Frontline - Ebola Outbreak
October 10, 2014 5:15 PM Subscribe
Frontline - Ebola Outbreak 30-minute Frontline piece on Ebola outbreak in Sierra Leone televised in September 2014. It shows the human toll of the disease by interviewing doctors, aid workers, and family members.
That was absolutely heartbreaking. I'm tempted to leave 4000+ dots in this thread.
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posted by dialetheia at 5:58 PM on October 10, 2014 [2 favorites]
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posted by dialetheia at 5:58 PM on October 10, 2014 [2 favorites]
That was absolutely heartbreaking
Yes, absolutely. I was impressed when the father managed to somehow find the energy to watch a video message from his kids.
posted by Nevin at 6:11 PM on October 10, 2014 [5 favorites]
Yes, absolutely. I was impressed when the father managed to somehow find the energy to watch a video message from his kids.
posted by Nevin at 6:11 PM on October 10, 2014 [5 favorites]
Medical workers fighting the Ebola scourge are heroes.
posted by oceanjesse at 6:22 PM on October 10, 2014 [13 favorites]
posted by oceanjesse at 6:22 PM on October 10, 2014 [13 favorites]
Médecins Sans Frontières really seem to be the only adults in the room. Or, the only adults in the room that have a media presence, anyway. They launched their emergency response in March. Their website has a "notes from the field" section which give a feeling for what it's like working in their clinics:
And in more bad news, Marburg in Uganda...
posted by BungaDunga at 6:51 PM on October 10, 2014 [19 favorites]
Journalists come to film staff in exotic yellow hazmat suits, to photograph tanned, exhausted expatriate aid workers, and then they go home and tell the story of the poor Africans and the brave foreigners who came to save them. They are in love with the romance of the dirt roads and killer virus, but miss the outrage and helplessness we are living every day. We see entire villages wiped out, we follow the tangled webs of extended families as one by one they become sick and die.Of course this is not journalism, and not unfiltered- MSF has their own point of view- but it's a very different view than I've seen in the media.
And in more bad news, Marburg in Uganda...
posted by BungaDunga at 6:51 PM on October 10, 2014 [19 favorites]
NOVA also just aired an Ebola episode, which I highly recommend.
posted by desjardins at 7:05 PM on October 10, 2014 [4 favorites]
posted by desjardins at 7:05 PM on October 10, 2014 [4 favorites]
Here's the NOVA episode on YouTube if the PBS site is blocked for you.
posted by desjardins at 7:07 PM on October 10, 2014 [4 favorites]
posted by desjardins at 7:07 PM on October 10, 2014 [4 favorites]
The best thing about Ebola coming to the United States is the lesson it teaches us about how we should be controlling it at the source. Here's a great chance for the CDC to add a huge "let's build bush hospitals like crazy" line into its next budget.
posted by Camofrog at 7:19 PM on October 10, 2014 [4 favorites]
posted by Camofrog at 7:19 PM on October 10, 2014 [4 favorites]
Here's a great chance for the CDC to add a huge "let's build bush hospitals like crazy" line into its next budget.
I heard a story on the radio this morning about US National Guard soldiers preparing to deploy just for that purpose. I would happily support continued giant budgets for the DoD and American Army boots stomping all over the world if it meant deployments to build hospitals and infrastructure and actual humanitarian world-building missions.
You want to "restore America in the eyes of the world" (whatever the fuck that means), do some actual good with the resources we have.
posted by crush-onastick at 7:27 PM on October 10, 2014 [22 favorites]
I heard a story on the radio this morning about US National Guard soldiers preparing to deploy just for that purpose. I would happily support continued giant budgets for the DoD and American Army boots stomping all over the world if it meant deployments to build hospitals and infrastructure and actual humanitarian world-building missions.
You want to "restore America in the eyes of the world" (whatever the fuck that means), do some actual good with the resources we have.
posted by crush-onastick at 7:27 PM on October 10, 2014 [22 favorites]
The Department of Defense just voted to move $750m in war funds to fighting Ebola. 4000 people on the ground. I hope it works.
It bothers me every time I read a discussion of Ebola that centers around "should we be worried?" We should be worried for the people at risk. They are us too.
posted by fshgrl at 7:42 PM on October 10, 2014 [19 favorites]
It bothers me every time I read a discussion of Ebola that centers around "should we be worried?" We should be worried for the people at risk. They are us too.
posted by fshgrl at 7:42 PM on October 10, 2014 [19 favorites]
Médecins Sans Frontières really seem to be the only adults in the room.
They've been getting all my donation money for about the last 3 years. They really, desperately, need cash right now.
posted by Devils Rancher at 7:44 PM on October 10, 2014 [3 favorites]
They've been getting all my donation money for about the last 3 years. They really, desperately, need cash right now.
posted by Devils Rancher at 7:44 PM on October 10, 2014 [3 favorites]
oceanjesse: "Medical workers fighting the Ebola scourge are heroes."
Maybe we could pay them as such
I don't know, because, on the one hand, it seems like this is something you worry about AFTER the issue, on the other, they DO deserve to be fairly compensated, on the other, JESUS CHRIST THIS IS A DISASTER, on the other hand, forcing people to work without pay is slavery, on the other, WE ALL GON DIE!
(Seriously, though...)
posted by symbioid at 8:48 PM on October 10, 2014 [2 favorites]
Maybe we could pay them as such
I don't know, because, on the one hand, it seems like this is something you worry about AFTER the issue, on the other, they DO deserve to be fairly compensated, on the other, JESUS CHRIST THIS IS A DISASTER, on the other hand, forcing people to work without pay is slavery, on the other, WE ALL GON DIE!
(Seriously, though...)
posted by symbioid at 8:48 PM on October 10, 2014 [2 favorites]
Médecins Sans Frontières really seem to be the only adults in the room.
And Cuba which is training and sending hundreds of doctors and nurses.
posted by fshgrl at 9:02 PM on October 10, 2014
And Cuba which is training and sending hundreds of doctors and nurses.
posted by fshgrl at 9:02 PM on October 10, 2014
"The Department of Defense just voted..."
What?
posted by Exchequer at 9:11 PM on October 10, 2014 [1 favorite]
What?
posted by Exchequer at 9:11 PM on October 10, 2014 [1 favorite]
I guess the dept of Defense requested more but the Senate Armed Services Committee limited them to the $750m
posted by fshgrl at 1:14 AM on October 11, 2014
posted by fshgrl at 1:14 AM on October 11, 2014
The House voted. The House is a legislative body.
Friday, the Senate Armed Services Committee moved an inch toward agreeing to the same expenditure:
Sen. James Inhofe (R-Okla.), the ranking member on the Senate Armed Services Committee, lifted his hold Friday on the Pentagon’s request for $750 million to fight Ebola, clearing the way for the emergency funds to be released....
The Pentagon had asked Congress to approve a $1 billion transfer from its war funds account to use for its Ebola response plan. But lawmakers placed limits on the funds and demanded more information from the administration on the plan to fight Ebola.
Because, of course, right now is the time to be deliberative.
The UK is also sending 750 troops.
posted by dhartung at 1:19 AM on October 11, 2014 [1 favorite]
Friday, the Senate Armed Services Committee moved an inch toward agreeing to the same expenditure:
Sen. James Inhofe (R-Okla.), the ranking member on the Senate Armed Services Committee, lifted his hold Friday on the Pentagon’s request for $750 million to fight Ebola, clearing the way for the emergency funds to be released....
