In the three and a half weeks Dr. William Fischer spent in Gueckedou, Guinea, he encountered between thirty and fifty patients suffering from Ebola. Only seven survived.
“It’s hard. It’s really hard work. It’s really intense work,” says Fischer. “But I’m totally sold on this idea that we can improve mortality with even just basic mechanisms right now.”
Fischer is a pulmonary and critical care physician at UNC Hospitals. He traveled to Guinea in May with the World Health Organization to help battle the latest outbreak of Ebola.
The current outbreak is the largest and deadliest on record. More than 1,200 have been infected and at least 670 have died in the past four months.
Unlike past outbreaks, which were located in remote regions in Central Africa, this began in West Africa, starting in Guinea before spreading to Liberia, Sierra Leone and Nigeria.
“It’s so easy for infection and infected patients to cross international borders, but it’s much more difficult for resources to follow that path,” says Fischer. “Increasingly we’re becoming a much more interconnected world. People are much more mobile. This is a very nice reminder of that interconnectedness, as this population is incredibly mobile and that mobility is sustaining this epidemic.”
The Ebola virus produces a hemorrhagic fever that is spread by contact with bodily fluids. The mortality rate among those infected can reach as high as 90 percent. There’s currently no cure, no vaccine, and no specific treatment, but Fischer says aggressive rehydration can help victims fight off the virus.
“I initially was skeptical about what care we could provide, but in fact, what I saw was that we can have a dramatic effect on reducing Ebola-related mortality with aggressive critical care.”
Yet Fischer said in his three weeks treating patients only a handful recovered, and when they did, the doctors were often happier than the survivors.
“One of the most difficult things about Ebola is that it doesn’t just kill people- it wipes out their families,” says Fischer. “This gentleman we were able to get through, but he lost his mother-in-law, his mother, and his wife and their unborn child. So you can imagine the despair that permeated every inch of that room when he heard that his wife had passed shortly after delivering their child.”
One of the biggest challenges facing doctors battling this current outbreak is convincing communities and individuals to seek medical treatment at the first sign of infection.
Western medical resources flood into the region only when an outbreak occurs, forming an association between doctors and death that’s hard for residents in the affected areas to ignore.
“They don’t understand that their best chance for survival is to come to a treatment facility early and that their best chance at preventing transmission to their loved ones is to go to the treatment facility,” says Fischer. “There’s an incredible amount of distrust between the people and the healthcare providers because they see their loved ones go to these facilities and then 90 percent of them return in a body bag. Facing those statistics, I’d be skeptical of those treatment facilities.”
Fischer says medical personnel need to reach out to community leaders to help stem the spread of the virus and build trust.
“This is a challenge. This is a major, major challenge. But it’s also an opportunity. If we can empower local community leaders to spread the word about the benefits of presenting early to a treatment facility- the benefits being it increases your chance of survival and decreases the chance of transmission- then we can have patients present earlier. If we can reduce that mortality we’re going to improve the trust between the community and the healthcare providers.”
This latest outbreak began in March and continues unabated. Fischer notes that with a twenty-one day incubation period and an increasingly mobile populace, this disease is poised to spread.
“I don’t see this ending any time soon, unfortunately. I do think that we are going to have to dedicate and we should dedicate a tremendous amount of resources, both from a material perspective as well as from a human infrastructure perspective in order to stop this outbreak before it gets even worse.”
Just last week a seemingly healthy man boarded an airplane in Liberia, only to arrive in Lagos, Nigeria with symptoms of Ebola. He later died. Officials are still trying to track other passengers on that plane.
The disease takes a toll on healthcare workers too, as they are often in contact with the bodily fluids that spread Ebola. Top doctors in Liberia and Sierra Leone have succumbed to the disease, and two Americans, a doctor and an aid worker, are currently in quarantine suffering symptoms. This has prompted two North Carolina-based charities to call for an evacuation of all non-essential staff from Liberia.
Nonetheless, Fischer says he is eager to return to the region.
