First Ebola Diagnosis in US

[Andy9o8 2]

I think it's perfectly reasonable to ask of doctors and nurses who are brave and self-sacrificing enough to risk going to Africa to treat and have direct contact with Ebola patients, that the last phase of their noble service is that when they return home, they need to sideline themselves in some kind of clinical isolation for long enough to be sure they're in the clear. Make it a matter of law that, for example, their income will be paid (we'll work out the details...) and their jobs will be held for them while they're in isolation.

[muff528 3]

That's just plain old common sense. The virus has never before been known or studied in the wild beyond small, isolated communities. I think only the recent outbreak in larger population centers like Monrovia, etc., has provided the "opportunity" for a clearer look at how it might spread or mutate ...or how to treat it. Proliferation through a larger population pool may allow it to mutate enough to do more (or less) damage before all of its victims are killed. Doesn't hurt to use a little more caution until it is better understood. It may ultimately turn out to be no more problem to control than the flu or tb. Then "protocols" can be relaxed. ...maybe not.

[JerryBaumchen 1,362]

Hi Andy,

Quote

sideline themselves in some kind of clinical isolation

And a fellow tradesman would agree:

http://www.cnn.com/2014/10/27/opinion/cevallos-ebola-quarantine/index.html?hpt=hp_t3

Always an interesting topic.

Jerry Baumchen

[billvon 2,990]

>I think it's perfectly reasonable to ask of doctors and nurses who are brave and
>self-sacrificing enough to risk going to Africa to treat and have direct contact with
>Ebola patients, that the last phase of their noble service is that when they return
>home, they need to sideline themselves in some kind of clinical isolation for long
>enough to be sure they're in the clear.

Or just stay home until they know they're in the clear. Seems more reasonable.

[GeorgiaDon 362]

Quote

Or just stay home until they know they're in the clear. Seems more reasonable.

Now you know better than that! Doctors and nurses that go to a foreign country to treat poor people (for free!!!) obviously cannot be trusted to take their own temperature and come in for treatment if they develop a fever. No, they need to be imprisoned in solitary confinement, ideally in an unheated tent without access to the internet, TV, or reading material.

Not that we would want to discourage anyone from going to Africa to help fight the epidemic.

Don

_____________________________________
Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996)
“Education is not filling a bucket, but lighting a fire.” (Yeats)

[Andy9o8 2]

There's really no need to demagogue it like that. Now you've hurt my feelings.

[billvon 2,990]

>So. if they want to pull these people out of line upon entry and isolate them for a
>few days while they pass a double lab test fore bola I'm fine with that.

Why isolate them if they show no signs of the disease? If they are asymptomatic they're not contagious. Test them and if they test positive, track them down. A LOT cheaper than putting everyone in a hotel for a few days.

[kallend 2,026]

jakee

You could barricade yourself inside your home, never go outside and you'd still have a far higher chance of being shot by a burglar than catching ebola.

And an even higher chance of being shot by a member of your family.

...

The only sure way to survive a canopy collision is not to have one.

[Andy9o8 2]

Hey! Hotel Ebola, starring Don Cheadle.



What, too soon?

[kallend 2,026]

billvon

>Then again, SUPPOSE - just suppose - Dr. Craig Spencer was contagious when he
> rode the NYC subway.. and SUPPOSE he sneezed some saliva and phlegm
>carrying contagion onto a surface, and then someone else touched it, and then
>touched their face, etc. ..well, you see where this is going.

Yes, there is a very, very small chance he could spread it.

Now let's compare it to tuberculosis. As of May there were about 600 cases in NYC, most coming from overseas. TB is far more contagious than Ebola, and so far in the US is about as deadly (about 12% mortality rate in both diseases.) You are FAR more likely to be exposed to TB in New York than Ebola, and are far more likely to die from it than Ebola.

On NPR this evening there was an epidemiologist who mentioned that the media and politician induced panic over ebola is taking resources away from TB and measles, each of which in fact pose a greater threat.

...

The only sure way to survive a canopy collision is not to have one.

[BillyVance 34]

Andy9o8

Hey! Hotel Ebola, starring Don Cheadle.



