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Subject: Would Hospital Ships Be Effective Controlled Environment Venues For Ebola Treatment?
CJH    10/18/2014 12:33:37 PM
If the current ebola outbreak is of the magnitude and duration we think it will turn out to have, would hospital ships be feasible as sites for treatment?

Should we maintain hospital ships for such purposes?

Would conversion of large container ships to hospital ships be worthwhile?

 
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WarNerd       10/19/2014 2:46:17 AM
Possible, by probably not desirable because of potential problems with transporting patients except in the early stages.  You would also want multiple smaller ships rather than 1 or 2 large vessels to limit losses to if containment is broken.
 
The real problem is supplying suitable containment.  You would also need means to reliably sterilize or destroy them afterwards.  Successful and reliable sterilization may require custom building them.
 
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CJH       10/19/2014 11:54:57 AM
I wonder whether a shipboard sterilizing nuclear radiation facility would be appropriate and not multiply risks beyond being manageable.

I am not that up on nuclear radiation but gamma radiation would do it probably. I guess alpha and beta might not. Gamma would probably require heavier shielding. I wonder it x-rays are good for this purpose.

I was just thinking about an apparently bygone interest in irradiating food to extend ts storage life. Maybe the same process would serve the need to sterilize large quantities of virus laden material. A ship could have the infrastructure to support the process.

 
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ker       10/19/2014 2:20:18 PM
Disenfecting shouldn't require gamma rays. Just removing the humans from a contaminatted area for a week would quite a ways towards killing ebola out side the body. Bleach water or even fire (small burners for heating the surface of floors) work and are much easyer than gamma rays. Hospital ships value comes from their ability to move in responce to a need. A ship on stand by to respond if ebola pops up Burma or Hondurs might be a good idea if we had etra cash. For now resource should go strait into West Africa. In America we are still just in the pregame warm up stage. Best thing to do is supress ebola at its source.
 
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WarNerd       10/20/2014 1:39:40 AM
I wonder whether a shipboard sterilizing nuclear radiation facility would be appropriate and not multiply risks beyond being manageable.
 
I am not that up on nuclear radiation but gamma radiation would do it probably. I guess alpha and beta might not. Gamma would probably require heavier shielding. I wonder it x-rays are good for this purpose.
 
I was just thinking about an apparently bygone interest in irradiating food to extend ts storage life. Maybe the same process would serve the need to sterilize large quantities of virus laden material. A ship could have the infrastructure to support the process.
It is not the materials produced in the treatment area (linen, isolation gear, medical samples, sewage, etc.) that are the problem, most can be incinerated. The problem is the treatment area plus any other areas the patients pass though and the quarters for the medical personnel (assuming they are kept isolated from the rest of the ship), and all the ship’s utilities unless also isolated. And if one of the ship’s crew comes down with the disease, then every nitch and cranny in the entire ship has to be sterilized. That’s why a specialized design may be required.
 
After some thought, I think a barge design you can tow into place might be a better choice. Fewer design limitations make it easier to optimize, though it would be slower to get in place. In fact you would hardly need anything that was not required to create the facility on a cargo ship given the lack of surplus utilities in the cargo ship.
 
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CJH       10/25/2014 8:21:44 PM
" I think a barge design you can tow into place might be a better choice. Fewer design limitations make it easier to optimize, though it would be slower to get in place"

I don't know but that a barge design might also afford a certain scalability (or modularity - there's another thought) were that to help out - raft multiple ones together.

 
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WarNerd       10/26/2014 1:15:06 AM
I don't know but that a barge design might also afford a certain scalability (or modularity - there's another thought) were that to help out - raft multiple ones together.
Keep the barges separate and self contained with different personnel. That way if it breaks out of containment on one barge it can’t spread to the other barges.
 
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CJH       11/9/2014 3:41:19 PM



I don't know but that a barge design might also afford a certain scalability (or modularity - there's another thought) were that to help out - raft multiple ones together.


Keep the barges separate and self contained with different personnel. That way if it breaks out of containment on one barge it can’t spread to the other barges.

Would it help to have the people on one of the barges specialize in dealing with a containment breech?

 
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WarNerd       11/10/2014 2:50:48 AM
Would it help to have the people on one of the barges specialize in dealing with a containment breech?
Doubt dealing with a containment breech, which would probably be determined by one or more of the staff coming down with the disease, would be any different than dealing with the disease itself.  Unless the disease is truly airborne, options would include:
• Move the infected staff into the barges treatment area and double up the decontamination proceedures.
 
• Move the infected staff and patients to another barge and presumably uninfected personnel to a different barge for observation.  Then sterilize the contaminated barge with techniques that cannot be used when occupied, i.e. live steam, pressure washers with toxic chemicals, etc.  One advantage of purpose built barges would be that all areas, especially the bilges, could be designed with decontamination in mind.  This could be performed by a separate barge, but more likely with equipment airlifted from a support vessel.  The cleanup crew would also need to go into isolation for observation afterwards.
 
• Evacuate as per above and scupper the barge in deep water.
 
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