White House briefing, shorter:
Yesterday: WHY IS OBAMA TRAVELING B/C EBOLA
Today: WHY IS OBAMA NOT TRAVELING B/C EBOLA
— Derek Wallbank (@dwallbank) October 15, 2014
News about the second nurse to contract Ebola, from the local Dallas/Ft. Worth station:
… CBS News Medical Correspondent Dr. John LaPook reports that Vinson called the CDC several times before boarding the plane concerned about her fever.
“This nurse, Nurse Vinson, did in fact call the CDC several times before taking that flight and said she has a temperature, a fever of 99.5, and the person at the CDC looked at a chart and because her temperature wasn’t 100.4 or higher she didn’t officially fall into the category of high risk.”…
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
Frieden specifically noted that the remaining 75 healthcare workers who treated Thomas Duncan at Texas Health Presbyterian Hospital will not be allowed to fly. The CDC will work with local and state officials to accomplish this…
Cleveland’s Public Health Director, Toinette Parrilla, said Vinson was visiting in preparation for her wedding. While there, she visited her mother and her fiance…
Hindsight being as always 20/20, how hard would it have been to reimburse the cost of Vinson’s (probably non-refundable) ticket, and set her up with Skype to discuss wedding details with her mom and fiance? She figured her personal costs against what the appointed authorities told her about the risks, and it turned out to be a bad gamble. Now “we” are going to pay a great deal of money to contact-trace, decontaminate, probably isolate more people and certainly waste a vast amount of time reassuring the ‘worried well’ that having once flown on a Frontier Air plane in 2004 is not a serious risk factor.
John Sopel at the BBC has a good op-ed on “The Ebola Fumble in Dallas“:
… This is a crude, and damning, statistic but so far Medecins sans Frontieres (Doctors without Borders) has treated thousands of people in West Africa with Ebola, and has seen 16 medical workers contract the disease. This hospital in Dallas has treated just one patient, and has two sick healthcare staff…
The Independent has a article showing that confining an Ebola outbreak can be done:
Nigeria will be officially declared Ebola-free in less than a week after containing the disease that has killed more than 4,000 people.
Eight of the 20 people infected in the country died and there have been no new cases confirmed since 8 September.
It means it is less than a week short of the 42-day period needed by the World Health Organisation (WHO) to confirm Nigeria has quashed its Ebola outbreak…
The outbreak started in July, when a Liberian-American development consultant, Patrick Sawyer, collapsed in the arrivals hall of Lagos airport…
The conditions seemed ripe for it to spread through the densely-populated city of 21 million people and beyond, through the workers travelling in and out of Lagos every day and international travellers flying from its airport around the world.
Knowing the potential of Mr Sawyer’s symptoms, staff at the clinic caring for him refused to let him leave despite alleged pressure from the Liberian ambassador.
Staff at the First Consultants Medical Centre paid a high price for their courage – 11 workers and their family members contracted Ebola and four died….
An emergency presidential decree enabled officials to access mobile phone records and use law enforcement agencies where necessary to track down people at risk.
Almost 900 people – 362 in Lagos and 529 in Port Harcourt – were traced and monitored for symptoms for 21 days to ensure they had not contracted Ebola.
Every one of those people had to provide health authorities with updates about their health twice a day, often through methods like text messaging.
Anyone who didn’t feel well or failed to respond was checked on, either through a neighbourhood network or health workers…
Nigeria’s Port Health Services worked with airlines to ensure outbreak notifications were made and the Ministry of Health activated an Ebola Incident Management Centre to lead the national response.
The Lagos state government, federal institutions, the private sector and global non-governmental organisations were all drawn in to control the outbreak and the operation seems to have been a success…
And, yes, any feints towards such BIG GUBMINT OVERREACH DIKTATER OBOLA FEMA CAMP efforts would’ve been cried down in Dallas, although the screaming across the interwebs would’ve been mostly a stalking horse for the real problem: All that preventive action costs money, and requires large-scale public service coordination, two things to which our modern Robber Barons and their Kochsucking enablers are deathly allergic.
