Showing posts with label Ebola outbreak in West Africa. Show all posts
Showing posts with label Ebola outbreak in West Africa. Show all posts

Sunday, October 19, 2014

Ebola- The Biggest Threat Is Human Hubris (And Bill Maher Is Right To Be Enraged!)


Bill Maher went apoplectic on Real Time - recounting the miscues that led to two Dallas RNs getting infected

Now that 3 weeks has passed since Patient Zero – Thomas Eric Duncan – made his 2nd appearance at Texas Health Presbyterian Hospital, we have learned many things. Nearly all have disclosed a disturbing degree of hubris – and we know it is hubris that has brought humans down from the beginning of civilization.

It started even as patient zero  arrived in Dallas, with the CDC's sundry assurances that there was "no need to worry", the U.S. health care system "could handle any problems" that emerged can quash them – because, after all, this wasn’t Liberia. Well, we found out how that worked out and also how many of Murphy’s laws were ignored or dismissed out of an abundance of hubris.

It contiued with Texas Health  Presbyterian itself which – as disclosed via his nephew’s letter on Melissa Harris Perry yesterday – showed that Duncan was basically given antibiotics and shown the door because: 1) he wasn’t an American, and 2) lacked health insurance. Thereby he put the whole rest of the Dallas community at risk for at least two days.

Then, when he did appear with pronounced symptoms – by now having spread the virus far beyond what would have been – the hospital did finally take him in, but still blew it by not immediately putting him into an isolation area. Instead, according to whistle-blowing RN, we learned how many CDC “protocols” were utterly violated how and the hospital literally didn’t know whether to shit or go blind.

Nurse Briana Aguirre (who ought to be commended for her courage) described scenes of “chaos” at the hospital, with staff having no idea how to tackle the virus and having been given no credible insight or training by the honchos .  Far from  the hazmat suits one saw actual CDC workers wearing (as they transported two Texas nurses – one to Bethesda, the other to Atlanta)  the Texas RNs were issued pathetic imitations which had large gaps in the neck. There was no taping of the gaps – leaving the Nurses exposed to possible contamination –that order only came from the CDC in retrospect.

Worse, Aguirre repeated to Matt Lauer in an NBC interview that the patient (Duncan) in the midst of all his bodily fluid expulsions – was left out in a public access area and that the soiled materials as well as the implements used to treat him were left festering in corridors for days.  Worse yet, samples of his virus-laden blood were dispatched for testing using the regular hospital system – along with ordinary blood, urine, stool samples – if you can believe it.

Aguirre  also claimed that doctors were told it was acceptable to move between rooms without disinfecting.

No wonder Bill Maher on Real Time Friday  night went apoplectic even as a soothsaying Brit guest tried to calm him down by some reference to having thought Bill was a bastion of “liberal rationality as opposed to right wing hysteria”. Bill’s reply was blunt, to the point: "This is not about the right wing. Germs do not have a political party/". Bill's outrage was also understandable as he observed this was "personal" to him, as his own mother had worked as a nurse.

But the misplaced assurances about U.S. hospitals weren’t the worst of CD lapses. Several days later one of those exposed RNs (Amber Joy Vinson) - who treated Duncan – and actually reported a 99.5F fever at the time, called CDC asking if she could board a flight to Cleveland. (Mind you, technically she shouldn’t have even had to ask anyone this question, it ought to have been common sense not to go given her close contact with Duncan – catheterizing him and all, and wearing one of those flimsy protective suits Aguirre  referenced)

The CDC person at the other end, as opposed to going by the principle that NO health worker who treated Duncan should board a commercial flight, instead went by the ‘letter’ of the rules – saying it was okay because Vinson’s temperature hadn’t reached 100.4 F. Can we say dumb? Yes we can.

The result has been consternation amongst the 750 or so people who'd taken the five flights that left Cleveland after Vinson had taken her flight (2402) from Dallas to Cleveland. These included: Flight 1104, Cleveland to Ft. Lauderdale; Flight 1105, Ft. Lauderdale to Cleveland; Flight 1101, Cleveland to Atlanta; and Flight 1100, Atlanta to Cleveland. All as reported in yesterday’s Denver Post (p. 10A).

