Ebola outbreak - general thread #9

[faw720]

So now we have another disease to worry about. Chikungunya, a virulent mosquito-borne illness with no known cure is sweeping the Caribbean. 1500 U. S. citizens have contracted the disease & brought it back to the U.S. Previously the U. S. only had about 30 cases annually. The good news is that is rarely fatal, but the symptoms sound like they could make someonewish they were dead.

It seems to me the only way to stop diseases here is to ban all travel to & from the U.S. I'm certainly not advocating that, but am just pointing out that it would be the only way we could avoid fear of previously unknown diseases here in America.

http://www.yahoo.com/travel/what-you-need-to-know-about-the-mosquito-borne-disease-101983478952.html

 

[SteveS]

(above, bbm)
And all I've ever said....was, if you are one of those people, who have come into contact with a highly contagious person...err on the side of caution and stay at home for 21 days.

I'd say that, if you don't have symptoms (a) self-monitor diligently, (b) avoid crowds, and (c) otherwise live your life since you can't infect anyone. In other words, follow the protocols in place. And as long as no one shines a spotlight on such people, the people who are scared when there's no reason won't be alarmed.

Part of the problem imo is being afraid of the person who can't infect you - that is irrational fear. When you cater to that irrational fear, it makes people more afraid rather than less.

The way to get past it is to force people to ignore such fear, rather than honor it.

Some people have mentioned, and I think it's insightful, that this is like the AIDs scare era, when people were afraid of catching something they couldn't really catch via casual contact. The solution wasn't to shove the "who knows if they are infected" person into a back room, but rather to educate and just go on with life. In time, when people saw that life continued and people were not catching AIDs by casual contact, the fear went away and life went on.

Ultimately imo this will be resolved the same way. The pols, now that elections are over, will eventually revise the rules in all locales to a level that's similar to what Kaci Hickox has, there won't be this spotlight on people who are simply being monitored but who bear no risk to others, and the scare will go away.

And in hindsight, Nurse Amber's actions were exactly right. She did her job, and then was cautious, but she went about her life according to the safety protocols for protecting others. She infected no one. She went to a hospital when she first had symptoms, protecting herself. She did good. I want nurses catering to the safety protocols that protect them and us, and freed to do so, not to the whims of public opinion and fears.

 

[oh_gal]

I'd say that, if you don't have symptoms (a) self-monitor diligently, (b) avoid crowds, and (c) otherwise live your life since you can't infect anyone. In other words, follow the protocols in place. And as long as no one shines a spotlight on such people, the people who are scared when there's no reason won't be alarmed.

Part of the problem imo is being afraid of the person who can't infect you - that is irrational fear. When you cater to that irrational fear, it makes people more afraid rather than less.

The way to get past it is to force people to ignore such fear, rather than honor it.

Some people have mentioned, and I think it's insightful, that this is like the AIDs scare era, when people were afraid of catching something they couldn't really catch via casual contact. The solution wasn't to shove the "who knows if they are infected" person into a back room, but rather to educate and just go on with life. In time, when people saw that life continued and people were not catching AIDs by casual contact, the fear went away and life went on.

Ultimately imo this will be resolved the same way. The pols, now that elections are over, will eventually revise the rules in all locales to a level that's similar to what Kaci Hickox has, there won't be this spotlight on people who are simply being monitored but who bear no risk to others, and the scare will go away.

And in hindsight, Nurse Amber's actions were exactly right. She did her job, and then was cautious, but she went about her life according to the safety protocols for protecting others. She infected no one. She went to a hospital when she first had symptoms, protecting herself. She did good. I want nurses catering to the safety protocols that protect them and us, and freed to do so, not to the whims of public opinion and fears.

But she didn't avoid crowds. And, after the fact, the directives given to her that it was ok to fly were later rescinded, as mistaken information.

 

[SteveS]

Again, the majority of people infected are UNABLE to recall how they may have been infected. No one describes being sprayed or soiled by body fluids of any kind and all wore PPE of varying degrees.

If transmission only occurs via body fluids, HOW did these people get sick?

