Ebola: UCSF in the Hot Zone Contributions Roadmap Background on - - PowerPoint PPT Presentation

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Ebola: UCSF in the Hot Zone Contributions Roadmap Background on - - PowerPoint PPT Presentation

Oct 04, 2022 326 likes •458 views

6/22/2015 Disclosures Ebola virus disease None Ebola: UCSF in the Hot Zone Contributions Roadmap Background on Ebola Keep Safe, Keep Serving Hernando Garzon, MD Ami Waters, MD Phuoc Le, MD 1 6/22/2015 Viral Hemorrhagic

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6/22/2015 1

Ebola virus disease

Ebola: UCSF in the Hot Zone

Disclosures

None

Contributions

  • Hernando Garzon, MD
  • Ami Waters, MD
  • Phuoc Le, MD

Roadmap

  • Background on Ebola
  • Keep Safe, Keep Serving
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6/22/2015 2

Viral Hemorrhagic Fevers Viral Hemorrhagic Fevers Ebola Species Ebola Transmission

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Transmission – Contact, Droplet Airborne? How infectious is Ebola, really? Clinical Course

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Ebola PCR and Ab ELISA Ebola Outbreaks – Key Interventions

  • Early Case Identification
  • Strict Isolation
  • Safe Transportation
  • Care
  • Supportive – but can we do more?
  • Contact Tracing
  • Safe Burials
  • 50% of infections with handling dead bodies
  • Health Promotion Outreach & Education

Supportive Care

  • Standing orders
  • Hydration - >2-3 liters/d
  • Co-Artem x 3d
  • Cefixime x 5d
  • Tylenol, Omeprazole
  • Symptomatic care
  • Antiemetics, Narcotics,

Anxiolytics, etc.

  • Diagnostics
  • Ebola PRC
  • Malaria RDT
  • iSTAT or lab supported

Lytes, CBC, LFTs

Ebola Treatment Units

  • Human Resources
  • 80-120 staff (10-15 or more international)
  • 30-45 clinical staff (MDs, RNs, etc)
  • 40-80 support staff (hygienists, logistics, psychosocial, drivers,

cooks, burial teams, etc)

  • >100 more peripheral support staff
  • Water – 100 liters/pp/pd (2500 gallons per day)
  • Chlorine – 0.7kg/pp/pd (70 Kg per day)
  • PPE – 100 suits, hoods/pd
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Ebola Treatment Units

ETU work environment

  • Full PPE
  • 45-60 minutes work cycle
  • High temp and humidity
  • Sensory & dexterity challenges
  • 1.5 liter sweat loss in 60 minutes!
  • Average 2 cycles per shift
  • No continuous meds (IV)
  • Very limited monitoring (VS,

diagnostics)

This Outbreak in Context Non-Ebola Consequences of Ebola

  • Indirect Mortality
  • One preventable medical death for every Ebola death
  • Food Security
  • Farms abandoned, decrease food availability
  • Child Protection
  • >3000 orphaned children
  • Stigmatization/Distrust
  • Recovered patients and workers shunned
  • Economic collapse
  • Estimate of $2 Billion lost in trade, commerce
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Ebola Outside West Africa Ebola Mortality

West Africa – 50-60% Elsewhere – 21% (5/24)

Ebola Outside West Africa Health Disparities

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6/22/2015 7 Global Health Fellowship: Going to the Last Mile The Canary in the Coal Mine: Ebola Virus

“The reasons to shore up health systems between epidemics are both moral and those of vital self-

  • interest. Ebola is signaling a new call to action. We

ignore this canary at our own peril.”

  • Alexandra Stanculescu, MD

2013-14 UCSF Global Health Fellow blog post May 2014

A Stand in Solidarity

“The idea that some lives matter less is the root of all that's wrong with the world.”- Paul Farmer

Last Mile Health in Liberia

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6/22/2015 8

Protecting Those Who Serve Protecting Those Who Serve

  • 370 health care workers

infected in Liberia

  • 178 of deaths
  • 28% never trained in IPC
  • 26% uncomfortable with

identification of a suspected Ebola patient

Rivercess County

  • Difficult roads
  • remote villages
  • Lack of supplies
  • infrared thermometers
  • PPE at facilities
  • Community disbelief
  • Lack of trust
  • Inadequate awareness
  • No ETU

Introducing Concepts

  • Ebola Basics
  • Context of Outbreak
  • Triage and Isolation
  • Donning & Doffing
  • Chlorine Preparation
  • Waste Management
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Small Group Exercises Building Confidence Taking It One Step Further Facility Mapping and Action Plans

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Keep Safe, Keep Serving

  • 200 Healthcare workers
  • 40 health facilities
  • Two counties
  • Monthly follow-ups
  • Ongoing mentorship

and supervision

“I learned a lot about Ebola I have never learned before. It is my first time.”

“I would like to see the training established in all districts.”

“I like this training and I want to see change in the near future.”

“Ebola Virus

  • kills. We need

more training days.”

“I would like to see regular supply of equipment for facility such as PPE and constant training on Ebola.”

Identifying Limitations Applying Concepts to Practice

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6/22/2015 11

The End of a Mission?

Or the Beginning of Another?

Questions?