Is the Ebola Quarantine Period of 21 Days Too Short? Dr. Oz Weighs In With New Research

"We have only sixty days to contain this epidemic or we face an unprecedented situation for which we have no plan" - World Health Organization

Dallas County Court Judge Clay Jenkins boldly asserted yesterday that the dozens released from quarantine in Dallas over the weekend posed "absolutely no risk" to the community. All of them had contact at some point with Thomas Eric Duncan, "Patient Zero", in the recent Ebola incident at Texas Health Presbyterian Hospital.

The problem is that this may not be accurate, given viruses change - in potency, as well as mortality rate and incubation period. This point was brought up two days ago by Fordham  Infectious Disease specialist Alexander van Tulleken, in a live interview with Dr. Mehmet Oz - on his Monday show. In his preface to the interview, Oz noted the "magic number being 21 days" for being safe,  but in the last week new research has emerged to controvert that. In other words, 21 days may not be a long enough period for those who've been exposed to the virus and they should be quarantined longer.

Dr. van Tulleken pointed out that we were "originally getting our ideas of what the incubation period should be from research done in the 1970s".  But recently a researcher, Dr. Charles Haas-  from Drexel University - has reviewed all the data from recent epidemics and found the actual incubation period is longer - with an average incubation period of 12 days (not 8 or 10) and the maximum being up to 30 days. So "if we want to catch everyone we need to probably extend it to thirty -one days" according to Dr. van Tulleken.

Thus, to have erred on the side of actual safety the Texas individuals should have been quarantined at least another ten days. The chance they may spread the disease to others while being infectious is admittedly small (about 12.5% of exposed persons are symptomatic after 21 days) but it is assuredly not "zero".  Thus, new cases could pop up in Big D and we shouldn't be surprised if that occurs and is traced to those released prematurely - based on this new research.

When asked about the WHO statement (top of post) van Tulleken observed that the response for stopping Ebola in West Africa is totally "inadequate" and he remains convinced this is the number one threat to global health at the moment - all the soothesayers babble to the contrary.

Oz then went on to give one of his trademark demonstrations to show why too many are not being serious enough (or humble enough) about Ebola.  He used a wall graphic depicting the spread of the virus in a body from 12 days after incubation -when symptoms begin- and also a 3D model of fluid expulsion and waste contamination. The first few days are when the virus just begins accompanied by a slight fever (e.g. 99.5- 100.4F) and muscle aches and pains. The problem with these symptoms is that most of us won't be able to tell the difference between what is happening and the flu. Thus, the Ebola virus is hiding in plain sight based on flu-like symptoms and causing too many to dismiss it as "just the flu" - meantime the virus is slowing down the body's immune response.

By day 6 or day 7 after the initial symptoms the virus is "exploding" in the organs: By a week out, blood pressure is dramatically dropping while there is highly infectious projectile vomiting, explosive bloody diarrhea and profuse bleeding from body cavities.

Oz observes that while a projectile bloody sneeze, for example, can travel far in the air (say from a passenger on a plane) that is not the primary fear, because it doesn't linger there. You'd have to have the sneeze droplets shot directly onto you.  It is thus "a weakling in the air".

The problems arise when the virus begins to overwhelm the immune system and the projectile vomit-diarrhea phase is underway.  Then, if the virus-laden fluids are ejected or expelled onto a surface - it can remain there "for up to three weeks" - according to Oz. In effect, it affects not only the nurses, doctors taking care of the patients, but also the janitor who has to clean the floors where the patient had problems. Even gloves may be inadequate because in pulling them off with even a couple drops of waste and getting it on the skin "could pose a major problem"

The huge issue then emerges as the VOLUME of this waste expelled and which then contaminates an area. Since each Ebola patient will generate 55 gallons of toxic waste PER DAY by the time of the immune system breakdown and fluid expulsion - that means any hospital purporting to treat Ebola patients must be prepared to deal with it. For example, if they take in two patients they will need to know how to eliminate up to 770 gallons of highly infectious waste each week. Where do they put it? They can't put it in regular trash. (For reference, one hundred and forty 55 gallon tanks of material were removed from Thomas Eric Duncan's apartment in Dallas, as noted yesterday morning on CBS News Early Show. This was incinerated at a facility in Galveston, Texas).