Obviously, when a person is in the last stage, it's really nasty stuff, and fluids are flying everywhere with extremely potent virus. The description of what happened with Duncan is horrendous - unexpected and frequent projectile vomiting, frequent massive unstoppable diarrhea, and fluids everywhere. A constant cleanup process, while also trying to care for a patient.

IMO the puzzling part isn't "how did two nurses catch it from him" but rather how did others avoid catching it.

 

[SteveS]

But she didn't avoid crowds. And, after the fact, the directives given to her that it was ok to fly were later rescinded, as mistaken information.

But, why was it a "mistake"? The CDC knew she wasn't contagious, and flying didn't change that. They didn't suddenly change their minds about whether she was truly putting others at risk in that action. And after the fact, we have confirmation that indeed, it was inconsequential.

 

[oh_gal]

But, why was it a "mistake"? The CDC knew she wasn't contagious, and flying didn't change that. They didn't suddenly change their minds about whether she was truly putting others at risk in that action. And after the fact, we have confirmation that indeed, it was inconsequential.

I am not the one who made the "mistake" statement, although I agree with it. You'll have to ask the CDC that, not me. Here's what they said:
"The CDC later said it was a mistake to allow Vinson fly. The health agency sent out a request to all passengers on the same flight as Vinson to contact the CDC. "
From this article:
http://www.ibtimes.com/dallas-ebola...was-ok-fly-after-thomas-duncans-death-1720092

 

[Muffet]

http://www.forbes.com/sites/fayefla...-doctors-fumbled-in-communicating-ebola-risk/

I hope everyone will read it through. It's not long.

I know there's a lot of frustration by scientists over so many absolutes being thrown around in the name of science, by people who don't know the science of this virus, the limited history we have of it.

People who remember learning about the scientific method lose trust when people try to force them not to panic, especially if they are snarky about it and demonstrate their lack of understanding of science, statistics, and logic at the same time.

I've had dozens ask me how afraid they should be. They walk away feeling more confident, because they know I know what can be known, don't try to bs them, and I don't insult their intelligence.

I have said from the start that being so focused on preventing panic will only create more, and that's exactly what has happened.

There is still very little to fear about catching it, but people need to stop whistling by the graveyard and saying "no chance" if they want to influence anyone.

There are serious costs involved that should not be as blithely dismissed as they are.

People are not as blind as they would need to be to swallow assurances that come with an agenda of any kind.

Like I said weeks ago - keep pinging people's hinky meters, and you only lose trust and create more fear.

And if I may be so bold, I think members should be verified scientists in virology, infectious disease, or microbiology before we are allowed to state "scientific facts" without a *scientific paper* or an "imo" here.

Until then, remember, science speaks in terms of probabilities. Statistics account for all variables.

And true science and math doesn’t let itself be swayed by fear, fear OF fear, or the fallacy of consequences of exposing the truth.


Via Tapatalk

 

[SteveS]

I am not the one who made the "mistake" statement, although I agree with it. You'll have to ask the CDC that, not me. Here's what they said:
"The CDC later said it was a mistake to allow Vinson fly. The health agency sent out a request to all passengers on the same flight as Vinson to contact the CDC. "
From this article:
http://www.ibtimes.com/dallas-ebola...was-ok-fly-after-thomas-duncans-death-1720092

Just so you know, the word "mistake" was not a word used by CDC, although they did backtrack on whether she should have taken a commercial flight. Their actual comment is in this article
http://mashable.com/2014/10/15/dallas-ebola-frontier-airline-nurse/

My guess is that the issue with commercial flights and large crowds is less an issue of actual exposure, and more an issue of the over-abundance of caution tracking-and-monitoring they do after someone comes down with the disease. It's a smaller pain in the butt to go to that extent when there are fewer in the mix.

We have to recognize that if it was TRULY a risk, they should be kept away from everyone, even just a few. But they don't.

In addition, even today they allow others in the identical situation as Nurse Amber to fly, so we have to consider that perhaps the reason why Nurse Amber "should not have" flown may have been more about the hysteria and the politics of the moment, and the perceived need to tell the public that "we're doing something," which have since changed.

