Ebola outbreak - general thread #8

[SteveS]

The day before Duncan arrived we didn't have any cases. I am not convinced that no one else with ebola will enter other then Dr's that have treated people with it. I will error on the side of caution as long as they are just doing temp checks, you know like the one that Duncan did.

From what I understand
(1) all the testing in the world wouldn't have detected ebola in Duncan as he entered the US
(2) but Duncan traveled before the temp checks began
(3) the protocols in place now are completely different from when Duncan traveled, including all of the following
a - temp check taken of every passenger who leaves any of those W African nations
b - any coming to the US can only enter through 1 of 5 specific airports
c - all of those are then monitored for temp as they enter
d - there is also a Q&A to determine how much risk this passenger had
e - some (including all HCW's) get automatically quarantined for 21 days
f - the others, classed as low risk, are educated, and then monitored for 21 days with mandatory twice-daily checks for symptoms - every last one of them
(4) All of that is completely different from how Duncan was handled, who entered the US without much notice of anyone, and no one (given the protocols at that time) gave much thought to him actually having ebola. A few days later he went to the hospital and was sent home. If it happened today, there'd be a 3-ring circus with his arrival at the hospital, and hazmat suits everywhere before he even got there.
(5) Since there is no way to detect the virus when someone has just been infected, there is literally no way to detect every infected person who comes into the US. It can't be done.
<modsnip>
(8) One other important point: let's understand that the awareness and sensitivity to this disease has undoubtedly also been heightened among those people who are entering from Africa. Common sense says that when they enter the US and go through all this screening, they become as vigilant as can be, because if they have it, they don't want to infect friends or delay treatment for even a day.

 

[jjenny]

Family of patient zero took measures that may have stopped spread of Ebola

http://www.wfaa.com/story/news/heal...ion-ebola-spread-stop-contamination/17632771/

It was reported before that he slept on every mattress, which sounded very bizarre. Now we find out he was kept in a separate room. I think it's rather obvious they suspected he had Ebola (or at least some infectious disease) and took measures to protect themselves by isolating him.

 

[IMO]

If humans were that bad at assessing risk there wouldn't be 6+ billion of us crowding the planet and we wouldn't be the Apex predator.

Do not discount instinct. It is all about sensing a threat and reacting. If you react and the threat was false then it is a good laugh, if you don't react and the threat is real...well then....you are a statistic.

Emotion drives our risk perception, not facts. There is ample evidence that we do not perceive risk based on fact. I have put some articles below. IMO the reason there are 6 billion of us on earth has everything to do with science (antibiotics, sanitation, vaccines, food tech) and very little to do with individual instinct. I really cannot think of a time when a gut feeling has saved my life, though in fairness if the gut feeling worked then I would really have no way to know that it saved me. Science, OTOH, has saved my life at least twice.

The fact that our fear of Ebola (US deaths=1) supersedes our fear of influenza (US deaths/year= 20,000) highlights this, as does the burgeoning fear of vaccinations. The problem is that while our perception of risk is very often incorrect, at the same time this phenomenon cannot be ignored when trying to communicate public health information. We just haven't quite figured out how to do it yet. IMO, as ever.

http://blogs.nature.com/soapboxscience/2011/05/11/risk-perception

http://scienceblogs.com/thepumphand...rceive-risk-paul-slovics-landmark-analysis-2/

http://www.psychologytoday.com/blog...erception-are-we-doomed-because-we-get-risk-0

http://www.pbs.org/wgbh/nova/body/risk-perception.html

http://bigthink.com/risk-reason-and...sk-perception-and-politics-put-us-all-at-risk

 

[Ladylub]

Respectfully, I wasn't aware that health care workers could pick & choose what diseases they would treat. When I was a child back in the 1940s I contracted polio which at the time was a deadly disease. I was still contagious at the time I was admitted to the hospital. Thankfully the nurses who took care of me were extremely kind & caring. I might not be here today if they had shunned me.