The Pentagon had asked Congress to approve a $1 billion transfer from its war funds account to use for its Ebola response plan. But lawmakers placed limits on the funds and demanded more information from the administration on the plan to fight Ebola.
Because, of course, right now is the time to be deliberative.
The UK is also sending 750 troops.
posted by dhartung at 1:19 AM on October 11, 2014 [1 favorite]
Ebola crisis: UK readiness for virus to be assessed in nationwide exercise... simulate symptoms of virus to test response of emergency services.
posted by Mister Bijou at 5:41 AM on October 11, 2014
posted by Mister Bijou at 5:41 AM on October 11, 2014
The best thing about Ebola coming to the United States is the lesson it teaches us about how we should be controlling it at the source.
True, but imposing our will on sovereign African nations smacks of neo-colonialism, even though they would be way better off given their weakness and corruption.
I would stop all international travel to and from West Africa for a month and let it burn itself out.
posted by Renoroc at 7:13 AM on October 11, 2014
True, but imposing our will on sovereign African nations smacks of neo-colonialism, even though they would be way better off given their weakness and corruption.
I would stop all international travel to and from West Africa for a month and let it burn itself out.
posted by Renoroc at 7:13 AM on October 11, 2014
It does smack of neocolonialism, but this outbreak might create a more receptive atmosphere. Cutting off travel will further destabilize the region, and that could make things even worse.
posted by Camofrog at 7:55 AM on October 11, 2014 [3 favorites]
posted by Camofrog at 7:55 AM on October 11, 2014 [3 favorites]
Cutting off international travel to and from West Africa will only make things worse. And it won't necessarily burn itself out- the people who have survived Ebola are immune to it, yes, but it's not clear, as far as I understand, that they couldn't be carriers going forward. And it's also not clear that the virus could develop a reservoir of hosts in other animals (dogs, cats, bats, what have you) that wouldn't show signs of infection but could infect humans. So closing off "West Africa" (whatever that is, in a region with extremely porous borders) is not the answer. And to add that it would be inhumane to cut off all the people living there from any sort of help.
posted by ambrosia at 10:19 AM on October 11, 2014 [4 favorites]
posted by ambrosia at 10:19 AM on October 11, 2014 [4 favorites]
I would stop all international travel to and from West Africa for a month and let it burn itself out.
This is possibly the least compassionate thing I have ever read here.
posted by dialetheia at 10:42 AM on October 11, 2014 [26 favorites]
This is possibly the least compassionate thing I have ever read here.
posted by dialetheia at 10:42 AM on October 11, 2014 [26 favorites]
That NOVA episode mentioned above was incredibly interesting and went into some detail about how ZMapp works, which was used to successfully treat Kent Brantley and Nancy Writebol. It seems quite promising, if they can get enough of it into production.
posted by Dr. Zira at 12:42 PM on October 11, 2014 [1 favorite]
posted by Dr. Zira at 12:42 PM on October 11, 2014 [1 favorite]
It does smack of neocolonialism, but this outbreak might create a more receptive atmosphere.
Yes and no.
Me, I put my faith in the private sector.
posted by IndigoJones at 12:45 PM on October 11, 2014
Yes and no.
Me, I put my faith in the private sector.
posted by IndigoJones at 12:45 PM on October 11, 2014
Ebola And Cultures Of Engagement: Chinese Versus Western Health Diplomacy – Analysis
posted by infini at 1:06 PM on October 11, 2014
posted by infini at 1:06 PM on October 11, 2014
The newest twist in the business of trying to capitalise on the outbreak of the Ebola virus is playing out in the US equity options market.
posted by infini at 1:07 PM on October 11, 2014
posted by infini at 1:07 PM on October 11, 2014
I wish that #CNN can stop talking about #Ebola. .. I mean really! ! Please somebody stop them! ! It is unbelievable! !
CNN Turns To Outbreak Fiction Writer For Ebola Coverage
Cook's theories on the transmission of Ebola are out of step with nearly every expert from international health agencies and the CDC. As Vox reported, "basically every health agency in the world agrees" that Ebola cannot be transmitted through the air. The CDC definitively says: "Ebola is not spread through the air or by water, or in general, by food."
posted by infini at 1:16 PM on October 11, 2014 [1 favorite]
CNN Turns To Outbreak Fiction Writer For Ebola Coverage
Cook's theories on the transmission of Ebola are out of step with nearly every expert from international health agencies and the CDC. As Vox reported, "basically every health agency in the world agrees" that Ebola cannot be transmitted through the air. The CDC definitively says: "Ebola is not spread through the air or by water, or in general, by food."
posted by infini at 1:16 PM on October 11, 2014 [1 favorite]
"basically every health agency in the world agrees" that Ebola cannot be transmitted through the air.
Currently. But we're talking virus, and they mutate, and it could happen. Probably won't, but it could.
posted by IndigoJones at 2:49 PM on October 11, 2014 [1 favorite]
Currently. But we're talking virus, and they mutate, and it could happen. Probably won't, but it could.
posted by IndigoJones at 2:49 PM on October 11, 2014 [1 favorite]
Yes. It must be terrifying to think of such an airborne danger from so far away able to mutate dangerously and decimate the population. But the troops will keep you safe.
posted by infini at 3:05 PM on October 11, 2014
posted by infini at 3:05 PM on October 11, 2014
At the risk of rehashing discussion from prior threads: http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
There's no reason to think that free Ebola RNA strands can successfully transit the air and cause infection the way many protein incased virii can, but there's reason to question old assumptions regarding spread via aerosols, that were I dealing with a case, my preference would be to err on the side of caution regarding respiratory protection.
IANAD
posted by The Legit Republic of Blanketsburg at 3:35 PM on October 11, 2014
There's no reason to think that free Ebola RNA strands can successfully transit the air and cause infection the way many protein incased virii can, but there's reason to question old assumptions regarding spread via aerosols, that were I dealing with a case, my preference would be to err on the side of caution regarding respiratory protection.
IANAD
posted by The Legit Republic of Blanketsburg at 3:35 PM on October 11, 2014
Yep, I know I said so in the other thread but since this is a new one and people may not have read them all, the line drawn between "airborne" and "spread via droplet (which can be sneezed or coughed)" is kind of arbitrary. If you are standing 5 feet from someone who coughs and you can catch it that way most people would call that "airborne" even though it technically isn't based on the strict definitions most medical people use.
posted by Justinian at 3:43 PM on October 11, 2014 [5 favorites]
posted by Justinian at 3:43 PM on October 11, 2014 [5 favorites]
I'm still not clear on how many medical professionals are contracting it, given that they're the best educated on transmission vectors AND they have the most access to protective gear. I am not prone to panic or paranoia, but that's what I find the most worrisome.
posted by desjardins at 4:00 PM on October 11, 2014 [1 favorite]
posted by desjardins at 4:00 PM on October 11, 2014 [1 favorite]
"In theory, theory and practice are the same" -Someone
People make mistakes, we make protocols and we train to minimize their frequency, but they do still occur. But bush-medicine is tough and the protective kit in some of these field clinics are improvised or absent, so thats a big one.
And then there's also the possibility of transmission via aerosols which aren't being procted against.
Resources are overtaxed and this means inadequate supplies and doctor to patient ratios which leads to compromises in safety.