For your further edification (triangulating the medical/social distance between Nigeria & the USA), the NYTimes has an excellent article on how “Spain Exposes Holes in Plans to Treat Ebola“:
The scene conveyed a First World precision: A 75-year-old Spanish priest, stricken with Ebola in Liberia, arrived in Madrid on a special military jet. A helicopter buzzed overhead as ambulances transported him for treatment. Expressing confidence in the preparations, a Spanish health official said the risk of the virus’s spreading was “virtually nil.”
There was just one problem: The city’s infectious disease center had been mostly dismantled as part of a government cost-cutting plan, and a temporary Ebola ward would have to be hurriedly constructed.
After the priest died on Aug. 12, the unit was closed again, and the same exercise repeated when a second Ebola-infected priest was airlifted from West Africa in September. He died two days later, and last week an auxiliary nurse who changed his diaper and helped clean his bed was found to have the disease…
A team of European Union investigators has found fault in the layout of the Ebola ward, while Ms. Romero’s co-workers have said they were forced to remove their gear in a very small space, with limited room to maneuver, even as temperatures rose quickly inside the suit…
Recriminations in Spain, like those in the United States, have been loud and swift, with blame aimed variously at cost cuts, inadequate training and safety protocols, government officials, and the nurse herself…
Beyond the uncertainty over how the infection occurred, much of the public confusion, and anger, is focused on the seemingly loose monitoring of Ms. Romero for more than a week after the death of the second priest. Even as she called in complaining of a low-grade fever and of feeling queasy, she was never told to return to Carlos III…
Javier Rodríguez, Madrid’s regional health minister, initially blamed Ms. Romero for her infection, saying she also may have lied to doctors, remarks that drew angry criticism. He also later seemed to mock the importance of training workers to remove their protective suits…
Unquestionably, the Ebola crisis has exposed the deep divide between health workers and Madrid’s government. In December 2012, Madrid officials announced a broad plan to cut costs by restructuring the public health system, privatizing some hospitals and closing two others, including Carlos III…
I remember some newsmedia-comment chatter about how ‘she wasn’t even a *real* nurse, just a glorified janitor from a tenement in the slums, so nobody important cared if she got sick’. There is a very old Spanish proverb: “God punishes all knaves and fools — but the fools, first.” Pretty clear Ms. Romero (like Ms. Pham and Ms. Vinson, in Dallas) got to serve as our unwitting ‘fools’…
lamh36
Ok, I’ve been at work all day.
But I’ve been getting pieces and bits on the newest Ebola case.
So I am a Microbiologist. I have worked in hospital labs for the past 10 years and I currently work here in NOLA. I lived in Dallas for 7 years. I worked in the big public hospital for 5-6 years then I worked for a sister hospital to Presby Dallas, and all I’m going to say is Presby Dallas has a reputation.
So when the first case came, I always figured from jump that Presby dropped the ball the first time he came to hospital. The entire team that day, including nurses, PA, MDs etc. failed arm Duncan that day and now that failure ended with his death and chickens are now coming home to roost.
The problem I had with this latest case was that the nurse knowingly travelled even after she absolutely came in contact with the Ebola patient, but now we find out that she actually called the CDC and they told her it was ok to fly??
What I now wonder if she was a buddy to the other nurse? A friend in DFW tells me the protocol at Presby is a buddy system. It should be the same as my current hospital protocol which is also a buddy system. For the laboratory purposes, this means that there is a “clean” tech and a “dirty” tech.
the buddy system is supposed to work where one helps the other when it comes to taking off PPE and also the buddy tech is supposed to be paying attention as the “dirty” tech manipulates the specimen…i.e. they are supposed to be eye balling you and making sure that u aren’t scratching, rubbing head or mopping sweat.
And as you see they are taking the latest case to Emory instead of Presby Dallas and I’m pretty sure I know why.
WereBear
Is it possible that under Rick Perry’s stewardship Texas has achieved Fourth World status?
lamh36
I honestly am beginning to think the problem is that this is all voluntary. Soon as this guy came through the 2nd time, the CDC probably should have quarantined the whole staff who was going to be working on him and just as they did the family, quarantine them right at the hospital and do not let them leave until a complete negative cycle of 21 days!
