Ebola response in
Liberia is hampered by infighting
The global response to the Ebola virus in Liberia is being hampered by poor
coordination and serious disagreements between Liberian officials and the
donors and health agencies fighting the epidemic, according to minutes of
top-level meetings and interviews with participants.
Even now, three months after donors began pouring resources into Liberia,
many confirmed cases still go unreported, countries refuse to change plans
to erect field hospitals in the wrong places, families cannot find out
whether their relatives in treatment are alive or dead, health workers sent
to take temperatures sometimes lack thermometers, and bodies have been
cremated because a larger cemetery was not yet open.â€¨â€¨
The detailed accounts of high-level meetings obtained by The New York
Times, the most recent from Monday, lift the veil on the messy and
contentious process of running the sprawling response to Liberiaâ€™s epidemic,
one that now involves more than a hundred government agencies, charities and
donors from around the world.
Despite these problems, with help from donors, Liberia, one of the three
most afflicted West African countries, and the one with the highest death
toll, has seen new cases drop to about 20 a day from about 100 a day two
months ago. Experts attribute that to fearful Liberians touching one another
less, more safe burials of bodies and distribution of protective gear to
health care workers. But they also warn that cases are now holding steady
and could explode again.
Participants in the meetings of the Incident Management System â€” which
replaced the National Ebola Task Force â€” said the atmosphere in the meetings
in the Liberian capital, Monrovia, should not be characterized as chaotic or
bogged down in bickering, instead calling them â€ścollegialâ€ť and â€śeffective,â€ť
although one who spoke on condition of anonymity described â€śshowmanship and
political posturing.â€ť Senior officials of the Centers for Disease Control
and Prevention who attended â€” Dr. Frank J. Mahoney and Dr. Kevin M. De Cock
â€” said in an email that there were â€śdifferences of opinion â€” accompanied by
At the meeting on Monday, Dr. De Cock cited serious logistics problems,
including regular hospitals that cannot separate out Ebola patients,
counties with no ambulances and temperature takers with no thermometers.
On Nov. 12, the representative of the United Nations secretary general
complained that â€śhundredsâ€ť of vehicles had been made available but there was
always a shortage. Asking where they are, he added: â€śThe recipient also has
to be accountable, just as the donor.â€ť
Also, the support documents with the minutes indicate that there is no
national plan for Ebola survivors â€” either for reuniting them with their
families or for using them to do nursing tasks because they are thought to
A report on the issue reads: â€śThe current and planned work presented by the
partners and government for survivors can be characterized as fragmented and
lacking in scope, scale, comprehensiveness, evidence base and
American military helicopters ferrying doctors to remote areas were
forbidden to fly back not only patients but even blood samples; recently
samples from a village had to be walked to a road four hours away. At
Mondayâ€™s meeting, according to the minutes, Dr. De Cock called this
â€śunacceptable,â€ť adding, â€śThis has to change this week.â€ť
Dr. Hans Rosling, a Swedish epidemiologist and consultant to Liberiaâ€™s
Health Ministry, said that the helicopter order came â€śfrom somewhere in
America.â€ť In an interview, he cited problems not listed in the minutes: one
Asian and two European donor countries are insisting on building new Ebola
field hospitals in Monrovia, where hospitals have empty beds, rather than in
remote counties where beds are desperately needed; they insisted because
they announced those plans two months ago, he said.
The national case count was not reported for two days recently because the
government employee compiling it went unpaid and stopped working. The
minutes of the Incident Management System were made available along with
PowerPoint files and other documents by an expert who said the
disorganization of the Ebola effort should be made public.
The meetings are usually led by Tolbert Nyenswah, the deputy health
minister, and include representatives from the Centers for Disease Control,
the World Health Organization, the World Bank, the United Nations Mission
for Ebola Emergency Response, numerous United Nations agencies, the United
States Agency for International Development, the United States Army, Doctors
Without Borders and medical, aid or military representatives from many other
countries. Dr. Nyenswah and other ministry officials could not be reached
for comment; Dr. Rosling has worked with the ministry since October.
The minutes make it clear that accuracy of the national case count is shaky.