Also, there's issues with burying the dead. Some places are getting survivors to help with this where they can, as they have resistance to the virus, but there are also place where the care teams are dealing with the bodies themselves and that's a risky manouver when your safety equipment is substandard/improvised.
posted by The Legit Republic of Blanketsburg at 5:24 PM on October 11, 2014 [1 favorite]
People make mistakes, we make protocols and we train to minimize their frequency, but they do still occur. But bush-medicine is tough and the protective kit in some of these field clinics are improvised or absent, so thats a big one.
And then there's also the possibility of transmission via aerosols which aren't being procted against.
Resources are overtaxed and this means inadequate supplies and doctor to patient ratios which leads to compromises in safety.
Also, there's issues with burying the dead. Some places are getting survivors to help with this where they can, as they have resistance to the virus, but there are also place where the care teams are dealing with the bodies themselves and that's a risky manouver when your safety equipment is substandard/improvised.
posted by The Legit Republic of Blanketsburg at 5:24 PM on October 11, 2014 [1 favorite]
This article from the NY Times magazine, "Dr. Matthew's Passion" was a pretty good profile of health workers in northern Uganda, and had a great description of the various hazards that lead medical professionals towards being exposed to it despite protective gear and training.
The tl;dr is that it's a combination of a) great volumes of patients and low staff presence leads to overwork and fatigue, along with constant exposure, b) protective gear having to be conscientiously and mindfully donned, used, washed and disposed of with every tour in and out of isolation zones, c) gear can be good at protecting or good at letting a health worker do their job, it's rarely ever both
ie. yes, you can wear goggles to protect your eyes. If those goggles fog up or if your eyes\face get sweaty and you need to wipe your face just so that you can see what you're doing, can you remember to do so with gloves that have been cleaned from all the blood that you've touched, or can you dispose of those gloves in a safe area where the blood on those gloves won't splash on to your skin? Can you do that every day perfectly? On four hours of sleep every day?
It'll catch up to you eventually. Do enough tours as a soldier, see enough battles, and eventually there's a bullet that will find its way into your armor.
posted by bl1nk at 5:29 PM on October 11, 2014 [3 favorites]
The tl;dr is that it's a combination of a) great volumes of patients and low staff presence leads to overwork and fatigue, along with constant exposure, b) protective gear having to be conscientiously and mindfully donned, used, washed and disposed of with every tour in and out of isolation zones, c) gear can be good at protecting or good at letting a health worker do their job, it's rarely ever both
ie. yes, you can wear goggles to protect your eyes. If those goggles fog up or if your eyes\face get sweaty and you need to wipe your face just so that you can see what you're doing, can you remember to do so with gloves that have been cleaned from all the blood that you've touched, or can you dispose of those gloves in a safe area where the blood on those gloves won't splash on to your skin? Can you do that every day perfectly? On four hours of sleep every day?
It'll catch up to you eventually. Do enough tours as a soldier, see enough battles, and eventually there's a bullet that will find its way into your armor.
posted by bl1nk at 5:29 PM on October 11, 2014 [3 favorites]
Even in the US, protective equipment (PPE) is incredibly cumbersome, and the dress and undress procedures are complex and physically demanding.
posted by rosswald at 4:40 AM on October 12, 2014
posted by rosswald at 4:40 AM on October 12, 2014
Second case in Texas: a Dallas healthcare worker who treated Thomas Duncan has now tested positive.
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said the worker had treated Duncan on multiple occasions..."Immediately when they developed symptoms, they isolated themselves, they were promptly isolated at the hospital so that any further spread from that individual was stopped," he said.
As a result of this new infection, Frieden said all health care workers who treated Duncan were now considered to be potentially exposed...Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said there "certainly had to have been an inadvertent, innocent breach of protocol of taking care of a patient within the personal protective equipment."
Frieden said the CDC will begin a full investigation of procedures, from before someone enters a patient's room, to caring for a patient, through the time that person leaves the room and removes protective gear. Removing it incorrectly can lead to contamination. The CDC also will look at "the interventions that were tried desperately to keep the index patient alive," including dialysis and intubation, which can spread infectious material...
"We know from many years of experience that it's possible to care for patients with Ebola safely without risk to health care workers," Frieden said. "But we also know it's hard. Even a single breach can result in contamination."
posted by mediareport at 8:25 AM on October 12, 2014 [1 favorite]
Dr. Tom Frieden, head of the Centers for Disease Control and Prevention, said the worker had treated Duncan on multiple occasions..."Immediately when they developed symptoms, they isolated themselves, they were promptly isolated at the hospital so that any further spread from that individual was stopped," he said.
As a result of this new infection, Frieden said all health care workers who treated Duncan were now considered to be potentially exposed...Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said there "certainly had to have been an inadvertent, innocent breach of protocol of taking care of a patient within the personal protective equipment."
Frieden said the CDC will begin a full investigation of procedures, from before someone enters a patient's room, to caring for a patient, through the time that person leaves the room and removes protective gear. Removing it incorrectly can lead to contamination. The CDC also will look at "the interventions that were tried desperately to keep the index patient alive," including dialysis and intubation, which can spread infectious material...
"We know from many years of experience that it's possible to care for patients with Ebola safely without risk to health care workers," Frieden said. "But we also know it's hard. Even a single breach can result in contamination."
posted by mediareport at 8:25 AM on October 12, 2014 [1 favorite]
Médecins Sans Frontières (MSF) aka Doctors Without Borders: MSF Ebola Blog
posted by Mister Bijou at 9:26 AM on October 12, 2014 [5 favorites]
posted by Mister Bijou at 9:26 AM on October 12, 2014 [5 favorites]
In addition to the Frontline and Nova pieces linked above, Vice recently posted a half-hour video report from Liberia, a half-hour tour of hospitals and streets in Monrovia called The Fight Against Ebola, that was pretty brave and eye-opening journalism, useful for understanding the horrifying challenges on the ground.
Also: Ebola Victim’s Family Blames Hospital and State:
Relatives of the first person to die of Ebola in the United States, joined by the Rev. Jesse L. Jackson Sr., continued on Saturday to denounce the treatment he and his family had received from a hospital here and from Texas officials, claiming that he had been cremated without their knowledge or permission and given substandard care because he was African...
They asked why Mr. Duncan had not been taken to Nebraska Medical Center, where two Americans who contracted the disease in West Africa have been treated. And they said the Dallas hospital, Texas Health Presbyterian, had not immediately informed them that Mr. Duncan had died and had led them to believe that he was still alive...
Mr. Jackson said the other Ebola victims in the United States “came back to Atlanta and Nebraska, got quick treatment and early treatment, and their lives have been spared.”
posted by mediareport at 2:23 PM on October 12, 2014
Also: Ebola Victim’s Family Blames Hospital and State:
Relatives of the first person to die of Ebola in the United States, joined by the Rev. Jesse L. Jackson Sr., continued on Saturday to denounce the treatment he and his family had received from a hospital here and from Texas officials, claiming that he had been cremated without their knowledge or permission and given substandard care because he was African...
They asked why Mr. Duncan had not been taken to Nebraska Medical Center, where two Americans who contracted the disease in West Africa have been treated. And they said the Dallas hospital, Texas Health Presbyterian, had not immediately informed them that Mr. Duncan had died and had led them to believe that he was still alive...
Mr. Jackson said the other Ebola victims in the United States “came back to Atlanta and Nebraska, got quick treatment and early treatment, and their lives have been spared.”
posted by mediareport at 2:23 PM on October 12, 2014
With the Frontline video in Sierra Leone (linked-to above in the OP), another thing that struck me was that the frontline healthcare workers tasked with tracking down the source of local infections travel into affected communities essentially without any protection, save for rubber boots.
