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Ebola - the best way forward?

(36 Posts)
papaoscar Tue 26-Aug-14 13:57:16

This disease is a terrible tragedy for all those affected including aid workers. However, I wonder if it was sensible to return the infected British nurse to the UK with the risk of spreading the infection. I think that it would have been better to let him recover in the country in which he became infected. Also the question of cost comes to mind. Surely it would have been a much more satisfactory use of funds to use them to further medical research rather than just pay for aircraft fuel and UK hospital charges.

janeainsworth Tue 26-Aug-14 14:04:26

Papaoscar I think the answer is that the affected countries don't have the facilities to treat patients effectively and that is why so many people have died.

The nurse is British and risked his life to help Sierra Leonians. I don't know which government department will have borne the cost of repatriating him, but I think it is an entirely appropriate use of the money.

Provided that precautions are followed, as they will be at the Royal Free, the risk of another health-care worker becoming infected is low.

Soutra Tue 26-Aug-14 14:35:28

Well said janeA I was horrified to read papaoscar's suggestion that a British nurse should be abandoned to his fate in a country with inadequate facilities. This is hardly the way to encourage highly qualified doctors and nurses to work in areas with real needs and to provide the best medical care possible. Organisations such as Medecins sans frontieres or the Red Cross and the like cannot be praised highly enough for what they do.

petra Tue 26-Aug-14 14:47:29

Would you be so concerned about the cost if it was your Son or Daughter.

papaoscar Tue 26-Aug-14 15:09:15

My concern is to limit the spread of this terrible disease and seek a cure as soon as possible. Those brave people who choose to volunteer to help in affected countries are indeed truly worthy of our praise and support, but I do not see any point in doing anything to encourage the spread of the disease across continents. God forbid that any member of my family were to contract some awful contagious disease, but if they did I would have to accept whatever the quarantine arrangements were. My own wishes would be secondary to the national good, however difficult that would be for me.

henetha Tue 26-Aug-14 15:09:40

It's entirely right, surely, that the British nurse has been returned to this country to be treated, regardless of cost. These medical workers who risk their health and lives deserve all our support. They are real heroes in my opinion.

Aka Tue 26-Aug-14 15:15:16

If we abandoned health workers to their fate, there would be less volunteering to go into infected areas, and diseases like ebola would run out of control and spread across continents. Then your family would be at risk papaoscar

Aka Tue 26-Aug-14 15:16:05

I am shocked at that suggestion

grumppa Tue 26-Aug-14 15:35:03

papaoscar's legitimate concern to prevent the disease spreading calls for a radical solution. Every diagnosed case should be mown down from beyond contagion range by a squad of marksmen with AK47s, and the remains destroyed by another squad wielding flame throwers, for ultimate disposal in quicklime.

Harsh maybe, but I am sure Jonathan Swift would have approved.


Galen Tue 26-Aug-14 15:35:08

It was a correct decision!

papaoscar Tue 26-Aug-14 19:24:21

Sadly, grumppa I am sure that AK47s would be all too easy to get hold of in Sierra Leone. More to the point, however, I remember that in the bad old days of my childhood the standard response to an epidemic (TB, polio, typhus, cholera, leprosy etc) was isolation well away from population centres, not slap-bang right in the middle of them. I appreciate that since those times medical science has progressed greatly and I am sure that now international medical agencies have mobile back-up and isolation facilities available in the field.

durhamjen Tue 26-Aug-14 19:37:56

Hope they have decent cleaners at the Royal Free.

JessM Tue 26-Aug-14 19:50:54

Sounds like they have managed to get hold of a dose of the monoclonal antibody drug for him. Pity this is not something that can be quickly mass-produced.
It does highlight the huge gap between the resources of rich and poor doesn't it.

janeainsworth Tue 26-Aug-14 20:29:42

I don't think it's simply a question of difference in resources between rich and poor Jess.
As I understand it, many of the people in the affected countries distrust western medicine and even if the monoclonal antibody drugs were available in the quantities needed, there would be an issue around valid consent to what is still experimental treatment.

Soutra Tue 26-Aug-14 21:18:00

I hope that was just a flippant tongue in cheek remark durhamjen. It is an extremely high level isolation unit with filtered air, and every possible other precaution. I believe it is the only one of its kind in London. And as DH will be just one floor down I too trust they know what they are doing. Having seen ITU, the Hepatology unit and Cardiology, I think I can trust them.

durhamjen Tue 26-Aug-14 22:59:31

It was and it wasn't Soutra.
My mother worked as a nurse in an isolation hospital when she first trained. She said that if they passed one disease to someone else on the same ward, they would have been sacked.
When she was in hospital just before she died she got MRSA twice. We saw nurses going out of her room to deal with other patients without washing their hands.
Like papaoscar said earlier, isolation hospitals used to be well away from centres of population.

absent Wed 27-Aug-14 01:38:03

Isolation wards/hospitals in the past and the state-of-the-art facility at the Royal Free can't be compared.

As far as the money for transferring the British nurse is concerned, the Government (i.e. tax payer) is not paying for or administering the research for suitable drugs to treat Ebola. Part of the problem is that Big Pharma likes drugs that will be used in the millions or billions over long periods of time - for treating arthritis, high blood pressure, etc. Ebola has killed a few hundred and spending huge amounts on research - and research does cost huge amounts - isn't cost effective.

Presumably, the nurse is officially resident in the UK and therefore entitled to treatment and care on the NHS.

thatbags Wed 27-Aug-14 07:17:32

absent, janea, soutra, good to read your level-headed posts.

JessM Wed 27-Aug-14 08:39:19

Jane its true there is mistrust but there are also millions who walk for miles to get their kids to places where they can be treated by western doctors and vaccinated against dangerous childhood diseases. I think it is dangerous to dismiss a whole continent as distrustful of western medicine.
Yes there are ethical considerations with experimental drugs.
However new drugs are, obviously, tried out initially on informed volunteers and if the drug was easy to produce then you can bet this would be rolled out briskly. The epidemic is not going to go away in a few months. Buy being a biological molecule I imagine that production would be extremely slow even if it were know to be safe already.

Agus Wed 27-Aug-14 09:24:50

I worked in infectious diseases units within two city hospitals. Having different diseases on the same ward was unheard of jen, due to the high risk of cross contamination. We also had isolation rooms for different cases.

Isolation procedures are not difficult to facilitate with trained staff and the right decision was made to bring this British nurse home.

janeainsworth Wed 27-Aug-14 10:13:25

Jess I wasn't dismissing a whole continent - simply referring to what has been reported - that the outbreaks have been worse in remote communities where primitive ideas of medicine are more prevalent.

durhamjen Wed 27-Aug-14 11:37:25

So, Agus, my mother was lying to me, was she?
Are you old enough to have worked pre NHS, as she did?

Elegran Wed 27-Aug-14 11:53:33

Is the ebola patient being admitted to a pre-NHS ward, then?

durhamjen Wed 27-Aug-14 12:06:14

No, elegran, but the NHS record on infectious diseases is not inspiring, is it?

Galen Wed 27-Aug-14 12:09:08

Actually I remember having different diseases on the same ward. Sometimes we ran out of isolation cubicles on the paediatric ward and we only had one cubicle on each of men's and women's medical wards.
I did my house jobs at a small provincial hospital.