Since these nurses work in the hospital they would know if they are ready to help cure this Dr of Ebola. They are the ones that know if they are fully trained to help and know if their PPE would keep them safe. Those that bowed out are more than likely not a good fit for helping an Ebola patient to begin with. Would you want someone who clearly is scared of you, treating with you? Ill take the one that is confident in their training.

Why have these 4 Ebola ready hospitals if Ebola patients are not moved there as quickly as possible? They were trained for this. While hospitals like Presby didn't even have the proper PPE to handle a virus like Ebola. And only after the HCW got sick did the CDC realize well you know we went in dressed head to toe to keep Ebola off us maybe that is how it should be for everyone.

 

[Elley Mae]

From what I understand
(1) all the testing in the world wouldn't have detected ebola in Duncan as he entered the US
(2) but Duncan traveled before the temp checks began
(3) the protocols in place now are completely different from when Duncan traveled, including all of the following
a - temp check taken of every passenger who leaves any of those W African nations
b - any coming to the US can only enter through 1 of 5 specific airports
c - all of those are then monitored for temp as they enter
d - there is also a Q&A to determine how much risk this passenger had
e - some (including all HCW's) get automatically quarantined for 21 days
f - the others, classed as low risk, are educated, and then monitored for 21 days with mandatory twice-daily checks for symptoms - every last one of them
(4) All of that is completely different from how Duncan was handled, who entered the US without much notice of anyone, and no one (given the protocols at that time) gave much thought to him actually having ebola. A few days later he went to the hospital and was sent home. If it happened today, there'd be a 3-ring circus with his arrival at the hospital, and hazmat suits everywhere before he even got there.
(5) Since there is no way to detect the virus when someone has just been infected, there is literally no way to detect every infected person who comes into the US. It can't be done.
<modsnip>
(8) One other important point: let's understand that the awareness and sensitivity to this disease has undoubtedly also been heightened among those people who are entering from Africa. Common sense says that when they enter the US and go through all this screening, they become as vigilant as can be, because if they have it, they don't want to infect friends or delay treatment for even a day.

C.D.C. officials said they were able to find the record of Mr. Duncan&#8217;s airport screening in Monrovia when he left the country and, with a temperature of 97.3 degrees, it clearly indicated that he did not have a fever.

http://www.nytimes.com/2014/10/03/w...ent-thomas-duncan-airport-screening.html?_r=0

bbm Since the above cancels out the rest until #6 and I can't respond honestly without getting a TO, #7 as well. He was temp checked and he lied on the form. So imo people trying to travel from those countries and those effected countries only should not be able to travel to the usa until there are no new cases from THERE for 21 days.jmo idk

 

[jjenny]

Incubation period is up to 21 days (and maybe even longer).
Neither Mr. Duncan nor Dr. Spencer had a fever upon arrival in the US.
So checking temperatures in the airport is not going to catch everybody by any means.

 

[RR0004]

[h=1]After Negative Ebola Test, Quarantined Nurse Criticizes Treatment at Newark Airport[/h]
http://www.nytimes.com/2014/10/26/nyregion/nurse-in-newark-tests-negative-for-ebola.html?_r=0

 

[CarmelEyesD]

Temp screening at the airport shows you do not have a fever at that time. It does not show if you might have one tomorrow or the next day.

 

[Elley Mae]

Temp screening at the airport shows you do not have a fever at that time. It does not show if you might have one tomorrow or the next day.

Exactly, but it makes the public, "feel good" that something is being done, what's being done is a waste of time. Until they radicate it from there AND stopping people from flying into this country it will not be stopped until a vaccine is available. jmo idk

 

[trigger]

Family of patient zero took measures that may have stopped spread of Ebola

http://www.wfaa.com/story/news/heal...ion-ebola-spread-stop-contamination/17632771/

I wish they would have told us this in the beginning. I was so worried for the children. I still have been worried lol but....

 

[Bonnie2487]

[h=1]After Negative Ebola Test, Quarantined Nurse Criticizes Treatment at Newark Airport[/h]
http://www.nytimes.com/2014/10/26/nyregion/nurse-in-newark-tests-negative-for-ebola.html?_r=0

Why is she in a tent? I do not think that is the way to treat her.