 Passengers on all seven flights did receive notification from the CDC or Frontier, and the six person crew was placed on a 21-day leave, as well as a number of people (including at a school in Cleveland) with whom Vinson came into proximity. But passengers have been left guessing as what to do – as reported in yesterday’s Denver Post. According to this news (p. 1A):

A Florida lawyer who Tuesday flew on the Frontier Airlines plane that a day earlier carried Ebola patient Amber Joy Vinson, said he placed precautionary calls to his doctor and the Ohio health department after he realized he was seated close to where Vinson had been seated but was referred to the CDC.”

 But the “expert” at CDC  told him: “I don’t have an answer for you.”

Huh?

At 8.30 p.m. Wednesday he was told “someone would be in touch” but according to the press report, “on Friday he was still waiting”.

And this is how it likely begins......or not. We don’t know. We’ve had so many soothe- saying idiots paraded on the tube and trying desperately to allay fears it’s hard to keep track. Including one doctor who actually said on one news piece yesterday that “Even if I’d been seated right next to Ms. Vinson I wouldn’t be worried!”

Really, Bozo? And you can assert that bollocks with 100 percent confidence given how CDC workers themselves are decked out in full HAZMAT suits when they even come within 3 feet of an Ebola-infected patient and those suits have their own oxygen supplies? (Oh, but of course, it is impossible the Ebola virus could be airborne, never mind Canadian experiments that show it is possible for the virus to spread along that route from one animal to another. But maybe the CDC doesn’t accept that humans are animals, eh?)

In the wake of the pathetic CDC non-response to the inquiring Airbus passenger, Wendy Aiello from Aeillo Public Relations of Denver had this to say (Denver Post, p. 13A):

This is one of the saddest examples of poor communications I’ve seen in 25 years of public relations. On a scale of ‘fantastic’ to ‘I can’t believe this is happening’ this weighs heavily to the side of ‘What in God’s name is going on?’

Well, incompetence is going on, and it’s not just the CDC, it’s the World Health Organization (WHO) as well. As The Post also reported (p. 12A, ‘WHO Failed on Ebola’):

Nearly everyone involved in the outbreak response failed to see some fairly plain writing on the wall. A perfect storm was brewing, ready to burst open in full force.”

Really?

Meanwhile, the co-discoverer of the Ebola virus, Dr. Peter Piot, wondered why it took WHO five months and 1,000 deaths before  declaring an international health emergency in August.

All of which points up that the calls for calm are only credible if we the people (the non-experts) can expect competence on the part of the health authorities and experts – whether in CDC, or WHO or our hospitals. It is not sufficient to tell us to “stay calm” or “don’t get hysterical”, if in fact the experts themselves don’t know their asses from holes on the ground and are literally learning on the fly. If they don’t know that a health worker with a 99.5F temperature – who cared for the “index patient” – shouldn’t board a plane, then they are learning on the fly.

 The other thing that keeps getting repeated by the assorted medical elites, as if on auto-play, is it’s so very, very, very hard to get this disease because it requires direct contact with body fluids (saliva, sweat, blood, semen, breast milk etc.). That is supposed to comfort us, but that repeated formula may also be our downfall. The reason is that the ‘low risk without direct contact’ meme can encourage too many to let their guards down as it has. It also takes no cognizance of the fact that: a) once a person is infected all his/her contact points must be immediately traced and this is bloody difficult work, and b) Actually caring for a symptomatic person requires an isolation room and – as Rachel Maddow pointed out two nights ago- there are only 9 in all at all the specialized facilities (including in Nebraska, at Emory, and at NIH) and 2 are already occupied.

Are we really going to entrust regular hospitals to care for the infected and symptomatic patients? Especially after Repuke state budget cuts from two years ago have left many operating on shoestrings? (Not to mention the CDC, which has experienced a real budget cut of 21% owing to inflation)

So no, I am not leaving out the hard right austerity fetishists by any means. Everyone literally, from our bought out politicos to the health authorities are to blame for letting this thing reach a stage it never should have.

In that respect, I damned sure share with Bill Maher the disposition to become apoplectic- and you should too!