While they have discarded their protective gear because it's scary to villagers and townspeople, they have also realized that the gear gives them a false sense of security.
They might feel protected by the gear, but they can easily contract Ebola if they don't remove the gear properly.
So they travel out to identify the source of transmission with no protection, save for perhaps washing their hands.
I wonder how long that man and that woman will last.
posted by Nevin at 12:56 PM on October 13, 2014
While they have discarded their protective gear because it's scary to villagers and townspeople, they have also realized that the gear gives them a false sense of security.
They might feel protected by the gear, but they can easily contract Ebola if they don't remove the gear properly.
So they travel out to identify the source of transmission with no protection, save for perhaps washing their hands.
I wonder how long that man and that woman will last.
posted by Nevin at 12:56 PM on October 13, 2014
I posted this in one of the other threads but I don't know how much cross-over there is so I'll stick up here as well - from Scientific American
posted by From Bklyn at 1:18 AM on October 14, 2014
posted by From Bklyn at 1:18 AM on October 14, 2014
This is possibly the least compassionate thing I have ever read here.
Pragmatism is not a crime.
This is a VERY contagious disease and there is a very rapid course from first symptoms to death. Even the people that are lucky enough to recover are severely debilitated for months. It's best to not even let it come in the first place. It's like HIV on performance-enhancement drugs. No joke.
We already have exposed people like TV's Dr. Nancy Snyderman who disregard quarantine because they think they are ok, and she's a physician for crying out loud! Imagine dozens of people like her expectorating and exsanguinating all over the place because they are afraid or in denial and its only a matter of time before its a national disaster.
posted by Renoroc at 12:41 PM on October 14, 2014
Pragmatism is not a crime.
This is a VERY contagious disease and there is a very rapid course from first symptoms to death. Even the people that are lucky enough to recover are severely debilitated for months. It's best to not even let it come in the first place. It's like HIV on performance-enhancement drugs. No joke.
We already have exposed people like TV's Dr. Nancy Snyderman who disregard quarantine because they think they are ok, and she's a physician for crying out loud! Imagine dozens of people like her expectorating and exsanguinating all over the place because they are afraid or in denial and its only a matter of time before its a national disaster.
posted by Renoroc at 12:41 PM on October 14, 2014
A GOP Senator Objects to Emergency Ebola Funding Because It 'Focuses on Africa'
posted by homunculus at 2:18 PM on October 14, 2014 [2 favorites]
posted by homunculus at 2:18 PM on October 14, 2014 [2 favorites]
Ebola Vaccine Would Likely Have Been Found By Now If Not For Budget Cuts: NIH Director
The stunning cuts to America's budget to fight disease outbreaks
posted by homunculus at 2:20 PM on October 14, 2014 [2 favorites]
The stunning cuts to America's budget to fight disease outbreaks
posted by homunculus at 2:20 PM on October 14, 2014 [2 favorites]
2nd health care worker tests positive for Ebola in Dallas.
posted by mediareport at 5:13 AM on October 15, 2014
posted by mediareport at 5:13 AM on October 15, 2014
The stories from anonymous nurses at the hospital where Duncan was treated do not inspire confidence in U.S. Ebola readiness. This statement yesterday from National Nurses United, the union that's been vocal about lack of proper equipment and training, is worth a read. They've scheduled a conference call for 3pm today.
posted by mediareport at 5:26 AM on October 15, 2014 [4 favorites]
posted by mediareport at 5:26 AM on October 15, 2014 [4 favorites]
Thomas Duncan's nephew wrote an angry piece in the Dallas Morning News that asserts much of what's been reported about his uncle - including the story that he helped a pregnant woman with Ebola before leaving the country - is not true:
Among the most offensive errors in the media during my uncle’s illness are the accusations that he knew he was exposed to Ebola — that is just not true. Eric lived in a careful manner, as he understood the dangers of living in Liberia amid this outbreak. He limited guests in his home, he did not share drinking cups or eating utensils.
And while the stories of my uncle helping a pregnant woman with Ebola are courageous, Thomas Eric personally told me that never happened. Like hundreds of thousands of West Africans, carefully avoiding Ebola was part of my uncle’s daily life....
The biggest unanswered question about my uncle’s death is why the hospital would send home a patient with a 103-degree fever and stomach pains who had recently been in Liberia — and he told them he had just returned from Liberia explicitly due to the Ebola threat. Some speculate that this was a failure of the internal communications systems. Others have speculated that antibiotics and Tylenol are the standard protocol for a patient without insurance...
posted by mediareport at 8:10 AM on October 15, 2014 [7 favorites]
Among the most offensive errors in the media during my uncle’s illness are the accusations that he knew he was exposed to Ebola — that is just not true. Eric lived in a careful manner, as he understood the dangers of living in Liberia amid this outbreak. He limited guests in his home, he did not share drinking cups or eating utensils.
And while the stories of my uncle helping a pregnant woman with Ebola are courageous, Thomas Eric personally told me that never happened. Like hundreds of thousands of West Africans, carefully avoiding Ebola was part of my uncle’s daily life....
The biggest unanswered question about my uncle’s death is why the hospital would send home a patient with a 103-degree fever and stomach pains who had recently been in Liberia — and he told them he had just returned from Liberia explicitly due to the Ebola threat. Some speculate that this was a failure of the internal communications systems. Others have speculated that antibiotics and Tylenol are the standard protocol for a patient without insurance...
posted by mediareport at 8:10 AM on October 15, 2014 [7 favorites]
Others have speculated that antibiotics and Tylenol are the standard protocol for a patient without insurance...
This is my biggest fear - people who have come into contact with Ebola patients*, have symptoms, but don't go/delay going to the ER because it would fucking bankrupt them. It's easy to think that no one would be crazy enough to risk their health, but denial and fear are powerful forces. Some of those people on the flight with the 2nd patient could have a tough choice to make. What if you just have a bad flu and spent hundreds or thousands of dollars for nothing?
Since this is a public health threat, anyone who tests positive for Ebola* should not have to pay for medical care.
*or any serious infectious disease
posted by desjardins at 9:11 AM on October 15, 2014 [5 favorites]
This is my biggest fear - people who have come into contact with Ebola patients*, have symptoms, but don't go/delay going to the ER because it would fucking bankrupt them. It's easy to think that no one would be crazy enough to risk their health, but denial and fear are powerful forces. Some of those people on the flight with the 2nd patient could have a tough choice to make. What if you just have a bad flu and spent hundreds or thousands of dollars for nothing?
Since this is a public health threat, anyone who tests positive for Ebola* should not have to pay for medical care.
*or any serious infectious disease
posted by desjardins at 9:11 AM on October 15, 2014 [5 favorites]
Holy shit. Another nurse has been diagnosed with Ebola.
She flew on a commercial flight the day before she developed symptoms. Despite knowing she was being monitored for ebola. What the hell is wrong with people?
posted by Justinian at 11:04 AM on October 15, 2014
She flew on a commercial flight the day before she developed symptoms. Despite knowing she was being monitored for ebola. What the hell is wrong with people?
posted by Justinian at 11:04 AM on October 15, 2014
Coming up on the next Bad Idea Theater: I've been treating the first known case of Ebola in the United States. One of my fellow nurses caught the disease but I'm okay so I'm going to get on a plane and travel.
posted by Renoroc at 11:41 AM on October 15, 2014 [1 favorite]
posted by Renoroc at 11:41 AM on October 15, 2014 [1 favorite]
Just to be clear, Justinian's nurse is Amber Vinson, the 2nd healthcare worker in the link posted this morning. She flew from Dallas to Cleveland on Oct 10, back to Dallas on Oct 13, then reported symptoms on the 14th:
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
[...] Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning. However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service.
