Ebola virus, Education & Telemedicine: a SmartER Combination
(ED NOTE: This is the best post I have seen on Ebola, and you can tell it was written by a doctor, who just happens to know digital healthcare)
Ebolavirus infection. Education & Technology can help, especially EDUCATION!
The recent news about the Ebola epidemic are really catching the world’s attention, and I feel that it is important to keep updating this post about this most important, life-threatening topic.
I’m not an Infectologist. I’m not an Epidemiologist either. I’m just a Surgeon.
Like many healthcare professionals, I have been thinking about it for several weeks. In my particular case, I’m extremely alarmed and do worry that this current epidemic, will spread fast and take an enormous toll on its way to be eventually defeated.
Some facts: Wikipedia/Ebolavirus
I don’t want to get too technical about this.
FACTS: It is a virus, basically (RNA) protein that infects a host (in our case, humans) and replicates quickly, overwhelming the bodies capabilities to fight it. It attacks, among several targets, the lining of blood vessels (endothelium) and organs like the liver and immune response cells. It likes neutrophils (cells in charge of alerting the body that there’s an infection going on), blunting their ability to evoke a defense response.
Transmission occurs by the way of (ANY) body fluid from an infected person (but only after that individual is having symptoms). Symptoms appear between a few days to 3 weeks.
The virus is A SURVIVOR. It can be killed or inactivated while on the surfaces, with 3% Acetic acid solution (vinegar, alcohol based products, bleach (1:10-1:100 for >10 minutes), heat (heating at 60 degrees for 30-60 min, oiling for 5 minutes), UV radiation (moderately sensitive), bleach powder, etc.
Outside the host, it can survive for WEEKS in blood or contaminated surfaces, especially at low temperatures (4 degree Celsius)…winter is coming!. These facts are based on experimental findings and NOT BASED on observations in nature.
I think that the problem will be controlled only by the development of a VACCINE ( to provide immunity to people NOT INFECTED yet) and/or the development of a RAPID, mobile DIAGNOSTIC TOOL that allows detection of the virus, in a host, BEFORE the individual becomesSYMPTOMATIC and INFECTIOUS, hence CONTAGIOUS.
The current scenario: a lot of effort in screening symptomatic people in many places (affected areas, airports,etc), mainly to check whether they have symptoms (fever, pains, bleeding, etc). If they don’t have symptoms, THEY ARE RELEASED TO GO, and that’s it.
Imagine how many people might be infected with the virus, but when they were evaluated by the current protocol, they were found not to be symptomatic, so they got through the checkpoint.
I believe that the use of technology such as Telemedicine (m-Health), has a definite role in extending the reach of providers to patients thought to be at risk of becoming symptomatic.
Imagine, for instance, the possibilities of REMOTE AND MOBILE VTAL SIGNS MONITORINGusing wearable technology to keep those patients in “the radar”, without exposing anyone to them and risking becoming infected, while the period of “quarantine” lasts.
Having potential carriers of the virus wear sensors that automatically track an objective parameter such as temperature, heart and respiratory rates, so that abnormal elevations (i.e. fever) are immediately detected, and appropriate measures taken right away. Mobile thermal imaging has a very relevant, potential role in the fight to contain the spread of this illness.
The use of virtual reality presence (telemedicine) clinical interviews and follow-up of cases would make an ideal tool for extending the reach of providers without exposing them to infection.
Tele-mentoring of remotely located health personnel, guiding them with expertise and advice could prove an invaluable tool to optimize the treatment of patients and the development and deployment of strategies to fight this potentially lethal disease. Wearable computers (such as GoogleGlass) could potentially add to the armamentarium of healthcare workers.This particular device has the capability of being a “Touch-free” / voice activated-interface ( along with the current developments to integrate gesture commands, like the Myo platform). See “GoogleGlass on Steroids”.
SO, MY QUESTION IS, what happens with that infected patient afterward?
How many of these “FELL THRU THE CRACK”, and any time between that moment at the airport and 21 days later, developed symptoms-“GOT A COLD” (cold-like symptoms) and started spreading the Ebola-virus. And they might not have been in an area of risk for Ebola, but maybe they just became contaminated by someone else, maybe a few degrees of separation from the actual individual who came from the geographic risk area.
I don’t want to BE ALARMIST but REALISTIC.
We have already seen three INFECTED, SYMPTOMATIC AND INFECTING, patients IN THE USA ( up to the latest report on October 22nd, 2014).
Unfortunately, my prediction is that we are only seeing the “tip of the iceberg” and that in he next several days, we would be finding out many more cases, since it takes at least 21 days for the symptoms to become evident.
I think that this is a problem that requires the most aggressive strategy and that the public needs to be educated (not alarmed BUT AGGRESSIVELY EDUCATED) about the potential of this epidemic to be disastrous, and of the many easy ways to prevent transmission.
ENCOURAGE PEOPLE NOT TO TOUCH ANYONE OR ANYTHING AS MUCH AS POSSIBLE.
ANY SEVERE “COLD” – LIKE SYMPTOMS SHOULD BE TREATED AS EBOLA INFECTION UNTIL PROVEN OTHERWISE, and those patients should be temporarily isolated.
Teach yourself and those around , to be “a little paranoid” about this issue.
Wash your hands and use alcohol-based sanitizer often.
If you come in contact with anyone, WASH YOUR HANDS , USE ALCOHOL BASED SOLUTIONS, DON’T TOUCH YOUR MOUTH, NOSE , EYES OR ANY OPEN SURFACES BEFORE “DISINFECTING” YOURSELF .
I think that this is the type of information that needs to be taught and spread in schools, in public spaces and in the media, as much as possible until this epidemic is under control.
To be informed, to remain healthy… is the right of every individual.
Go wash your hands please.