Step back, take a deep breath, and realize that someone out there in the US right now is thinking, "Ebola would be a cute name for a baby."
— Rohan (@RohanG__) October 1, 2014
Amazing how quickly we humans can pivot from “AIEEEE we’re all gonna die” to “welcome to the New Normal”. Per the Washington Post, Texas health officials have ordered “four close family members of hospitalized Ebola patient Thomas Eric Duncan to remain home and not see any visitors”, while tracing “a list of about 100 potential or possible contacts and will soon have an official contact tracing number that will be lower”. The Post also has a helpful article answering the oft-asked “Why hasn’t the U.S. closed its airports to travelers from Ebola-ravaged countries?”
Back story, from the Guardian:
… Thomas Eric Duncan told a nurse at a Dallas emergency room that he had recently visited Liberia, which has been ravaged by the Ebola outbreak. But an executive at Texas Health Presbyterian hospital told a news conference that the information was not widely enough shared with the medical team treating Duncan, and he was diagnosed as suffering from a “low-grade common viral disease”.
Duncan’s sister, Mai Wureh, told the Associated Press that he first visited the emergency room on Friday, but was sent home with a course of antibiotics – an outcome that hospital chiefs described as a matter of “regret”…
I’ve seen commentors speculating on other websites that the nurse just didn’t want to risk being put into quarantine herself for what was almost certainly probably just another everday infection. I certainly hope that’s not true…
… Speaking in the parking lot of the apartment complex where Duncan was staying, Mesud Osmanovic, a 21-year-old manual labourer who lives there, said he saw the ambulance arrive.
“When the ambulance came his whole family were all screaming, he got outside and he was throwing up all over the place … when he was throwing up he was trying to walk and he couldn’t walk,” Osmanovic said. He said he had met Duncan only a couple of times but knew him as kind and helpful to residents. “I know him through his family … This ain’t his first time coming to America,” he said. “He was a quiet guy, a really nice guy.”…
There was little panic among commuters at a bus stop across the street from the hospital. Billy Herman, 62, said that he was worried “to some degree, yes, but I have confidence in the CDC, that they have a standard process in place, [and] that they’re doing a traceback to see who he’s come in contact with.
“I am confident in the healthcare system in America and that if other individuals are infected, if they start having symptoms that we can control it and it won’t be mass death, fear and destruction like in those third world countries,” he said, adding that he would move away if sat close to someone with flu-like symptoms…
Mr. Duncan, according to the NYTimes, fell prey to the ancient folk wisdom that no good deed goes unpunished:
… In a pattern often seen here in Monrovia, the Liberian capital, the family of the woman, Marthalene Williams, 19, took her by taxi to a hospital with Mr. Duncan’s help on Sept. 15 after failing to get an ambulance, said her parents, Emmanuel and Amie Williams. She was convulsing and seven months pregnant, they said.
Turned away from a hospital for lack of space in its Ebola treatment ward, the family said it took Ms. Williams back home in the evening, and that she died hours later, around 3 a.m.
Mr. Duncan, who was a family friend and also a tenant in a house owned by the Williams family, rode in the taxi in the front passenger seat while Ms. Williams, her father and her brother, Sonny Boy, shared the back seat, her parents said. Mr. Duncan then helped carry Ms. Williams, who was no longer able to walk, back to the family home that evening, neighbors said…
Meanwhile, for catastrophe connoisseurs, Michael T. Osterholm, “director of the Center for Infectious Disease Research and Policy at the University of Minnesota”, offers a special tidbit to Politico:
… We know how the disease will likely spread in the months ahead. Each year, thousands of young West African men and boys are part of a migratory work population not too dissimilar from U.S. migrant farm workers. Crop-friendly rains wash over West Africa from May to October, forming the growing season. These young men typically help with harvesting in their home villages from August to early October, but afterward head off for temporary jobs in artisanal gold mines in Burkina Faso, Mali, Niger and Ghana; cocoa nut and palm oil plantations in Ghana and Cote d’Ivoire; palm date harvesting and fishing in Mauritania and Senegal; and illicit charcoal production in Senegal, Mali, Cote d’Ivoire, Ghana, Burkina Faso and Niger.