What, too soon?

Never!

"Mediocre people don't like high achievers, and high achievers don't like mediocre people." - SIX TIME National Champion coach Nick Saban

[Anvilbrother 0]

I'm sure they searched him out just for his alternate view to get a "different" side of the arguement for view count. I'm sure he was well compensated for his expenses to be on the show too.

Postes r made from an iPad or iPhone. Spelling and gramhair mistakes guaranteed move along,

[billvon 2,990]

>On NPR this evening there was an epidemiologist who mentioned that the media
>and politician induced panic over ebola is taking resources away from TB and
>measles . . .

And having a few other negative effects. Two kids from West Africa were beaten and hospitalized in New York after being called "ebola" and attacked by classmataes.

[kelpdiver 2]

Andy9o8

That's why I don't blame the NY & NJ governors for reacting to the Spencer case with enhanced emergency quarantine rules. Yes, Nurse Hickox's quarantine seems like it may have been handled a bit clumsily, and she's mightily pissed off about it, but I still think on balance the governors were more reasonably prudent than not on that call.

The facebook nutsphere is lighting up with stories that Hickox is a CDC plant to kill any quarantine programs in NY/NJ as part of a CDC/Obama plot to infect America with Ebola. Nutty as all fuck, but most interesting is a claim that she has scrubbed from her linkedin data any references to her involvement with the CDC.

Couple that with the annual 'flu vaccines are killing you' stories. Facebook has made crappy email chain mail even easier to spread about.

[GeorgiaDon 362]

Andy9o8

There's really no need to demagogue it like that. Now you've hurt my feelings.

A bit over the top I admit. Maybe I need a time out in Hotel Ebola.

Disclaimer: the issue is a bit personal for me, as I work with pathogens that cause malaria and Chagas' Disease and am pretty tired of know-nothing fear mongers who constantly agitate to block universities from conducting any research on infectious diseases, in the name of "public safety". The fact that such research has gone on for over 100 years without a single incident of accidental infection of any member of the public makes no difference to these people. Likewise the fact that almost all of the advances in basic science that has lead to the drugs, vaccines, and such that have allowed them to escape most of the diseases that plagued our ancestors have come from university-based research makes no impact. They simply can't see past their paranoid fear that we are all mad scientists determined to inflict "experiments" on the unsuspecting public.

Similarly I work regularly with people who have dedicated their lives to combating malaria, schistosomiasis, lymphatic filariasis, Chagas disease, and other diseases. These people spend an astonishingly large fraction of their lives away from home, working under incredibly difficult conditions. To see them written off as "doctor douche" is incredibly offensive to me.

Well, off to Hotel Ebola for a good night's sleep.

And to everyone who doesn't catch malaria, yellow fever, cholera, typhus, whooping cough, tetanus, or polio, (all of which used to be common in the US) tonight, you can thank some Doctor Douche who put themselves on the line so you could live lives free of those diseases.

'night all.

Don

_____________________________________
Tolerance is the cost we must pay for our adventure in liberty. (Dworkin, 1996)
“Education is not filling a bucket, but lighting a fire.” (Yeats)

[billvon 2,990]

>The facebook nutsphere is lighting up with stories that Hickox is a CDC plant to
>kill any quarantine programs in NY/NJ as part of a CDC/Obama plot to infect
>America with Ebola.

I like it. Nutty with a healthy dose of fearmongering, a dash of government conspiracy and a nice shout-out to the right wing. And look at that name - Kaci Hickox. Full of K's and C's, like communist, and terrorist, and North Korea.

[jakee 1,489]

Anvilbrother

I'm sure they searched him out just for his alternate view to get a "different" side of the arguement for view count. I'm sure he was well compensated for his expenses to be on the show too.

Or, he's absolutely and completely right. Ebola is a complete non issue in the first world. Even in Africa it's a long way from being the biggest public health threat.

Do you want to have an ideagasm?

[wolfriverjoe 1,523]

Anvilbrother

I'm sure they searched him out just for his alternate view to get a "different" side of the arguement for view count. I'm sure he was well compensated for his expenses to be on the show too.