In the minutes, Liberian officials regularly complain about the donors, and
the donors argue back. On Nov. 12, James Dorbor Jallah, the task forceâ€™s
deputy manager, said: â€śPeople will sit in D.C. or Geneva and want to direct
what is happening here.â€ť
The health minister, Dr. Walter T. Gwenigale, backed him up, complaining
that â€śthe U.N. and other agencies got their money before the ink was even
dry,â€ť while, he said, a group run by a Liberian pastor to teach rural people
about Ebola â€śhas not gotten one cent.â€ť
On Sunday, President Ellen Johnson Sirleaf replaced Dr. Gwenigale without
explaining why, but said he would remain an adviser. Dr. Emmanuel T. Dolo,
Johnson Sirleafâ€™s youth adviser, complained that the donors were â€śshowing a
level of disrespectâ€ť by judging Liberian community groups by â€śharsh
standardsâ€ť and â€śWestern standards.â€ť
At the same meeting, Nyenswah, the deputy health minister, pointed to his
governmentâ€™s â€śteam leadersâ€ť and warned, â€śPartners in the room have not been
engaging them and involving them in strategy â€” but you have to.â€ť
Visit the New York Times for the story.
Class I Recall:
Respironics California, Esprit V1000 and V200 Ventilators
Respironics California Inc. has initiated a recall of Esprit V1000 and V200
Ventilators, Model V1000 and V200, installed with 3rd Generation Power
Supplies, and 3rd Generation Power Supply Repair Part Kits. These devices
were manufactured and distributed from December 21, 2012 to July 9, 2014.
The 3rd Generation Power Supplies are installed in Esprit V1000 and V200
Ventilators and are also sold as 3rd Generation Power Supply Repair Kits. A
part in the 3rd Generation Power Supply may prevent the ventilator from
using AC power (electricity from a wall socket) or may fail and prevent the
ventilator from switching back to AC power after using battery power.
Additionally, if a battery is not present or is used up, the ventilators
will not work.
Failure of the power supply may cause the ventilator to shut off, which
may result in too much carbon dioxide in a patientâ€™s blood, not enough
oxygen in the blood, or death.
There have been no reports of death or serious injury related to this
A Philips field service engineer, trained service provider, or distributor
will contact customers to schedule a replacement of the recalled 3rd
Generation Power Supply with a 3.1 Power Supply on all Esprit V1000 and V200
ventilators, and all 3rd Generation Power Supply Repair Part Kits.
Visit the FDA for the notice.
billions in trial over decade-old bidding war
Johnson & Johnson (JNJ) asked a federal judge to award it $7.2 billion over
its failed decade-old effort to acquire heart device-maker Guidant Corp.
J&J claims Boston Scientific Corp. (BSX) owes it that amount, in damages and
interest, for a broken contract in a case that went to trial in Manhattan
federal court. J&J alleges that Guidant violated their merger agreement to
pursue a more lucrative offer by Boston Scientific.
â€śWhat J&J is trying to do here is hold Guidant accountable for its willful
breach,â€ť Harold Weinberger, J&Jâ€™s lead attorney, said in his opening
The suit threatens Boston Scientific, which has a market capitalization of
$17.1 billion, with additional costs tied to an acquisition that has been
called one of the worst in history. The company, which took on $10 billion
in debt to buy Guidant, wrote down $2.7 billion tied to the deal in 2008.
Boston Scientific shares have lost 40 percent since it took over the
J&Jâ€™s damages from the failed transaction are $4.35 billion plus interest,
for a total of $7.2 billion, Weinberger told U.S. District Judge Richard
Sullivan, who is hearing the trial without a jury.
William Ohlemeyer, a lawyer for Guidant, argued that the company didnâ€™t
violate the agreement with J&J and that the worldâ€™s biggest seller of
healthcare products is better off without Guidant. The deal â€śwould have
resulted in a multibillion-dollar loss for J&J,â€ť he told Sullivan.
The first witness, former J&J chief executive officer William Weldon,
testified that he didnâ€™t believe his company came out ahead by losing the
Negotiations that started in 2004 led to a merger agreement in which J&J
agreed to pay $63 a share, or about $21.5 billion, for Guidant. Boston
Scientific then made an unsolicited offer for $72 a share, or $25 billion.
Boston Scientific eventually won the bidding war, buying Guidant for $27.5
billion, with Guidant paying J&J a $705 million termination fee. Boston
Scientific also sold Guidantâ€™s heart stent business to Abbott Laboratories (ABT)
to avoid antitrust issues the merger would otherwise have caused.