“I’d like to go back. I think, for me, leaving was just as difficult as going. It was the thought that I was leaving in the midst of the epidemic as opposed to the end of the epidemic. I feel a strong draw to go back. My hope would be that I could, through aggressive critical support, reduce the mortality and then improve community trust.”
You can read Dr Fischer’s dispatches from Guinea here.http://chapelboro.com/news/international/epidemic-worsens-unc-doctor-details-battle-ebola/
With the rising concern of the dangers associated with fracking, many North Carolinians are deeply uncertain about what lies ahead for the state relying on the questionable method of obtaining fuel and energy.
WCHL’s Ron Stutts spoke with Therese Vick of the Blue Ridge Environmental Defense League, and with Martha Girolami, a citizen of northeast Chatham County that has found out recently that she lives atop of what is known as the “Triassic basin,” which is one of the potential locations that fracking companies may take advantage of.
The Blue Ridge Environmental Defense League is a “regional, community-based, non-profit environmental organization.” They focus on issues including “industry’s dependence on toxic chemicals, utilities’ refusal to adopt sound energy alternatives, industrial development and highway construction at the expense of public health, intensive livestock operations’ effects on agriculture and the environment, and huge waste dumps.”
When asked what she personally found so dangerous about fracking, Girolami says that her two biggest issues come from the health risks and how quickly the practice of fracking is being accepted despite a lack of real preparatory analysis.
“Fracking so bad because it’s so polluting,” says Girolami. “It’s so polluting to ground water, surface water, air, air health, and it’s been so rushed. So rushed we haven’t done a health study, we’ve done no air rules. The Energy and Mining Commission has been meeting for two years, but there are big gaps in the rules they put together.”
Vick reminds of the recent legislation created that states it is a misdemeanor to disclose what chemicals are used for digging. She says that this is not how the community should be treated when it comes to this form of resource gathering.
“The community has the right to know what is being injected into the ground under their feet,” says Vick. “Our organization just passed a resolution on chemical disclosure that we hope to share with other folks, but my feeling is that the reason they don’t want people to know is because of that potential liability.”
***Listen to the full interview here***
For more on the Blue Ridge Environmental Defense League, click here.http://chapelboro.com/news/health/anti-fracking-response-interview/
Four people died from the flu last week and three additional flu deaths from previous weeks have been discovered, according to the North Carolina Department of Health and Human Services.
At the last report, 74 people had been killed by the flu in North Carolina this flu season. The total is now up to 81, which is 22 more than last season’s total of 59.
Four deaths is the lowest reported total since the first full week in January showing a continued downward trend since the peak of 12 in late January. This time period also marked just the second week since January 12 that a pediatric death has not been reported.
To see more statistics of flu-reported deaths in North Carolina, click here.http://chapelboro.com/news/health/four-new-flu-deaths-nc-last-week-three-additional-found/
NORTH CAROLINA – Flu season is still a month or so away from its peak, and health officials are urging people to get their flu shots with the number of cases continuing to rise.
Because of the uptick in cases, all Duke University Health System hospitals began restricting visitation rules on Monday, including ambulatory surgery patients being limited to immediate family or designated care givers, 18 and older, those who are not sick with the flu, and patients can’t have more than two adult visitors at once.
The restrictions are only temporary; Duke put similar restrictions in place last year.
Health officials are still stressing to the public to get flu shots. It takes about two weeks for the vaccine to kick in once administered. Some pharmacies have noticed an increase in demand and therefore a decrease in supply.
Eight people have died from the flu in North Carolina this season.
For information about Health Department clinics in Orange County, click here.http://chapelboro.com/news/health/flu-season-putting-stress-vaccine-supply/
CHAPEL HILL – The Food and Drug Administration is funding 14 tobacco centers of regulatory science, and out of the 40 universities that applied, UNC was the only school to receive two.
The two research teams combined will receive nearly $40 million from the FDA.
Associate professor, Robert Tarran, is leading one of the teams and four of the projects at UNC. Tarran has experience doing tobacco research on COPD (Chronic Obstructive Pulmonary Disease) for several years. He says he thinks UNC received funding because of the expertise at the school.