I think though that what needs to be understood is that this IS NOT considered to be an outbreak. Because so far the only people who have become infected so far are the two who were in close contact and caring for Patient 0, in this case Mr. Duncan
The thing to do now is CONTAIN the virus so that it doesn’t spread outside of the zero zone in this case Presby Dallas. Hopefully the nurse who travelled wasn’t in the contagious stage and no others become infected, but we won’t know until we know
As to who should be contained? I think they should contain any and everyone who came in contact with Mr. Duncan, particularly the care givers at Presby Dallas. If it means they don’t let them leave the hospital, so be it. The family of Mr. Duncan is still being monitored and will continue doing so. The same should be done for any staff at Presby Dallas.
The problem you have is the free-will of the people quarantined. In other words, you have a case like the MSNBC physician, Nancy Synderman, who left her quarantined cause she was tired of the food they were giving and she wanted some soup! That is a breach of protocol that should not have happened, but how to you stop someone from exercising their free rights?
Cause let’s be clear, the same ones who are outraged now, would be the same one outraged if they were told that they were being monitored and quarantined. How many among us would be happy with that, particularly if we feel fine and don’t think there is a chance that we contracted
Mike in NC
The corporate media will drop the Ebola scare stories in mid-November in order to work on the annual “War on Christmas” reporting.
Omnes Omnibus
@lamh36:
In your professional opinion, does this fact make a difference in how you view her actions?
Hal
The fact that she called the CDC several times seems to indicate she was hesitant. Also, as I said in a previous post, she is a healthcare professional directly working on a patient who dies of Ebola, with a co-worker who was infected in in treatment for Ebola. She should have known better.
Also, I’m wondering if the media will ever turn it’s eye to Texas’ fuck yeah free market healthcare system.
jl
I just heard a CBS news report that the nurse as not symptomatic when she traveled and specifically sought guidance about a fever that did not reach Ebola symptom threshold. Had clip of some CDC person saying that protocols would be strengthened for travel on public carriers. Not sure how consistent that is with block quote in post.
Anyway, maybe someone should notify Dr. Cole, stat.
JPL
@lamh36: When I lived in Dallas in the eighties, Presby was a pretty good hospital. The Administrator lived a few houses down from me. This was before they were paid for profit. He left the position but it was because they adopted two abused children and he was threatened because the hospital performed abortions. It was bizarre because here is a family that is adopting children threatened by the whackos who want to save the fetuses.
jl
From what I heard, the nurse tried to follow protocols as they existed. She ‘should’ have known this or that or done whatever my fat ass. You set rules and you follow the rules. If health care workers run off and quarantine themselves every time they run a small fever or get cough or nose drips, that is problem too.
Everything will work great running on those principles during flu season.
People should quit picking on the nurse. Or maybe they should volunteer to care for an infectious patient.
JPL
@jl: we did.. no problem.
Omnes Omnibus
@jl: It’s come up in a couple of lower threads. Cole responded to me raising it with this.
jl
@Omnes Omnibus: Well, I guess we come to this blog for that kind of entertainment. Vintage Cole. Strong work, Cole.
Omnes Omnibus
@jl: I miss DougJ.
Omnes Omnibus
@efgoldman:
I got Scott fucking Walker and I sure as hell didn’t vote for him. Sorry, that whole thing still pisses me off. Tom Barrett is an amazingly decent person* and good liberal; he should have won it at a walk.
*He lost a couple of teeth intervening to try to stop a mugging.
The Raven on the Hill
My wife asks for the Spanish proverb—in Spanish. Anyone know?
a hip hop artist from Idaho (fka Bella Q)
@Omnes Omnibus: So do I.
Anne Laurie
@The Raven on the Hill: Probably won’t help, but I remember being told it was used in Don Quixote… since Cervantes seems to have been the Spanish equivalent of Shakespeare when it came to inventive language, he may have been, shall we say, an early user?
lamh36
@Omnes Omnibus: Personally, I would still have not flown. The fact of a fever and I actually came in contact with Mr Duncan. I would have erred on the side of caution.
As a Microbiologist, I work with infectious body fluids alot. We handle, blood, urine, tissue, sputum, stool, discharges, aspirates, drainages, abscess fluids, etc on a daily basis. I work a lot of time in a TB lab in which I manipulate and culture all types of Mycobacteria. So when I have a respiratory issue, I take it very seriously.