It must either be incinerated using specially designed medical incineration units, or it must be sterilized in an autoclave (which few hospitals have because they can't afford them). The medical waste incinerators are also rare - given many states have outlawed them on account of pollution. To make matters worse, neighboring states with specialized incinerators have refused to accept the waste from  other states.

As Sen. Barbara Boxer has aptly put it: "Storage, transportation and disposal of the waste will be a major problem".

She was referring to the two formidable aspects of the Ebola waste problem: 1) the highly contagious nature of the waste generated, and 2) the sheer volume of it.  Hardly any U.S. hospitals are prepared to cope with this no matter what they say, or the CDC says. They are, in fact, under-trained to the task and under-funded (no thanks to many state budget cuts) so have less than adequate resources.

Oz' other guest, Darriah Gillespie, M.D.,  pointed out that Emory "trained for years" before the first Ebola patients ever arrived. They made sure they already had state of the art isolation wards, the right sterilizing equipment and positive pressure suits and knew how to use them - especially in the arduous decontamination procedure. Only four special centers in the U.S. have such wherewithal, so let's not kid ourselves.

 This is why I totally agree with Mehmet Oz' recommendations for being proactive in view of the risks. These include:

- Four specialized hospitals and 11 beds is not enough if there is an Ebola outbreak of large magnitude so regional centers must be found - this means all funding taken away in earlier budget cuts must be reinstated.

- Training can't be done in a day or an hour. Weeks of training are needed - as Dr. Oz noted- merely to get "gowned up" for a regular hospital procedure. Ebola may require even more and can't be done "on the fly" (which likely happened in Dallas)

- As it is the focus of infections is to ensure only that doctors don't infect patients, not the reverse (more likely in the case of Ebola) so many more resources need to be provided which currently aren't there. "Providers should be protected with every resource possible" in the words of Darriah Gillespie.

- While no airport procedure will definitely,  100 percent stop an Ebola -infected person from coming to the U.S. and a total travel ban may not be practical (they can slip over into Mali, and obtain travel from there etc.)  we can still (Oz recommendation) limit the visas of those from the affected nations - especially Liberia - who want to come here to visit.

His reason is sound: Because these "put us at risk", while health care workers "have to be able to get in there."

This seems to me a balanced solution, midway between a total travel ban and simply allowing any and all non-essential travel from the hot zone. Given the obvious difficulty associated with hospital capacity to deal with a significant Ebola outbreak - including management and disposal of the infectious waste  - it is better to have a plan in place apart from simply checking people for fevers at selected airports.

Let me make it abundantly clear here, that I am not trying to spread "Ebola fear" or "Fear-bola" as some liberal websites have called it. I am not part of the whacky Right's memetic entourage, i.e. i using this in the mid-terms or against Obama. BUT... I do believe our officials aren't leveling with us or doing enough, and though the confirmed cases (3)  of the disease are so far rare- we need to be more proactive as Oz has said. If we want to quell the fear and panic then the gov't needs to be proactive and first show it's competent to deal with the crisis as it exists now - and that means adequately funding our gutted health care -medical system. Or let me put it this way, putting back in place the funding already cut. Until that happens, and our hospitals undergo specialized training to deal with this disease, fear and hysteria will reign. It is a natural outcome, flowing from the lack of political will to do anything substantive to show we can handle the worst IF it arrives!

See also:
http://www.smirkingchimp.com/thread/ted-rall/59328/the-governments-ebola-cover-up-never-let-you-see-them-sweat

and

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

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 2^nd 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

The Essential Kit Every Air Traveler Needs To Have --- NOW

After two nurses as Texas Health Presbyterian  Hospital in Big D have now been infected with Ebola - as tests show- and nurses from that hospital have reportedly  told a National Nurses Union no protocols were place, the protective wear was "generic" and further,  the patient (Thomas Eric Duncan) was left in a public access area for hours - it is time for people  (at least airline passengers) to take their safety into their own hands. It is clear to this observer that your standard hospitals aren't ready, and worse we can't even be sure of airline flights now, as the most recent RN infected-  Amber Joy Vinson - was actually told she could get on a plane to Cleveland by the CDC, despite having attended to Duncan) and having a fever of 99.5F. (As MSNBC's Chris Hayes' observed last night, he's having a harder and harder time defending the CDC to his friends, as well as opponents, given their spate of lapses.)

