-- Alan Watts, "The Way of Zen"

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Re: Ebola thread

Postby addams » Thu Nov 13, 2014 2:45 am UTC

I'm glad you are posting in this thread, EMTP.
You and Angua are voices I understand.

I may not always agree with you.
But; Damn it! I understand it.
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

AarexTiaokhiao
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Re: Ebola thread

Postby AarexTiaokhiao » Fri Nov 14, 2014 5:25 pm UTC

When I search "Ebola" on Google, I got:

(Source: cdc.gov) Ebola is a rare and deadly disease caused by infection with a strain of Ebola virus. The 2014 Ebola epidemic is the largest in history, affecting multiple countries in West Africa. The risk of an Ebola outbreak affecting multiple people in the U.S. is very low.

What you need to know: Ebola is spread through direct contact with blood and body fluids of a person infected by and already showing symptoms of Ebola. Ebola is not spread through the air, water, food, or mosquitoes.
I QUIT

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addams
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Re: Ebola thread

Postby addams » Fri Nov 14, 2014 5:32 pm UTC

That seems right, to me.
But...The American People and the Mass Media need more.

We could give them Rabies.
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

Tyndmyr
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Re: Ebola thread

Postby Tyndmyr » Fri Nov 14, 2014 6:40 pm UTC

EMTP wrote:That hasn't been my experience. A number of my colleagues in residency made military commitments which they are serving out now (and got their tuition paid thereby) and they are fine doctors.

Trauma surgeons (which are what an active combat zone mostly needs) frequently volunteered for service in Iraq -- in addition to the financial benefits, they also got continuing education in major trauma far in excess of what the most violent inner city could supply. Many of them did research and advanced trauma care (and their careers) in the process. I've seen some of them at work in the trauma bay -- while trauma surgeons are known for their, ahem, demanding personalities, there no question that there's a level of mastery and fearlessness that they came back with.

If you are looking at a full-on military career as a physician, there is certainly a financial hit you are going to take there, and it's likely not going to have the prestige of an academic appointment. Hence the constant recruitment drive. But I would not say that the physicians who make that choice are in general sub-par.

As I said above, I think it would be politically very sticky to use military doctors and nurses to fight Ebola. I have no doubt that they could do it and do it well, and that the vast majority would do so professionally and without whining about it. But the toxicity of our political culture at the present moment is such that the inevitable minority of complainers would star in a 24/7 merry-go-round of cable news, op-eds, and congressional hearings. "Obama sent us to die for the sake of random African foreigners" would I imagine be the gist of it. But of course I'm only speculating.


As someone with extensive experience with military medical, I feel safe saying that it is, in general, rubbish. This is not quite the same as saying that the doctors themselves are the problem. Quite a lot of care isn't carried out directly by doctors, for instance. One such example is that they tend to triage heavily, even stateside. In the civilian world, if you want to see a doctor, you pretty much just make an appointment. In the military world...you might just get sent home with a bottle of motrin instead. Failures of this system are rarely tracked, as we often seek civilian medical care at our own expense(as I did). I dare say this is indicative of a shortage of good medical care, even if many of the doctors who do contribute are fine folks.

So, in a sense, both of you are correct. They really do have a shortage of good people(and I can assure you that at least a few of them are utterly terrible), but the reserves, which you are seeing, is a very different ballgame than active(I've served in both).

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Re: Ebola thread

Postby addams » Mon Nov 24, 2014 3:07 am UTC

If your mind drifts toward Ebola, the BBC has reading material.
http://www.bbc.com/news/world-africa-28754546

Five from Scotland are there.
http://www.bbc.com/news/uk-scotland-30158305

From London thirty are on their way.
http://www.bbc.com/news/health-30148979

(oh, sniff-sniff) One of the people flying out came from Sierra Leone.
Another one lived there as a child. They are going Home to help.

The Drugs. The Vaccines.
Are you getting enough information?
I'm not.

Tobacco Plants. They say Tobacco Plants will save us all.
http://www.webmd.com/news/20140804/ebola-virus-vaccine

That did not tell me how to make that stuff or how exactly it works.
It Did tell me something I did not know.
Thomas Geisbert, MD, professor of infectious disease at The University of Texas Galveston Medical Branch, has been studying the Ebola virus since 1988.

That man said this.
“If we can prove that whatever the treatment was worked, that’s fantastic,” he says. “That’s exciting. But I’m cautiously optimistic, because with this particular outbreak, almost 40 percent of patients survive without treatment. So we want to make sure that it wasn’t somebody that was going to survive anyway."


40 percent survival??
It beats the snotty out of Ten Percent!
That's Great!

Another little Ebolia tid-bit.
It’s rare, but the Ebola virus can stay in semen for 3 months after a man recovers, so he should avoid sex or use a condom to keep from infecting others.

Survivor's get a new lease on life.
No one enjoys sex like a survivor.

Condoms People!
Get those Condoms Out!

