Group, I hope you'll help rally with Eric on this important initiative!

Eric, I made this conversation the "Manager's Choice" for the week. Good luck!

Last Tuesday, SAVSU Technologies announced a new version of their nano insulated containers for shipping and storing temperature sensitive samples, medicines, vaccines, etc. Called the EVO. Uses embedded smart technology. However, their original product, the Nano-Q, might be the most useful in this situation. Nano-Q was originally developed for PATH and WHO to transport and store temperature sensitive medicines in areas with no, or limited electricity. Perhaps this can be of some help. http://www.savsu.com

Company is based in Santa Fe, NM.

There seems to lack of concern about respiratory transmission of Ebola, which I understand. However, Ebola Reston(RESTV), was first described in 1990 as a new "strain" of Ebola virus (EBOV), a result of mutation from Ebola virus,was shown to transmit infection via inhalation.

I believe that we should be aware that "mutations" could take place and transmission by inhalation, though not probable, could be possible such that precautions should be taken.Thus, filtering of the air and use of masks capable of filtering-out virus particles where infected patients might be, would be warranted.

Garnet Ward III Steven: Interesting about it going airborne but I agree with many other scientist on it not going airborne. But, if some one that is contagious and infected sneezes on you or vomits that's another story. I agree using better mask is a must no matter what viruses your dealing with, so better to be over prepared then under.

http://scienceblogs.com/gregladen/2014/09/30/ebola-will-not-become-airborne-and-here-is-why/

There are anti-bacterial coatings, surfaces and materials available for many uses. Hospital and office furniture having anti-bacterial features are available at Isku Interior in Finland, Europe.

Scott Spinka The ruling position these days is no symtoms - no ebola. The truth is, there must be a symptom development period wherein symptoms are developing. Some of these symptoms may be noticeable some may not. Are we susceptable during this period? So how does this work? I wonder if the ruling position needs some further definition/explanation?

Excellent Environment & Personal Protection Equipment Suggested . However , considering the Limited Infrastructure and Resources at Africa . Movil Clean / Controlled Environmental rooms can be Implemented , as well as Improve Personnel Protection Equipment with recommended Gloves , Masks , Micro-Clean Overall . Segregation & Access Control to Infected people MUST be a priority .

William Rasmussen Its my experience having worked in isolation and burn units that barriers are the key-obviously something is better then nothing-but when it comes to multiple patients, the process of gown-glove-mask-is a problem each and every time. there should be a way to do single patient easy in-out protection-not unlike the highest level bio-protection where the tech can step in and out, the thought being like in Andromeda strain-but make it simpler. A curtain wall surrounds the patient-protects cross contamination, the suit is reused by multiple people to care for single patient. you can AC the air coming in-but at least its not so confining that its that horrible to be in. have a set clean area in the area, for things to be handed to you.

There are many advantages to this-one saving time, not having to gown and all each time, save money-not having to use single use items as often-but more important-not having all the bio waste. Better protection-stronger barriers, better use by providers-leave no mistakes

if you made it totally self contained-you could literally roll the whole thing up and burn it for disposal-wall covering-bed cover-isolation gear-everything inside-no contact bio-waste

but thats just my idea of working 20 years in patient care in field hospitals and ICU

A funding source should be made available to develop personal protective equipment (PPE) that is able to meet the requirements needed for health care workers. Overheating is a major deficiency and if this issue can be addressed in the design of the PPE then health care workers may be able to work longer than one hour before needing to remove the PPE. This is an immediate and tangible need. I am the point-of-contact for further information.

William Rasmussen I was also thinking that instead of direct protecting the provider-cocoon the patient. work like in a glove box. its small enough, does need some facilities to maintain fresh air and all, and does pose some social issues Im sure. But that would free the providers up a bit more.

Andrew Kyle I would ask what the probability of transmission by insect vectors. For instance, can bedbugs spread the disease? Or other blood dependent parasites that could feed on one individual and then fly to another?

We probably don't really understand how uncomfortable the care givers must be... would a suit like "bubble boy" of years back be an alternative for the healthcare worker?

Technology from the space program?

Quarantine... seems to be a time tested alternative. Until it is under control, I would personally like to see the area quarantined and travel limited. Spreading the infection will dilute the resources and focus on controlling it at its source. Unlike the CDC, I don't believe we are as ready to combat this disease as we are told.

William Rasmussen bubble suit sounds good to me-the problem with normal isolation-gown-gloves and all-is its repeatedly doing it-take them water-fix a pillow-all takes time-and mistakes happen-especially when your over worked and its a bad day. you have to make it easier for the provider-sorry to say -this isn't the time to be subtle about what things look like. This is their protection from others too. This is the one way to get a handle on it-everyone is in their own little space-nothing comes from another, nothing comes out. keep everything in the room-until everything-including the patient is ready to leave. lets hope they walk out.
My guess-something could be made for $50, with right resources-up and running in less then a week. The military has the resources to support a unit like this-AC, water, electric, technical.

Garnet Ward III I work for a Medical company and have a degree in Public Health and the main issue contract tracing in Africa is much more difficult to fathom! As far as trying to protect Employees you need clean rooms and the cleanest environment for treating patients if you don't have that it is a huge uphill battle. This web site via the CDC is very helpful:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm

I would suggest a holding area for those who test positive but are not showing any symptoms yet and you need "Medical" Clearance and documents to fly out of the country.

I would also incinerate all infected dead bodies and use super heated steam to sterilize any area where infected patients are being treated.

http://www.menikini.com/us/about-steam/health/kill-germs-bacteria.html

I have liked the meeting a bout Ebola. On my opinion we need to protect both parties the patients and medical staff. I have observed patients are nursed without protective gear's however the measures in nursing Care is fine. We need to improve on creating maximum barier by also drepping patients in the same way (protected gear) we should unite and fight Ebola together
By Florence equal gmail.com

Robert Feldtman In Air Force we used PCR rapid cycler for quick ID of bio agents. Surely Ft Detrick has carried this to Ebola. Lt Gen PK Carlton (retd) was active with anthrax/ 9-11 response. Politics aside we need to stop flights til we can rapid ID sick folks. Yes I am here at Dallas Methodist three miles from ground zero! Just waiting at our hospital. We will all know within a month. If CDC is wrong we have a major ID catastrophy

William Rasmussen sounds like we need to put all people flying into a quarantine holding center on either side-navy Seabees are building hospital, maybe do the holding centers too-yes its a pain to travel like that, but we detain illegals all the time here.
I can see that as being just a bit of a problem

Sandro Pires Gomes Everyone is undermining the Importance of Prevention saying that Ebola is only spread by contact. Not true: Ebola is also transmitted by water droplets in the air: sneezes and caught can spread Ebola: Using surgical masks has I often see on Media is not effective.

Thanks You!

William Rasmussen so-we need to improve screening and preliminary isolation first, then improve the protection for patient and providers, then get treatments that work, then immunization to protect everyone. No sweat-
we just have a problem that people would rather fly under the radar, we have to depend on people to do whats right in first place-and thats not happening as it is now. Someone is going to have to really sell the whole thing to the public there and here, and keep the pundits out of it. Isolation only works if everyone does it.

Garnet Ward III Well Prevention is alway key to keeping viruses and bacteria at bay! Well, you need to come into contact with a person that is contagious, sure it can be transmitted via a sneeze , cough or vomit, diarrhea.... But if memory servers me right there is not many viruses that are transmitted via fluid that have ever gone airborne, regardless I think we need to go beyond a surgical mask and go to better gear for people who are caring for these sick patients.

Bruce Dobsch The operating assumption should be that it can spread in all ways. The Aids intrusion into the US should have taught Doc's that until proven beyond a reasonable doubt take all precautions. Too many folks died due to scant knowledge or willful ignorance of best practices. Let's not do it again with EBOLA.
Bruce

Bruce Dobsch The operating assumption should be that it can spread in all ways. The Aids intrusion into the US should have taught Doc's that until proven beyond a reasonable doubt take all precautions. Too many folks died due to scant knowledge or willful ignorance of best practices. Let's not do it again with EBOLA.
Bruce

Sandro Pires Gomes True.

