Clutching our world views with a death grip

By Mary Odum

As I write, I am sitting in what might be my last airplane seat, stacked cheek to jowl with a couple with a cute but runny-nosed baby. My trip was with girlfriends on a bike tour in California, and I made the most of it, living very much in the moment. As I traveled, I wore my infection control hat, scanning the settings with new eyes for potentially dangerous situations. I was careful in public places such as airports, trolleys, and the BART, washing my hands frequently and keeping them folded in front of me. I was much more aware of impulses to touch my face. I watched a couple in the San Francisco airport who were headed to Nairobi touch their faces, many times, as they waited. Airport bathrooms were mostly hands-free, but the automatic toilets sprayed their contents powerfully in all directions when flushed. There was a new sign in the TSA line warning us to wash our hands because of Middle East Respiratory Syndrome (MERS), but no mention of Ebola (EVD). TSA used gloves to pat me down, but they were not washing their hands after contact with people. Boarding passes, drivers licenses, and credit cards were swiped and exchanged, along with bills and coins. I saw a large homeless population on the waterfront in San Francisco with no access to bathrooms or handwashing, who were using the streets as open latrines. I saw prostitutes. Hotels had carpets and mattresses that would defy cleaning in an outbreak. I saw people hugging, and shaking hands, and doing all kinds of human, caring, or even loving things that would be extinguished in a pandemic.

Today the first nurse within the US healthcare system has acquired EVD. My nursing friends are worried. Are we ready for this? How do we communicate risk, or should we settle for optimistic reassurance that our system can handle this? What are our biggest needs in preparation?
Continue reading Clutching our world views with a death grip

The 4S’s of surge capacity

By Mary Odum

Welcome to the arcane and short-sighted world of public health strategic planning. This post introduces the term surge capacity, a term we will hear often in the coming months of this growing Ebola (EVD) epidemic. Surge capacity is the ability to manage sudden or prolonged increases in overall healthcare demand, and the key components are the 4 S’s of staff, stuff, structure and systems, for hospital and community preparedness (Adams, 2009). During a pandemic, lack of surge capacity in all four of these areas become key limiting factors:  hospital isolation beds (structure), healthcare providers (HCP-staff), isolation gear (stuff), and an efficient, just-in-time, high-transformity system, which is an obstacle to resilience.  Continue reading The 4S’s of surge capacity

Ebola as a game-changer?

By Mary Odum

In crises, anxiety focuses attention. I continue to focus on the growing Ebola epidemic, which has no real restraints to keep it from becoming a global pandemic. Overpopulation, inequity, peak oil, and disturbed natural environment have converged with the problem of Ebola, to set up the conditions for a pandemic. If we add a slow response from complacent, frozen bureaucracies to this toxic mix, then we can expect a global pandemic to occur. We have met the enemy, and he is us.

Healthcare professionals need to speak up about healthcare inequity and US readiness for pandemics. And I have a particular interest in this topic, since I am potentially most exposed as a nurse to acquiring Ebola through patients shedding the virus in body fluids, and women are at high risk as typical care givers in the home and hospital. I have studied handwashing in hospital settings, with insight as to the gaps. So I will continue to perseverate here, and add my nursing voice to the choir of concerned healthcare professionals. Continue reading Ebola as a game-changer?

Stop growing or meet the four horsemen?

By Mary Odum

I took some time off from writing this summer, as I was busy getting unmarried and moving back to my original home, Florida. Don’t ever change your name—it’s a real hassle to change it back, from Logan to Odum. The divorce was quite amicable, after almost 40 years together, and Alaska provides few obstacles to the process. The house in Alaska sold quickly, to friends, so here I am, literally a hot mess, in north-central Florida, trying to re-acclimate to 92 degrees in the shade with 95% humidity. Instead of wolverines and bears traipsing through the yard, it is raccoons and possums. Instead of goshawks eating the chickens, I have fledgling cardinals at my feeder. And instead of glorious mountain tundra runs, I have quiet paddles along sacred springs and lakes. I have encountered enough old friends and acquaintances here that I am quickly regaining my sense of place in this sunny, hot, subtropical, watery paradise. Continue reading Stop growing or meet the four horsemen?