See also:

http://www.denverpost.com/News/Local/ci_26755507/Ebola-is-one-of-many-lethal-infections-threatening-US-hospitals

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:

http://www.smirkingchimp.com/thread/ted-rall/58739/ebola-is-here-in-america-why-arent-we-angry


Wednesday, October 1, 2014

Ebola Arrives in Dallas: Why The U.S. Needs To Get Serious About It



The news that a patient at a Dallas hospital tested positive for Ebola ought to alarm people enough, but the further news that he'd been carrying the disease around with him for 7 days before becoming symptomatic enough to show up at a hospital ought to scare people even more. And also, that most of this time he spent with his family members (he'd apparently just arrived in Dallas from Liberia and had shown no signs or symptoms on the plane - or so we've been told.).

The CDC said the patient had come to Texas "to visit family" and they confirmed Ebola after tests had already been conducted by a state lab.

Dr. Richard Besser, ABC Medical Consultant, asked last night about the incident said:  "It is very concerning".

Well, it ought to be!

Here's the thing: If lawmakers and Texas governor Rick Perry are so occupied with ISIS terrorists crossing the Mexican border why aren't they similarly exercised about the bio-terror of Ebola entering into the country aboard planes from Liberia? Or entering from ANY of the affected nations: Guinea, Sierra Leone as well as Liberia?  One would have thought that by now, with the cases in those nations increasing geometrically,  all flights originating from the Ebola -affected nations would have been halted - as other countries have done.  But no, it's business as usual in the US of A..

This isn't good enough! And I don't buy the soft soaping and PR that we have  "a great infrastructure to deal with an outbreak" as spouted by Zachary Thompson (Director of Dallas County Health and Human Services), and quoted in an AP report. 

The fact is, as reported on last night's ABC News segment,  when the patient (now identified as Thomas Eric Duncan)  first showed up at Texas Health Presbyterian Hospital, an RN completely blew it by not passing on the critical info that the man had come from West Africa. Because of this breakdown the hospital wasn't able to properly diagnose Duncan, so they released him back onto Dallas' streets.  It wasn't until Duncan's  2nd try three days later that Texas Health Presbyterian Hospital finally got it right and admitted to the isolation ward. But no one knows how many people came into contact with this U.S. "patient zero"  in the hiatus between hospital stops.

Gen. Anthony Zinni, appearing on the Bill Maher Real Time show, was blunt in giving his assessment of the comparative dangers of ISIS and Ebola. He properly and correctly noted that the latter is a real "existential threat" but not ISIS - which is a regional threat. This is similar to how I already put it in terms of comparing ISIS to global warming. Again, the latter is the existential threat, not ISIS. ISIS is Halloween scary with their black masks, beheadings of journalists and screeching radical Islamic piffle - but not at the level of Ebola or climate change.

What should be done then? The U.S. forthwith needs to take off the kid gloves and treat all entrants from the Ebola -affected nations as possible bio-threats and potential  bearers of Ebola. This means shutting off ALL flights from the three affected nations until such time the outbreak is brought under control. Not to do so is, to me, little different from allowing ISIS -infected American radicals back into the country to wreak havoc. It is, in other words, common sense.

The fact that one Dallas hospital completely missed this patient's disease, and last week another doctor returning from Liberia expressed concern at arriving in Miami and not being screened, shows we are living in a fool's paradise and the luck may soon run out.

The appearance of the Ebola positive patient in Big D is a shot over our bow. It is now time to get serious and throw the hammer down, No more incoming flights from those nations until the outbreak subsides. We cannot put our trust and faith in the medical infrastructure alone!

Saturday, August 2, 2014

Bringing Ebola Patients To The U.S.- Not A Very Good Idea!


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

"The road to hell is paved with good intentions"- John Ray, 1670

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")


At this stage, with one of the Samaritan Purse workers (Dr. Kent Brantly) infected with Ebola en route to the U.S. and Emory University Medical Center's Isolation Ward in Atlanta, one must wonder about the wisdom of the move - as well as that of the 2nd worker (Nancy Writebol), also being flown in via medevac in the subsequent flight.