It's NPR. What are they going to compensate him with? A tote bag or a coffee mug?
And it's radio. Listeners, not views. And the vast majority of interviews are "phone ins." What expenses did he incur?

And you also said

Anvilbrother

These people need to learn to take one for the team! They told us if we ran a call with someone suspected we were immediately getting into the Ems unit and going to isolation wherever the state epidemiologist tells us. Not getting back into the fire truck, going back to the station, or going home until we were determined to be ebola free.

There's a huge difference between "taking one for the team" and "getting hosed because the politicians are panicky, ignorant sheep."
If your "state epidemiologist" is halfway competent, he'll say "let them go where they want to, have them take their temp every 6 to 8 hours, and if they start to show symptoms, get to medical care immediately."

Exposure, if standard BBP protocols are followed, doesn't mean infection. And even if infection takes place, they aren't going to be contagious until symptoms start to show up.

And

muff528

That's just plain old common sense. The virus has never before been known or studied in the wild beyond small, isolated communities. I think only the recent outbreak in larger population centers like Monrovia, etc., has provided the "opportunity" for a clearer look at how it might spread or mutate ...or how to treat it. Proliferation through a larger population pool may allow it to mutate enough to do more (or less) damage before all of its victims are killed. Doesn't hurt to use a little more caution until it is better understood. It may ultimately turn out to be no more problem to control than the flu or tb. Then "protocols" can be relaxed. ...maybe not.

The health care community (WHO & CDC in particular) have seen and studied Ebola Zaire for almost 40 years. There is a lot about it (particularly the host) that isn't understood, but how and how easily it's transmitted is.

And I hope like all hell that it's easier to control than the flu (influenza). Despite vaccines, education and prevention, there are still thousands to tens of thousands of deaths each year in the US.
But we don't really worry about that. It's "just the flu."

"There are NO situations which do not call for a French Maid outfit." Lucky McSwervy

"~ya don't GET old by being weak & stupid!" - Airtwardo

[kelpdiver 2]

jakee

Or, he's absolutely and completely right. Ebola is a complete non issue in the first world. Even in Africa it's a long way from being the biggest public health threat.

For the countries are basically being walled off until it dies out, it is killing their economies and their ability to easily get help for the usual problems (hiv, malaria, and the other fun mosquito diseases).

[muff528 3]

***...
And

muff528

That's just plain old common sense. The virus has never before been known or studied in the wild beyond small, isolated communities. I think only the recent outbreak in larger population centers like Monrovia, etc., has provided the "opportunity" for a clearer look at how it might spread or mutate ...or how to treat it. Proliferation through a larger population pool may allow it to mutate enough to do more (or less) damage before all of its victims are killed. Doesn't hurt to use a little more caution until it is better understood. It may ultimately turn out to be no more problem to control than the flu or tb. Then "protocols" can be relaxed. ...maybe not.

The health care community (WHO & CDC in particular) have seen and studied Ebola Zaire for almost 40 years.

But not its behavior as an infection spreads from host to host through several "generations" in larger population centers.

Quote

There is a lot about it (particularly the host) that isn't understood, but how and how easily it's transmitted is.

This is looking at least a little doubtful since there are seemingly conflicting statements concerning things like "no airborne transmission" yet the virus can be present in aerosol droplets from coughs or sneezes; "you can't catch it on a bus" yet "infected persons should stay off the bus"; a person can become infected with the introduction of as few as 1 - 10 virions ; survivability of the virus outside the body on various objects at various temps; etc.

Quote

And I hope like all hell that it's easier to control than the flu (influenza). Despite vaccines, education and prevention, there are still thousands to tens of thousands of deaths each year in the US.
But we don't really worry about that. It's "just the flu."

The Spanish flu pandemic, (almost 100 years ago ...even before "vaccines, education and prevention") had a Case Fatality Rate of "only" 10-20% ....way more than today's CFR for the flu, and now fewer folks are becoming infected because of the vaccines, education, & prevention. The CFR for the current Zaire Ebola outbreak is more like 70% for victims with "confirmed outcomes". We can only hope we can get to the level of control we now have with the flu. I think containment is the answer for the near future.