She visited relatives who work at Kent State, who are now being asked to stay home, but Kent, Ohio is now on the U.S. ebola radar as well.
posted by mediareport at 11:42 AM on October 15, 2014
“Those who have exposures to Ebola, she should not have traveled on a commercial airline,” said Dr. Frieden. “The CDC guidance in this setting outlines the need for controlled movement. That can include a charter plane; that can include a car; but it does not include public transport. We will from this moment forward ensure that no other individual who is being monitored for exposure undergoes travel in any way other than controlled movement.”
[...] Frontier Airlines is working closely with the CDC to identify and notify all passengers on the flight. The airline also says the plane has been thoroughly cleaned and was removed from service following CDC notification early Wednesday morning. However, according to Flighttracker, the plane was used for five additional flights on Tuesday before it was removed from service.
She visited relatives who work at Kent State, who are now being asked to stay home, but Kent, Ohio is now on the U.S. ebola radar as well.
posted by mediareport at 11:42 AM on October 15, 2014
As I am not an epidemiologist nor a legal expert, I'm not offering suggestions, but what is the legal precedent for forcibly curbing the travel of a person who might have been exposed? i.e. putting her on some sort of no-fly list?
And what does it mean when people "are being monitored"? I assume it's somewhere between "hey, take your temp every day and give us a call if you spike a fever" and "we're putting an officer outside your door so you don't leave" but I have no idea where on the scale "being monitored" falls.
posted by desjardins at 12:43 PM on October 15, 2014
And what does it mean when people "are being monitored"? I assume it's somewhere between "hey, take your temp every day and give us a call if you spike a fever" and "we're putting an officer outside your door so you don't leave" but I have no idea where on the scale "being monitored" falls.
posted by desjardins at 12:43 PM on October 15, 2014
The legal precedent is United States v HOLY FUCK SHE HAS EBOLA.
...
Technically it is 42 U.S. Code § 264 "Regulations to control communicable diseases". But really it's US vs HOLY FUCK SHE HAS EBOLA.
posted by Justinian at 12:48 PM on October 15, 2014 [4 favorites]
...
Technically it is 42 U.S. Code § 264 "Regulations to control communicable diseases". But really it's US vs HOLY FUCK SHE HAS EBOLA.
posted by Justinian at 12:48 PM on October 15, 2014 [4 favorites]
(And the basis for the Constitutionality of 42 US § 264 is the Commerce Clause. Which... well... the government uses the Commerce Clause to do whatever the hell they want so why not this too I guess)
posted by Justinian at 12:49 PM on October 15, 2014 [1 favorite]
posted by Justinian at 12:49 PM on October 15, 2014 [1 favorite]
Related: http://www.eboladeeply.org/
posted by From Bklyn at 12:54 PM on October 15, 2014
posted by From Bklyn at 12:54 PM on October 15, 2014
It'd be nice if we had, you know, a Surgeon General right around now. Asshole Republicans.
posted by Justinian at 12:57 PM on October 15, 2014 [2 favorites]
posted by Justinian at 12:57 PM on October 15, 2014 [2 favorites]
Oh, ffs. The hospital didn't have workers wear protective gear for TWO GODDAMN DAYS while treating Duncan, even as he was suffering projectile vomiting and diarrhea. We'll be damn lucky if it's only two personnel that come down with it. What a bunch of goddamn incompetents, no wonder the CDC is moving the second patient to Atlanta where they have some clue what they are doing.
posted by tavella at 1:20 PM on October 15, 2014 [5 favorites]
posted by tavella at 1:20 PM on October 15, 2014 [5 favorites]
I am fully aware that this is not the same thing as Ebola, but if you want to be thoroughly terrified about disease spreading through a hospital, the second part of the Frontline episode that aired last night has you covered. (Starts at 37:00)
tl;dw - an antibiotic-resistant bacterial infection sweeps through the ICU at the NIH hospital even after closing the ICU, disinfecting it with robots, and reopening it. A year after the last patient died, they're not still sure they've eradicated it. (Again, I'm aware that this is very different from Ebola, which does not survive on surfaces that long. It's just sort of on-topic since this is a Frontline + disease thread.)
posted by desjardins at 1:27 PM on October 15, 2014
tl;dw - an antibiotic-resistant bacterial infection sweeps through the ICU at the NIH hospital even after closing the ICU, disinfecting it with robots, and reopening it. A year after the last patient died, they're not still sure they've eradicated it. (Again, I'm aware that this is very different from Ebola, which does not survive on surfaces that long. It's just sort of on-topic since this is a Frontline + disease thread.)
posted by desjardins at 1:27 PM on October 15, 2014
Yeah, seriously, read tavella's link. I guess now we know what the "breach in protocol" was, and also why nurses got furious when it appeared the official story was blaming them for not taking off their hazmat garments carefully enough. Looks like some pretty bullshit spin, if the story of those 2 days holds up:
Health care workers treating Thomas Eric Duncan in a hospital isolation unit didn’t wear protective hazardous-material suits for two days until tests confirmed the Liberian man had Ebola — a delay that potentially exposed perhaps dozens of hospital workers to the virus, according to medical records.
The 3-day window of Sept. 28-30 is now being targeted by investigators for the Centers for Disease Control and Prevention as the key time during which health care workers may have been exposed to the deadly virus by Duncan, who died Oct. 8 from the disease.
Duncan was suspected of having Ebola when he was admitted to a hospital isolation unit Sept. 28, and he developed projectile vomiting and explosive diarrhea later that day, according to medical records his family turned over to The Associated Press. But workers at Texas Health Presbyterian Hospital Dallas did not abandon their gowns and scrubs for hazmat suits until tests came back positive for Ebola about 2 p.m. on Sept. 30, according to details of the records released by AP.
posted by mediareport at 2:03 PM on October 15, 2014
Health care workers treating Thomas Eric Duncan in a hospital isolation unit didn’t wear protective hazardous-material suits for two days until tests confirmed the Liberian man had Ebola — a delay that potentially exposed perhaps dozens of hospital workers to the virus, according to medical records.
The 3-day window of Sept. 28-30 is now being targeted by investigators for the Centers for Disease Control and Prevention as the key time during which health care workers may have been exposed to the deadly virus by Duncan, who died Oct. 8 from the disease.
Duncan was suspected of having Ebola when he was admitted to a hospital isolation unit Sept. 28, and he developed projectile vomiting and explosive diarrhea later that day, according to medical records his family turned over to The Associated Press. But workers at Texas Health Presbyterian Hospital Dallas did not abandon their gowns and scrubs for hazmat suits until tests came back positive for Ebola about 2 p.m. on Sept. 30, according to details of the records released by AP.
posted by mediareport at 2:03 PM on October 15, 2014
It'd be nice if we had, you know, a Surgeon General right around now. Asshole Republicans.
To Best Fight Ebola, We Need A Surgeon General
posted by homunculus at 3:02 PM on October 15, 2014
To Best Fight Ebola, We Need A Surgeon General
posted by homunculus at 3:02 PM on October 15, 2014
Pragmatism is not a crime.
This is a VERY contagious disease and there is a very rapid course from first symptoms to death. Even the people that are lucky enough to recover are severely debilitated for months. It's best to not even let it come in the first place. It's like HIV on performance-enhancement drugs. No joke.