 

[jjenny]

Why is she in a tent? I do not think that is the way to treat her.

I don't think she is in the tent. Article says she is in the building.

 

[Sonya610]

Family of patient zero took measures that may have stopped spread of Ebola

http://www.wfaa.com/story/news/heal...ion-ebola-spread-stop-contamination/17632771/

WOW. Just.....wow!

The media said it, therefore it must be true.

They immediately bought gloves and bleach and disinfected the apartment (spraying bleach on the carpet among other things). Then they had to have food and other supplies delivered. Then the kid/s went to school during the quarantine.

But as it turns out they saved a LOT of lives because they were SO CAREFUL and so KNOWLEDGEABLE!

They are heroes. Truly.

 

[chipmunk]

The Chicago Tribune is usually pretty good but the author writes incorrectly that the doctor returning from Guinea to New York "came back infected." It's a poor choice of words since it implies he was sick and contagious went be arrived. Medically, he is only considered to have the ebola virus, eg, be infected when symptoms, especially a fever occur.

What I mean is infected is a scary word for the public vs exposed. It's true ebola (enough of the virus) is very, very likely to cause infection, ok be infected, and for the person to then develop the active disease.
Compare this to MRSA where most exposed just become carriers. Are MRSA carriers infected? They have the bacteria in their body, in their blood. So I guess they are. But they don't have an infection, a localized lesion, sore on their skin or manifestations such as sepsis.

I was just thinking about exposure vs an active infection but this depends on which virus or bacteria we're talking about. Does anybody understand what I'm trying to say?

 

[jjenny]

Yea, we are getting lots and lots of conflicting information here. First we are told Mr. Duncan slept on all mattresses in the apartment. Now it's the opposite, he was isolated and they bleached everything. Not sure what is the truth.

 

[trigger]

Incubation period is up to 21 days (and maybe even longer).
Neither Mr. Duncan nor Dr. Spencer had a fever upon arrival in the US.
So checking temperatures in the airport is not going to catch everybody by any means.

Yup ITA...Maybe they took a handful of excedrin to..Who knows.

 

[Sonya610]

Yea, we are getting lots and lots of conflicting information here. First we are told Mr. Duncan slept on all mattresses in the apartment. Now it's the opposite, he was isolated and they bleached everything. Not sure what is the truth.

The truth exited the building a while ago.

 

[WichitaFalls]

Obviously health protocols regarding Ebola since Mr. Duncan's demise in Dallas have improved by leaps and bounds in a short time frame. But . . . imo stupid mistakes such as the NJ nurse's experience upon arriving back in the U.S. Are you kidding me? Shameful. Disorganized. Clueless. Unprofessional. and Insensive. Bravo to the nurse for voicing her experiences and I send my thoughts and prayers to a very brave woman. We need level heads and good hearts - they seem to be in short supply. I'm super surprised that the officials New York made the travel restrictions they did without any input from scientist. Wow.

 

[nrdsb4]

Yea, we are getting lots and lots of conflicting information here. First we are told Mr. Duncan slept on all mattresses in the apartment. Now it's the opposite, he was isolated and they bleached everything. Not sure what is the truth.

If you have to choose one to believe, given that these very close contacts remain healthy, it would seem perhaps they knew to be very very careful. Seems to me if that didn't have a clue, at least one of those people should be sick by now.

 

[Sonya610]

If you have to choose one to believe, given that these very close contacts remain healthy, it would seem perhaps they knew to be very very careful. Seems to me if that didn't have a clue, at least one of those people should be sick by now.

Yeah I don't think it was because they were careful. Resistant? Maybe.

Nothing about that situation was "careful".

Can you imagine disinfecting an apartment INCLUDING spraying bleach on the carpet? Can you? If you were that "careful" you wouldn't even TRY to disinfect the carpet, and you would NOT send your potentially exposed child to school after being told you were in isolation.

You also wouldn't sit in the apartment after "bleaching it" for days and complain about it. You would get yourself and your kids OUT OF THERE and demand sanitary quarters.

Be realistic here.