Omnes Omnibus
@efgoldman: I know. I just can’t fathom how people who live around my family’s cabin could have voted for a shit like Walker over a fundamentally decent person who is interested in improving life for the working person like Barrett. The Milwaukee exurb and Waukesha people (but I repeat myself) I can understand; they are assholes. The WI woods folk, the ones who call to see it it is okay if they hunt on our land each year and make a point of driving by the cabin once or twice a week to make sure that no one has broken in, those I just don’t get. I know their issue is guns, but it is irrational.
/end rant
Omnes Omnibus
@lamh36: Okay, thanks. There has been a lot uninformed blather on the topic here. And some commentary from informed professional too, In my layman’s opinion, the CDC okay seemed to absolve the nurse of the asshole tag. Sure, she could have done better, but she wasn’t acting improperly.
Omnes Omnibus
@efgoldman: I don’t understand that either, but I have peed on Joe’s grave.
lamh36
Oh yeah, I also worked in the State Public Heatlh Lab in the Bacteriology and Bioterrorism testing unit. The only thing between me and some of the worse Bioterror organism was my PPE (Personal Protective Equipment). As a Lab tech, you are taught from the beginning of the program, about PPE and proper use and how it is the barrier between you and potentially a very virulent organism. This is even before you get a job in a laboratory environment.
minachica
@lamh36: Even if you thought you could lose your job if you didn’t show up for your shift? I understand that she flew out to Cleveland on the 8th, before her colleague was diagnosed, and had no reason to think she was in danger of being exposed, since she followed the hospital’s (obviously inadequate in retrospect) protocol. She called the CDC before her return trip to Dallas, and they told her she was fine to travel back. I would guess she felt some pressure to get back to her job so she wouldn’t be fired.
I’m asking honestly; I don’t really know what to think…
lamh36
@Omnes Omnibus: I agree. Could the nurse chosen to err on side of caution…yes. But at the least she did do exactly what the CDC asked of people to do..so calling her an asshole is not right.
I still have friends who work in the labs in DFW. The things they are telling me about Presby Dallas and their “protocols” are mind blowing. Let’s just say I no longer lay blame at anyone other than the Hospital!
lamh36
@minachica: I’m not saying it’s not a hard choice to make, but my understanding is, that her co-worker wasn’t sick before she traveled to make wedding plans. As soon as she found out her co-worker was ill she started monitoring herself. BEFORE she boarded the plane back to Dallas after finding out about her co-worker she realized she had a 99.5 degree temperature. She called the CDC and the CDC has record of the call. They told her that since her temperature was under 100.4 that she could still fly.
I’m assuming since she was flying out that she was already off, so she could have chosen to spend her off days in DFW rather than fly. But as I said she called CDC and they gave her the “okay”.
Now, this is a special case though, I cannot imagine that if she had called her job and told them that she was exhibiting symptoms of Ebola that they would have fired her. The hospital is already under pressure for their protocols.
kc
Thanks, AL.
Ripley
John Cole Apology Watch Day 1: The Bumblefuckery.
Elie
I really take issue with your using the nurses as unwitting “fools” to a system in which they are victims. BOTH are RNs. In training we learn a certain approach to responsibility for one’s actions that transcends what you are “told”. They are not mules or automatons and indeed both evidenced responsibility in taking their temperatures and communicating appropriately. Still the system and they messed up. Humans are complicated and so are our social systems.
I think we have learned a lot about modeling expectations from this little “walk on the wild side”. Learning is good but finger pointing blame and negatiive judgments of various people and organizations doesnt do much if there is not enough to learn from…
I think we can still very much get past this. In the next few days, Lord willing, the first wave of folks exposed by poor Mr Duncan in the hospital’s first encounter with him, will be past the 21 day mark. That is a very important milestone for them and us and would reinforce current knowledge about the transmission of this disease. We then have another couple of weeks for this second wave of people who are a higher risk because we are unsure of their techniques and they took care of Mr Duncan at his sickest, when he was most communicable.
If we get through this, we can hopefully take a breath and batten down the hatches for the next wave, which will definitely be coming IF WE DONT GET ON TOP OF THIS IN AFRICA. Count on it. There is no logical reason, all carping at corporatist health care and all kinds of other shit, why we can’t do this — take care of people sick with this illness like they do/did in Nigeria. Its ridiculous for professionals to be screaming about not knowing or being able to do what workers are doing RIGHT NOW in Sierra Leone, Senegal and Liberia with much less resources. Medicins sans frontieres has been handling thousands (THOUSANDS) of people with only 16 people infected.