We already have exposed people like TV's Dr. Nancy Snyderman who disregard quarantine because they think they are ok, and she's a physician for crying out loud! Imagine dozens of people like her expectorating and exsanguinating all over the place because they are afraid or in denial and its only a matter of time before its a national disaster.
Nobody said anything about crime. But your idea is not pragmatic, it's the same idea espoused by Bill O'Reilly and was part of the Daily Show's "moment of zen" the other day. Maybe after a decade or so of education in epidemiology you'll know what the actual pragmatic, practical options are. You don't appear to currently.
Yes. We'll "seal the borders," create an international panic, and scatter it everywhere. The CDC does actually think these things through.
posted by aydeejones at 3:08 PM on October 15, 2014 [2 favorites]
This is a VERY contagious disease and there is a very rapid course from first symptoms to death. Even the people that are lucky enough to recover are severely debilitated for months. It's best to not even let it come in the first place. It's like HIV on performance-enhancement drugs. No joke.
We already have exposed people like TV's Dr. Nancy Snyderman who disregard quarantine because they think they are ok, and she's a physician for crying out loud! Imagine dozens of people like her expectorating and exsanguinating all over the place because they are afraid or in denial and its only a matter of time before its a national disaster.
Nobody said anything about crime. But your idea is not pragmatic, it's the same idea espoused by Bill O'Reilly and was part of the Daily Show's "moment of zen" the other day. Maybe after a decade or so of education in epidemiology you'll know what the actual pragmatic, practical options are. You don't appear to currently.
Yes. We'll "seal the borders," create an international panic, and scatter it everywhere. The CDC does actually think these things through.
posted by aydeejones at 3:08 PM on October 15, 2014 [2 favorites]
What the hell is wrong with people?
Clearly I need to start waiting for information. Because the second nurse is reported to have called the CDC and told them she had a fever of 99.5 and asked whether it was okay to get on the airplane and they told her to go ahead.
I don't even know what to say to that.
posted by Justinian at 4:47 PM on October 15, 2014
Clearly I need to start waiting for information. Because the second nurse is reported to have called the CDC and told them she had a fever of 99.5 and asked whether it was okay to get on the airplane and they told her to go ahead.
I don't even know what to say to that.
posted by Justinian at 4:47 PM on October 15, 2014
That said, if I had been getting puked on (and worse) by a dude with ebola and I started running a fever of "only" 99.5 I would basically be camped out in the hospital demanding admittance. But, yeah, CDC if this report is true you done fucked up.
posted by Justinian at 4:48 PM on October 15, 2014
posted by Justinian at 4:48 PM on October 15, 2014
Jesus, this is like wathcing the idiot children of Felix Hoenikker bobble a bottle of Ice-Nine on the beach of San Lorenzo.
posted by Devils Rancher at 6:04 PM on October 15, 2014 [2 favorites]
posted by Devils Rancher at 6:04 PM on October 15, 2014 [2 favorites]
Holy fuck. It's unconscionable that the CDC released info that the nurse flew without also noting that she got permission to do so from the CDC itself. The vitriol aimed at that poor woman already today could have been avoided. So, so wrong.
posted by mediareport at 6:55 PM on October 15, 2014 [3 favorites]
posted by mediareport at 6:55 PM on October 15, 2014 [3 favorites]
I'm guessing Tom Frieden will probably not be at the CDC for much longer...
posted by dilaudid at 6:59 PM on October 15, 2014
posted by dilaudid at 6:59 PM on October 15, 2014
Yeah, particularly after the details from the anonymous Texas nurses become more widely known. It's worth reading today's press release from National Nurses United in full; the first few paragraphs are familiar but there are additional descriptions/accusations I hadn't seen before, including this tidbit:
There was no one to pick up hazardous waste as it piled to the ceiling.
Here's more, including nurses observing CDC staff themselves not following basic infection control procedures:
Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present. No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training. Subsequently a nurse supervisor arrived and demanded that he be moved to an isolation unit– yet faced resistance from other hospital authorities...
Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids...
Patients who may have been exposed were one day kept in strict isolation units. On the next day [they] were ordered to be transferred out of strict isolation into areas where there were other patients, even those with low-grade fevers who could potentially be contagious...
Some hospital personnel were coming in and out of those isolation areas in the Emergency Department without having worn the proper protective equipment. CDC officials who are in the hospital and Infectious Disease personnel have not kept hallways clean; they were going back and forth between the Isolation Pod and back into the hallways that were not properly cleaned, even after CDC, infectious control personnel, and doctors who exited into those hallways [had been] in the isolation pods...
Advance preparation that had been done by the hospital primarily consisted of emailing us about one optional lecture/seminar on Ebola. There was no mandate for nurses to attend trainings, or what nurses had to do in the event of the arrival of a patient with Ebola-like symptoms...
There was no advance hands-on training on the use of personal protective equipment for Ebola. No training on what symptoms to look for. No training on what questions to ask...
Guidelines have now been changed, but it is not clear what version Nina Pham had available.
The hospital later said that their guidelines had changed and that the nurses needed to adhere to them. What has caused confusion is that the guidelines were constantly changing. It was later asked which guidelines should we follow? The message to the nurses was it’s up to you. It is not up to the nurses to be setting the policy, nurses say, in the face of such a virulent disease. They needed to be trained optimally and correctly in how to deal with Ebola and the proper PPE doffing, as well as how to dispose of the waste.
In summary, the nurses state there have been no policies in cleaning or bleaching the premises without housekeeping services. There was no one to pick up hazardous waste as it piled to the ceiling. They did not have access to proper supplies and observed the Infectious Disease Department and CDC themselves violate basic principles of infection control, including cross contaminating between patients. In the end, the nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own.
posted by mediareport at 7:53 PM on October 15, 2014 [3 favorites]
There was no one to pick up hazardous waste as it piled to the ceiling.
Here's more, including nurses observing CDC staff themselves not following basic infection control procedures:
Mr. Duncan was left for several hours, not in isolation, in an area where other patients were present. No one knew what the protocols were or were able to verify what kind of personal protective equipment should be worn and there was no training. Subsequently a nurse supervisor arrived and demanded that he be moved to an isolation unit– yet faced resistance from other hospital authorities...
Nurses had to interact with Mr. Duncan with whatever protective equipment was available, at a time when he had copious amounts of diarrhea and vomiting which produces a lot of contagious fluids...
Patients who may have been exposed were one day kept in strict isolation units. On the next day [they] were ordered to be transferred out of strict isolation into areas where there were other patients, even those with low-grade fevers who could potentially be contagious...
Some hospital personnel were coming in and out of those isolation areas in the Emergency Department without having worn the proper protective equipment. CDC officials who are in the hospital and Infectious Disease personnel have not kept hallways clean; they were going back and forth between the Isolation Pod and back into the hallways that were not properly cleaned, even after CDC, infectious control personnel, and doctors who exited into those hallways [had been] in the isolation pods...
Advance preparation that had been done by the hospital primarily consisted of emailing us about one optional lecture/seminar on Ebola. There was no mandate for nurses to attend trainings, or what nurses had to do in the event of the arrival of a patient with Ebola-like symptoms...
There was no advance hands-on training on the use of personal protective equipment for Ebola. No training on what symptoms to look for. No training on what questions to ask...
Guidelines have now been changed, but it is not clear what version Nina Pham had available.
