Id |
Subject |
Object |
Predicate |
Lexical cue |
T1 |
93-178 |
Epistemic_statement |
denotes |
suggest that we have misunderstood their commentary (Martin-Moreno et al., 2014a,b) . |
T2 |
179-297 |
Epistemic_statement |
denotes |
However, we quoted directly from their commentary in our editorial, so cannot identify the scope for misunderstanding. |
T3 |
298-599 |
Epistemic_statement |
denotes |
A fuller direct quote than we included in our editorial is ''In fact, goggles and masks might not even be necessary to speak with conscious (Ebola) patients, as long as a distance of 1-2 metres is maintained (the maximum distance that infectious droplets might reach)'' (Martin-Moreno et al., 2014a) . |
T4 |
600-650 |
Epistemic_statement |
denotes |
We maintain that we do not support this statement. |
T5 |
785-1067 |
Epistemic_statement |
denotes |
As we outline in our editorial, given the high case fatality rate of Ebola and the uncertainty about transmis-sion modes of Ebola, the precautionary principle must to invoked to ensure the occupational health and safety (OHS) of health care workers (HCWs) caring for Ebola patients. |
T6 |
1187-1325 |
Epistemic_statement |
denotes |
The unpredictability and changeable nature of the acute clinical setting makes it unfeasible and impractical to make such recommendations. |
T7 |
1838-1990 |
Epistemic_statement |
denotes |
If our health workers do not feel confident in the level of protection afforded, this will compromise the ability of health systems to respond to Ebola. |
T8 |
2084-2306 |
Epistemic_statement |
denotes |
It has come to light that several health workers in West Africa adhered to strict infection control protocols but contracted Ebola anyway, which suggests transmission modes are not as clear-cut as suggested (Cohen, 2014) . |
T9 |
2307-2521 |
Epistemic_statement |
denotes |
Blaming this entirely on failure to don and doff properly is pure speculation, not supported by evidence (Fischer II et al., 2014) , whereas there is ample evidence that Ebola can spread through non-contact modes . |
T10 |
3122-3241 |
Epistemic_statement |
denotes |
What we have further raised is a serious inconsistency of Ebola PPE guidelines for HCWs compared to laboratory workers. |
T11 |
3510-3739 |
Epistemic_statement |
denotes |
Yet the Centers for Disease Control and Prevention (CDC) advocates airborne precautions for management of known and suspected cases of MERS-CoV and use of an N95 respirator (Center for Disease Control and Prevention (CDC) 2014a). |
T12 |
3740-3950 |
Epistemic_statement |
denotes |
This is despite it being documented that MERS Co-V is not easily transmitted from human to human (Drosten et al., 2014) , nor present in high concentrations in the upper respiratory tract (Guery et al., 2013) . |
T13 |
4093-4213 |
Epistemic_statement |
denotes |
Many HCWs have contracted Ebola despite wearing PPE, which in itself supports the case for conservative recommendations. |
T14 |
4214-4481 |
Epistemic_statement |
denotes |
Whilst there is some increase in discomfort with use of a N95 respirator compared to a mask, (MacIntyre et al., 2011 (MacIntyre et al., , 2013 comfort should not be the primary consideration in making recommendations for a disease with such a high case-fatality rate. |
T15 |
4482-4551 |
Epistemic_statement |
denotes |
Nor should the duration of tolerability of PPE drive recommendations. |
T16 |
4816-4973 |
Epistemic_statement |
denotes |
Suggesting HCWs use lesser protection because they could work 3 h instead of 40 min is illogical, when the risk of working longer in lesser PPE may be death. |
T17 |
4974-5148 |
Epistemic_statement |
denotes |
Whether they comply or not due to comfort is their choice, but to recommend less for frontline doctors and nurses than for laboratory workers, is not defensible on any level. |