Ok, the fever was below the threshold (100.4 F) the CDC had set, BUT the RN had cared for him. As CDC Honcho Thomas Frieden noted, under no circumstances should she have been flying any commercial airline flights. The immediate return flight to Dallas - when she actually had manifest symptoms - put 132 fellow passengers at risk - not to mention the hundred on the five additional flights made from Cleveland to Ft. Lauderdale, Atlanta, etc. before finally being "deep cleaned" by CDC standards back in Cleveland.

So what's an airline passenger to do? Take a clean up kit along when you board a plane, that's what! We have found that since we have been doing this regularly this year (on 3 flights en route to Barbados and 3 back to COS, then 3 flights en route to Switzerland and 3 back) we have not become ill - for the first time in years.

What is this kit? It includes a box of vinyl (non-latex) gloves - like surgical gloves, and a box of Chlorox wipes. As we find our way to our seats the first thing done is to don gloves, then remove the wipes and wipe down all seat surfaces, arm rests, tray tables (especially)  the whole works. Yes, some people will look at you as if you're a hypochondriac - or maybe from Mars - but I warrant not so much now after we know Ebola traveled with Ms. Vinson to Cleveland and back.  Now, I will bet they're thinking: "Hmmmm....why didn't we think of this sooner!" (Especially now that Frieden has admitted the virus can survive on surfaces - even when the spittle or barf has dried - for up to 7 hours, oh and they have now upped the fatality rate to 70% from 50%)

By the way, we leave all the magazines and the safety instruction plastic cards in the seat pockets alone, They are now known to contain the highest percentage of virus (and one drop of Ebola blood had 10 billion virus particles compared to 1 million for HIV) and are difficult to clean. If you want magazines, bring your own  - and look at the attendant when she delivers the safety spiel - forget about the card. (In any case, any experienced air traveler should already know where the exits are, etc. and how to handle an oxygen mask, use the seat bottom for life preserver, etc.)

The deal here is to make to use the same cleaning protocol on each leg, and if a guy in the next aisle howls with laughter and mocks the extraordinary precautions, just chirp: "Well, at least we won't get Ebola!"   

All this is now what we must do because it's evident our Neolib gov't has no plans at all to halt flights fro the hot zone. We keep being told that doing that "this will not stop the spread of the disease"  - but I feel it's more a case that "doing it will cause the stock market to crash" as we almost saw yesterday (400+ point drop during the day - from airline stocks diving)

And, clearly, the greatest fear of Neoliberals is not 50 people a day getting Ebola in the U.S. but the DOW crashing by 500 pts, because of bans on unnecessary air travel from the region.

Oh, there are also memes circulating, as I beheld in today's Denver Post, that "human rights" may clash with health security if travel bans are mandated. Excuse me? Traveling cross-continent  or trans-Atlantic by plane is NOT a right. It is a privilege. Having clean water and decent health care should be rights, but not traveling wherever the hell you want - because you think you need a vacation or whatever.

It's no wonder we're in somewhat of a mess when people can't distinguish true rights from privileges. But that has been the tenor the past 25 or 30 years as Neoliberalism has eviscerated the memetic landscape - so why be surprised?

All those who plan air travel anytime soon, especially for the holidays, would be well-advised to take along the wipe kit suggested. And, btw, it's good not just for Ebola but for the new Enterovirus-68 and the flu too!

The Harsh Truth: Too Many U.S. Hospitals Unprepared to Deal With Ebola

Most U.S. Hospitals lack positive pressure suits, or don't know how best to use them especially in disposing of fluid waste.

Contrary to the PR piffle we’ve been fed the past two weeks, it now is clear U.S. hospitals have not been prepared to deal with the emergence of Ebola in the U.S. In fact, had it not been for the incident in Dallas with Thomas Eric Duncan, we’d likely never have learned how pathetically unprepared our hospitals are. All this after the brainiacs at the CDC have been assuring us that ‘oh yes, we are prepared to meet any challenge’.

Let me make it clear that I’ve always detested PR, or public relations. I believe it cripples a country and makes it believe it’s pursuing truth and objective reality when in fact it is encouraging rampant delusion. But the lack of reality and appreciation of it is exactly what can bring a nation down because it obscures the search for real solutions to its problems. The primary fear then is not so much ISIS, or even Ebola, but the uniform incapacity to accept and deal with reality! After all, it was author Chris Hedges in his ‘Empire of Illusion’ who observed that a nation that does not deal with reality will end up in the dustbin of history for all intents.