This migration is about to begin, even for young men whose villages have been recently hit by EVD. These workers find daily laborer jobs at $5 per day, half of which they remit to their families back home. Like their ancestors before them, they use little-known routes and layovers through forests to avoid frontier checkpoints. They usually have ECOWAS ID cards, providing free passage to all the member states of the Economic Community of West Africa States. It takes one to three days to travel from the EVD-affected countries to these work destinations. There is no need for Ebola to hop a ride on an airplane to move across Africa: It can travel by foot.
Densely populated African cities such as Dakar, Abidjan, Lagos and Kinshasa—teeming with jam-packed slums as far as the eye can see—could be most at risk. This is the nightmare scenario…
scav
Well, here, to go with the means of diffusion and spread of diseases theme: HIV pandemic originated in Kinshasa in the 1920s, say scientists
“Thriving city with multiple transport links and influx of male labourers made it perfect incubator for pandemic strain of HIV”
EriktheRed
So are we fucked?
Gin & Tonic
Felix Salmon just Tweeted that the official position of the national Libertarian party is that control of ebola in Africa is a matter for private charitable groups like MSF, and that the NIH and CDC should stay out of it.
Gin & Tonic
Should I have capitalized Ebola?
skerry
Wonder why we haven’t heard from the Surgeon General about this “crisis”?
Oh yeah, the NRA stopped the Senate from voting on the last guy nominated, Dr Murthy. Because he thought guns and gun safety was a valid public health issue. No matter that all the major medical organizations supported him.
The position has been open since July 2013.
Tommy
@skerry: WTF. I recall this. Sad beyond words.
scav
@Gin & Tonic: Not if you’re developing an homage to ee cummings, although, in which case, the preferred spelling is eebola.
Gin & Tonic
@skerry: Not to diminish the obstructionism, but the Acting Surgeon General is very highly qualified and very effective.
Baud
@EriktheRed:
Always and forever.
Mnemosyne
As was coming up in the other threads, the Americans who are most likely going to be at risk of Ebola are healthcare workers who come into physical contact with patients and/or their bodily fluids. For the most part, the general public isn’t at high risk.
Though I’m sure someone will come into this thread and lecture me about how morally horrible I am for being concerned about Ebola patients when the US is bombing babies in the Middle East.
BillinGlendaleCA
@Mnemosyne: To say nothing about the NSA listening in on your phone calls.
skerry
@Gin & Tonic: I realize there is an “acting” in place, but it is never the same. They just don’t have the same power as a permanent office-holder. True for any agency.
Anoniminous
@Gin & Tonic:
Another box ticked. Only need the anti-vaxers yelling about how a Ebola vaccine will cause autism for the derp to be complete.
SatanicPanic
@BillinGlendaleCA: and kids dying from eating GMO hamburgers
RSR
My nephew is on a semester-at-sea which was originally scheduled to stop at a couple/few west African ports, but they are bypassing all of them and heading to South Africa instead.
dr. bloor
You can hope as hard as you want, but the world history of outbreaks is littered with stories of amateur epidemiologists and pathologists who prioritize short-term convenience at the risk of very serious consequences.
Bobby Thomson
@EriktheRed: unless you plan on handling corpses, no.
moderateindy
As far as why the info about this guy spending time in Liberia never got to be well known around the hospital quickly, if you have ever spent a decent amount of time in the hospital, you know how little communication there is either upward from nurse to doctor, or sideways from shift to shift. Doctor’s rarely listen to nurses, and I doubt that the meetings that nurses have between shifts get very specific.
Mnemosyne
@Bobby Thomson:
Or live patients.
skerry
@dr. bloor: Also in Texas, nurse exposes over 700 newborns and 40 other employees to TB. Hospital knew she had TB, but no state regulation to monitor her “latent” infection. She worked in the hospital for 6 weeks after being diagnosed with TB and complained of fatigue and coughing up blood.
The hospital KNEW this and did nothing because they didn’t have to.
Mike G
“Best healthcare system in the world!!”
USA! USA!
scav
@Bobby Thomson: Well, in that case, wouldn’t Erik be needing the active tense of the verb?
Amir Khalid
Something else to worry about with regard to Ebola: it’s the week of the Haj, one of the largest religious events in the world, with millions coming to Mecca from all over. The Kingdom has banned pilgrims from Sierra Leone, Guinea and Liberia, and is vetting the travel histories of pilgrims from elsewhere; but if even one Ebola carrier does get through …
Howard Beale IV
@Gin & Tonic: Here’s Felix’s source for his Tweet. Needless to say, they’re all over the board.