...and not only on the role of the Pros but also on the role that politics haves in economics...
and hope for the best!

On my field of work: Spectra Shield face masks we can't believe what we see and ear often from mainstream media that protect Medical Suppliers in the most affected areas saying that the current Protection they have will work just fine. It's not true.

And I'm also very astonished with some African Companies the sell medical devices. They not only know that Ebola can be spread by water droplets in the air and they even say that is not their problem. So this naif ignorance propelled by mainstream media haves a huge impact on the death toll and contamination.

Hope you the best William!

Garnet Ward III Sandro, Nice data base of good knowledge. The mainstream media need to get more good experts on this disease reporting on it, instead of having a lot of misinformation floating around which I see everywhere these days! :(

http://monkeysuncle.stanford.edu/?p=1463

William Rasmussen Im going to hope that they have a handle on this soon-my opinion from what Ive heard is its pretty weak response in the countries so far. But should it continue. There needs to be a quarantine of affected areas, which will be hard enough, but more important-the outside community needs to bring food-water-what ever they need to keep the people in place. the good news-hopefully its only a week or 2, but keep and treat onsite.

I think besides the provider protection-space/ bubble suits, this is where we need to concentrate, its what the US is good at and able to do. have medical assets available inside the areas, we provide the resources to the people, and let it run its course.

I was thinking that people with CBR background have a pretty good take on how to do whats needed, and how to operate-this could get past the point of being strictly a medical issue at some point if not already.

Sandro Pires Gomes Thanks Garnet!

I can always send to this discussion much more then this.

Thanks all!

Star Simkins, RAC (US, EU) Inovio Pharmaceuticals is capable of making a vaccine not from the virus itself but a DNA synthesized version "We were able to see 100 percent protection in animal models, in two separate animal species, after these animals were vaccinated with Inovio's Ebola vaccine," the CEO said, adding that the subjects avoided illness and death. The results, he added, were published in a peer-reviewed medical journal late last year.

William Rasmussen I think you have a market now

Just I few words, please visit the following web site: www.who.int and check Ebola outbreak and other topics. Finally collaborate with WHO organization, thanks.

Sandro Pires Gomes http://www.engr.psu.edu/iec/abe/database.asp#b

Robert Feldtman I suspect Dallas is a test case. If thirty days from now not much has happened, CDC will have been right. If instead, we are seeing a dozen new unexplained cases , then CDC is wrong. Bad problem is a year from now it won't matter one way or the other except for the million or so dead (Spanish flu scenario)... and no I do not trust our technologically advanced country because there is no cure, only fluids, blood components. etc. We cannot grow tobacco plants that fast! Thus my leaning very "rightward" towards time tested quarantine, travel restriction etc. EBOLA is inside our OODA loop, big time.

William Rasmussen so-what about people on a vent-the air coming out is not filtered, so all that was in the lungs is now everywhere. 2 things they ought to consider-filter the exhalation valves, and using PFC to help the lung compliance and maybe helping to keep hold of the infectious waste a bit better

Robert Feldtman We need the UV killer filter, i briefed our hospital a year ago, then had General Carlton brief them. Got it in OR but not in ER or ICU areas. AF tested this for B part of NBC. Works to >10 to the 6th power reduction. I do so wish those "in power" would listen to us doctors!!!! Both local and federal

Robert Feldtman No comment on personnel. Ebola gets "established" and <25% of employees will show for work. Dallas has been hammered with patients cancelling elective surgeries, even doctors office visits. I am above 50% on no shows all this week for both! and I am NOT at Presby. Rumor is nobody wants to go to Presby for anything.

Garnet Ward III Dr. Feldtman: Interesting on UV killer filter, as I know they work but how effectively? I would expect exposure time would have to factor in, meaning how much of a concentration of UV will it effectively kill a virus or bacteria? I use to be involved with UV systems on the water side of things, and I was contemplating even putting one on our furnace. (Son had asthma) thankfully grew out of it. Sorry to hear about the economic impact, one patient in very strict isolation you would hope not effect too much but incorrect information and the media being a venue for it doesn't help.

http://www.sanuvox.com/en/medical.php

William Rasmussen So-does a facility have to say "we are Ebola Free " I used to work at Methodist, Baylor, St Paul, Childrens, I can see it being a big issue-so why not have a designated facility to take these cases ? trying to set up correct best practices at 12 hospitals is going to be hard to do, thats why we have a designated trauma center, burn, etc. Think Parkland could handle being the regional Ebola Center, take the pressure off everyone else .

Robert Feldtman If "centers of excellence" for transplant, neurointerventional etc then why not for Ebola! Brand new one billion Parkland hospital right out of the window I am sending this from. Not every hospital can be competent not every BIG hospital can!

William Rasmussen so throwing a question out-does the body -skin release any type of markers when someone is sick but not necessarily showing major symptoms ? do they release histamines or other proteins that come thru pores. We are searching for people with fevers, and I can take tylenol to mask it.
Im taking a remote sensing class now and we looked at water content inside leaves using low IR imaging. They can use multispectral to pick up trace minerals from airborne sensors, could it pick up high fluid loads in skin, increased pore size, spectral signature of a protein, or some other marker ?

Garnet Ward III Ok, where is the editing feature on here! LOL Trying to do this remote like on a smaller screen doesn't fly with good proper grammar etc..

William, good questions as usually histamine levels activate tissue receptor proteins which can trigger inflammation but that can happen with the flu or common cold etc.. Typical ELISA or PCR test are preformed to see if you have specific viruses etc..

http://lpi.oregonstate.edu/ss07/inflammation.html <<<<<< This research associate at Linus Pauling Int. wrote a good paper/newsletter regarding biomarkers and inflammation she or some one she knows might now if there are biomarkers via the ski route.

http://jvi.asm.org/content/75/22/11025.full

William Rasmussen Thanks Mr Ward-sent Dr Drake an email asking- maybe something will come out of all this-my wife is just glad Im retired from the military

William Rasmussen Dr Rasmussen-might want to talk to Seattle Childrens Research Foundation -they also may have some ideas-especially about remote medical care. The Director is really good to work with.

Take a look at Mirasol from Terumo BCT as a pathogen reduction agent for the blood supply and Provodine from Microdermis as a topical professional antiseptic. I can discuss more details offline if necessary.

Garnet Ward III And some good news! Trials being fast tracked and there are several more... Vaccines are going to be key here. The media needs to talk more about this has hope is always better than despair but of course not if you want to sell market share..

http://www.cbsnews.com/news/ebola-vaccine-being-tested-in-rapid-fashion-say-researchers/

Jerry Robinson Ebola is here....

I live in Dallas - it's real..... and people are not knowledgeable or trained how to deal with this... My son is helping (I think) in Africa - with med device/facility deployment.

*********************

The #1 thing to do - is BRING UP a web site - already 37% of doctors RELY on this to help make diagnosis..

For the average person - this is where they are going to look - for WHAT THEY CAN DO....

Reliable Information is critical... and people (rightly so) don't trust or fully believe our government. A good piece of LIES and thinks that's what "managing the problem is".

****
First... when people realize that this problem is REAL - they tend to PANIC.. that's the worst thing to do.. RELIABLE INFORMATION - that is FACTUAL - is the #1 way to stop that problem..

************

I work on that REMOTE MEDICAL thing... It's just too far away (time wise) for widespread distribution and deployment...

I see a parallel between Ebola and AIDS. Before AIDS was understood, fear was rampant.

I believe Ebola can be contracted in much the same way: The exchange of bodily fluids with the sick. Is this correct?

Eric Rasmussen, MD, MDM, FACP Colleagues,

Thank you for all of this.

I've just completed two days of meetings in DC around good ideas related to the fight against the Ebola virus in West Africa. I carried with me a 12-slide presentation filled with ideas submitted to me by you and people like you over the past week.

In the room for the discussion were representatives from the White House, USAID, MSF Liberia, MSF Belgium, HHS, DoD, CDC, UN relief agencies, Harvard, MIT, Stanford, Johns Hopkins, and a range of people with on-the-ground experience in West Africa for a variety of reasons.