 

[winnnancy]

To be clear, the ebola issue under discussion is not one of accommodating "public safety" but rather "irrational public fears."

Yes I must self-monitor my actions to keep from harming others in an accident. But I am allowed to buy a red car, even if it makes someone scared because they think of blood when they see red.

Fact is, despite the fears, no one is catching ebola by traveling next to someone else who has been exposed but has no symptoms. In fact, despite the fears, no one out in public has ever caught ebola anywhere in the US. Ever. Two nurses, in a hospital room treating a HIGHLY contagious person they knew had ebola, while he's spewing bodily fluids everywhere, are the only transmissions of the disease at any time and in any place in the US.

So, there's a lesson to learn. If you are scared and want to avoid ebola, stay out of hospital rooms with patients who have ebola projectile vomiting, sweating, and diarrhea everywhere. That's a rational thing to fear. We also hear you might avoid hugging the dead body, if your family member or friend dies from ebola -- but since no one is dying from ebola in the US, that's probably not a real issue for anyone.

Otherwise this thing isn't gonna chase you down and catch you. I'm far from worried. But, be scared if you wish.

Buying a red car is like choosing to hang out in sweat pants while quarantined vs dress slacks. Some people will just say you're a slob. It doesn't matter that some people associate the red car with blood or wearing sweat pants with being lazy, the point is you're self monitoring your actions TO KEEP FROM HARMING OTHERS in an accident just as you're acting responsibly by keeping away from others when you may be potentially infectious TO KEEP FROM POTENTIALLY HARMING OTHERS.

A point I made is that many of the people who have been infected are unable to identify when they were infected. In fact, there are no statistics on asymptomatic people passing it on. Just because there is no scientific evidence, doesn't mean it can't happen. Truly, how do you study such a group? You'd have to have people confirmed infected but asymptomatic and expose healthy uninfected people to them, continuously test them for "seroconversion" to occur( Interestingly in HIV, in 80% this is a flu-like ill period- 20% will be asymptomatic) ). There is a window period as well during which tests can be false positive. It appears that in the case of ebola the quarantine is for this window period. plus the longest( with a safety margin) sero conversion period.
While ebola is not HIV, there are many variables and not all are a known at this time.

None of the infected people know how and when they were infected precisely. None say they were spattered or soiled with body fluids.

aidsmap.com

 

[oh_gal]

Just so you know, the word "mistake" was not a word used by CDC, although they did backtrack on whether she should have taken a commercial flight. Their actual comment is in this article
http://mashable.com/2014/10/15/dallas-ebola-frontier-airline-nurse/

My guess is that the issue with commercial flights and large crowds is less an issue of actual exposure, and more an issue of the over-abundance of caution tracking-and-monitoring they do after someone comes down with the disease. It's a smaller pain in the butt to go to that extent when there are fewer in the mix.

We have to recognize that if it was TRULY a risk, they should be kept away from everyone, even just a few. But they don't.

In addition, even today they allow others in the identical situation as Nurse Amber to fly, so we have to consider that perhaps the reason why Nurse Amber "should not have" flown may have been more about the hysteria and the politics of the moment, and the perceived need to tell the public that "we're doing something," which have since changed.

I didn't insert the word "mistake" in my quote to make it sound more sensationalistic. I quoted what I did, verbatim.
It's interesting that they have allowed others to fly who had just been caring for someone with ebola who then died, and who flew when they had a co-worker they worked with contract ebola from the same person who later died, and who then went on to contract ebola themselves, and who, by their own admission, has no idea how they could have contracted ebola. Do you happen to have a link to those instances?

And if you look at the article you mentioned in your text, the very headline of it is, "Nurse Shouldn't Have Flown to Cleveland."

 

[SteveS]

Buying a red car is like choosing to hang out in sweat pants while quarantined vs dress slacks. Some people will just say you're a slob. It doesn't matter that some people associate the red car with blood or wearing sweat pants with being lazy....

Nope.

