Instapundit » Blog Archive » JERRY POURNELLE: A New Ebola Czar; Military deploys to plague zone. Competence in government. “God…

Plus: “The rest of the article is worth your time. Five of the 58 medical professionals involved in the Science Magazine study died of Ebola before the paper was published. . . . Nine Doctors Without Borders physicians, all equipped with the best of isolation and prophylactic gear, have died of Ebola. Of the physicians and nurses who have died of Ebola in this epidemic, most (more than 60%) had what was considered more than adequate protective gear and were instructed in its use. The US Military being sent into the plague zone have had four hours of instruction.”

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Emphasis mine.

Fifteen years ago, I’d have felt fairly comfortable with a four hour block of instruction.

First, usually monthly, but at least quarterly, I would undergo actual hands on training in donning personal protective equipment (PPE). More importantly, I’d also undergo hands on training in removing contaminated PPE, and decontamination procedures. To be sure, the contaminant in question was usually mustard gas or nerve agent, both of which can be treated. But the key was, don’t get contaminated doffing your gear.

But the past decade has seen the Army emphasis on training in nuclear, biological and chemical warfare environments wither. Not because the Army doesn’t see the need, but rather relatively low chance of needed to operate in NBC compared to the huge numbers of tasks that absolutely troops will be required to perform in a combat deployment. That means that both the average individual skill level and the institutional knowledge in avoiding contamination has faded.

Another key aspect of any successful training program is repetition. You don’t train until you get it right. You train until you can’t get it wrong. How many times will troops deploying to Liberia actually practice the techniques they need to master?

God bless them and keep them.

9 thoughts on “Instapundit » Blog Archive » JERRY POURNELLE: A New Ebola Czar; Military deploys to plague zone. Competence in government. “God…”

  1. One of the best ways to prevent contamination is also one of the easiest to implement: oversight. Whenever you have personnel doffing potentially contaminated garb there should be someone trained in the doffing procedure who does nothing but watch the doffing to identify violations.

    1. Yup. I suspect you nukes had a similar process.

      Also, I guess one day I should write about the M256 chemical detection kit, and the part of the procedure that calls for “have the most expendable private unseal his mask.”

  2. When I was in a supposedly combat-ready-24/7 unit in Germany, prepared to take on the Soviets at a moment’s notice, the CBR training ranged from nonexistent to abysmal. I was told by the supply clerk that we did actually have things like PPE but it was packed away neatly in a trailer, ready for inspection (equipment is always ready for CMMIs if it is never used).

    On exercises we would put on our masks and a poncho to protect against simulated nerve agent attacks. Decontamination after the attack? Nope.

    I don’t know if you are familiar with the M17 protective mask, but the filter is changed from the inside. In order to replace it you must take off the mask, then remove the filter, possibly contaminating the inside of the mask or the replacement filter.

  3. This morning I read an article by a guy in Maine who went through FEMA’s training and seriously critiqued what he was seeing around the country. This included lack of training and drills. He pointed out that both suiting up and removal of PPE could not be done alone, yet that was exactly what was happening. He is at a small hospital in Maine and is shocked that the large hospitals are sorely unprepared.

    He also pointed out that he is not medical personnel and that most of the Medicos in this country have no idea what they are doing.

    I can’t find the article now (I just searched for the last half hour). If I find it, I will post the link.

    1. The infection rate for health care workers for ebola is in the neighborhood of 10%. I’m struggling to think of how many tons of…bricks Naval Reactors would come down on us like if we has even a 1% rate of skin contamination. There are ways of doing this safely and – relatively – cheaply. I don’t know why the medical community isn’t adopting them.

      I’m beginning to suspect that the solution is to put the patient in a large glove bag.

    2. “I don’t know why the medical community isn’t adopting them.”

      Gotta bend that cost curve down. This country spends too much on health care.

    3. But that’s the thing, finding the ex-nuke in the facilities management department (there’s pretty much guaranteed to be at least one) and telling him to watch the doctors and nurses working around these high-risk patients and identify whenever they violate contamination control protocols wouldn’t cost that much. Far less than the bad press and replacing a doctor or nurse would.

    4. Jeff, that is a common sense, inexpensive, sure to work system for protecting people. Can’t have that! How will the insiders skim off money from that?

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