People in this thread received a positive comment during the evaluation of the options I presented.

Now you need to please submit that idea to the beginning of the funding mechanism and see if it is selected for further development.

I have no voice in that selection, and would recuse myself if I did, but I can tell you that the people doing the selecting heard your idea and considered it worth a submission.

So, if you're interested in possibly making your idea real in Liberia, Sierra Leone, and Guinea, please go to the just-established Open Ideo Ebola website below and tell us about it:

https://openideo.com/content/fighting-ebola

You may have given me more than one idea. Submit any and all, separately.

I will continue to be involved in the Ebola response, particularly on the design of the critical field infrastructure related to the Ebola Treatment Units. That work may or may not involve your idea.

Good luck,
Eric

How thrilling. Thank you for the excellent work you're doing, Eric.

You heard him, Folks. If you submitted an idea on this string, the next step in making it real is posting it at the Open Ideo Ebola website at https://openideo.com/content/fighting-ebola

William Rasmussen Hi Joe-back in the 80s I was working in Dc and half my patients were HIV positive. we took precautions and all -but this is a lot more dangerous, HIV isn't viable out of the body and is pretty fragile. its not contracted thru the skin. Ebola is really nasty-I think of it so nasty -if you look at it wrong -it will get you. Its that serious. When an RN who is being careful get infected-theres a problem,

Tom Houck Cleaning, disinfection, and sterilization of medical devices and facilities are difficult issues in the developing world. They may not have access to all the chemicals that we take for granted. Get them an adequate supply of gloves and other personal barrier garments, and utilize more UV-C systems for decontamination. The latter only requires electricity, not a supply of chemicals. Hydrogen peroxide disinfection equipment may also be useful. And above all, use good infectious disease protocols. Accidents can kill, but so can sloppiness.

Robert Feldtman UV killer filter work has been done- just need to implement it. POC here in Fredricksberg Texas

Tom Houck It's not just UV filters, but also for disinfection of devices and facilities.

Infra-red technology has been used previously for detecting Bird Flu victim through the measurement of the area between the nose and eye. I understand this area is close the temperature of the blood so can detect increased body temperature from a distance.
Long shot but worth considering.....

Garnet Ward III Tom, as discussed before it will be highly critical to disinfect, I think the CDC needs to put out a memo if they haven't already about how critical this is. Even if your the most careful person on earth, disinfecting could have missed some thing and once you rubbled your eye or nose and thats all it can take. UV and Steam combination sure would help. I know there are some devices out that use steam that are highly effective on viruses and bacteria.

This needs to be stopped at the source and I think flight restrictions need to be put in place for West Africa, some European countries already have done this and I think we need to work with Europe and other countries to reduce and eradicate the pandemic, and here is hoping the vaccine they are developing will work.

http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html

Tom Houck Agreed on flight restrictions, but that may need to be extended to "travel". Flights are just the fastest way out. This is really a tough deal, because people, healthy or not, may just be trying to get away from the outbreak of the virus. Who can blame them? Heck, people in DFW are apparently avoiding the hospital where they treated the ebola patient.

As for being careful, failing sterile technique can be deadly to the caregiver. Absolute discipline is critical. It is your life at stake, and maybe others.

RINA (JC) OTTO If the MOR(Mortal Oscillatory Rate) of the Ebola virus is established, the at-risk service provider or infected patient can be treated with Resonance therapy which kills the virus. This Resonance research has been done by Dr Royal Raymond Rife around 1950's where he proved that various pathogens, including virus can be eradicated in the body and the patient cured. Unfortunately this mode of treatment through a MEDICAL DEVICE was overpowered by the pharmaceutical industry methods. Various devices based on the Resonance concept are in use throughout the world (except in USA where it's only used for experimental, vetinary and personal treatment) for diagnostic as well as treatment purposes. One such device is manufactured and licenced in Europe. Reply if you need more specific info.

Robert Feldtman Removing the PPE is the weak link

Scott Spinka It appears there are many great sources of expertise and knowledge that may be useful for dealing with the potential spread/containment/eradication of Ebola. We can easily see from this short discourse that much may be contributed.

It also appears that we sorely need a single leadership clearinghouse, We presently do not have this. The CDC is trying to play this role but I do not believe they are the right choice.

As you probably know, the government does not presently have a "Surgeon General". We need leadership as much, or even more so, than clinical/technical support. If for some reason this virus gains footing here in the US and cases begin to break out in multiple locations, leadership will be crucial!

Garnet Ward III Rina,

Very interesting, I don't think with Ebola you are going to see any magic bullet that any pharmaceutical can provide, but what you will hopefully see is a vaccine which will be highly needed especially in Africa. Back many years ago when people in Western Africa and the Congo you would see whole villages wiped out, but now since people travel more this out break is going to be difficult to contain, but if you can provide a vaccine that works this could change a bleak out look that many people have over to hope!

https://web.stanford.edu/group/virus/filo/history.html

Now I wish more media services would talk about what we need to do, instead of death and destruction!

Garnet Ward III Scott, lets hope some one higher up in our government is reading this thread, because your spot on with your comments!

Robert Feldtman Question should be "what enabled the survivors to survive? Immunologically" that is where we need a whirlwind of research

Garnet Ward III Robert: Well now we are talking! There was a recent information sent down from CDC on this that had to do with Biomarkers and Survival in Pediatric Patients with Ebola. There is a podcast and a pdf. IgG levels might play a role in immune activation. There are new and old information in the pdf and podcast etc..

http://www2c.cdc.gov/podcasts/media/pdf/EID_10-14_Pediatric_Ebola.pdf

http://www2c.cdc.gov/podcasts/player.asp?f=8633631

Sent you an email this morning, Eric.

Scott Spinka I am reminded of the days of "Rosie the Riveter" during WWII. Terrific resources (primarily women) stepped in to do needed work in factories when the men were no longer available to do it (shipped off to fight).

We have another great resource in America, right now, that may be "pivotal" in assisting with Ebola Prevention: Baby Boomers!

Many of these people have significant career knowledge and expertise related to viruses and containment; many may come from healthcare and laboratory backgrounds; and many may only work part time or are retired. A meaningful population of these people could be qualified/mobilized to help with hospital protocol education across the entire country and to perform other specific needed information dissemination and tasks.

The personnel that currently operate hospitals today have full time responsibilities as is; to ask them to shoulder this work on top of everything they are already doing may be too much.

William Rasmussen the problem is the PPE is the problem, its 5-8 different piece of equipment (goggles, mask,gown, 2 gloves, maybe shoe covers) yes its possible to take these on and off safely, a couple times, but try it after a 12 hrs shift. The easiest way is to go in and stay in-we do that for lung and heart transplants. But that presents issues of its own. Whats needed is a one piece unit that you step into-has the full covering, including boots, gloves and mask-eye protection, one piece on-one piece off. I still like the bubble idea-but seems Im in a minority-so lets come up with a design that is easy to put on-easier to take off-rule of thumb-you use your hands only at chest level, and dont actually touch the body. I think entry from back so you step into it feet first, put hands into arms and gloves, then pop head thru to the head protection. Then getting out just push out, leave everything behind.
maybe have a device that actually pulls the sleeves so you dont use your hands.

I understand that everyone is concentrating on PPE-which they should-But the design is inherently flawed- they try to take the OR dress to isolation, its not the same-so lets stop treating it the same-we are killing people with poor design.

RINA (JC) OTTO Great idea, William!

Robert Feldtman I bet we are ahead of CDC on the ideas! Where is Ft Detrick in this? When I was AF Col in mid 90s I got a senior level brief and tour. Certainly they are and have been working this. At the time we were worried about dead camels and congocrimean hem fever as well as Marburg etc. maybe the powers to be have silenced their input into the social media sphere - but some of us still have robust connections. Indeed - we need a new poopie suit!!!