The assertion you made was that it's legitimate, normal, and proper to cater to the irrational ears of others. My red car analogy was illustrating how we do NOT otherwise cater to the irrational fears of others, nor do we feel any need to honor or legitimize them. If people have them, that's their biz but not something that needs to alter the lives of everyone else.

If people can't catch ebola from an asymptomatic person, for a plethora of reasons that have been determined to be definitive, then they can't. They pose no danger to others. So, when others fear them, even though they present no danger, what next? Catering to irrational fear is the wrong response imo.

 

[SteveS]

I didn't insert the word "mistake" in my quote to make it sound more sensationalistic. I quoted what I did, verbatim.

I didn't say it was your word. You read an article that in essence characterized the words of the CDC, and used the descriptive word from the article. But I wanted you to be aware that the CDC did not use the word "mistake." I provided the article with the CDC's actual words, in case you are interested.

And, in relation to in what reasoning was underlying their view that they "should not have" let her fly, we don't know their minds, but I will reiterate my guess at their thinking.

1 Possibly the issue with commercial flights and large crowds is less an issue of actual exposure, and more an issue of the over-abundance of caution tracking-and-monitoring they do after someone comes down with the disease. It's a smaller pain in the butt to go to that extent when there are fewer in the mix.

2 We have to recognize that if being around people was TRULY the risk, they should be kept away from everyone, even if it's just a few. But they don't require that.

3 It's also informative that even today they allow some of the others in the identical situation as Nurse Amber (have been exposed, but show no symptoms) to fly. So we have to consider that perhaps the reason why Nurse Amber "should not have" flown may have been more about the hysteria and the politics of the moment, and the perceived need to tell the public that "we're doing something," which have since changed.

 

[SStarr33]

Amber said in her CNN interview with Don Lemon that her neck was covered at all times.

http://www.cnn.com/2014/11/06/health/amber-vinson-ebola-nurse-interview/

 

[SStarr33]

http://www.lse.co.uk/AllNews.asp?code=56ob1jhg&headline=Ebola_Out_Of_Control_In_Guinea_Experts_Warn

Ebola "Out Of Control" In Guinea, Experts Warn

Thu, 6th Nov 2014 06:30

Better link:

http://www.dpa-international.com/ne...ts-warnby-kristin-palitza-dpa-a-43205613.html

 

[Sonya610]

In an interview with CNN, Amber Vinson says more training is needed. She still cannot identify what happened that led her to contract ebola. Her engagement ring was destroyed when her apartment was decontaminated so I think we might be able to assume that the decontamination was thorough. All persons who flew on the same planes with Amber have also been recently cleared.

http://www.dallasnews.com/news/loca...ho-caught-ebola-says-more-training-needed.ece

Huh? How did her engagement ring get destroyed? I can see not wearing it if one has to wear surgical gloves but she just came back from a trip to buy dresses.

Oh and that sort of "thorough decontamination" of personal possessions is why people are WORRIED about Ebola!

Contrary to popular belief the folks that are upset over Ebola in this country are not just paranoid and ignorant, the situation was VERY badly handled by the authorities and an Ebola diagnosis comes with a MAJOR loss of property and personal rights and seriously endangers companion animals.

 

[SteveS]

Contrary to popular belief the folks that are upset over Ebola in this country are not just paranoid and ignorant, the situation was VERY badly handled by the authorities and an Ebola diagnosis comes with a MAJOR loss of property and personal rights and seriously endangers companion animals.

Yes, ebola is a bad thing to get. Don't catch it.

But no, people in the US are not being put at risk in the general public. If they wander into a hospital room with a dying ebola patient, there's good reason to be afraid of catching the disease - otherwise, not really. Being fearful of catching it in public in the US is indeed, to use your terminology, "paranoid and ignorant," or I prefer to simply say it's irrational.

 

[Detective Klimpt]

Huh? How did her engagement ring get destroyed? I can see not wearing it if one has to wear surgical gloves but she just came back from a trip to buy dresses.

Oh and that sort of "thorough decontamination" of personal possessions is why people are WORRIED about Ebola!

Contrary to popular belief the folks that are upset over Ebola in this country are not just paranoid and ignorant, the situation was VERY badly handled by the authorities and an Ebola diagnosis comes with a MAJOR loss of property and personal rights and seriously endangers companion animals.