Mnemosyne
@skerry:
WTF? Here in California, at the medical center job I had years ago I didn’t have any patient contact (our office was not even on the same grounds as the hospital) and I still had to have a negative annual TB test to keep working there.
Kyle
We’re talking about Texas here.
“Liberia? Ain’t that the cold place in Russia? Do you have frostbite?”
Anoniminous
@Bobby Thomson:
Not complete.
The Snarxist Formerly Known as Kryptik
OT, but Fifth Circuit Court upheld the Texas anti-abortion laws, effective immediately. Say goodbye to 90% of reproductive health services in the state.
dr. bloor
@moderateindy: The most surprising thing–OK, it’s not all that surprising–is that only one person seems to have asked him where he had been recently. People get annoyed at having to answer the same questions over and over again in an ER, although the redundancy is there for some very good reasons.
beth
Listening to the radio today Glenn Beck told me how AlQueda was going to weaponize Ebola by having terrorists drink infected blood, travel to the US or Mexico, join the busiest health clubs in the biggest cities and work out to spread their sweat. I now have a really good excuse for not going to the gym!
Roger Moore
@Gin & Tonic:
This kind of thing is exactly why the Libertarians shouldn’t- and won’t- be allowed anywhere near the reins of power. Even normally anti-government Republicans seem able to see that Ebola is exactly the kind of thing where governments are necessary.
srv
Conan says Texas is on it.
Amir Khalid
@beth:
Gee, why does Glenn Beck work so hard at coming up with ideas for al-Qa’ida?
Iowa Old Lady
Let’s block all flights from Texas.
Howard Beale IV
@Amir Khalid:
Methinks yer going to be off by 3 to 4 orders of magnitude. Fun times ahead.
Roger Moore
@Mnemosyne:
They no longer require people with no patient contact to have annual TB tests, though we are required to fill out an annual health questionnaire that includes questions related to TB. We’re also required either to get flu shots or wear a face mask at all times while in areas where there may be patients.
JPL
@skerry: That’s surprising because before I could volunteer in the local schools, I had to have a tb test. Of course, that was decades ago when the schools were good and politics were whacko.
also.. my rep was Phil Gramm, a democrat that I didn’t vote for.
JPL
@Mike G: If that is true, why prescribe antibiotics? hmmm
Throwaway
Everyone is throwing this poor nurse under the bus. What ever happened to personal responsibility? This patient had contact with an Ebola patient, and never brought it up with anyone as far as we know aside from one offhand comment about being in that part of the world to a nurse. This reminds me of that other Liberian-American who got Ebola and was apprehended at the Lagos Airport, then went on to purposefully infect four of his nurses by peeing on them.
Baud
@beth:
Is radio music really that bad?
JPL
Chris Matthews is all over ebola. I’m going to listen for five minutes.
TaMara (BHF)
Hey if anyone is interested, the conservative school board in Jefferson County (CO) is meeting tonight and there are hundreds of people gathering to protest, to support the teacher and student walkouts from the last two weeks. It will be live streamed:
http://www.9news.com/story/news/education/2014/10/02/live-stream-jefferson-county-school-board-meeting/16595327/
or
http://www.thedenverchannel.com/live
Story here.
Mnemosyne
@Roger Moore:
This was at UCLA Medical Center prior to 2004, FWIW.
Roger Moore
@Mnemosyne:
We definitely had to do annual TB tests back then. I think they let people without patient contact stop getting them around 2007, but I don’t remember exactly when they stopped. As far as I know, people who do have patient contact are still required to have them.
Howard Beale IV
@Kyle:
No-that’s the flag those cruise ships fly that advertise on that there TV….
TS
@The Snarxist Formerly Known as Kryptik:
There is no end to the GOP war on women – there is no other way to describe the continual attacks on the constitutional right to abortion. Self hatred is a woman voting for a GOP candidate
beth
@Baud: I was curious to see what the right wing spin would be. For all their hatred of Rahm Emmanuel, they really are the ones who never let a crisis go to waste. Plus I like to be forewarned about what my next conversation with my sister will be like.
Baud
@beth:
Damn, I’m sorry.
Jay C
@beth:
Beck is in good company here (“good” is snarky sarcasm here, please note), right-wing derp-mongers are having a field day whipping up idiotic paranoia over Ebola: check out Little Green Footballs for some doozies: “Sweat Terrorists at the Gym” is only par for the course….