William Rasmussen Dr Feldtman- Im working on that I think-made some connections here at CSU to redesign the isolation suit-I have some ideas-would like to get some others involved also-I have some postings on the OPENIDEO webpage. Im thinking of a one piece head to toe bunny suit with face shield that you get off with no hands. I hope I convinced the Fashion and Marketing Proffessors here that this is something they can do to make the world a better place-will see

Hello Dr.Rasmussen, this is Dr Uviedo, CEO of SCA. Our company is working on a new project set up in Ghana, including health and Pharmaceutical. One of our partners, Dr.Peter Hu (from Shanghai) has developed a gene remodeling system which he ensures is able to stop the illness spread out. I think that we should hear him.

Behold this string, the latest example of we can do as a group.

I hope some of you are jumping over to the Open Ideo Ebola website at https://openideo.com/content/fighting-ebola to bring your suggestions a step closer to reality.

Hello, this is Dr Clauzon, basis to prevent viral spread consists in stopping migratory flow. It is important to stop air transport and mass meetings in infected countries. Infected health-care workers should be remain on the spot to avoid occidental spread. A quality care system in countries hit by Ebola is essential. Indeed, if workers are repatriated for treatment, the local population will not trust in the efficiency of medical care. Numerous Ebola infected patients will not go in treatment centers what will contribute to epidemic.

Scott Spinka Our government is not behind the curve. It is our leadership that is behind the curve! It is absolutely atrocious that we don't have a Surgeon General; instead, we have a
Commander-In-Fundraising and a Hacker-In-Chief (his handicap is the United States).

WHAT'S WRONG WITH THIS PICTURE...

Troy Smith I would like to be available for surface disinfection. We have the equipment, studies, and science to support your effort

William Rasmussen Hi Troy-I have an idea for using some equipment to help take isolation gear off, and maybe doing disinfection -are you interested ?

Troy Smith very much so, we do the same in isolation, and quality control cases. Please contact me at: tsmith@radiantuv.com

William Rasmussen So heres what Im thinking about isolation gear-in the hospital-a 1 piece cover that you can take off not using your hands -best option, Im thinking using heaver -non-disposable gloves mid forearm in length that goes inside the sleeve of the gown and hooks to the thumb ring . having 2 straps from the back closing flap that you pull to open the back of the gown to help pull it forward and off. Then a head cover that comes off with the rest of the gown. Its open in the back-has all the face protection with it, hands never touch anything but the 2 straps.

Best case would have a box that you put your gloved hands into-its sticky or has rollers, that hold the gloves in place and you basically just back away-so you never touch it. If its motorized it sucks it right into the trashcan. If thats not available-use hands to pull the tabs-grab one hand with other glove-pull it off-use that hand to reach in to push the opposite glove off-and push the whole thing away-bundling at now practice for disposal.

Your not reaching/ grasping to take off the gloves or mask-only surface exposed is the inside. If they use the box system-its literally step away from it.

I think this can be done with the existing isolation gowns on the market-just a matter of adding things as you gear up. The design for the head piece is the hard part now, how to cover the face with eye protection -you could wear a mask inside the suit so not exposed-have it open from the back, and attache to the cover gown to be pulled off.

If the system is preassembled-gear up I think in under 1 minute, to gear down-maybe a minute. I think we can design this for better comfort and better protection since we aren't adding layers that get in the way.

open to ideas

Troy Smith the tacky approach to gear down is quite simplistic. To add in disinfection of a person in gear prior to "action" and "Gear-down" would stop the contamination after event. Yes, we can get into this and manufacture

Troy Smith Garnet, that is directly in line with our efforts of a disinfection chamber. We would like to collaborate on this effort so we can assist with the disinfection and cross contamination through disinfection control.

William Rasmussen Most big hospitals have isolation rooms with attached ante rooms, they can do reverse air so they can get pretty specialized. But heres one problem, they store everything and anything in there sometimes. So space is limited. As far as isolation gear-they usually have a trashcan and maybe a hamper for gowns if they arent disposable. So that means the provider also has to sort their stuff-more handeling. See how the system can fail. So-we make it one stop shop with nothing touched once you start take the gear off. If they disinfect prior to that-great, but most of the gowns now are disposable.

Another problem Ive run into is that we wash our hands -a lot-every patient-in and out. So chemicals that are hard on skin is a definate problem. I had to wear gloves one time with my hands soaked in hand cream they had such a reaction to the soap. Im not trying to say we need to wash less, we just need more barriers that protect us so we dont have to tear up our skin in the process. Now if we nuke the materials and waste--Im all in for that

Troy Smith we have done this work before, nuking - shredding - destruction = no problem

Garnet Ward III Well there are plenty of companies out their that have had zero transmissions of viruses and bacteria on the Biologic side of the fence so the technology is there, we just need to implement it on a smaller scale in a hospital setting. I been in many IVIG facilities that deal with plasma and blood and the amount of controls in place to stop this are amazing. We are dealing with some thing totally different here and logistically way more difficult.

William Rasmussen Some of the doc and RNs on here can probably fill you in as to what theyve seen where they work, my info is several years old. But Im old school and we made it work with what little we had, Im sure its better now--I hope

Troy Smith we are here to work out those details and design to the application. We have similar concerns in food process controls - Ebola has been studied since the early 90's. The concern is how we handle what we cannot see - contamination. The solution for materials and surface must work in our humanistic favor to compliment the work of the staff. We can create the solution, the technology is there and as you said the ability to scale it is the key. Our company is ready to lead this charge.

Scott Spinka In reading Williams comments above, I noted his verbiage, "...if they disinfect prior to that great, but most of the gowns now are disposable." I am not disagreeing with William; but, I depart slightly on the notion that disposable is as good as disinfecting. I have a feeling that most of the potential contamination may come from taking the garb off. If we are diligent in disinfecting prior to removal it seems more likely that the potential for personal contamination would be reduced.

Garnet Ward III Scott, as stated in my comments above, disinfecting the gear as much as you can before you take it off is a good thing, along with the person inside the gear of course.

Sophie: Well the good thing is incinerating will kill this virus, radioactive waste is a totally different matter and very difficult to dispose of, I think disinfecting after treatment of patient of gear and person is critical and then disposing of the items can be done by incinerating. This virus is lipid based "Fatty Outer shell" that can be destroy outside the host if done correctly.

Hi all,
I Know nothing about contaminations and solutions but why does the patient do not wear any protection themselves?
Why there is no mask,no goves given to all the population there?
This could reduce the expandation to other people or animals ...
Jack

Troy Smith Disinfection of the person in gear is exactly what we are proposing, sounds like we are on track

1. Public education. People need to understand that they need to Minimize contact if you suspect that you may have contacted the disease.
2. PPE education in healthcare setting. Comes down basics. Less is more. Wearing 3 gowns vs 1 gown. 1 is better, less risk of contamination when taking off.

William Rasmussen Exactly-never underestimate the power of good engineering-Im sure lives can be saved

Garnet Ward III William, sounds great it would also be nice to have another room beside the treatment room for disinfecting the gear one has on before you take it off. Some type of shower with a high volatile disinfectant and or steam Disposable gear would be nice and then have it incinerated immediately if possible, might not be cost effective but neither is dealing with a small out break in the US as the economic impact can be vastly horrific as well.

http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf <<<< Older Article that needs to be updated but good info.

Here is a newer one by Kimberly Clark Hospital Division which is a good one, with Ebola being a Lipid Enveloped virus a good S/D Solvent Detergent should do the trick, almost like a Spray Foam type of detergent (Strong) and then shower off the equipment and also this room should be equipped with UV light etc..

http://www.kchealthcare.com/media/133353/k-c-ebola-precautions-brief-truscott-final.pdf

Robert Feldtman fluidic application of virucidal agents before "doffing" PPE is a good idea, but really needs to be done in a UV light room as there will be aerosolization of the material.... potential for inhalation as well as contact with the airborne material. Indeed, the virus is being "killed" but what about that chunk of semi dried sputum that hit the PPE and was blasted loose with the fluid, but the fluid hasn't killed the virus? We need real level IV procedures with this virus. We really need to air evac all the sick patients to one of the four US level IVs... Galveston in TX.

William Rasmussen Galveston ?? UTNB ??? wow didnt know that, have friends work there. with the system Im thinking of-because we are using the heavier gloves-using a viriside (sp) should not be a problem- I am more prone to go with a liquid just based on the crud factor-UV may not penetrate into a glob of what ever-sorry Im a Respiratory Tech. - So-if we get to the point they dont need to use their hands -do they need to disinfect the gloves.