Let’s take the case of the codswallop we’ve been fed by the CDC about U.S. hospital preparedness for an Ebola outbreak. First, I never bought into this bunkum. Probably because I 've been well aware how far behind the curve most American hospitals and medical centers are,  especially in terms of medical mistakes – basic ones! Look no further than the recent death of Joan Rivers, which as Dr. Mehmet Oz reported on one of his recent shows (Sept. 19th), was due to carelessness and lack of accountability during a basic outpatient procedure called an endoscopy.

This is a procedure I also had some four years ago. It entails introducing an endoscope down the patient’s throat to examine it for any evidence of lesions or cancerous growths. In my case none were found but in Rivers’ case a small tumor was observed on the vocal cords.  At that point Rivers’ own physician – a non-specialist who had no business even being there -  proceeded to take a biopsy and created a critical situation..

As Oz noted, the problem with this was twofold: 1) Rivers signed NO consent form to allow a biopsy to be done at the same time, and 2) when a biopsy is performed on the vocal cords a breathing tube  must have already been inserted into the airway before the procedure because – if not- the excision will cause the cords to swell up and block the throat – preventing air from getting in. This is exactly what happened with Rivers but few people are aware of it.  Thus, the idiot dr. that performed this on the fly, and despite no consent form,  caused Rivers’ passageway to be blocked and an inability to breathe. She went into a coma even as they tried desperate measures to revive her but it was already too late.

It is geniuses like this on whom we are supposed to rely in the case of an Ebola outbreak  - when the most direct and serious solution would be to prevent all non-essential passengers from traveling to the U.S. from the Ebola-affected regions. But oh no, our Neoliberal government, the State Dept. and CDC doesn’t want to send any negative signals out regarding free trade and free travel!  Denver Post Op-Ed columnist Michael S. Woodson wrote yesterday (Perspective, p. 1D, 'U.S. Has Left Itself Open to Ebola Outbreak'):

 

"A plethora of journalists and the government have emphasized the fact that Ebola is not as contagious as flu viruses to mute justifiable outrage at their policy for leaving such a wide preventable loophole."

 

What loophole?  Allowing non-essential passenger travel from the West African Ebola outbreak zone  to the U.S. "inviting the uncontrolled exposure of Americans to the Ebola virus." As he also emphasized, Ebola has already been classified by the CDC "as a Class A, bio-terrorism agent". Some have even speculated that ISIS might use Ebola infected pawns to spread the virus - but as Woodson notes:

 

"A natural versus weaponized Ebola is a distinction without much difference".

 

In other words,  we ought to treat all those leaving  the hot zone for whatever reason (including 'holiday')  as possible carriers of the virus.  That means shutting down all non-essential air traffic from the West African hot zone - lest we make the U.S. another hot zone. In Woodson's words:

"All non-essential, untraced passenger travel from the Ebola outbreak zone should be banned. All essential relief travel must be screened, and livable, isolated  staging areas set up by the CDC and Department of Homeland Security to observe U.S. entrants until after the incubation period for the Ebola virus has passed."

Clearly, Woodson - like me - doesn't trust the medical infrastructure to do the job to keep us safe. And why the hell should we?

As reported in Saturday’s Denver Post (p.1A, p. 8A) after the Duncan Dallas episode, a CDC official affirmed that “many hospitals remain confused about how they are supposed to react when a suspected patient shows up.”

Seriously?  I thought they all had it covered given the info has been circulating, according to the CDC, since June. I thought from what the assorted CDC honchos have been yapping about on the morning and evening news we were all safe since every hospital in the land knew exactly how to screen for the disease and had the wherewithal – including isolation wards – ready. Turns out it was all bull shit.

The Post piece went on (p. 8A):

“The agency sent additional guidance to health care facilities this week, as it has numerous times in recent months, on everything from training personnel to spotting the symptoms of Ebola to using protective gear.”

The article goes on to state that Emory University Hospital (which treated the two American medical volunteers)  has already provided advice to dozens of hospitals, “many of which are struggling with a lack of awareness about safety protocols and fear among workers who feel ill –prepared.”

Oh really? Well, then imagine what the public must feel as all the truth comes out in bits and pieces that our illustrious medical- industrial establishment wasn’t really prepared after all. We are continually told there is no reason to panic and we must not panic, and yet these people have given us no reason not to. They have literally played the fool!

