We are in way over our heads.
Even though the virus appears to be presently only transmitted through direct contact with body fluids, we are being naive with how consistent the medical system and humans are with the protocols. The second infected nurse is an excellent example. She ended up traveling on an airplane with a fever. So now we have a 100 plus passengers that need to be tracked but we also will have to track the passengers that were on the plane immediately after the nurses flight. How well do you think the airline cleaned the plane on turn around? Would you want to fly on that plane before it was properly disinfected? I would not.
We have the issue of the waste streams which nobody pays much attention too. It used to be common that all health care facilities had incinerators for disposing of human waste, soiled materials, and general bio-hazard type materials that were disposable. Due to EPA regulations and the fact that the incinerators were frequently not well maintained, they have almost all been eliminated. Bio-hazard waste is now disposed of at approved incineration facilities. Sometimes this material ends up in the landfill due to mishandling and protocol breeches. The contaminated waste must be handled and transported which exponentially increases the chances of mishap and exposure.
The other major waste stream is the hospitals sanitation system. A proper level IV containment would incinerate or irradiate all off the waste streams including the waste from sinks, showers, and toilets. Hospitals which are built to local and national plumbing codes are not required to have a method of disinfecting the sewerage discharge into the municipalities waste water system. The problem is that the architects, engineers, and contractors do not make design considerations with the input of experts in the field of communicable diseases.
Why I raise these points is that the fortress wall is only as strong as the smallest unguarded door. We do what we do very well, however ebola is a third world disease that we have zero experience with outside of the laboratory here in the west. The third world health care facilities, as crude and spartan as they are, are actually very well suited to helping in the containment of a virus such as ebola in the third world setting. We like to use high density energy efficient buildings that substantially increases the probability for a virus to survive and or be transferred to another host. Our hospitals are not anywhere close to as sanitary and clean as we think they are.
My final concern is that because of the way we do health care, the system will rapidly become overwhelmed if the number of infected individuals gets much greater. What the issue is is that with patient zero, we used at least 70 health care givers for his immediate care givers and this was the number without using all of the proper protocols. All 70 now are at some level of risk and probability of infection. We have at present, two care givers that are infected. The second nurse that just became ill has exposed at least 100+ other individuals. We do not currently know the probability of their infection but past experience would suggest that there will be another 2.5 infected individuals from this nurse alone. If we are going to consume 70 health care givers per patient during a patients treatment, we will rapidly consume our manpower resources in a very short time. Add to this the personal risk and sacrifice that this will require and the added frustration of dealing with an ill prepared bureaucracy and medical establishment, you will have a significant portion of your staff that will chose not work.
We have a situation that is barely containable at present unless we become extremely proactive.