But if they dont have the no hand system-I fully agree to use the disinfectant. But heres a problem -is it a Dip or spray, a wipe ? where are they going to do it ? I assume the anteroom, any one of these have some issue of some sort. Also how much exposure does the disinfectant need to have to be effective ?

I like wipes because it helps get all the crud off and keeps the gloves dryer-no drips-easy to dispose of.

One thing I am concerned about is the feet-shoe covers help-but do they wear in the isolation room all the time ? Do we need to look at disinfecting the bottom of shoes-crud ends up on floor eventually. I am looking at pants type -with shoe covers-that are all in one unit, but that is another problem.

And yes-definitely we need to keep these in special units- regional Infection units. Transport is an issue, but in the long run-its better care and safer to all.

Robert Feldtman UTMB - Univ of Tx Med Branch...
I'd not use shoe covers, but rubber boots with long over drape of suit or even hermetically attached boots to the suit (like my duck hunting waders) - a real level IV suit is what is needed. And the wipes and dips seem safer than a spray to me.

William Rasmussen Agreed-no just how to get them off
Im thinking that we can use existing cover gowns that you add the head gear, gloves and maybe the foot gear as you gear up. so that would reduce the cost. I can just see making some modifications to whats out there now-adding a pull strap to the back, some closures-the ties we usually tie in front-so when you release them-usually break the strap-its behind you-and contaminated.
the procedure I see would be pull the straps that are at your shoulders to pull the back apart and peel it open, place the hands into something to hold the gloves-and back away from the suit, The head gear falls off onto the suit as you back out.
Then its a matter of the feet.
Then its a matter of getting it together and putting in the waste-I like the idea of a no touch-a system that pulls the gloves and everything into the dumpster-so you dont touch it as you take the gear off. Faster and safer all around

Robert Feldtman I think the gowns should not be disposable... but reused... Just like the level IV labs do it. Have the gowns (not gowns but and entire body enclosure) be re sterilized chemically, then with UV, then even with noxious gas (like we sterilize our surgical instruments)- and even scanned for protein before reissue, like we do our sterile OR instruments. This would help with the hazardous waste disposal, ensure a perfect fit every time. Even have NAME tag embossed..AND - breathing air should be "piped in" with a flexible hose with tank back up for emergencies. Don't filter and breathe air from the room.

William Rasmussen I love the idea-but lets identify where this system is used- can you see that used in a hospital isolation unit by nurses ? I can do easy a nondisposable bunny suit for the floor-and I know there is work already on some isolation suits in the field. I think theres is enough people with connections that can do the sterilization and all that.

I think we can come up with a design thats adaptable to add levels of protection, you dont need MOPP level for a cold, even for AIDS, but with Ebola-yea we need another level-so add a layer of protection-using a mask and layer of protection from body fluids

then if theres a SARS or superbug -we add another layer of protection.

But the key is to have it so there isnt any handling of materials-taking the suit off. So have the suit provide an exterior to protect everything inside-mask and faceshield, that when you take the gear off-it takes all the contamination with it,

If we need to go to higher level, the same system could be used to enclose everything-I think that breathing air would be supplied or wearing a HIPPA Mask or gas mask but its enclosed in the suit

The beauty is-same procedure to get on and off the basic covering-use no hands and no touch. Use some equipment to take care of the suit for waste or recycling-but thats better done at a facility that has the resources.

Now-for the idea of having something reusable during a shift. Only one way to technically do it is have the suit stay in the room, and have an entry from a clean room-I still like the bubble suit for that. easy to use, low cost when you consider your using it by everyone that cares for that patient-its not assigned by provider-its patient specific. You have fresh air, you have easy in and out, and you save a lot of time. Cant do it everywhere-but you can set up in an open bay ward, a patient room, just about anywhere-and dont have to have all the specialized rooms to change -waste disposal-laundry-and reused , you could literally nuke it. I think I could make something for under $100

Sure a lot safer

Garnet Ward III Good suggestions! It sounds like the nurses (Current media) are saying they where not wearing the right type of protective gear and that their necks were exposed and removal of the gear the first couple of times before he was tested wasn't done properly. I think the CDC should have sent a Rapid Response Team from the get go. Ironically the family hasn't shown any signs of Ebola yet, which is a good thing, I know a few of the procedures they did on Mr. Duncan could have exposed them even more. But in this media feed, the gowns they are using are not enough, I think some of the procedures they did to try to save his life put them at a much higher risk. (opinion of course).

http://www.dailymail.co.uk/news/article-2792457/Ebola-patient-cared-70-hospital-staffers.html

Scott Spinka I have been following the dialogue and threads of communication here which Eric Rasmussen stimulated several days ago. I am not a clinician or a scientist.

During my cogitations of the various inputs I received through this thread, I began to wonder about some of the loose ends regarding patients/people who may have come in contact with the Ebola virus. Specifically, I thought about Mr. Duncan (the patient who died that visited Liberia) and his family living in their apartment in Dallas. I am aware that a hazmat team eventually scrubbed down that location and removed all potential hazardous waste. I wondered what about the waste that goes down the toilet and then out into the public sewer system. I considered that some of this waste could be hiding on the inner walls of the sewage pipes and beyond… Even a gallon of bleach poured down the toilet would not necessarily kill all pathogens that traveled before it into the sewage system. Not fully appreciating how this matter is handled on an everyday basis; I wonder about the hazard potential of these systems. I am aware that sewage waste is treated once it reaches its final destination at the sewage treatment facility; but, what about all of the square footage of piping that maps throughout the system. Is there any way to disinfect all of it? Is it an issue?

Perhaps the Ebola virus has such a half-life that it may not last in that environment?

Any thoughts...

Garnet Ward III Scott: It was my understanding that Mr. Duncan was from Liberia and came back to the United States to visit his family. I doubt the hazmat team flushed stuff down the toilet as that is not protocol, but I am sure the family members did and I am sure if he puked and or went to the bathroom that could have been an issue. Remember Ebola is Lipid based virus and simple S/D Solvent Detergents can do enough to kill it, and it can't survive outside a host very long so I doubt if this will be an issue. The amount of Chemicals and S/D to go down a city sewer pipe is much astronomical, and sewage treatment centers are equipped with chemicals that kill bacteria etc..

Andrew Kyle With the third case of Ebola reported here in Dallas, I would want to express how urgent it is we provide the same level of healthcare equipment to the USA hospitals we are sending to West Africa and reinforce my personal belief that closing travel to West Africa is a sane and logical step until we get a handle on this disease. Ebola has no conscious nor care except that we are a food source for its descendents. We should provide every possible device to our own country before stripping our resources here to address another location. The President's comments about Ebola not reaching the USA are hollow... we need a strong decisive no-nonsense non-political commander to address this health care emergency. Perhaps we can then also use this technique to address other dangerous infectious diseases like the antibiotic resistant bacteria that also are a threat to each and every living person.

Politicians do not impress me at all. Their concerns are not those of us who better understand medicine and the dangers about us from microbes and other unseen dangers that lurk about.

Hesitation is only going to be rewarded by greater threats to public health.

Robert Feldtman And she took a trip to Cleveland? Not confirmed, but a rumor. Returned with a fever and tested positive. Why hadnt CDC quaranteined these people?

Garnet Ward III Some sources confirmed this, frankly anyone caring for this patients need to be quarantined and monitored at this rate. Pretty "F"ing stupid if she got on a plane after caring for a highly contagious person who had just died of Ebola. "if true". 1 person dead from Africa, 3 others recovering and 2 infected, hopefully they can get a handle on this and restrict flights to anyone exposed and any flights coming from Africa. I mean come on and use some common sense, lets not let this thread get like "Facebook" there is so much mis-information on there its more frightening then the disease itself!

Scott Spinka Garnet is absolutely correct. Common sense should rule the day.

How does the CDC or anyone in a position of healthcare executive authority allow someone to travel (especially"by air") after just caring for an infectious Ebola patient?

