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The Irish Widow and the Liberian Fiance: Ebola, CEO Disease, and the Public Good

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From flickr.com/photos/69583224@N05/14886734222/: ebola hazmat suit
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Outbreak

The Ebola crisis highlights the absurdity of pretending that a private, for-profit health system can do what a real public healthcare system must.

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Remember the deadly-Ebola-like-virus movie where Dustin Hoffman and Renee Russo and Morgan Freeman and a whole state-of-the-art medical team, along with a small army (There's always an army!) swoops in to quarantine the sick, catch the monkey, whip up a vaccine, and save the country?

Keep dreaming. That's a fantasy. In reality, there is no public healthcare system. There is no serious publicly-funded and publicly-managed infrastructure, institution, or set of resources devoted to healthcare as a public good.

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As the Washington Post said: "The hospital that treated Ebola victim Thomas Eric Duncan had to learn on the fly how to control the deadly virus." The CDC? It runs a web site and holds press conferences. The medical professionals are all in private hospitals, now mostly folded into large private healthcare conglomerates, that do whatever the MBAs who manage them dictate--which is what the MBAs who manage the private for-profit health insurance companies are willing to pay for. As Rob Urie points out: "Missing from this 'process' that now finds Mr. Duncan dead, two nurses who attended him with Ebola themselves, the American health care system revealed as wholly unprepared to deal with what at present seems a moderately communicable disease, is any notion of a public interest."

Here's Juan Gonzalez , talking to Karen Higgins, to co-president of National Nurses United:

The executive director of your union, RoseAnn DeMoro ", specifically raised the fact the CDC has no control over these individual hospitals, that in the privatized hospital system that we operate in here in the United States, the CDC can only offer guidelines, and it's up to individual hospitals whether they're going to enforce those guidelines, practice those guidelines. And, in fact, the CDC said yesterday"that they have no plans to investigate what happened at Texas Health Presbyterian, that that's the responsibility of the local Department of Health in Texas. Karen Higgins: I think, you know--unfortunately, I think she's right, as far as what powers the CDC has. " And what happens is then CDC makes recommendations, guidelines, and then it falls apart, because what you do with it as an individual hospital, because every hospital is pretty much individual, is where it starts to fall apart.

When we look at what happened to "index patient" Thomas Eric Duncan at Texas Health Presbyterian Hospital Dallas hospital (known as "Presby"), we see concretely how the interest of the patient and the public starts to fall apart. National Nurses United union co-president, Deborah Burger recounts what happened:

When Mr. Thomas Eric Duncan first came into the hospital, he arrived with a temperature that was tested with an elevated temperature but was sent home. On his return visit to the hospital, he was brought in by ambulance under suspicion from amongst his family he had Ebola. Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present. Subsequently, a nurse supervisor arrived and demanded that he be moved to an isolation unit, yet faced resistance from other hospital authorities. Lab specimens from Mr. Duncan were sent through the hospital tube system without being specifically sealed and hand-delivered. The result is that the entire tube system, which all the lab specimens are sent, was potentially contaminated.

There was no advance preparedness on what to do with the patient. There was no protocol. There was no system. The nurses were asked to call the infectious disease department. The infectious disease department did not have clear policies to provide either. Initial nurses who interacted with Mr. Duncan wore generic gowns, used in contact-droplet isolation, front and back, three pairs of gloves with no taping around the wrists, surgical masks with the option of an N95 and face shields. Some supervisors said that even the N95 masks were not necessary.

In defiance of the hospital management's threat to fire anyone who spoke to the press, Briana Aguirre, a nurse at Presby, told reporters about the "extreme chaos" in the treatment of Thomas Eric Duncan:

"The nurses were throwing their hands up and saying this is unbelievable," she said of the isolation ward.

Aguirre also said the protocols from the U.S. Centers for Disease Control and Prevention were confusing and not clear. When Aguirre was given personal protective equipment that left her neck exposed, she was horrified.

"We were told, 'You take our guidelines and you do with it what you will,'" said Aguirre of CDC guidelines.

Aguirre also said that "suspected Ebola patients were wheeled around the hospital without protection and that doctors were told it was acceptable to move between rooms without disinfecting." She also confirmed Deborah Burger's observation that: "Our infectious disease department was contacted to ask 'What is our protocol?' And their answer was, 'We don't know'. There were no special precautions, no special gear. We did not know what to do with his lab specimens."

The CEO Disease

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http://www.thepolemicist.net

Former college professor, native and denizen of New York City. Blogging at www.thepolemicist.net, aiming to be intellectually rigorous and politically challenging from a left-socialist perspective. Also publishing on CounterPunch and Z.


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