The Post confirmed that the usual PR is still afoot as it noted:

“At the White House on Friday, federal officials sought to reassure the public that the nation’s health care system was well equipped to treat the virus and stop it from spreading.”

 

But pardon me if I don’t buy it. The Dallas case shows this is a PR myth, promoted for expedience so the gov’t can continue to cover its hide while it allows unlimited plane traffic from the affected areas – to appease the airline industry and Neoliberal market capitalists. 

You think these capitalist money grubbers really care about you or your family's welfare? Think again!  They are all about business and profits and that is ALL they care about! They don't want to kill the golden goose never mind that goose may be a Trojan horse for Ebola. Woodson also cites (p. 6D) a White House Fact Sheet that admits more concern for disrupting West African trade than for U.S. health security. He quotes it reading as follows:

 

"The State Department also has encouraged airlines operating in the region to maintain or reinstate service while ensuring appropriate precautions.  CDC is assisting with exit screening and communications efforts in West Africa to prevent sick passengers from boarding planes. It has also issued interim guidance about Ebola virus infection for airline flight crews, cleaning personnel and cargo personnel."

 

In other words, go all out to keep those planes flying - take all conceivable precautions -  but halting them isn't on the table.  Woodson goes on NOTE:

 

"The White House and State Department  argue that flight bans hurt international efforts  to combat the Ebola outbreak in West Africa. However, they fail to distinguish between controlled, essential travel for relief and stability operations versus non-essential travel to the United States."

 

He has a point.

 

Further, the admission by numerous hospitals that they aren’t prepared and they’ve had to pick the brains of those at Emory (and now likely Texas Presbyterian too) isn’t designed to instill confidence.  That the feds can remotely make the specious claim the “nation’s health care system is well equipped” to deal with Ebola is ludicrous and they must think we’re stupid or not paying attention. Maybe they believe we’re more entranced by “Survivor” or “Amazing Race” among other diversions, like shopping for the latest tech gizmo.

According to Craig deAtley, administrator of the D.C. Emergency Healthcare Coalition, the Dallas case is now prompting health care institutions across the nation to look at their individual abilities to respond.

“Facilities might not realize, for example, how much practical planning goes into training and staffing personnel, configuring isolation rooms, and determining what to do with dirty bedsheets and other waste”,  according to deAtley.

Well the fact that “dozens” of hospitals have had to call up Emory for guidance shows there’s  no “might not” about it – they really don’t know what to do! Ok, let me rephrase that: they didn’t know what to do before they called, and there may be hundreds more that haven’t found out yet. (Maybe they will phone in for guidance after another infected Liberian arrives - say in Tampa - and this time with full blown symptoms. And btw, the case yesterday of a sick Liberian arriving at Newark Airport  - but found not to have Ebola - ought to be another shot over our bow to take action!)

Oh and here’s the real butt kicker (ibid.):

“CDC officials acknowledged that widespread hospital awareness didn’t kick in until the Dallas case.”

Right, so we have had to wait until a possible full scale outbreak before our great medical establishment and health care system had all its ducks in a row. Criminy!  And  we're supposed to believe it's now "kicked in"? I doubt it.

More comforting words from Abigail Tumpey, a CDC spokeswoman:

“We let our guard down a little bit”

Yuh think?

Keep watching as this saga unfolds, and mind whether action is finally taken to halt all non-essential flights from the hot zone if an outbreak begins in Big D!  If nothing happens, you will know the Neoliberal state places its own welfare over yours!
-------

10/7  Footnote: Supporting my contentions, on CBS this morning is the news of a Sept. 24 Nurse's protest in Las Vegas, with the RNs marching to show their fear that their hospitals are not ready for Ebola. Also, of more than 1500 nurses that responded to an online survey nearly 80 percent said that their "hospital has not communicated to them any policy regarding admission of patients infected by Ebola."   Another Nurse from San Francisco interviewed by John Blackman affirmed her hospital had none of the positive pressure suits she herself had seen on TV.

Then a clip of CDC Honcho Thomas Friedan was shown claiming he wanted health workers to be "scared". He wants them to have a healthy respect for the consequences of any lapse". Fine, Maestro, but then make sure the hospitals are all provided with the wherewithal needed, and until then stop the PR.

"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