William Rasmussen so-lets clarify what we need-what we can do something about right now. The isolation equipment is a big issue all the way around, lets fix that first priority. The disinfection issue is good-lets get some ideas in place to get that going. Monitoring of staff and possible patients--thats going to be tricky, as is the whole travel thing, some of this is way above my paygrade and I cant fix it from here. so lets fix what we can. Lets fix the problems.

Robert Feldtman Simple. Mil Air Evac every positive Ebola test patient to a level IV facility. They apparently just did that with one of Dallas patients - to Emory. Don't try to re-invent Level IV care all across America in every yahoo hospital or every "smarter than the guys down the street" hospital no matter how big. Yes some ivory tower places think they are smarter than the ivory tower across the street. The virus doesn't care, it just kills everybody. And close down the damn airplane from Africa, and make CDC do their job of watching the patients. We were told yesterday that the 25 CDC agents were too busy watching the patients (as they should be) to come teach our nurses how to doff and don...... all the while miss smart RN was flying to Cleveland, they weren't watching very well. 30 days out of your life ain't bad for a jail term. Many guys get that with a few too many beers.

Andrew Kyle Robert is absolutely right. We cannot possibly equip every hospital in the USA to treat this deadly disease. We need to focus our resources and stop the infection in its tracks and then as so well stated "...close down the damn airplane from Africa and make the CDC do their job of watching the patients..." So politically incorrect but so dramatically accurate... the virus does not care and can kill anyone... President on down... Sometimes, I think GOLF should be banned when you are President... but that would detract from important matters like raising money to ensure we are "politically" correct!

Garnet Ward III William, the CDC needs to put into place protocols much like a hospital has when it comes to caring for these patients and the people caring for them. Right now everything seems to be contained in Dallas Hospital. Putting better things into place like the correct biohazard suit is key first step along with the people that deal with biohazard materials etc.. Proper training of the equipment otherwise the equipment is useless, and proper disinfection methods, people in suits need to be sprayed down with disinfectant a strong one that will kill the lipid layer of Ebola and then proper disposal of any hazardous materials from infected or contagious people and have those materials incinerated as most hospitals I know of have incinerators on hand.

http://www.nytimes.com/2014/10/16/us/ebola-infected-dallas-health-worker-was-on-flight.html

What I don't get is it says she (Dallas Hospital Worker) took a flight from Cleveland to Dallas? Well did she drive to Cleveland or fly to Cleveland first then Fly to Dallas. News agency need to get their ACT TOGETHER!

William Rasmussen cool-so lets do something-We can talk all day.
Identify the problem-one-the isolation suits used in hospitals are a stupid rag tag slopped together system. We can and need to do better. I have ideas to new design. We have some that can do the protection using disinfectants and disposal.

lets come up with material, technique, and implementation

We need some people to work on the manufacturing aspect

we need someone from infection control to oversee the process and write protocols

We have the expertise on here-lets do it-step up theres room for everyone-or else all we do is talk.

Im taking the new design and materials.
.

Robert Feldtman William is right, our gowns are rags. But we don't have time to spin up for this present crisis. Do the design and make them, but tomorrow is not fast enough. I am meeting tomorrow with some high level Dallas folks and will pass along what I can.

Garnet Ward III Well you need to throw politically incorrect right out the window when it comes to this type of disease.. I agree you can't equip each hospital in the US, but there should be a few hospitals in each state to handle this type of disease. Right now their are only 4.

1. Emory
2. University of Nebraska
3. St. Patricks Hospital in Montana
4. NIH in Bethesda

Andrew Kyle However, we have over 70 potential contacts here in Dallas. We cannot move all those people to those hospitals. This situation reminds me of the WWI influenza epidemic... soldiers brought that disease back home... that is something to worry about... if our healthcare professionals can get ill...what about the 5000 military headed for Africa?

William Rasmussen Good-to know we can concentrate-
Dr Feltman-you have been on here a lot and know what needs to happen-can you take on Medical Direction-you need to look at the whole thing-the patient and staff ?

Mr Ward-can you take on the implementation-line up who-what-where specifics, we need a manufacturer of some sort-any connections ?

I can have some preliminary drawing out later today-will scan but need to post them somewhere-maybe easiest to do on our linkedin page so everyone can access

We need someone to prototype-nothing fancy-just have equipment and some supplies-I think maybe $30 in materials-plan working with paper for now til further along.

theres companies out there can want to be a part-and maybe sell their stuff, I have no problem, but we stay focused on whats we need immediately and can do based on cost-Liberia doesnt have a lot to spare.

We maybe need some financial backing to get this going-start rattling some chains-Kaufman-Gates-Trump-dont care

thats just my pitch-we need people to step up-and could use some help in my soil physics class

Its just time and effort to make a change my friends-lets do something constructive

Robert Feldtman I will have more data after tomorrows meeting

Garnet Ward III Andrew, I am sure they will be quarantined before they can fly home, plus it's more like 3000 troops from what I have read. Ironically we haven't heard much on Duncan's family as they are nearing the 21 days... As William stated we need to get them the critical biohazard suits now and anything that will help in disinfecting UV Special lighting and anything that can disinfect the suit and the person in it. Some one should tap into the money that Warren Buffet and Zuckerberg donated! :)

Troy Smith Radiant is ready to manufacture. We are currently putting a proposal together for the CDC and hope to present next week. We are seeking the funding and looking to tap into a few folks in this thread for ideas and support as we go. We would like to lead the manufacturing role on this

William Rasmussen while Im worried about My Guys over there-I think theyll be ok- we tend to figure things out pretty quickly and we seem to have a way with keeping locals away.

soo-who is doing what ?

Andrew Kyle Garnet,

Understand after waking up three separate days to hear about Ebola in Dallas of all places, my confidence in the CDC or other government bodies is a bit shaken right now. Dallas is not Africa and we cannot seem to have any containment here in a very modern city with great healthcare resources. Politicians are using this for photo opportunities and to further their political careers and, in my mind, taking chances like Dr. Nancy Sniderman pf NBC and then walking away from the right action she initially took to protect the public.

Garnet Ward III To All: Well I took a shot and sent Mark Zuckerberg a link to this page. Any help on the money front won't hurt. It's a long shot but some times you need to take a chance especially when it comes to the spread of a deadly virus! I use Facebook to stay in touch with people so I might as well put it to some good use! Here is hoping! Now I just need to find Warren Buffets e-mail, but he doesn't have one! :(

Great ideas on here, lets hope implementation happens quickly!

William Rasmussen I just talked to Troy-see above-they can take on the manufacture side.
Ill work on design-but dont want this one man show-
Mr Ward-want to lead this parade ?

Garnet Ward III Andrew: I did a internship years ago with the FDA and if the US government gave them enough money to do their job effectively we would be a lot better off. The same goes with the CDC, remember their are a ton of viruses out their that have caused more harm and damage than Ebola. The CDC and what they do has helped keep a lot of these disease at bay and companies like Troys and many others go a long way to protect the people that have to treat the sick. Remember Africa has over 3000 + Dead and 8000+ infected we have 1 person dead that brought it from Africa and 2 people who contracted in from the infected person from Africa. 2 people recovering and the camera man in Nebraska still being treated. So lets not loose hope yet! I do agree with you on government not reacting quickly enough, and this will cost more political careers than further any.

Garnet Ward III Willam: I have a Public Health Degree and work for a Biologics company not sure if I am qualified as there seems to be better qualified people than myself on here. I will offer any help I can, I deal with Blood Supply/Sales and health related issues in my everyday job, but its been awhile since I practice on a daily basis my Public Health Degree. Just honored to be presence of all the good people on here!

William Rasmussen We need someone that can put this whole thing together-you seem to have a good toolbox of things to pull from

we have a manufacturer that has stepped up, I have some design ideas but need some help with some of that, we need an MD for oversight, and we need someone to put it all together-You got the perspective and social aspects I dont. Look at it this way-if not you -Who?