“So UNC has an expertise in airway biology, and so we were able to put together a whole bunch of different researchers who have complimentary research experience to put together this comprehensive project,” Tarran says.
Tarran says that his team will receive $20 million over the next five years for a flexible range of tobacco products. Currently, Tarran says he’s focusing on the effects of hookah and “little cigars,” but in the future may research other new tobacco products.
The money from the grant will not only employ researchers here at UNC but will provide a training component for graduate students.
“There’s an actual separate component on this for training grad students, and then part of that gives them the advantage, so there’s like a mechanism for a grad student to come into this and then go and get experience at other centers as well,” Tarran says. “And so we get to train the next generation of scientists who look at tobacco research.”
Professor in the School of Public Health at UNC, Kurt Ribisl leads the other research team that looks at how to communicate the facts about tobacco products to smokers. Having researched in this area for 19 years and involvement in the Surgeon General’s report last year, Ribisl says he has high goals for his project.
“The ultimate goal of all of this work is to reduce the public health burden of tobacco use, design research that will help inform and guide what the FDA does when they regulate tobacco products,” Ribisl says.
The new FDA funded research will allow for studies to be conducted on subjects where there is very little data. Tarran says the funds will allow for precise, fact-driven research that hasn’t been done.
“Well see it’s going to be interesting, I think its nice now that we can sort of have a better debate about whether or not these new products are dangerous or not, I think the precise research hasn’t been done so this gives us opportunity to do that and then to better help the FDA on governing these products,” Tarran states.
Ribisl says that one of the new aspects they will look at is warning labels for E-Cigarettes.
“We really need to understand what consumers think about the risks of these projects, and when we find if they have really distorted views of the risks, then we want to more properly align what the consumer believes with the actual risk of the product;” Ribisl says “so we are thinking about testing new labels for E-Cigarettes.”
With a combined $40 million for research over the next five years, UNC will produce new data related to cigarettes and other tobacco products. A mix of health studies on the lungs and how to effectively communicate the risks of tobacco products will dovetail nicely for the FDA.http://chapelboro.com/news/health/fda-funds-two-tobacco-centers-at-unc/
I do not handle stressors as well as I should.
There, I said it.
Those who know me well would dispute that statement, saying I am a calm and collected individual. My grandfather once told me, “Never let them see you sweat.” Sound advice — which has certainly been internalized in my case. When it comes to stress management though, it becomes a façade. I may look collected on the exterior, but there are times when I let stress build up to levels that are damaging to both my mental and physical health.
I bet you don’t handle stressors well either.
A 2004 article in the academic journal Occupational Health presents the idea that information overload is the culprit explaining why mental health problems are just as prevalent, if not more prevalent, than physical health problems in society today. It makes sense, let us take a look:
When was the last time you took a leisurely stroll through the neighborhood, just to get some fresh air? When was the last time you sat watching the sun set over the horizon? When was the last time you sat in complete silence for even just a handful of minutes?
Please do not feel that I am calling you — the reader — out, for it has been far too long since I have participated in any such activity myself. Humans today are on the go. We have important things to do and important people to see (or so we tell ourselves). We work overtime, use electronics incessantly, stay out too late, and piece together our lives on a whim. Another way to say it: We skimp on sleep, get by with coffee, never turn our minds off, and never slow down. We are constantly stimulated, and have been socially conditioned to believe this is the way things should be.
In addition to information overload, I believe we have developed poor mental “nutritional” habits as well. Think of mental nutrition similar to physical nutrition — you are what you eat. Put nutritious food into your body, health follows. Put engineered food-like products into your body, things go downhill quickly. The same can be said of our minds. Do you fill your mind with positive thoughts? Do you listen to and read positive and thought provoking commentary and ideas? Do you surround yourself with uplifting individuals?
Unfortunately, this is not often the case. I will provide one prevalent example: the news. The majorities of people I interact with on a daily basis are fairly up to date with, and watch, newscasts on television. Modern day newscasts are heavily threat-based, and this is what hooks us. Human beings are hard-wired to pay attention to threats in our environment; it is very pro-survival. Now it mainly creates a large quantity of negative stress in our lives. Let us not get started on commercials and advertisements.