But on a more serious level, the whole mess only points out the near-impossibility of absolutely quarantining any part of a world so intricately connected by high-speed air travel. Much as the fear-mongers might like to.
Howard Beale IV
@efgoldman: According to Wikipedia, the top registrars for cruise ships are Bahamas, Panama, and Liberia under the ‘Flag of Convenience’ doctrine.
Villago Delenda Est
I suppose it’s too much to hope that asshat twits like Donald Trump are even more likely to contract this than just plain old folks?
Hmmm….if it just targeted Villagers, it would be a very good thing indeed.
Tommy
@Baud: You can’t understand family. Thankgiving, X-mas, a birthday or two. It is not going to be pretty. The only good things is I can bite my tongue.
BobS
@skerry: Thanks for bringing Outbreak News Today to my awareness.
Baud
@Tommy:
Maybe I’m cold-hearted, but I have one semi-wingnut relative, and if he insisted in talking politics to me, I would ostracize him.
trollhattan
@Anoniminous:
Just came from the doctor with one arm full of flu virus and the other, tetanus and pertussis, so I expect to be autistic by dinnertime. I assume I can still drink, will I know if I enjoy it?
Baud
I wonder if we’ll notice.
D58826
Listening to Tweety the only conclusion is we are all going to die from Ebola. He has politicians, who count’t find Liberia if you hit them on the head with a map, making medical analysis.
He keeps misstating what Obama said. Obama never said the Ebola would never get to the US, just that an outbreak was unlikely. ‘Outbreak’, as in what is happening in Africa.
Tweety talked about how well Rudy handled the anthrax outbreak. He seems to forget the number of people who would not pick up mail from their mail slot or the run on plastic sheeting and duck tape to wrap around ones house.
We need information not a rehash of the 1938 War of the Worlds.
trollhattan
@Throwaway:
Liberia is displeased with the patient.
Am so demanding a wheelbarrow my next hospital trip.
Howard Beale IV
@efgoldman:
Well, I could have said that I heard some cruise line ads on on TV that stated their ships registry was in Liberia, but what fun would that be now?
At least that’s one of the nice things about being a telecommuter: I can avoid the office sickos when the influenza season starts, and my employer even offers free flu shots.
Jay S
When I read this I went ballistic. They are still prescribing antibiotics for viral infection diagnosis when we have antivirals? That’s a basic medical care failure right there.
Tommy
@Baud: I am the only liberal in my family. In the coming weeks folks will say a a lot of stupid shit. I hate these weeks. I will just say that …… it is hard ……
raven
Can someone arrange for me to meet tweety somewhere?
Howard Beale IV
@trollhattan: Does Liberia have a extradition treaty with the US that covers this kind of situation?
JPL
@D58826: Before 9/11 Rudy made some terrible mistakes in preparation for a terrorist attack. After all, NYC had been attacked before but in tweety’s eyes he is a god. I listened until the Rudy is god segment.
Baud
@raven:
I would pay to see that.
Woodrowfan
@Anoniminous: don;t forget the Chemtrails!
D58826
A goper congressman is now demanding that Obama appoint an Ebola czar to solve this problem. Its obvious that the Obama team is second rate in trying to solve this problem. I’m sure Saint Ronulus the Uninformed would just wave his magic woopie stick and all of the Ebola virus would run back into the jungle.
Baud
@Tommy:
I don’t like people who don’t respect me, and conservatives today are all about disrespect. But it’s a personal decision each person needs to make.
raven
@Baud: Now the punk has our local douchebag Kingston on.
JPL
@D58826: wtf.. Obama should appoint the congressman.
Let him go to Presbyterian Hospital and interview the patient and then travel to Liberia. While the congressman is there, stop all flights in and out of the country.
haha.. I just saw Raven’s comment. Since Kingston no longer has a job, he would be the perfect candidate.
Mike in NC
That’s the future the Koch brothers have in mind for us all.
skerry
@BobS: It never ceases to amaze me what you can find on the internet.
trollhattan
@Howard Beale IV:
Jeez, no idea but given the long-term relationship between the nations, we may.
Mike in NC
@JPL:
You mean like locating the office responsible for responding to a terrorist attack in the World Trade Center?
D58826
The ‘funny’, as in sad, thing is there is a real outbreak of a disease – the enteravirus 68 (not sure of the spelling). It is in 43 states, 500+ cases and 4 deaths linked to the disease. But Ebola is the new Benghazi!!!!