John V. Thompson Unless I'm missing something (and that's surely possible), infectious desease and isolation protocols including gowning, gloves, goggles, shields, booties, cuff closures, respirators, disinfectants, even negative presents room ventilation, etc. have been well-established SOP in healthcare and labs for decades. Though I have no direct experience with Ebola, I surely remember - and directly participated - in the roll out of the (then new) OSHA Blood Born Pathogens protocols in hospitals following the HIV/AIDS outbreak (and the concerns and paranoia that accompanied that infectious disease. It seems that Ebola is little different than HIV in terms of how it can be - still can be - transmitted. Are we saying that the presents from desease precautions, isolation and handling protocols, and protective gear we surely must have in adequate stock or in the manufacturing pipeline is insufficient and/or inadequate to effectively deal with and contain the Ebola virus if properly identified and the protocols executed, i.e. training/re-training, effective accurate screening and case identification, proper execution of all protocols and precautions. I don't know, but is there a need to invent a new wheel with entirely new designs and materials (ignoring costs and time factors for the moment), and procedures vs. taking what seem to be a much more efficient and effective tact by simply ensuring we're effectively utilizing the resources we have on hand and in place?

John V. Thompson My apologies for the typos and grammatical errors - I'm attempting to respond via Droid. It appears fat fingers rule.

William Rasmussen Im not saying the whole thing is inadequate-it does have some glaring inadequacies-but you said it yourself-gloves,goggles, boots, cuff and all. The people that are using these things are pretty smart, so its not a problem of educating. Im sure an MD or RN have been in enough isolation units during their time in school or training. Ive been in enough Isolation units to hate having to gown up. its time consuming and generally a pain.

There is an engineering problem. its too complicated to take off. What I am working to is cut it from 20 + steps to 3. The design I am working is to modify whats already out there-save money-save time-and no need to retrain the staff. The problem in the hospital is the staff go in and out all the time-just more ways to screw up , so make it easier-safer.

Could use a hand in the design-if your interested

Garnet Ward III Willam: Well a good top Infectious Disease doctor, one of course with experience studying Ebola and these types of disease is a must, as I am sure there are some across the country. One that has common sense and good social graces to deal with the media.

As far as suits go, it would be great to see a scaled down version of this suit with UV lighting on it...

http://www.dailymail.co.uk/sciencetech/article-2589893/Which-spacesuit-Nasa-make-Agency-reveals-three-bizarre-designs-wants-YOU-pick-one-launches.html

John: All good points as biohazard suits have worked before, no worries on grammatical errors as this place doesn't have a edit feature yet!

William Rasmussen I am finding I can not post pics on here-I have a rough draft drawing to start and a description available-if you want to see -drop an email-I just sent it to Troy for his input-can use more input

the email is
bill_rasmussen2001@yahoo.com

we can talk about specifics with something in hand that you can see.

William Rasmussen I just heard on NPR about the nurses union and their response about all this preparation- I dont think Im paraphrasing too bad to say the isolation gear was thrown together and hap hazard, and this was Presby Dallas.

I represent http://www.medizoneint.com http://www.asepticsystems.co.nz here in New Zealand. Have contacted our head office you will hear from them.

Here is a short overview explaining our system and a Joint Venture with http://www.medizoneint.com/recent-news-coverage/
also http://www.medizoneint.com/2014/09/20/an-update-on-events-hosted-by-medizones-president-and-director-of-medical-affairs-dr-michael-shannon/

If I can help any further please contact me

William Rasmussen shoot me an email-at
bill_rasmussen2001@yahoo.com
lets talk

Garnet Ward III Ross,

Now we are talking, nice segment on disinfection. Ozone has been used to eliminate pathogens in other areas as well, they been used in Chillers and cooling towers that are used to cool large office buildings along with UV light. So it doesn't surprise me you guys have perfected something this good.

Helen K 77 people were taking care of #1 patient. Way too many.

William Rasmussen OHHH yea-way too many -hense the isolation suit issue is so important, 77 ways -times how many times in and out-lets say 2 times-so lets say 150 times people in and out

Troy Smith that is a great use of technology for space disinfection - cannot be around humans as we know ozone is harmful. The cleaning personnel chamber we are working on will disinfect the person suited with UV, chemical wash, and air suction through destruct filtration

Troy Smith Today at 2pm CST we will host a conference call to discuss direction and options for equipment and gear.
Please join if you would like to input or just listen
Phone: 605562-0020
Meeting ID: 194-314-341

Garnet Ward III Interesting news today as second nurse infected, knew she was treating a patient that had Ebola and knew she had a fever and got on a plane? I mean where in the hell did common sense go on this one, sounds more like a conspiracy theory, after all the news of this guy flying from Africa infected with a deadly virus and she gets on a plane. Sorry for the expletive abbreviation but "WTF"! We need a edit feature on here! lol

Troy, I might be able to get on today.

Dr. Juno,

Great information and hopefully the people at the CDC will use this as well.

Troy Smith great info, looking forward to it

Russ Juno Garnet, don't get me started on that. But the surgeon in Liberia talks about how is could be "easy" to track and montor potential exposed patients, but also haow if you do not it can quickly get out of hand. Instead of having all those 70 people taking care of one patient reduce the number and have the others making phone calls and having the exposed "check" in for exam every 48 hours or so. We just need to listen to those who are there and have been through this and try not to reinvent the wheel. Obviuously there should be some "centers of excellence" on this. Emory-Atlanta, handled 2 patients already without any mishaps.

Garnet Ward III Russ:

Emory handled it pretty well, as did University of Nebraska but they are 2 of the 4 equipped hospitals in the country to handle this kind of thing and Emory is pretty tight with the CDC as well. The main problem there isn't enough "centers of excellence" if this gets too out of hand, hopefully it won't! The lapse in common sense is beyond fathomable and almost criminal what this 2nd nurse and first patient did.

Burt Houtz, PMP The African private sector and many device/pharma corporations from the US and Europe are active in the continent and have expertise that should also be utilized. Public-Private Partnerships that companies such as BD, Roche, Siemens, and Abbott have established with PEPFAR or Ministries of Health have been shown to bring excellent management skills that assist / enable local leaders to take ownership. Its not just the technical stuff, its also building management skills that is essential for countries to manage crises. Let me know if you wish to discuss further.

Jerry Robinson I'm in Dallas...

Ebola case handling was botched here - pretty obvious at the time... AND they KNEW BETTER>.. What works as a protocol for standard fall illnesses or broken legs - DOES NOT work for Ebola... and the administrators knew it.. but "who" would pay for the necessary costs?

That same "broken" theme is still in place... When someone is ILL, where do they go? clinics? Doc in the Boxes? - but RARELY to the ER. WHy? what's the cost? Can the people MOST IN NEED pay it?

So at "minute clinics" or such... there are NO effective protocols or biohazard preparation in place... That's going to burn us all....
****************
This observation - does not apply to USAID - which asks the RIGHT QUESTION - what can we do now - that is effective? and will help BLUNT the edge of the problem.?

I think there are very effective, non-traditional answers that can be applied..

ALMOST ALL of the stuff above - from capable people - does not address the NOW part of the problem. That is hard...

I work on aspects related to a big piece of the problem solution - but it's slow development.

John V. Thompson Thank you for adjusting my perspective. My comments were focused just on U.S. healthcare facilities vs.field ops in Africa (and other hot spots. I agree re: the KISS approach to reducing steps and complexity re: isolation garb and disposal/processing. I also totally agree with trying to address the immediate problem at hand; identifyng and quarantining infected - or just exposed - individuals. Though the PC indications re: restricting travel and ports of entry have been mentioned, I'm not sure there are many other effective options. Such steps would be temporary. It is disheartening that what seems would be prima facia common sense measures are judged more on their social acceptance rather than their effectiveness to provide an immediate concrete impact on containing a potential worldwide pandemic - an apparently truly deadly epidemic (compared to say the avian and swine flu pandemics). I would be happy to assist anyone with any effort to the limits of my insights and expertise.

Troy Smith John and Thompson and Jerry Robinson, you both have insight to this.
Please join our call at 2pm CST today to discuss direction and options for equipment and PPE disinfection.
2pm CST
Phone: 605-562-0020
Meeting ID: 194-314-341

Garnet Ward III Troy/William All: Great ideas, glad I could make the call today.