The hospital later said that their guidelines had changed and that the nurses needed to adhere to them. What has caused confusion is that the guidelines were constantly changing. It was later asked which guidelines should we follow? The message to the nurses was it’s up to you. It is not up to the nurses to be setting the policy, nurses say, in the face of such a virulent disease. They needed to be trained optimally and correctly in how to deal with Ebola and the proper PPE doffing, as well as how to dispose of the waste.
In summary, the nurses state there have been no policies in cleaning or bleaching the premises without housekeeping services. There was no one to pick up hazardous waste as it piled to the ceiling. They did not have access to proper supplies and observed the Infectious Disease Department and CDC themselves violate basic principles of infection control, including cross contaminating between patients. In the end, the nurses strongly feel unsupported, unprepared, lied to, and deserted to handle the situation on their own.
posted by mediareport at 7:53 PM on October 15, 2014 [3 favorites]
At this point I won't be surprised if there are another half dozen or so ebola cases here in the USA from this one vector. Given that ebola is generally considered to have an r0 of 1.5 or so that would mean that we actually did significantly worse than what you would expect if we had just let the guy run around in public with no treatment at all. Hell, we're already at 2 and I'd be quite surprised if that doesn't increase at all even if it isn't another half dozen like I fear.
This is not exactly a ringing endorsement of our preparedness given this was the very first test of the system.
posted by Justinian at 8:53 PM on October 15, 2014 [2 favorites]
This is not exactly a ringing endorsement of our preparedness given this was the very first test of the system.
posted by Justinian at 8:53 PM on October 15, 2014 [2 favorites]
the very first test of the system
And even for a first test, it should have been slam dunk! How much more obvious does it get than someone who is recently flown in from Liberia, with 8/10 abdominal pain, a headache, and a 100+ degree fever? This is the easy case; what happens with the person from Cleveland with the 99F fever two weeks further into flu season who, by the way, happened to sit in the same seat on the airplane as the nurse who was OK'd by the CDC to fly with a low-grade fever? And yet it's as though they intentionally made terrible decisions at every step of the way.
I'm very frustrated with how badly this has been bungled, and downright livid at the hospital authorities in the US and Spain who keep blaming the nurses for infecting themselves when the real problem is horrifying administrative shortcomings.
posted by Blue Jello Elf at 9:25 PM on October 15, 2014 [6 favorites]
And even for a first test, it should have been slam dunk! How much more obvious does it get than someone who is recently flown in from Liberia, with 8/10 abdominal pain, a headache, and a 100+ degree fever? This is the easy case; what happens with the person from Cleveland with the 99F fever two weeks further into flu season who, by the way, happened to sit in the same seat on the airplane as the nurse who was OK'd by the CDC to fly with a low-grade fever? And yet it's as though they intentionally made terrible decisions at every step of the way.
I'm very frustrated with how badly this has been bungled, and downright livid at the hospital authorities in the US and Spain who keep blaming the nurses for infecting themselves when the real problem is horrifying administrative shortcomings.
posted by Blue Jello Elf at 9:25 PM on October 15, 2014 [6 favorites]
"On Friday, Sept. 25, 2014, my uncle Thomas Eric Duncan went to Texas Health Presbyterian Hospital Dallas. He had a high fever and stomach pains. He told the nurse he had recently been in Liberia. But he was a man of color with no health insurance and no means to pay for treatment, so within hours he was released with some antibiotics and Tylenol."
Source: Dallas Morning News (15 October 2014)
posted by Mister Bijou at 12:22 AM on October 16, 2014 [1 favorite]
Source: Dallas Morning News (15 October 2014)
posted by Mister Bijou at 12:22 AM on October 16, 2014 [1 favorite]
Dallas Presbyterian treated one Ebola patient and had two (so far!) of its workers contract Ebola. Médecins Sans Frontières has treated thousands of Ebola patients and has had 16 of its people contract the disease despite working in far worse conditions with far less money. We need to move past the ridiculous Frankenstein's monster of a health care system in this country before it gets us all killed. I wish this affair would be a wake up call but instead I assume they'll find a fall guy in Dallas and oh, this was an isolated incident and we have the best health care in the world and go back to watching your television and don't worry.
posted by Justinian at 2:57 AM on October 16, 2014 [4 favorites]
posted by Justinian at 2:57 AM on October 16, 2014 [4 favorites]
The one bright spot in all the mishandling of the US cases is that Thomas Eric Duncan's family seems to have avoided coming down with the disease so far (I believe they're currently 18 days into the monitoring), despite taking care of him and being kept in the apartment for several days after his diagnosis. Which is reassuring that yes, people have to be quite acutely ill before they're very infectious.
posted by Blue Jello Elf at 7:18 AM on October 16, 2014 [2 favorites]
posted by Blue Jello Elf at 7:18 AM on October 16, 2014 [2 favorites]
From the comments of the article I linked above:
1. The media and many scientific authorities are unified in saying that transmissibility begins upon onset of measurable fever and metabolic upsets. This is biologically false. Transmissibility increases progressively as the viral density increases during incubation. There is no step function in transmissibility at the point when the immune system detects disease and initiates fever.
This makes sense, and points to the unreliability of the 'only contagious when feverish' idea. Which makes the nurse being told yes, you can travel even more worrisome as, you know the CDC should know better
posted by From Bklyn at 7:57 AM on October 16, 2014 [3 favorites]
1. The media and many scientific authorities are unified in saying that transmissibility begins upon onset of measurable fever and metabolic upsets. This is biologically false. Transmissibility increases progressively as the viral density increases during incubation. There is no step function in transmissibility at the point when the immune system detects disease and initiates fever.
This makes sense, and points to the unreliability of the 'only contagious when feverish' idea. Which makes the nurse being told yes, you can travel even more worrisome as, you know the CDC should know better
posted by From Bklyn at 7:57 AM on October 16, 2014 [3 favorites]
It's amazing how humans, largely, will do anything they can to avoid taking preventative measures until certain death stares them in the face and by then it's too late, particularly when they're in a position to know better. I wonder if Thomas Duncan's initial handling in this case will finally cause more Americans to demand a change to the entire fucked up bullshit system of health insurance. Do people really think publicly funded health care would be worse than this?
It's not even about compassion. The whole idea of necessary health care being something people in a civilized nation have to earn, or pay for, is incredibly shortsighted. By not being willing to treat people who can't afford treatment, we put all of society at risk by exposing them to illnesses that could've been properly treated, or at least contained, if the hospital they went to wasn't worried about getting paid for treating them. I truly don't care if all the health insurance companies go out of business. The system as it is is a horrible monster that is destroying us.
They threw antibiotics at this guy with a high fever and stomach pains just to get him out of there. What did they even think they were treating? How are antibiotics still the default response for an undiagnosed illness that hasn't even been verified as bacterial, with all we know about resistance caused by their overuse? Really, pretty much everything about this story is terrible. The government can tell us not to be alarmed all they want, but they are continually giving us plenty of excellent reasons to be alarmed.
posted by wondermouse at 8:19 AM on October 16, 2014 [5 favorites]
It's not even about compassion. The whole idea of necessary health care being something people in a civilized nation have to earn, or pay for, is incredibly shortsighted. By not being willing to treat people who can't afford treatment, we put all of society at risk by exposing them to illnesses that could've been properly treated, or at least contained, if the hospital they went to wasn't worried about getting paid for treating them. I truly don't care if all the health insurance companies go out of business. The system as it is is a horrible monster that is destroying us.