Exactly Sonya. I must have posted similarly several times. Why did Amber's home have to be decontaminated when she was just at the early stages?? Anyone? And why is Dr. Spencer's fiance on 'mandatory' quarantine when his fever was only 100.3? Anyone?

I'm not paranoid or worried at all at this point about catching Ebola <mod snip>It really bugs me that so many non-usa-citizens from W. Africa are entering the country and creating so many problems.

 

[SteveS]

I just feel very strongly that there should be a visa ban on non-essential travel into and out of Ebolaland, at least until they get the disease under control. It really bugs me that so many non-usa-citizens from W. Africa are entering the country and creating so many problems.

This is the "restriction" that does make sense to me. Other than HCWs, going to and from, I've never understood reasoning to justify random travelers into the US from those countries, and vice versa.

 

[faw720]

Huh? How did her engagement ring get destroyed? I can see not wearing it if one has to wear surgical gloves but she just came back from a trip to buy dresses.

Oh and that sort of "thorough decontamination" of personal possessions is why people are WORRIED about Ebola!

Contrary to popular belief the folks that are upset over Ebola in this country are not just paranoid and ignorant, the situation was VERY badly handled by the authorities and an Ebola diagnosis comes with a MAJOR loss of property and personal rights and seriously endangers companion animals.

I assume she left her engagement ring at home. Had she worn any jewelry to the hospital she would have been required to send it home & since she is a nurse, she would have known this. Apparently the decontamination team took everything in her home & destroyed it. When Nina was diagnosed with ebola, the news widely publicized that there was a dog in her apartment. I do not know this but suspect that someone from the SPCA immediately went into action to save Bentley. Poor little guy probably barely missed the executioner.

I have never said that anyone was just paranoid & ignorant. I simply do not understand the excessive fear. And yes, I agree the situation was initially handled badly. I continue to hope that lessons have been learned by officials & medical personnel.

 

[nrdsb4]

Buying a red car is like choosing to hang out in sweat pants while quarantined vs dress slacks. Some people will just say you're a slob. It doesn't matter that some people associate the red car with blood or wearing sweat pants with being lazy, the point is you're self monitoring your actions TO KEEP FROM HARMING OTHERS in an accident just as you're acting responsibly by keeping away from others when you may be potentially infectious TO KEEP FROM POTENTIALLY HARMING OTHERS.

A point I made is that many of the people who have been infected are unable to identify when they were infected. In fact, there are no statistics on asymptomatic people passing it on. Just because there is no scientific evidence, doesn't mean it can't happen. Truly, how do you study such a group? You'd have to have people confirmed infected but asymptomatic and expose healthy uninfected people to them, continuously test them for "seroconversion" to occur( Interestingly in HIV, in 80% this is a flu-like ill period- 20% will be asymptomatic) ). There is a window period as well during which tests can be false positive. It appears that in the case of ebola the quarantine is for this window period. plus the longest( with a safety margin) sero conversion period.
While ebola is not HIV, there are many variables and not all are a known at this time.

None of the infected people know how and when they were infected precisely. None say they were spattered or soiled with body fluids.

aidsmap.com

You don't have to be spattered to be infected. Taking off the equipment is difficult and carries risk. It is very possible to make a mistake. Making a mistake doesn't mean the caregiver is careless, just that they are human. Caregivers get tired, their buddy gets tired. It doesn't take a big contamination to infect someone when the patients are in the very sick stage and shedding tons of virus. Anything on a glove which is not removed absolutely correctly can contaminate the hand. People unconsciously touch their faces hundreds of times per day. It's really that easy.

Any health care worker who says that they cannot make a mistake or has never made a mistake is someone to be wary of.

We know that you have to make contact with body fluids to become infected. Someone who says they don't know how they were infected is not indicative that they did not come in contact with body fluids, just that they don't know when it happened. It doesn't indicate anything sinister or that it's possible to get ebola without coming into direct contact with body fluids. It also does not indicate that there are asymptomatic people infecting others.