The other night Maddow had the head of the ER dept at Columbia on. They talked about the disease, its symptoms, how those symptoms present, the risks, etc in level normal tones of voice. No politics, no hysteria.
Tree With Water
Yawn.. Ebola, shmebola.
Commies in the State Deptartment, commies ‘neath the bed, Viet Cong in San Francisco, better dead than red.
Whipping up hysteria. It’s what the GOP does.
dr. bloor
@trollhattan:
Make sure it’s covered by your insurance. That’s a $12,000 line item.
Roger Moore
@raven:
I assume you’re hoping for a dark alley with a lead pipe in your hand.
SiubhanDuinne
@Tommy:
Thanksgiving in particular is going to be rough. My sympathies.
SiubhanDuinne
@Tommy:
Tommy, maybe you’ve answered this elsewhere and I just missed it, but did you take your trip to Scotland yet? Or is it deferred for another day? (Apologies to all; I realize this is not an open thread.)
SiubhanDuinne
@D58826:
An “Ebola Czar”??!! There’s, like, ONE confirmed fuckin case of Ebola in the entire country right now, and this dude wants a fuckin CZAR?!?!?!
Amir Khalid
@SiubhanDuinne:
Never too early to start panicking.
beth
@SiubhanDuinne: Who was it that was complaining about Obama appointing all those unelected czars? And now they want another one?
D58826
@SiubhanDuinne: Yep. but he must know what is is talking about he is a congressman (soon to be ex) after all.
As this story unfolds it makes it painfully obvious that the education system and the journalism profession have failed.
I will say Chris Hayes and Rachel seem to be discussing the situation in a more adult like manner..
raven
@Roger Moore: I don’t need no fucking lead pipe!
lamh36
@Roger Moore: I work as a Microbiolgist, I don’t work with patient care at all much, but I do work with Tuberculosis. All of Patholgy including the majority of us who don’t have patient care contact have to yearly get a mandatory TB skin test
dr. bloor
@D58826:
If you polled Congress, the inevitable 27% would identify the CDC as being a cable channel.
AuntieNomen
Nigeria says that that Mr. Duncan lied on his airpot screening form, which is about as disregardful of others as refusing to vaccinate your kids. (http://www.nytimes.com/2014/10/03/world/africa/dallas-ebola-patient-thomas-duncan-airport-screening.html) I don’t know why he did this — humans are complicated — but I’m not sure he’s being punished for his good deeds.
I hope he survives.
AuntieNomen
Liberia dangit, not Nigeria. Teach me to post tired. At least they rhyme.
lamh36
@D58826: Enterovirus,..
raven
@JPL: Hope the fucker moves back here.
lamh36
talking about the guy in Ebola in DFW and how the guy went to ER at Presby D and based on his symptoms at the ER and sent him home with antibodies, even though he told them about his recent travels to West Africa. They speculated that it might have to do with his insurance, ya know whether he had it or not and/or what kind? And then i got to thinking hmmm i wonder too. I used to work at the big public hospital in DFW. Public hospitals wouldn’t turn anyone away even before the ACA. Ive also worked for a private hospital and i know what these private hospitals do.
Course you know who will be blamed…ACA, even though Perry et al refused to expand medicare rolls to increase the number of people with insurance.
tybee
@raven:
i have a pair of catfish skinning pliers i’ll loan you.
raven
@tybee: OOO, I likey! I’m planning my Thanksgiving trip and now it seems they have not only put AJ’s off season but red grouper as well. It’s almost as if they are trying to put the boats out of business. I can be happy surf fishing and maybe yakin the bay but I’ve really come to enjoy the blue water.
Botsplainer
@trollhattan:
If you start writing computer code and proclaim a desire to play Magic:the Gathering or World of Warcraft, we’ll know for sure.
tybee
@raven:
charter a ride to the barrier islands for big reds. you can’t keep them but you can sure tire yourself out with them. and turkey day is right in the middle of the bite.
from the chesapeake to mosquito lagoon, you’ll find reds that time of year.
raven
Chris Hayes just announced that an NBC camerman in Liberia has ebola and will be flying stateside.
raven
@tybee: Where, over to Apilachicola? We’ll be in Seagrove.
Anne Laurie
@raven:
You might want to observe good sanitary protocols, however, for fear of the brain-eating prions Mr. Pierce observes have eaten so many media brains….