I've got Ebolia on The Brain.
http://www.nationaljournal.com/health-c ... s-20141029
That link is basic vaccine stuff, for anyone that wants to review it. Wikipedia is probably better. (shrug)

There has been some serious work done.
http://jvi.asm.org/content/77/18/9733.full
I don't know where to look for the date published.

This paper is old by science standards.
We may be closer to a cure, today.

Still; It is clear and it explains things well.
http://jvi.asm.org/content/77/18/9733.full
(same link. don't ask)
Through this interaction, sGP may contribute to immune evasion by inhibiting early steps in neutrophil activation (as measured by the down-modulation of L-selectin) that would ordinarily assist in virus clearance

They know how it knocks out a natural response.
That's nice, I suppose.

ok. Review.
Mr. Peabody's way back machine.

virion envelope glycoprotein (GP)

It's simply the sugary protein shell that causes most of the trouble.

What else has a shell that causes loads of trouble?
A bacteria that children get....darned.
Gram Negative cell walls kill... I don't remember. Do you?

Back to the article.
Analogous coiled-coil regions have been defined for GPs of influenza virus, murine retroviruses, HIV, and simian immunodeficiency virus (SIV) as well as for some cellular proteins, called SNARES, that function in intracellular vesicle fusion (44). For HIV gp160, it has been possible to identify peptides that bind to a transient intermediate form that precedes hairpin formation. Because of their potent inhibition of viral entry, these reagents have shown considerable promise in clinical trials (21). The Ebola virus GP contains a homologous hairpin structure for which a possible inhibitory peptide has been identified (43), a region that remains a potential therapeutic target.

It works for HIV. (right?)
No. I don't understand the reagents.
I am so glad there are smart, doggedly patent people out there.

ok. Finely a clear statement about use of survivor's blood.
however, anecdotal reports have indicated that serum from recovered patients did not consistently protect against infection or exhibit neutralization of virus replication in cell culture. Furthermore, passive transfer of antibodies in animal models only delays the onset of symptoms and does not alter overall survival

Still...An inconsistent transfer of antibodies is better than no transfer.

ok...Bone Marrow....
More recently, the neutralization of virus replication by selected monoclonal antibodies isolated from the bone marrow of recovered patients was demonstrated in vitro (24), and monoclonal antibodies that recognize specific epitopes of Ebola virus GP have been shown to confer immune protection in a murine model of Ebola virus infection

You survive Ebolia. Whew Hew!
You get to give Bone Marrow.
If you are a Rat!

Would you do it?
If you were the clinician; Would you do it?
If you were the donor; Would you do it?

It seems Booster Shots work.
Priming-boosting immunization protocols that use DNA immunization followed by boosting with poxvirus vectors carrying the genes for pathogen proteins have yielded dramatically enhanced immune responses in animal studies, with 30-fold or greater increases in antibody titer from the booster


Make Vaccine.
Make Vaccine.
(fingers crossed)
Come on, you guys.
Make Vaccine.
Recently, an accelerated vaccination has been developed that confers protection against a lethal virus challenge in nonhuman primates after a single immunization (36a). If this vaccine works similarly in humans, it may be useful in the containment of acute outbreaks by ring vaccination.

They have darned near Got It!

But...But..We don't know it is safe in Humans...
We Know Ebola w/o vaccine is not safe for Humans!

Was that fun?
OK. It's your turn.
You read one.
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

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Angua
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Re: Ebola thread

Postby Angua » Fri Mar 13, 2015 11:01 am UTC

'Look, sir, I know Angua. She's not the useless type. She doesn't stand there and scream helplessly. She makes other people do that.'
GNU Terry Pratchett

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addams
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Re: Ebola thread

Postby addams » Fri Mar 13, 2015 2:37 pm UTC

Dog Gone It! Angua;
When I saw your name in the Ebola Thread,
I Expected Good News!

Where is that Vaccine?
(fuck!)

Angua; The Americans don't want their Vaccine.
I'm sure they won't mind the Africans having it.

What are The Rules?
I forget.

It must be kept Refrigerated during Transport.
(Right?) That can be problematic.

It only lasts about as long as a gallon of milk without Refrigeration.

oh, My education is Old.
Your education is New.

Angua; What can we do to inoculate the people that want to be inoculated?
Damn It! I, just, had a doubt!

Spoiler:
oh, fuck.
What if, it's True?
What if, the MMR gives people varying degrees of Autism?
What if, that explains the Fucked Up behavior of Americans.

That Horse is out of the Barn with Americans.
We would not want to do that to the Africans.

They have enough problems.
A bunch of Emotional Disconnected people with low levels of Self Control would be an added burden, not a gift.
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

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sardia
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Re: Ebola thread

Postby sardia » Fri Mar 13, 2015 2:47 pm UTC

Addams, vaccines don't cause autism.

When it rains, it pours. Don't forget the economic damage of the disease and resulting fear.


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