J&J sued in September 2006, claiming Guidant, based in Marlborough, MA,
broke their merger agreement by disclosing confidential business information
Abbott and Boston Scientific were also accused by J&J of improperly
interfering with its deal with Guidant. The following year, a federal judge
in Manhattan dismissed Abbott from the case and narrowed J&Jâ€™s claims to a
The case is scheduled to run through Nov. 25, then resume Dec. 15.
Visit Bloomberg for the story.
workplace obesity website after complaints
The CDC has taken down a website that offered an â€śobesity cost calculatorâ€ť
to help American bosses tally financial losses linked to their overweight
employees, a spokeswoman for the agency confirmed Tuesday.
Called Lean Works!, the federal program drew recent criticism from some
nutritionists and advocates for overweight Americans who claimed the site
and its obesity calculator fueled workplace discrimination and perhaps even
led some companies to fire fat people. NBC News first reported those
concerns Nov. 2.
Brittany Behm, a spokesperson for the U.S. Centers for Disease Control and
Prevention, said via email that content once at Lean Works! â€śis under
review,â€ť adding: â€śThe calculator is also under review and will be
potentially updated with new information, technology.â€ť
â€śThe recent attention to the LEAN Works! program caused us to put this part
of the website at the top of the list for review, hence why it is currently
down,â€ť Behm wrote. â€śâ€¦ The potential misuse of this information is something
we will certainly consider in our upcoming content review.â€ť
Joanne P. Ikeda, nutritionist emeritus at the University of California,
Berkeley called the move a â€śvictoryâ€ť for people who are â€ścommitted to ending
discrimination based on body size.â€ť
Visit NBC News for the story.
To stop Ebola,
trust in healthcare workers is crucial
To stop the current Ebola outbreak and prevent future ones from becoming so
large, it's crucial for healthcare volunteers to build trust in the
communities where the disease can spread, well before a crisis starts,
Without such trust, it is hard to get people within those communities to
accept and follow public health advice, which can allow an outbreak to
spiral out of control, according to a recent study.
"It's not a simple, easy thing to tell a mother that she can't touch her
sick child if [the child] has a fever," said Timothy Roberton, of the Johns
Hopkins School of Public Health, who conducted the research and presented it
at the American Public Health Association Meeting. "We've got to remember
that what we're asking people to do has profound implications."
In the study, researchers interviewed Red Cross volunteers in Guinea during
a two-week period in July. They found that part of the reason why the Ebola
outbreak escalated so dramatically is because people in the some parts of
the country were reluctant to adhere to advice from healthcare workers
regarding how to stop the disease's spread.
For example, people in some villages did not believe that an Ebola outbreak
existed, and some were hostile to volunteer healthcare workers, Roberton
said, during his presentation. Some people believed that the Ebola outbreak
was a hoax, and a way for the government to raise money. There were also
rumors that the Red Cross volunteers had made up the disease to steal body
The recommendations to prevent Ebola also interfered with the local customs
of preparing the body for burial, so some villagers would not allow Red
Cross volunteers to safely bury the bodies of the dead, Roberton said.
To overcome resistance from villagers, Red Cross volunteers contacted
community leaders, such as regional and political leaders, to get everyone
on the same page as to what needed to be done to stop the spread of Ebola,
In addition, when someone died from Ebola, the Red Cross volunteers began
allowing family members to put on protective equipment and watch the burial,
and pray over the body from a distance, Roberton said.
Visit Live Science for the article.
3M earns USDA
Certified Biobased Product Certification and Label
3M has earned the USDA Certified Biobased Product Label for its 3M Avagard
Gel Instant Hand Antiseptic and 3M Avagard Foaming Instant Hand Antiseptic.
The USDA Certified Biobased Product Label verifies that the productâ€™s amount
of renewable biobased ingredients meets or exceeds levels set by USDA.
Biobased products are finished or intermediate materials composed in whole
or in significant part of agricultural, forestry, or marine ingredients.
â€ś3M develops sustainable solutions and product platforms to help our
customers â€“ and us â€“ manage environmental footprints,â€ť said Andrea Albrecht,
Global Marketing Manager, 3M Infection Prevention Division. â€śWeâ€™re honored
to receive the USDA Certified Biobased Product Label, which solidifies
Avagard Instant Hand Antiseptics as another valuable solution in the
All biobased amount claims are verified by independent labs and monitored by
the USDA. Consumers may feel secure in the accuracy of the biobased amount
and be empowered in making better informed purchasing decisions.