Here is contact info with Engineers without borders...

William: Here you go....

http://www.ewb-usa.org/our-story/contact-us

Troy Smith Thank you everyone for your participation

Jerry Robinson I think eveyone means well.. but need to first consider what the "boots on the ground" medical provider needs... then sort and respond... there is IMMEDIATE response - and succeeding waves of supplies and such... Let's look...

This is a NYT video:
http://www.nytimes.com/2014/10/17/world/africa/because-of-ebola-ambulance-work-in-liberia-is-a-busy-and-lonely-business.html?_r=0

Mr. Gordon Kamara is an Ambulance Nurse. He is being overwhelmed. What resources does HE HAVE and how can WE (all of us....) help him?

"MONROVIA, Liberia — Racing along cracked and bumpy roads here, Gordon Kamara shouted into his cellphone over the shrieking sirens of his ambulance. The phone had been ringing nonstop since 5 a.m.

“Not today! Not today!” Mr. Kamara, an ambulance nurse, yelled later in the day. “We are on the opposite side of town!”

The calls have all been the same in recent weeks: from friends, friends of friends, extended family, complete strangers. All of them have loved ones sick with Ebola and beg him to come quickly. Seven days a week, Mr. Kamara and his crew span Monrovia, Liberia’s capital, in a donated, old American ambulance — with California license plates still attached.

“It never stops,” said Mr. Kamara, getting another call the moment he hangs up."


Bodies are being carried out and put in the street. Numbers... that you see... are probably low - and reporting - is getting more difficult...


It's good to read about US treatment options.. Living in Dallas - I can ATTEST that the even application of the proper protocol is NOT happening.. No one is "in charge" of this whole effort, either..


History... is RIFE with stories of Epidemics - and their spread... with may be 8000-16000 people having contracted Ebola - we already have it here in the US. History talks about - constantly - people fleeing the plague - and then taking the disease with them... When numbers hit 1M people who have contracted the plague - how many will have it in the US... ? Scaling says it will be a substantial number...


A lot of people in the US - (how many??) - shy away from Hospitals and the huge ER charges - so how prepared are "doc in the boxes" and "family clinics" - to deal with this issue? It's a thought...


We need "disruptively effective" solutions - and probably the FIRST thing is WEB BASED (1) training and (2) family advice on "what to do"... lack of real information - leads to panic... This approach is virtually free - and could be deployed overnight...

And then lets get Mr. Kamara what he needs AS SOON AS IS POSSIBLE.....

FYI - Lagos, as one city alone - has 21.5 million people in it. That's almost more than LA and New York COMBINED... Acting "now" matters....

Troy Smith powerful video, we can do better. We can disinfect the ambulance, living conditions, people. This can be done quickly

Jerry Robinson Getting it to Mr. Kamara - quickly, will be TOUGH..

One approach - is "what can we do TODAY"... What can we DEPLOY TONIGHT.. HOW can that make a difference TOMORROW.. and just keep pounding on this idea...
--jr

William Rasmussen so-we are working on the projects to deploy now, and the what will be following, need to get some way once we are up and going to get it out there-we need to look at getting into that supply chain. More important-get it to where its needed. I remember a lot of stuff all over the tarmac after Katrina-sat there for weeks-no way to get it out.

Need to think about a lot of things at same time-like this-so putting the call out for someone to do logistics-make the connections to move stuff down the pipe. Maybe DOD-maybe Doctors, maybe WHO-so we have a lot of work to do.

Burt Houtz, PMP I think implementing a mentorship approach while applying effective solutions is key - as long as local health officials are involved. We have a lot of folks that know biohazard containment. Ensuring we are all on the same page with an Expert is important. Gathering information, coordinating information and activities and having accurate and updated disease surveillance is also badly needed.

William Rasmussen I agree completely with your last 2 comments-there is a lot of room for collaboration especially when things are pretty stressed as they are. I learned a while back to include others that are being affected -otherwise if we tell them to do it this way-theres push back-just ask the US Army about that. I just sent a contact request to someone thats been over there-and considering connecting with some of the foreign students here for some input

Im open to any suggestions

Russ Juno go to the American College of Surgeons website and look at the letter from a Liberian surgeon to the ACS director. She has some points. www.facs.org/ebola.

Garnet Ward III Here is a very good video from the epicenter and we are rarely shown it, but remember there is no organization and very little infrastructure it needs to be controlled and Infected bush meat is most likely the cause of it this time around. 3000 troops isn't going to cut it, we are going to need help from other countries.

https://www.youtube.com/watch?v=EaZqfwFVjgQ#t=477

Russ Juno The ACS updated its page. Here is an intervirew with the head doc at Emory. He seemed pleased with their work.

http://www.healio.com/infectious-disease/practice-management/news/online/%7b443af8d6-a116-4071-9c72-a743bc1ff078%7d/lessons-learned-treating-ebola-patients-in-us

First need to control the disease hear and set up our "defenses." I see one of the Dallas nurses was sent to the NIH. Good. But is this doctro or a member of their team involved? Lets nail down the US situation. Also looks like their is some mandatory qurantine going on. Good. Next look into the suits and PPE you are all talking about to gte over to Africa. Good luck.

William Rasmussen We are talking about 2 approaches, improving the PPE and disinfection of personnel prior to exiting the suit, between the 2 should improve the isolation all around. Trying to make it easier for all concerned-using tech to reduce exposure

now if we can get the talking heads out of the way-except maybe getting some money moving

Ruth Clark I am preparing a PPE proposal but just thought I would also add that many Hospitals in the UK have switched to Tea Tree Oil based cleaners and have cut their hospital acquired infections by a significant amount. Has any one tried this against the Ebola virus?

Burt Houtz, PMP Many great ideas by a lot of highly-talented folks! Also keep our eye on ball in terms of "How" these solutions get implemented. Working with healthcare providers, directly, and seeing direction from private-sector leaders to help influence policy is badly needed. We really need leadership on this from those that know how to deliver products and services on a big scale.

William Rasmussen Hi Mr Houtz-couldn't agree more-I have some ideas on how to do that-and working on that side too-if you have any expertise -drop a line-lets talk
bill_rasmussen2001@yahoo.com
thanks
Bill

https://openideo.com/challenge/fighting-ebola/research/does-the-cdc-understand-how-thermal-cameras-work-a-review-of-published-research-on-the-cdc-website

Bogdan Baudis I think we all have a case of NIH (Not-Invented-Here).

Absent from the White House invitation (unless I missed it) and even more tellingly form this discussion are Doctors Without Borders,

This organization had long and quite record when dealing with Ebola on-site in very difficult conditions while given the number of their people involved, maintaining very low rates of contraction among their personnel.

I am afraid it has to do something that their official name and roots are .. French.
Sometime ago I heard the opinion from a professional that from all the former colonial nations the French had the best tropical medicine...
Can we please loose a little of our pride and ask kindly for help?

I have a friend who received HazMat training and maintains the capability.
We had few conversations over the weekend and couple beers about Texas and I think while he is more chemical than biomedical oriented, he would be better there than the supposedly professional personnel and their supervisors...

Please have them push for more non-contact thermometers. I work for this company and we can not keep up with the inquiries regarding this, soon our devices will be able to take many vitals without contact.
Contact me for more details if interested.

Ruth Clark I have completed a document that outlines the CZ Gripper. This device could be worn with full PPE gear and enables fine dexterous hand type function. It can be made out of metal and sterilized after each use, or made as single use disposable devices. The uses that come to mind include doing fine, detailed personal care (feeding, washing, etc) ; helping in clean up vomit and diarrhea ; while cleaning private homes and handling bodies of the diseased etc.
More information can be found at (https://openideo.com/challenge/fighting-ebola/research/personal-protective-equipment-providing-strong-dexterous-grasp-and-handling-with-up-to-20-inches-of-stand-off )
I look forward to reading your comments and answer questions.
Ruth

Robert Feldtman I did find out Dallas Presby had a PCR machine for rapid detection, but FDA wouldn't let them use it. CDC isn't only federal idiot group. Anybody else find this push back on PCR?