This is effing doable and I am truly sick of the whining. Lets get about it. Nurses here are NOT victims. STOP with that. That is poison to getting on top of what we are about.We need to project positive energy to build confidence. Yes, maybe some people were in environments where mistakes were made in protocols, but lets be about breaking the chain and figuring out how to fix it and not the victim shit
gene108
@Omnes Omnibus:
There are many, many irrational people in this country, when it comes to their guns. Perfectly functional in all other aspects.
As evidence, the great run on guns and ammo in the fall of 2008, after Barack Obama was elected President; a candidate, who explicitly ran on a platform of not doing a damn thing about existing gun laws managed to get the nut-jobs on the Right to whip up gun owners to clear out stores of guns and ammo because Obama was coming for their guns.
We’re at a point where Democrat = Gun Grabber. Republican = Gun Lover.
The organizations that are for “gun rights” and push out “warnings” to gun owners seem to follow this rule of thumb.
Unfortunately for Democrats, liberals are not very enthusiastic about gun laws. Better gun laws are a nice idea, but meh…I’m not going to vote for someone solely on their stance on gun laws, when there are soooooo many other liberal purity tests, in which they are found lacking…
Right-wingers can be dedicated single issue voters or some combo of a very short list of issues. The Republican candidate has to be for banning abortions, and “gun rights” and that’s enough to earn a right-wing vote or two or two thousand.
EDIT: The Goal Posts for “gun grabber” and “gun rights” enthusiast keep changing. Opposing gun ownership now includes opposing the ever expanding range of public displays / uses of gun ownership from SYG laws to open carry to concealed carry laws or any law that makes owning and operating a gun in public harder.
jl
@Ripley: Maybe we could pester Cole into putting up a days without apology clock.
Appeal to his contrary side. It will work.
Hey, Cole, you old coot, get your (edit: fat mile wide) ass down here and put up a ‘days without Cole apology to nurse clock’, or we will all punch you in the neck, asshole.
Remember to be impolite and offensive in your requests, following standard BJ etiquette. A little loving kindness and consideration works wonders around this blog
Omnes Omnibus
@Elie: I may have missed something in this thread, but I haven’t seen anyone characterizing nurses as victims (except for the two who contracted Ebola – who are certainly victims of the disease).
Elie
@Omnes Omnibus:
THAT is what I am talking about. They were not our or anyone’s “fools” as portrayed in the last paragraph in this post. They are professionals in a complex situations which was fraught with error from different sources.
They represent victims in the scenario painted and takes us along the “victim” state of mind on thinking about this situation. That is not an empowering or enabling mind set for nurses or anyone. I just want that to stop. Its not helping anything.
If we can’t speak of them in neutral terms of their “doing their jobs” or trying to do the right thing, lets skip talking about them. We have work to do here and we need to have the mental and psychological energy to do that — to not be sapped by vignettes of these professionals as “victims”. I don’t want to sweep misdeeds of the system under the rug, but this is a critical time where we need to figure out how to get ourselves straight and ready to meet the challenge.
Omnes Omnibus
@Elie: Okay, so if I take you right, the nurse did nothing wrong according to the protocols in place at the time, but those protocols should be subject to review and change in view of what happened?
Joel
@lamh36: Speaking of tuberculosis, we’re dealing with an ongoing pandemic, right?
Elie
@Omnes Omnibus:
We (or rather people who know more at the heart of the situation), should review, collect information and make decisions about what went wrong and how to fix it. Some of that might involve actions by the professional team, but I don’t see them as victims in this process but as willing, professional participants who want to inform and improve care given by them and the hospital. Lets elevate this some and think of the longer term and larger event horizon. We have to assume that this is the beginning (seems wise to do so) and what we need to get ourselves ready from modeling different entry scenarios to different places that people who are ill can show up… what are the downstream impacts and how should we be ready to deal with it rationally with everyone doing their part. We cant get everyone to do their part if the wise guys have to find someone to blame at every turn. We have to be psychologically ready to learn and to flex with new situations and demands. People and organizations who are “victims” or blamed do not function well and since we can’t jettison anyone at this point, we have to have everyone “ready to go” morale-wise
lamh36
@Joel: TB truly is a nasty bug. TB protocols have been in effect in hospitals for a long time, particularly in places where TB is endemic in the population. Here in NOLA
and also at the hospitals I worked at in Texas, if a patient shows up with a history of TB or showing signs and symptoms of TB, mucousy or bloody cough, sweating, fatigue, etc, they are automatically isolated from other patients and are placed in a negative pressure room and all the personnel who comes near that person has to follow airborne/droplet precautions until that patient is cleared, either through 3 consecutive laboratory screening method or PCR.