For more information about Avagard Instant Hand Antiseptic Products, please
Deaths from heart
disease down, up for blood pressure, irregular heartbeat
Deaths from heart disease are dropping, but deaths related to high blood
pressure and irregular heartbeats are on the rise, a new government study
finds. From 2000 to 2010, the overall death rate from heart disease dropped
almost 4 percent each year, the U.S. Centers for Disease Control and
Prevention, researchers found. At the same time, death rates linked to high
blood pressure-related heart disease increased 1.3 percent a year, according
to the study. The researchers also found that deaths tied to irregular
heartbeats rose 1 percent a year.
"While we are continuing to improve in the overall heart disease death rate,
we still have considerable work to do," said lead researcher Matthew
Ritchey, a CDC epidemiologist. "During this 11-year period, more than 7
million heart disease-related deaths still occurred, including 600,000
deaths in 2010, making heart disease the leading cause of death in the
United States," he said.
Heart disease is a broad term for a number of conditions affecting the
heart. Coronary heart disease, which is caused by plaque build-up in the
blood vessels, is one type of heart disease. Congestive heart failure is
another type, and generally occurs when the heart muscle isn't strong enough
to pump blood efficiently. Heart disease from the strain of high blood
pressure is another type of heart disease, according to the study.
"Despite declines, coronary heart disease remains the leading cause of
heart-disease-related death," Ritchey said. "In 2010, it accounted for about
64 percent of all heart-disease-related deaths," he said.
Heart disease also includes abnormal heartbeats (arrhythmias). The normal
beating of the heart relies on electrical impulses progressing in a
particular pattern. When these impulses do not occur in the correct order,
heartbeats become irregular.
Ritchey said the increase in deaths from arrhythmias might be due to the
aging population and people living longer with heart failure, kidney disease
and high blood pressure.
Although this study didn't report death rates based on the type of
arrhythmia, another study found that the rates of ER visits for a common
type of arrhythmia called atrial fibrillation increased by 24 percent from
2006 to 2011.
The reasons for the increase in deaths linked to high blood pressure are
unclear, but Ritchey thinks that uncontrolled blood pressure and obesity are
the likely culprits.
According to the report, deaths associated with high blood pressure
increased among whites. For blacks, the rate remained the same, but overall
was still higher than the rate in whites.
In 2010, high blood pressure was a leading cause of heart-related death (12
percent) among people 35 to 54 years old, as well as for those in the 55 to
74 age group (6.7 percent), according to the study. In people 75 and older,
heart failure was the leading cause for heart-related death at 12 percent,
the researchers found.
The study was published in the Nov. 19 issue of the Journal of the
American Medical Association.
Visit HealthDay for the report.
Methodist Hospital safeguards soft surfaces with bacteria-resistant privacy
X-STATIC Antimicrobial Technology has been chosen by Nebraska Methodist
Hospital to elevate its standard of care for fabrics in the healthcare
environment. The facility will install bacteria-resistant Arc-Com privacy
curtains powered by X-STATIC in the Post Anesthesia Care Unit (PACU) of its
new surgery center.
Terry Micheels, MSN, RN, CIC, and the Service Leader of the Epidemiology
Department at Nebraska Methodist Hospital explained, â€śWe have things we do
to address soft surface fabric risk in the facility already. However, we
felt a better solution was needed for the new PACU, which would contain a
number of cubicle curtains for patient privacy needs.â€ť
A 2012 study published in the American Journal of Infection Control
concluded that privacy curtains are rapidly contaminated, with 92 percent
showing contamination within one week. Micheels evaluated antimicrobial
solutions and determined a technology which is permanently integrated into
the product was optimal next to a temporary topical solution. The durability
of X-STATIC, certified at 200+ commercial launderings, was a critical
Peg Luebbert, MS, MT (ASCP), CIC, CHSP and Founder of Healthcare
Interventions, LLC., offered suggestions for anyone evaluating soft surface
fabric solutions: â€śI suggest you pay close attention to any kill claims
made by antimicrobial fabric manufacturers and ensure those claims are
backed by the appropriate approvals. For example, a fabric that claims it
â€śkills MRSAâ€ť needs to have a public health claim approved by the
Environmental Protection Agency (EPA). To my knowledge, there are no soft
surface fabrics currently available that have the ability to make the kill
For more information, visit