Dr. Tom Frieden of the CDC refers to travel bans as “solutions that are quick, simple and wrong.” Is the nation in agreement that it would be unfair to restrict West Africans from traveling to the United States? Twenty-two countries already do, including most African nations. In fact, Nigeria has successfully contained the epidemic with a travel ban, plus an incredibly stringent contact tracing program.
The concept of “fairness” relates to political correctness. The issue of travel restrictions should be as it is in other countries—a public health issue and not a political one. We cannot expect politicians to make the tough decisions between political correctness and public safety. Our top health officials are expected to do just that, however, and may have to before long to protect the health of US citizens.
IN THE MEANTIME…
With the proper screenings, the experts believe that travel is safe, including travel to and from West Africa’s Ebola-infected areas. Essentially, anyone who travels to or from those areas will be given health information about Ebola and instructed in how to monitor themselves for symptoms.
Temperatures will be taken with specialized thermometers that do not make contact with their subject, and anyone with even a slight fever will be quarantined. There is no answer, however, to the question: What stops a person determined to get to the United States from taking acetaminophen (Tylenol) to keep their temperatures down artificially? Nothing.
If a passenger is directed to quarantine, the individual will be further examined for other symptoms of Ebola and either hospitalized or released. Dr. Frieden explains that health officials expect to see some patients with fevers during entry screening, “and that will cause some obvious and understandable concern at the airport,” but people should not panic—thinking everyone who has a fever at the airport does not have Ebola. Dr. Frieden is right when he says that most will have some other illness.
NOW YOU KNOW…
Better systems are now in place for screening international travelers for possible Ebola infection, but the system is not perfect and could possibly be circumvented. Travel restrictions from West Africa have become a political issue but should really be a public health issue. Any travel restrictions should leave an open door to relief flights to the affected countries of Liberia, Sierra Leone, and Guinea.
8. The Sick Room
The United States is lucky to have had few cases of Ebola on its shores, but who knows what will happen in the uncertain future. In good times, we have the luxury of modern medical facilities and advanced techniques to isolate a sick patient from healthy people. If we ever find ourselves in an epidemic scenario, hospitals will be overloaded and your only choice may be to fend for yourself. Our modern advantages will go the way of the dinosaur, and we will be placed in, essentially, the same medical environment we experienced in the nineteenth century.
Not completely, however. We have better knowledge of sterilization and the modes of transmission of infectious diseases like Ebola than we had in previous centuries. If we put this knowledge to work, the average person can become a medical asset in times of trouble.
With highly contagious diseases such as Ebola, it makes sense to separate the sick from the healthy. To do this, every household should designate a “sick room” before an epidemic arrives. The family “medic” can put together a working isolation area that will protect the healthy while giving an organized place to care for the sick.
When I say “protect the healthy,” that means you as caregiver as well as everyone else. Ebola is harsh on medical personnel, infecting hundreds and killing more than half.
The sick room should be an area at one end of the house, preferably away from common areas like the kitchen. This room should have plenty of light and ventilation from the outside. Open windows will decrease the concentration of viral particles that may be suspended in the air. Assuming that you have power, air ducts are acceptable for diseases like Ebola, which is spread mostly via bodily fluids. For severe influenzas like bird flu, these ducts should be taped.
Your home may not be large enough to keep a clear space between the infected and the healthy. In this circumstance, screens and plastic sheets will come in handy. Even if the room has a door, plastic sheets should be hung to provide a barrier.
Furnishings in the sick room should be minimal. A bed or beds, an area for exams, a work surface, and a “latrine” may be sufficient for your purposes. Cloth surfaces, such as what you see in sofas, carpets, etc., can harbor pathogens (disease-causing organisms) and should be avoided, if possible. Plastic covers on bedding or furniture in the room will make daily cleanings more manageable. In the case of Ebola, a blood-splattered mattress may need to be thrown away and burned if it’s not covered with plastic. Remember: the more areas that can be wiped down and disinfected easily, the better. Carpet and soft plush furnishings are your enemy.
It’s important to have a way to eliminate waste products, especially from bedridden patients, even if it’s just a five-gallon bucket and some bleach. Have closed containers like hampers to put used sick room items that need to be cleaned (or thrown away). We’ll discuss proper disinfecting techniques later.
It’s wise to establish a station near the entrance of the room or tent for masks, gloves, gowns, and disinfectants. Here you’ll need a basin with water, alcohol, bleach, and towels that should be kept for exclusive use by the caregiver. If at all possible, there should only be one person involved in caring for an Ebola patient, in an effort to place few people at risk for contamination.
TIP
It’s important to have a way to eliminate waste products, especially from bedridden patients, even if it’s just a five-gallon bucket and some bleach. Have closed containers like hampers to put used sick room items that need to be cleaned (or thrown away).
The average citizen won’t be able to afford $1,000 Powered Air-Purifying Respirator equipment. He or she will have to make do with items that will afford some protection, at least, from the infection.
For supplies, get plenty of masks and gloves. I strongly recommend putting on two pairs of gloves every time. Gowns can be commercially made, can be plastic coveralls, or, in extreme situations, even dry cleaner clothes covers. Many people consider medical supplies to consist of gauze, tourniquets, and battle dressings. These are useful for injuries, but you must also dedicate sets of sheets, towels, pillows, and other items to be used in the sick room. Keep these items separate from the bedding, bathing, and eating materials of the healthy members of your family or group. You’ll never have enough of these items, as you’d discover if you found yourself having to deal with an Ebola victim.
Accumulating all these items may seem excessive to you, but you can never have enough dedicated medical supplies. You may save the life of a loved one or even your entire family if you are diligent in putting together your medical stores.
You’ll want to clean the sick room as thoroughly as possible on a daily basis. It’s imperative to clean surfaces that may have germs on them with a bleach-and-water solution. These include doorknobs, tables, sinks, toilets, counters, and even toys. Wash bed sheets and towels frequently; boil them if you have no other way to clean them. As a rule, all bedding, clothes, and personal items of the ill are infectious. Wash your hands right after touching them. The same goes for plates, cups, etc. Any equipment brought into the sick room should stay there.