In general, it is not a good practice to transfer patients infected with one of the most lethal viruses on the planet into a non-infected nation. This is different, materially and substantively, from keeping the virus in a Level 4 containment lab in one of the most secure places on Earth (ok, at least we thought so until cardboard boxes containing Variola (smallpox), Anthrax and a lethal Bird flu were discovered).  In the case of the latter, the actual contact with the virus can at least be controlled - and more importantly  - the risks of contamination don't extend to having to add many more protocols to confine the spread of the contaminated fluids spewed out of actual bodies. Workers need only control their contact with the actual isolated virus and not with the infectious diarrhea, vomit, sweat or blood spewed out.

Hence, there is much greater probability of things going wrong when stringent added protocols are incorporated -  to protect against Ebola-laden fluids - and there is, literally, no margin for error.  Murphy's Laws, which many take only in a facetious or non-serious vein, are actually apropos here. They really do provide a mental caution against adopting hubris or projecting human arrogance, especially the ever present human failing embodied in the misplaced belief that all their systems are "perfect" and "nothing can go wrong."  ("We have it all under control." - perhaps the sorriest words ever written or said.)

Actually, many things can. The transport to Emory itself means a 20 mile trip along a highway to get to the Emory center. Though a police escort is to be provided, the possibility of some kind of accident still exists. But we can concede this is relatively low.

Move now to the Emory Isolation ward itself which will keep each patient separate from the rest of the hospital and with an air-filtered space to boot. Two specially trained nurses will tend to each patient and 4 infectious disease specialist doctors. However, there is no indication whatsoever that any of these Emory people have had previous experience in handling Ebola patients. That implies they will not be as careful as say, a 'Doctors without Borders' specialist in Sierra Leone, who knows every single pitfall and goes the extra mile to avoid human error.

Again, these specialists won't be working with the virus per se but rather treating two symptomatic patients expelling contaminated body products. We can expect as the two patients are attended to, they will still be in the phase of vomiting, diarrhea as well as hemorrhagic release from multiple orifices, so that the slightest drop of any fluid on a pressure suit or even its duct tape will be an alert or alarm point. How will the nurses, doctors deal with it? How intensely will they clean themselves after being in contact with the patients? How sure are they that there are no minute holes in their suits? How will any contaminated clothing, bedding be handled? Even if the doctors themselves work on the patients from outside using robotic type devices, someone will have to go in, collect the fouled bedding, clothing and dispose of it.

It is in the handling and disposal of those contaminants that the real risk inheres and Murphys' laws come to the fore.  While it is true Ebola is "not contagious like the flu" (so far as we know) it is still quite capable of penetrating medical barriers erected against it, as Dr. Brantly found out. Hence, one must exercise constant and meticulous care if error is to be avoided. It only takes one misstep!

This is especially important given we live in a country which already sees something like 98,000 deaths by medical accident or  hospital infection each year. In the case of the latter, most of those deaths  - say from c. diff. or MRSA - could have been easily prevented if proper disinfectant techniques had been observed. But they weren't.

 Many people forget that, especially those who demand we show "compassion" to the two aid workers. (Forgetting that the needs of the few or the one do not exceed the needs of the many.) Well, we do, but also suggest that reasonable compassion can't mean putting many thousands or millions at possible risk, or compassion at any price.

Maybe the Emory specialists and CDC honchos are correct that there's nothing at all to worry about and nothing will go wrong. But having seen a number of Murphy's laws in action in other settings I am not so sure. I definitely lack the hubris or overt self -assurance detected in the words I've beheld uttered by one of the Emory docs who will be treating the patients. ("We know what we have to do and we're confident!")

We've been given all the reasons this move is a great idea, including that the patients can now receive the best of care (of which I have no doubt) and also the protocols are in place to ensure maximum safety (of which I am unsure). We also have been told the protocols in Africa are too difficult to follow because of the lack of supplies, etc. However, I dispute that given the disease has been in the spotlight and studied since 1976, and some of the best specialists have been there to treat and tend to the disease in its actual environs. They have also flown in all the equipment they might need, to specific locations. Yes, the Emory site does afford some extra advantages (more easily controlled temperature environment, more backups) but again, are the risks worth it?