I suspect this is the type of precautions that will be used for things like Ebola in the future, with added PPE precautions, of course.
Omnes Omnibus
@Elie: Got it. Thanks.
divF
@lamh36:
To expand on Joel’s comment above, the Feds have the legal authority to quarantine anyone with one of a list of highly communicable diseases. See this link to the CDC. Viral hemorrhagic fevers are specifically called out.
scav
@divF: as I’m not a lawyer, do the Feds have automatic first run authority over within state infections, isolation and quarantine? International and interstate travel, definitely, but to me at least it gets confusing as there’s a clear separate section about state, local and tribal control. But the law can take funny turns, so I’d be happy to see it spelled out by one of the breed.
Elie
@lamh36:
I admire what you do…
(just saying) really important
Omnes Omnibus
@scav: It’s not really lawyer territory. This shit is MD stuff.
lamh36
Ok so here we go…containment. This though is still voluntary. Can anyone imagine if there was a forced or mandatory quarantines? I suspect that’s why the language of this is less “urgent” than what we would expect
scav
@Omnes Omnibus: The authority to order hard quarantines with consequences for breaking them? Any time it seems to be a matter of state v federal v tribal authority I rather expect to find them (eta, meaning lawyers). We certainly saw TX, not the CDC making decisions about necessary qualifications.
Omnes Omnibus
@lamh36:
I may be obtuse, but could you make your point plain? I believe that you are making a serious point, but, right now, I am missing it.
Omnes Omnibus
@scav: I don’t know those rules. That was my point. It is outside of my area of knowledge.
divF
@scav:
@Omnes Omnibus:
According to the CDC, the federal authority derives from the Commerce Clause, specifically section 361 of the Public Health Service Act (42 U.S. Code § 264).
So this is both lawyer and doctor territory. The last time the Feds invoked this authority on a large scale was during the Spanish Influenza epidemic of 1918-1919, and mass transportation technology has evolved considerably since then. I suspect that the Feds will make a case for taking whatever measures are required, even if they include what are strictly speaking actions within the borders of individual states.
ETA: the following is germane to some of the recent comments:
scav
@divF: My confusion is from further down
I’d like to get a better understanding of who wields what power in these exact circs.
lamh36
@Omnes Omnibus: the fact that they have “offered” rather than make it a Code Yellow type emergency where “essential” staff are required to be at hospital and stay there until the emergency is considered clear.
What I am saying, is that the aren’t mandating that the workers exposed should report back to the hospital now.
Omnes Omnibus
@lamh36: Thanks.
divF
@scav:
I think that the last sentence says that the Federal government has the final say if there is overlapping authority. An underlying issue is whether, in the case of an Ebola outbreak, there is any situation where the Feds couldn’t assert supreme authority. This is a place where the Commerce Clause intersects public safety. IANAL, but I have a difficult time imagining a federal judge blocking a quarantine order under circumstances where the individual in question was contagious. How about exposed, still in the incubation period, but not yet contagious (e.g. Dr. Nancy above)?
lamh36
ok. I’m off to bed now. I’ve got work in the morning.
BTW, if you were wondering we were told today in my lab that all testing on possible Ebola infected or suspect Ebola risk, will be tested entirely in the Microbiology lab because out of all of the labs we are the only ones equipped with the biosafety hoods and other biosafety equipment that the CDC requires any lab it have when manipulating these types of infectious specimens and because, as I said, we literally deal with infectious substances on a daily basis.
which means that yours truly may have handle these specimens in they come to NOLA.