A 2007 study published in the International Journal of Behavioral Medicine showed that watching a mere 15 minutes of a nationally broadcasted newscast increased levels of anxiety and perceived stress in individuals for up to an hour after watching. Consider that many people watch or read the news multiple times each day.
Many studies have shown that these modern stressors we deal with have negative impacts on our health, both mentally and physically. Humans who report high levels of perceived stress are more likely to suffer from depression & anxiety, get sick more often, have higher risks of metabolic diseases, and are more likely to abuse alcohol. None of this sounds like fun to me.
I have presented to you quite the conundrum, but have not provided a solution. The first step in managing stress comes from the awareness that is indeed a real problem for each and every one of us, and there are consequences for not handling it effectively. I will discuss some ideas on how to effectively manage stressors in your life next time around, but for now I leave you with two simple challenges.
Until next time I will do my best to slow down and relax. I hope you do the same.
1. Donkersly, T. An interview with Dr. Andrew Weil. 2012. http://www.greenlivingaz.com/?p=3027.
2. Hammen C, Kim E, Eberhart N, Brennan P. Chronic and acute stress and the prediction of major depression in women. Depression & Anxiety. 2009;26(8):718-723.
3. Holland E. Stress substantially slows human body’s ability to heal. Ohio State Research News. 2005. http://researchnews.osu.edu/archive/wounheal.htm.
4. Info overload causes mental problems. Occupational Health. 2004;56(7):11.
5. Rod N, Grønbæk M, Schnohr P, Prescott E, Kristensen, T. Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile: a longitudinal study. Journal of Internal Medicine. 2009;266(5):467-475.
6. Szabo A, Hopkinson K. Negative psychological effects of watching the news in the television: relaxation or another intervention may be needed to buffer them. International Journal of Behavioral Medicine. 2007;14(2):57-62.
Image via Deja Photo from Lens to Picture
Got any idea how many people ride their bikes to work in Chapelboro?
I don’t. But I do know that Ride Your Bike to Work Week (this week) and Ride Your Bike to Work Day (Friday) is a good way to nudge more in that direction. Lots of local activities left this week including a fun Friday night ride. Details here.
Another nudge is the Bicycle Commuters Benefit Act which allows employers to give up to $20 per month to employees who pedal to work. The money is tax-free to the employee, and the company can take a $240 write-off on its own federal taxes per eligible employee enrolled.
Google nudges the use of bikes, rollerblades or good old-fashioned feet with their Self-Powered Commuter Program which,
“encourages employees to reduce their personal greenhouse gas emissions by getting to work under their own power… Those who participate in this program earn points, which can then be put towards a donation from Google to any charity of their choice. Google will donate $100 for every 20 days of self-powered transportation.” from Google Rewards for Going Green by Jordan Van Gorder
Perhaps the biggest nudge of all is just knowing that biking helps us be leaner, meaner and perhaps not as mean. It helps our minds be keener and helps our environment and pocketbooks be greener.
And if an entire work group or team were doing it – just imagine how much better everyone would feel, how much nicer everyone would be and how much more they could accomplish.
Practical? Maybe not for those of us who live far from work or visit lots of businesses during the day.
For this group, perhaps it could be a nudge for us to jump on our bikes instead of into our cars for quick trips to anywhere – the Farmers Market, office supply store, post office, or a quick trip to visit a neighbor. A great way for pressed professionals to sneak in some exercise and enjoy the benefits of being leaner, meaner, keener and greener.
Plus that wonderful feeling of the wind on your face and blowing through whatever hair isn’t under a helmet. Feeling like a kid again – or maybe a teener.
What about you?
Do you regularly ride your bike to work?
Are you celebrating Ride Your Bike to Work Week or Day?
Does your business encourage or reward the use of self-powered transportation?
Please tell me about it and send pictures to Jan@Chapelboro.com.
P.S. Be sure to check out the great local resources for bicycling at www.CycliciousMovement.org