(/snark, in case anyone wondered)
Percysowner
To counter doom and gloom about Ebola Woman saves three relatives from Ebola. She had no protective gear, so she made her own out of trash bags, gloves, boots and a raincoat. A fourth relative infected with Ebola died. She did this all on her own, the local doctor would talk to her over the phone, but would not come to the house and hospitals did not have room for her family. International aid workers are now teaching her makeshift protective gear to people who are nursing family members and who do not have access to official gear.
I just thought we should acknowledge the people who have ingenuity, dedication and gumption can make a real difference.
PurpleGirl
@beth: Yet certain high-ranking Republicans couldn’t believe that an airplane could/would be used as a bomb.
Villago Delenda Est
It’s interesting that the people in hysterics about Ebola, a possible threat, are in utter denial about climate change, a real threat.
D58826
@Villago Delenda Est: And the impact of the anti-vaxxers.
Anne Laurie
@efgoldman:
Nah, I just take extra precautions cuz I’m a front-pager. With great power (mainly, AFAICT, the ability to embed youtube videos) comes great responsibility…
Roger Moore
@lamh36:
Of course you need regular testing if you have an occupational risk of exposure. The point is that people like Mnemosyne and me who had no patient contact and no occupational risk were still required to undergo annual testing until quite recently. We had to argue for a long time to get them to give up mandatory testing. That’s a big contrast to the situation in Texas, where apparently not even nurses are required to be tested.
dmbeaster
@scav: And that conclusion is pretty damn speculative. There are no known cases of AIDS prior to 1959. The inferences based on alleged mutation rates is highly suspect because HIV does not mutate at all like DNA based viruses. There is little good science on the mutation rates for RNA based viruses which mutate much more rapidly and in unique ways. There is no real basis for linking various HIV strains to an alleged common ancestor as opposed to multiple unique infections from various parent SIV strains. Very little is known about SIV strains from which HIV is believed to have been derived. One clear outlier is HIV-2 which arose at the same time and is linked to SIV from sooty macaques in West Africa and not from chimps. The origin in Cameroon is also highly speculative since there is no medical evidence for an outbreak there. It is picked because the m strain seems derived from SIV from a subspecies of chimps from that area. The idea that it passed into humans only in the last century despite thousands of years of exploiting chimps for bush meat is suspect. The article suggests that allegedly HIV strains had percolated for hundreds of years in tiny isolated populations and died out, only to have the m strain suddenly go pandemic. Nothing about HIV suggests this is likely.
So much bad science. The same loose talk occurs with ebola. No known natural resevoir is known even though fruit bats are suspected in transmission. But they dont find it when testing fruit bats.
D58826
@dmbeaster:
Without that reservoir it will make it very hard for an outbreak to gain any traction in the country, even if we totally botch the quarantine/chain of contact efforts now under way. One more reason that panic is not called for.
The Obvious One
I drive past the Apt complex the dude was staying at everyday to and from work, my job is close by. Its a very non-white area FWIW, so I can’t help chuckling at seeing the throng of white middle aged media folks loitering about. People are still out walking, kids are still playing although a nasty storm knocked out power this evening as well as snapped perfectly good trees off like toothpicks. Could be the endtimes or just a bad run for us folks one never knows. Here’s to hoping the guy,his friends and love ones are okay.
We’re all very interested, but I have to say I’m shocked at how well us Dallas folks have taken this did not predict that.
MomSense
@Woodrowfan:
…and the HAARP rings.
PurpleGirl
@Mike in NC: It was actually in Building 7, which was part of the World Trade Center because it was owned by the company that was managing the WTC. It was not part of the WTC development when initially built. Locating the Emergency office in Building 7 was a political favor to Silverstein Properties. It’s how NYC government and real estate developers work.
ETA: I get picky about what was part of the WTC development and what wasn’t and what was political favors.
Pogonip
I have 2 questions I have not seen addressed on the news.
1). If it’s so hard to catch Ebola, why are France and Great Britain cancel long flights to the afflicted countries? What is their rationale?
2). I have seen reports that Ebola is only transmitted by bodily fluids and not by coughing and sneezing. This seems contradictory to me. Aren’t the droplets sprayed out by a sneeze fluid?