So…good night.
mai naem
The fucking nurse is an idiot. I don’t care if she called the CDC. Seriously, you have a low grade temp, you know you’ve been exposed to ebola, you know one of your coworkers had ebola and you decide that “damn, I have to go because its my wedding and I wanna see my mommy and my fiance.” Seriously????? WTF. You are a fucking dumbass if you don’t sit your ass at home until the temp goes down because unless you’re going to Nebraska or Emory, you want to be where they’re already treating somebody else and you’re familiar with it. And, oh, yeah, the buddy thing just started for nurses so I doubt it was in place when they were working on Duncan. And one last thing – Why is Rick Perry not being blamed for any of this? Everything is Obama’s fault except Texas’ supposed awesome economy.
scav
@divF: I would hope so, but there’s the sane world and there’s state’s rights world plus TX. I’ve vague memories of the Commerce Clause and Interstate trade coming out in the most unexpected contexts. I’m probably just being hyper-vigilant about wanting citations right now.
catclub
@mai naem:
This. I noted it earlier today. Texas Miracle indeed.
Mnemosyne
@mai naem:
FWIW, she apparently didn’t start running the fever until she was getting ready for the return trip to Texas. I’m not sure what her options were at that point other than renting a car and driving herself back.
hamletta
@Mike in NC: Go fuck yourself. This is really serious. It is literally life and death.
Keith
A temporal displacement?
Have Ebola will time-travel?
Keith
@lamh36:
Any thoughts on why the first symptomatic nurse (Pham) was not also a candidate for transportation to Emory? Too late? Presby now AOK to handle? Impossible to say?
Tripod
@Omnes Omnibus:
That’s noted epidemiologist and public health educator John Cole to you.
Tripod
@Keith:
I wonder if he had presented at a public-teaching hospital like Parkland if things would have gone differently. Half-assed human behavior is what it is, but I’m guessing the staff there sees a lot more transmittables like TB and Hep C (compared to a suburban general hospital) and act accordingly.
g
“She called the CDC.”
Details are important. Did she call a designated person who was actually dealing with the crisis? Or did she call a general number, speak to a customer service person instead of a clinician? Sounds like the person who looked at the chart was reading from prepared information.
Are we requiring all our health-industry receptionists and low-level customer service reps to be clinicians, now?
Why didn’t she consult with a doctor or have someone examine her? Why would she make a phone call and just do what a person on the other line advised?
Manyakitty
@Keith: I wonder if it has to do with her blood type or something. The first nurse got a transfusion from an Ebola survivor and she’s recovering. Why wouldn’t they do the same for the second nurse if it was an option?
brantl
“Should” the nurse have known better? Probably. Who really cocked this up? The CDC. Period.
StringOnAStick
I figure a lot of this ‘chicken with head cut off’ (no offense, Betty C.) stuff has to do with the fact that the CDC and NIH have had their budgets halved since 2006, and more than 40,000 public health professionals have lost their jobs thanks to austerity and rethug budget slaughter. You know, the kind of local public health officials that are your first go-to person on stuff like this. I also have no doubt that the person manning the phone lines at CDC has a script and flowchart to follow, with no room for wiggle since they are not clinically trained and have no doubt been told that “winging it” means you’re fired.
I really appreciate what lam36 has had to offer. My very first impression was that this hospital was a true example of Texas Free Market Paradise ™, with all that implies. Without regulations, for-profit entities are well known for cutting corners; “training for staff is expensive so why bother training for such a rare event?” is no doubt exactly what admin thought, and 99.99% of the time, so far, that had worked for them. Until it didn’t.
Throwaway
@jl: This is such a bullshit excuse. Are you fucking kidding me? If I have sex with an HIV+ person, then get an HIV test soon after which states I’m negative, does that let me have sex with whoever I want without protection? In a sense, maybe, but in reality, no considerate person would do shit like this.
Despite what some commenters here seem to think, nurses are not trained to be idiots. If I (as a doc) tell a nurse to inject a hypoglycemic patient with insulin, she has the obligation to refuse the order because it will kill the patient. It’s not enough for her to say “well, the doc ordered it so I did it”, that would never hold up in a court of law. Why is she being excused from irresponsible behavior now?
Last but not least, she’s a fucking nurse. She’s literally surrounded by doctors all day. If she’s really concerned, she should ask a doctor, maybe even one of those who are trained in infectious diseases, what they think, instead of relying on some customer service rep. I don’t call my realtor when my house is burning down.