Friday, October 3, 2014

"We Have It Under Control!" - BUT Ebola Patient's Contacts Now Reach 100

Researcher working with Ebola using a BSL-4 positive pressure suit

Murphy's Laws:

1)  "If anything can go wrong it will"

2)  "If there is a possibility of several things going wrong, the one that will cause the most damage will be the one to go wrong"

3) "If anything just cannot go wrong, it will anyway."

4) "If you perceive that there are four possible ways in which something can go wrong, and circumvent these, then a fifth way, unprepared for, will promptly develop"

5)  "If everything seems to be going well, you have obviously overlooked something."

6) "Mother nature is a bitch". (Addendum: "And not an obedient one at that")

Nora O'Donnell, on CBS Early Show, for once got all her 'ducks in a row' on an issue and forthright asked Dr. John La Pook: "We know they're casting a wide net but should we be concerned about this uneven response ( in Dallas)?" She was referring to the contact net now extending from Ebola  patient zero (Thomas Eric Duncan)  to 100 from the original eighteen - more than a five fold increase. The goodly doc responded:

"I think we should be concerned because there's been a huge difference between the theory and the practice.  We were told we had a robust health care system and that is true. We're not Africa. That is true. When somebody comes here they should be identified quickly, put into isolation and quarantined so things should be controlled. That didn't happen here.

The person came in. Guy said he was from Liberia. Info put into electronic records which had problems. Say, how about walking down the hall and saying 'Hey, we have a guy here from Africa who says he has symptoms.' So we need to have redundancy of systems."

Yet we didn't even see such "redundancy" when the U.S. was seeing 98,000 deaths each year (now down to 75,000) from medical errors, including failure to take proper precautions before handling surgery patients - leading to a mass of infections including MRSA and c. diff.  SO the blabber about having a "robust health care system" is just that - and only valid if we compare our system to what's on offer in Africa or China. The Europeans, meanwhile, are light years ahead of us in redundant practices.

So yeah, the difference is between theory and practice - which at times can amount to a gulf in our system. As with this recent case of the hospital dropping the ball the first time Duncan appeared with marginal symptoms, but sending him  home with antibiotics to make more contacts for three extra days.  So the truth is that what we've been fed about the system "working" is patent balderdash, designed more to prevent panic than actually deal with this emerging problem.

The fact there was a breakdown, and a significant one for a disease that's fatal 50-60 percent of the time is worth noting. Also, that United Airlines has taken to now trying to notify all its 250 passengers who've been on two planes with Duncan to watch for symptoms. Why? What are these PR soft soap liars not telling us?  Also,  how can they justify their continued bollocks of "having it all under control" when we've already seen a major breakdown that allowed the Ebola infected patient back onto the Dallas streets?

Worse than that, it now appears Duncan lied on his health declaration before leaving Liberia  - regarding not having any contact with an Ebola patient. As was shown last night, when Dr. Richard Besser on ABC News retraced all his steps, including carrying the vomiting woman into the JFK Hospital-Care Center, he sure as hell knew he had contact with Ebola (it wasn't 'morning sickness') and he outright lied about it. Again, showing that we now need draconian travel measures in place little different from screening terrorists and putting them on 'no fly/' lists.

Let's also note that  the threshold for "symptoms" is not a fixed target. They don't necessarily mean observable diarrhea and vomiting or bleeding profusely. In fact, not so observable nausea may well be the first symptom and before the person vomits once,  his or her perspiration may already carry the virus - as even La Pook admitted. Thus, a mere handshake with another person who has a small cut could spread the virus. Why do you think those research workers shown are wearing positive pressure suits?

The soft soaping of this really knows no bounds and is deplorable. It's as if these PR- obsessed schmucks simply don't know how to level with the people. (But then given our society is mostly based on PR this is understandable) Then there was Libertarian John Stossel the other night arguing that no - under no circumstances -  should we even think of 'no fly' lists for Africans traveling from the affected nations. Stossel actually said: "Do we stop people coming in from countries with Mad Cow disease? Or do we stop people traveling when the flu is spreading and that kills 3 million a year."

Ok, you dumb shit, first Mad Cow is an "elected"  disease - meaning one gets it by eating beef  - which is infected.   If you decline to eat beef, you won't be. As for flu, the yearly mortality is more like 1 million and that's unusual. Typically it's less. Also the fatality rate for typical flu and even past pandemics is extremely low relative to Ebola. For example, Hong Kong flu which I got in 1968 had a fatality rate of 0,1 %.  Even the horrific Spanish Flu was at barely 2.5 %. Ebola is at 50-60 percent so there is no comparison. In addition, we DO have flu vaccines, we have zilch for Ebola other than one exotic treatment used twice in Atlanta.

True,  it's only "spread by contact",  but  you can drive a metaphorical Mack truck through that escape clause. As another M.D. ( Dr. David Agus,) noted this morning on CBS:

"The disease only spreads when you're symptomatic, but what about an hour before you're  symptomatic?  What about a day before you're symptomatic? The truth is, we just don't know."

It  is precisely within this gray zone of variability that the greatest danger lurks and errors are most probable. And anyone who dismisses that danger is an idiot. Agus, reinforcing this, also pointed out that while the average incubation period is 8-10 days for Ebola it can be as few as two days and as long as 21 days - which is why armed guards are now at the entrance of Duncan's apt. preventing four close family members from leaving.

Now, if we only had the gumption and wherewithal to stop those in the affected nations from heading for the U.S. (Especially if they are prepared to lie about their Ebola contacts). And if you believe this is carrying things too far, I want you to think again about what's going on with this ONE patient in Dallas. This one guy has now created a 'web'  of  100 contacts to keep health specialists working overtime,   and each of their contacts may have to be investigated if another case emerges. The total cost already is estimated at between $1 million and $10 million. Imagine then if four more infected Liberians turn up in Nashville, Milwaukee, Tampa and Tucson. Imagine all that and the increased levels of quarantine and protection needed.

La Pook said this morning:

"Yeah, we're seeing a lot of panic out there. People are saying 'why should we believe the CDC they're always lying to us."

But that misses the point. It's not the lies as much as the blunders - such as having smallpox, Avian flu, Anthrax and other nasties hanging around in cardboard boxes at facilities. THAT is what many of us are concerned about, so that the CDC's past errors have really only forced us to question whether the 'experts' are getting it right now.

Read each of Murphy's laws again, then think about them. Carefully! Especially the last, recognizing that already in Africa , Ebola is manifesting 'Mother Nature's' fury at its most extreme and is spinning out of control - exceeding all medical efforts to contain it. Then ask if it is truly a good idea, irrespective of any notions of promoting "free trade" and "free travel" not to be imposing serious travel restrictions NOW here in the USA   -as other nations are doing.

This isn't being xenophobic, it's being rational - especially given the critical medical breakdown that's already happened in Dallas and the dishonesty of Duncan in completing his health forms before departing Monrovia.

Apart from all this, WHY aren't more Americans  outraged at these inexcusable  lapses in our health system? See, for example:

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