[Scubanaff 0]

Quote

It's NPR. What are they going to compensate him with? A tote bag or a coffee mug?

Npr NETS about $20 million per year.....

[billvon 2,990]

>This is looking at least a little doubtful since there are seemingly conflicting
>statements concerning things like "no airborne transmission" yet the virus can be
>present in aerosol droplets from coughs or sneezes;

Right. In other words, if someone sneezes in the next room you won't get it, but if someone sneezes on you and you get a big booger in your mouth, you might.

>"you can't catch it on a bus" yet "infected persons should stay off the bus";

Symptomatic people _should_ stay off public transportation. You won't catch it sitting on the same bus as an infected person, but if they are symptomatic and vomit on you, you might. (Infected but non-symptomatic is not contagious.)

>a person can become infected with the introduction of as few as 1 - 10 virions ;

Right. That's an example of how it's understood.

[Anvilbrother 0]

Quote

big booger in your mouth, you might.

The immediate vomit that would happen should clear you from any chance of infection lmao

Postes r made from an iPad or iPhone. Spelling and gramhair mistakes guaranteed move along,

[jakee 1,489]

Quote

This is looking at least a little doubtful since there are seemingly conflicting statements concerning things like "no airborne transmission" yet the virus can be present in aerosol droplets from coughs or sneezes; "you can't catch it on a bus" yet "infected persons should stay off the bus"; a person can become infected with the introduction of as few as 1 - 10 virions ; survivability of the virus outside the body on various objects at various temps; etc.

If you read conflicting news reports on the same skydiving fatality you'd probably come to the conclusion that no-one knows how parachutes work, but it's not the case.

Quote

The CFR for the current Zaire Ebola outbreak is more like 70% for victims with "confirmed outcomes". We can only hope we can get to the level of control we now have with the flu.

The second sentence of that Flu article begins with the words "It infected 500 million people". What in god's name do you mean by 'control'?

Ebola is incredibly easy to control compared to the flu. According to the fear mongers here everyone in the US from the local hospitals, PD, FD, CDC and border control has made a complete pigs ear of dealing with ebola... and nothing's happened. Everybody's fine.

Do you want to have an ideagasm?

[muff528 3]

jakee

Quote

This is looking at least a little doubtful since there are seemingly conflicting statements concerning things like "no airborne transmission" yet the virus can be present in aerosol droplets from coughs or sneezes; "you can't catch it on a bus" yet "infected persons should stay off the bus"; a person can become infected with the introduction of as few as 1 - 10 virions ; survivability of the virus outside the body on various objects at various temps; etc.

If you read conflicting news reports on the same skydiving fatality you'd probably come to the conclusion that no-one knows how parachutes work, but it's not the case.

Quote

The CFR for the current Zaire Ebola outbreak is more like 70% for victims with "confirmed outcomes". We can only hope we can get to the level of control we now have with the flu.

The second sentence of that Flu article begins with the words "It infected 500 million people". What in god's name do you mean by 'control'?

Ebola is incredibly easy to control compared to the flu. According to the fear mongers here everyone in the US from the local hospitals, PD, FD, CDC and border control has made a complete pigs ear of dealing with ebola... and nothing's happened. Everybody's fine.

That's my point. A century ago, when the Spanish Flu pandemic was out of "control" (no vaccines, education or prevention), it only produced a
Also, to answer billvon-- I "get" that the advertised contagious state is only when the patient is symptomatic. But a symptomatic person is not likely to be on a bus. However, an infected person who is not yet symptomatic still carries the virus at some stage of that infection. If he happens to sneeze for any reason, firing off a booger or two, there is a chance, however small, that said booger may have a virion or two riding along (that's all it takes) ...maybe more. If the booger enters the mouth of a fellow traveler and he somehow manages to not immediately puke it up he could be infected. Small chance but not zero. I'll take that chance riding on a bus with someone who has the flu. If he's got Ebola and I have a choice, I'm not getting on that bus.

Dammit, I just realized I missed the ISS flyover. Perfect night for it, too!