If anyone has seen reliable info answering either or both of these questions, please post a link. Thanks!
rikyrah
@skerry:
This is crazy
PurpleGirl
@lamh36:
refused to expand medicare rolls
MEDICAID… repeat after me… MEDICAID
Throwaway
@Pogonip: 1) My understanding is that there’s two reasons for this: one is that the flight attendants have been circulating petitions demanding to not be sent to those countries because they are afraid they’ll get infected while there, the other is that, as the Dallas case showed us, just because a passenger fills out a form saying they pinky swear that they haven’t been around Ebola doesn’t mean that they actually aren’t already infected and liable to spread it to the destination country. I think they’re overestimating the risk, but hey, so far they haven’t had anybody come to their country with the infection undetected, and we have…
2) So you’re right that if an infected Ebola patient sneezes directly on to an open wound on someone else, or in that person’s eyes, or some other surface where virus can easily access the bloodstream, then the infection will spread. However, sneezing isn’t commonly seen with Ebola, and even if it was, that kind of scenario doesn’t really happen. What happens with a lot of viruses, like flu for example, is that the virus particles stay suspended in the air for a long time after the sneeze, and somebody can get infected just from inhaling those particles. Ebola doesn’t seem to have this kind of staying power in the air.
Pogonip
@Throwaway: Thanks!
Elie
In somewhat hopeful news, statins (for treating high cholesterol) and certain other drugs that impact inflammation of the blood vessels such as ACE Inhibitors and ARBs are associated with greater survival of bacterial and viral sepsis. The way Ebola kills is through viral sepsis where the virus overwhelms the blood then organ systems to kill a person. These drugs are relatively cheap and available and might have use to distribute to care givers in Africa — many of whom have very few ways to decrease their risk. There has been research on this going back to 2007-8 — so it is not new.
We need something good to work…
ciotog
Probably the worst thing about this news story is that they diagnosed the patient with a viral illness and gave him a course of antibiotics. Maybe we should be a little more worried about antibiotic-resistant bacteria and a little less worried about one dude in the entire country with Ebola.
Ella in New Mexico
@Throwaway:
It happens when doctors are scared they fucked up and don’t want to admit it–look around for first nurse on the case you see and find some minutiae to hold her accountable for. That’s why we’re taught to keep good nursing notes.
If I understand the Dallas situation, the RN did take the history but when she asked him if he had had contact with any sick people in Liberia, the patient denied it. Still, apparently it was the system in the ED there that meant the physician was not alerted. The system of communication is going to be key, I suspect, not necessarily the individuals.
I can vouch for the fact that right now, with all the changes going on in hospitals to implement Electronic Health Records and Computer Physician Entered Orders, it’s a BIG cluster-fuck in many places. Hospitals are trying to meet the deadlines for new rules and quotas of how much of your patient population and activity gets done on a computer vs. paper, with an emphasis on paperless charting systems. These deadlines have been known for a few years, and were set by the changes from ACA and Medicare, but instead of sucking it up early on and purchasing expensive and well-researched software programs, hospitals are patching up their own crappy, error-filled, ancient software. (Ours is so old that you cannot buy it anymore, and it still uses DOS commands for half the things you do for Christ-sake). These programs are frustrating to get around because they don’t localize information in one, easily retrievable place. They are confusing for physicians and nurses to use to enter orders because they don’t do it straightforwardly.–you have to dig around and go in and out of areas with multiple screen clicks and commands, and take an order that used to be one, brief phrase written in a chart and turn it into three different entries. They don’t have the best “red flag” warning systems, either. In a busy ED, especially if the RN and the MD are not particularly face-to-face in the food chain, I could TOTALLY see him not getting the heads up about the guy’s recent travel from Liberia. The MD still should have done his assessment, however, and asked the obvious, as I am going to assume this guy had a heavy, foreign accent and looked dark complected so HE MIGHT BE FROM AFRICA. But don’t forget: docs are trained to diagnose the MOST LIKELY ILLNESS, not some freak, obscure, House MD disease.
AND I sincerely doubt that the RN was trying to avoid getting quarantined so she withheld information. That would just not make logical sense.
And the TB case in El Paso? The woman had latent TB, presented to Employee Health sick and even coughing up blood, and they still let her work. I’m betting that her hospital, like mine, FORCES people to work when they are sick. Most have a policy that you are only allowed so many call-ins–for us it’s 4 within the past 12 months. You can be written up, suspended and even fired if you exceed those numbers, regardless of if you have strep throat, cancer, have just had a car accident, or you worry you have TB.