Only time will tell, and if one of Murphy's laws is violated and an outbreak of Ebola occurs in Atlanta, we have to hope it is expeditiously contained and doesn't spread. Bill Maher, as on Real Time last night, may mock "morons" for expressing their fears about the situation and its potential unraveling - but alas, those fears aren't warrantless, they're quite real.  Alas, the real morons will be those who proclaim- in the aftermath of other possible cases in the area weeks later:   "We never knew it could happen!  We thought we'd done everything humanly possible to prevent it!"  

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 "humanitarian" aspirations, to have brought it to our shores. 

Will our good intentions possibly have visited "hell" upon us? We will see.

Wednesday, July 30, 2014

What We're Not Being Told About The Ebola Outbreak - And Why a Pandemic Is Not Impossible


The Ebola virus in an electron micrograph

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

Ok, I readily admit my specialty is not biology, viruses or human epidemiology. Hence, you may take this blog post for what you believe it's worth. But I have been following news of the latest Ebola outbreak in West Africa and I become more alarmed with every new report - especially the latest in which an American (Patrick Sawyer) actually got on a plane and flew into Africa's 2nd largest city (Lagos) with 21 million people.

The medical media cognoscenti continue to soft soap the incident and I believe it may be to prevent any public alarm. But I think the public ought to have plenty alarm and here's why:

In the most recent AP report (Denver Post, 'New Fears About Ebola Spread After Plane Scare', July 29, p. 13A), we are informed:

"Witnesses say Sawyer, a 40-year old Finance Ministry employee en route to a conference in Nigeria, was vomiting and had diarrhea aboard at least one of his flights with some 50 other passengers . Ebola can be contracted from traces of feces or vomit, experts say."


I would like you to read that over again and think about it. If a passenger is ill on a plane he or she has two choices, reach for a barf bag or try to make it to the nearest rest room and let it rip. In the last case it is probable no "witness" would have been present to see anything and especially any diarrhea. If the passenger couldn't make it and is constrained to release in his seat - THEN it is likely there would be witnesses to both unfortunate emissions (in the case of the diarrhea, more likely as a god awful odor - which in fact, the Ebola virus produces.)

Now, the fact bio-lab and CDC et al research workers have to wear  BSL-4 positive pressure suits when working with the virus (see above image) means it is no walk in the park for any unprotected people if a guy on a passenger plane displays any eruption of body fluids! I mean, this is serious! It means possibly five or six people might have been affected, if not more. And at the Ebola phase of fluid ejection, even bloody droplets from the victim's eye can cause infection.

Now, here's the bitch. As the article observes:

Sawyer was quarantined upon arrival in Lagos - a city of 21 million people-  and Nigerian authorities say his fellow travelers were advised of Ebola's symptoms and allowed to leave.

Allowed to leave!? WHY?  WTF!  This disease kills 60- 90% of those infected!

They ought to have ALL been quarantined on the spot, given the "authorities" had no a priori clue who had come into direct contact with Sawyer's bodily fluids - if even in a happenstance way  - say him rushing out of his seat to the toilet with drops of virus-laden stool leaking from his spattered trousers (the diarrhea is almost as bad as c.diff. and cholera) onto hapless passengers. Who, may have believed it to be just some juice from a drink (though the odor ought to give it away).

My point is that if those who work with Ebola need positive pressure suits, and people in an airplane have nothing and are exposed and allowed to walk out of the airport - then something is seriously amiss. The "authorities" did not practice due diligence and allowed 5 or more possibly infected sources of the virus to escape!

Then there's the problem with "looking for symptoms".  The sad fact is that they can take up to 21 days (3 weeks) to manifest and some sources cite 25 days. By that time most of the passengers might have forgotten about it. The next thing, the symptoms are initially vague and general - often mistaken for a bad flu.

The symptoms usually begin with severe headache, sore throat and muscle pain accompanied by a burning fever.  As it progresses, hiccups are often soon to follow with severe nausea. By now, it's critical the person get himself to a treatment center to begin prepping for the process of re-hydration, because the explosive vomiting and diarrhea will soon follow, along with hemorrhagic bleeding from multiple orifices. At that phase, the danger for cross infection of others is at a maximum.

In the movie, 'Contagion', many passengers aboard commercial aircraft are infected by the victims of the depicted deadly virus coughing or sneezing. The problem is that they don't turn themselves into hospitals, but they go home to try to recover. There, they infect loved ones, and the epidemic soon turns into a pandemic.

Could it happen with Ebola? If so, it would mean airborne infection is possible in the new outbreak and we're not being informed. Indeed, Canadian scientists believe the disease can now be transmitted through the air, which would explain the rapid spread of this new outbreak and the deaths of 3 doctors (two Americans and an African)  who took every precaution, including positive pressure suits. As reported in the link above:

"Canadian scientists have shown that the deadliest form of the ebola virus could be transmitted by air between species. In experiments, they demonstrated that the virus was transmitted from pigs to monkeys without any direct contact between them.

The researchers say they believe that limited airborne transmission might be contributing to the spread of the disease in some parts of Africa."

If that is the case we're really for the high jump. But let's stay conservative and hope it's no more than a possibility. In that case the spread would require a long chain of total screw ups by everyone involved, from airport authorities to local officials to the CDC. But hey, after several old supply stores of smallpox and anthrax were found improperly stored at the latter, it could happen!

Sawyer, the American working with the Nigerian government, ultimately would have returned home to Minnesota - and indeed was planning to do so next month. So what if, I say IF - he'd have still not shown his symptoms outwardly by the time he got on a jet home. Then, after arriving home had begun dispersing the virus to his family via his bodily fluids - they'd have surely tried to clean up after him.

I would argue all would have been infected.

Well, Sawyer was stopped in his progress at Lagos Airport, but a lot of possibly infected people (who came into contact with him on the plane) are on the loose. The medical authorities insist the risk from any of them - say catching a plane to New York or Chicago - is "low" and they'd "likely report to a medical center if they see symptoms".

Let's hope these medical soothsayers are right.

For my part,  I remain skeptical.  Actually you can call me a pessimist! Reinforcing my pessimist take is this statement from Dr. David Heymann, Professor or Infectious Diseases at the London School of Hygiene and Tropical Medicine, quoted in the Post piece (ibid.):

"The best thing would be if people did not travel when they're sick, but the problem is that people won't say when they're sick. They will lie in order to travel, so it is doubtful that travel recommendations will have a big impact."

I suspect the same applies to those who travel,  then show symptoms, and are supposed to then report to a medical center, pronto.

We have to trust that the medical gurus are right and affected people are cooperative enough to understand the greater good trumps anything else. I am just not so sure that will hold.

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UPDATE: Friday, Aug. 1:

Dr. Jon La Pook informs viewers  (CBS) this a.m. that U.S. entry airports are NOT screening any passengers from West Africa - specifically from  the affected nations.  Need I say, must I, that this amounts to callous oversight for which we may a dear price? By contrast, the Chinese have  sophisticated infrared-thermal detectors trained on all arriving passengers and sequester any with temperature readings above 99.5F. The Chinese take their nation's interests and welfare seriously and we evidently do not. Meanwhile, the words of media medical gurus like LaPook and Richard Besser (from ABC) continue to ring hollow on how they are "certain" any problems can be contained here in the U.S. Sorry, I don't buy it.

Further, I predict this ghastly virus will spawn an outbreak on our shores before the month is out. I also challenge LaPook's and others' claims that "infection can only occur by direct contact with bodily fluids". I challenge it because Canadian drs. have already demonstrated in their labs it can spread by air! Further, the patients being flown to the U.S. for treatment are being contained in AIR TIGHT vestibules and - once they arrive at Emory University in Atlanta for treatment - will be confined to special isolation units with their own air systems and filtration.

Now, you figure it out,  dear reader. Who exactly is being fed a load of bollocks here? Should we be lulled into a sense of false security, or should we ourselves begin taking every precaution we can? You be the judge!

See also:

http://www.smirkingchimp.com/thread/william-rivers-pitt/57242/all-the-blood-in-your-body

and:

http://www.telegraph.co.uk/news/worldnews/northamerica/usa/10998222/Ebola-outbreak-Victim-who-sparked-fears-of-global-epidemic-was-on-way-home-to-US.html