They threw antibiotics at this guy with a high fever and stomach pains just to get him out of there. What did they even think they were treating? How are antibiotics still the default response for an undiagnosed illness that hasn't even been verified as bacterial, with all we know about resistance caused by their overuse? Really, pretty much everything about this story is terrible. The government can tell us not to be alarmed all they want, but they are continually giving us plenty of excellent reasons to be alarmed.
posted by wondermouse at 8:19 AM on October 16, 2014 [5 favorites]
"As Sirleaf recently pointed out, the Dallas Cowboys football stadium consumes more energy each year than the whole of Liberia. It is very difficult to take care of critically ill patients in the dark; fluid resuscitation depends on being able to place and replace intravenous lines."
Source: London Review of Books... Ebola
posted by Mister Bijou at 12:37 PM on October 16, 2014 [1 favorite]
Source: London Review of Books... Ebola
posted by Mister Bijou at 12:37 PM on October 16, 2014 [1 favorite]
I wonder if Thomas Duncan's initial handling in this case will finally cause more Americans to demand a change to the entire fucked up bullshit system of health insurance. Do people really think publicly funded health care would be worse than this?
Coming from Canada, which has single-tier publicly-funded healthcare, I doubt Duncan's situation would have been any better here. Governments are always struggling to reduce ER wait times (there can be very long waits here in ER), and doctors and nurses are pressured to rush through patients to meet their numbers. In British Columbia nurses are being replaced in some situations with graduates from those crappy little privately-run vocational schools.
As well, Canada is home to institutional racism in its publicly-funded healthcare system, with truly horrifying results.
While publicly-funded healthcare is certainly cheaper, it does not guarantee better health outcomes overall.
posted by Nevin at 7:49 AM on October 17, 2014
Coming from Canada, which has single-tier publicly-funded healthcare, I doubt Duncan's situation would have been any better here. Governments are always struggling to reduce ER wait times (there can be very long waits here in ER), and doctors and nurses are pressured to rush through patients to meet their numbers. In British Columbia nurses are being replaced in some situations with graduates from those crappy little privately-run vocational schools.
As well, Canada is home to institutional racism in its publicly-funded healthcare system, with truly horrifying results.
While publicly-funded healthcare is certainly cheaper, it does not guarantee better health outcomes overall.
posted by Nevin at 7:49 AM on October 17, 2014
While publicly-funded healthcare is certainly cheaper, it does not guarantee better health outcomes overall.
Actually, it does.
posted by zombieflanders at 9:11 AM on October 17, 2014 [1 favorite]
Actually, it does.
posted by zombieflanders at 9:11 AM on October 17, 2014 [1 favorite]
A guy vomits and dies on a flight from Nigeria to JFK. The CDC says it wasn't Ebola. Do read the comments. So you can see how bugfuck crazy people are getting over this. (Hint: It's all #Obola's fault)
-ONLY IN AMERICA would this type of insanity rule! And many millions of Americans now recognize this for what it is: the willful, purposeful TAKEDOWN of the United States, and the end result will be catastrophic. Our government is consciously setting up the scenario for a unprecedented Ebola outbreak in the United States!
-I wonder if these geniuses [by which he means the CDC] know that when you die the body gets cold so they won't find an elevated temperature and that in 13% of the cases of Ebola the Fever may not be present. [Yeah bro I think the CDC probably knows all that shit]
-If the current rate of transmission persists, with an exponential doubling time around 1 month, the human population will be infected to 2016. This will happen.
-CDC has 70 patents on Ebola. The Ebola Epicenter in Sierra Leone was a US Lab paid for by Bill & Melinda Gates Foundation and George Soros, both of whom support 95% depopulation. Ebola was EXPORTED to Africa, weaponized and tested, then IMPORTED back to the U.S. on all these flights -- DELIBERATELY! DO NOT TAKE THE EBOLA-ZOMBIE-ism VACCINE!
-Does no one remember the Zero Population Growth movement of the late '60s and early '70s? Well the hippies behind that movement are running the show in Washington now. If they can accomplish their goals of reduced population by importing some diseased Africans into our nation then they will celebrate and high-five each other at the end of the day for a job well done.
How long until a black guy with the sniffles gets shot dead in Texas, I wonder?
posted by showbiz_liz at 10:42 AM on October 17, 2014 [2 favorites]
-ONLY IN AMERICA would this type of insanity rule! And many millions of Americans now recognize this for what it is: the willful, purposeful TAKEDOWN of the United States, and the end result will be catastrophic. Our government is consciously setting up the scenario for a unprecedented Ebola outbreak in the United States!
-I wonder if these geniuses [by which he means the CDC] know that when you die the body gets cold so they won't find an elevated temperature and that in 13% of the cases of Ebola the Fever may not be present. [Yeah bro I think the CDC probably knows all that shit]
-If the current rate of transmission persists, with an exponential doubling time around 1 month, the human population will be infected to 2016. This will happen.
-CDC has 70 patents on Ebola. The Ebola Epicenter in Sierra Leone was a US Lab paid for by Bill & Melinda Gates Foundation and George Soros, both of whom support 95% depopulation. Ebola was EXPORTED to Africa, weaponized and tested, then IMPORTED back to the U.S. on all these flights -- DELIBERATELY! DO NOT TAKE THE EBOLA-ZOMBIE-ism VACCINE!
-Does no one remember the Zero Population Growth movement of the late '60s and early '70s? Well the hippies behind that movement are running the show in Washington now. If they can accomplish their goals of reduced population by importing some diseased Africans into our nation then they will celebrate and high-five each other at the end of the day for a job well done.
How long until a black guy with the sniffles gets shot dead in Texas, I wonder?
posted by showbiz_liz at 10:42 AM on October 17, 2014 [2 favorites]
In a setback for the Ebola vaccine, GlaxoSmithKline now says work will take longer than hoped
GENEVA — The Ebola crisis took new twists Friday, with another somber update from the World Health Organization on the outbreak in West Africa and a bleak warning from a major drug manufacturer that a safe vaccine likely won’t be ready before the current epidemic has passed. Dr. Ripley Ballou, head of Ebola research for Great Britain’s GlaxoSmithKline, told the BBC that full data on a vaccine’s safety and efficacy won’t be ready until late 2015, and full-scale production for general use won’t happen until well into 2016.
The World Health Organization had said a month ago that it hoped data from clinical trials on two vaccines would be available by next month, and the vaccines would be available for use by health care workers by January.
GlaxoSmithKline’s Ebola CAd3 vaccine was one of the two vaccines. The other was the VSV vaccine, made by NewLink Genetics Corp., which is headquartered in Ames, Iowa. The GlaxoSmithKline vaccine has been developed in collaboration with the U.S. National Institute of Allergy and Infectious Diseases.
Ballou’s assessment alarmed experts at the the medical charity Doctors without Borders, which has more than 3,000 staff members fighting the epidemic in the three most affected countries, Liberia, Sierra Leone and Guinea. The organization, at least 16 of whose workers have contracted the disease, urged GlaxoSmithKline to step up its efforts.
“This is a disaster scenario,” the organization’s executive director for drug access, Manica Balasegaram, told McClatchy. “We want to see serious acceleration. We need to be more ambitious. It’s worrying to hear timelines into 2016. We have got to accelerate. The situation on the ground is a catastrophe.”
...Catherine Hartley, a GlaxoSmithKline spokewoman, told McClatchy the drug company is working as fast as it can. She said the company already has begun manufacturing 10,000 doses of the vaccine so that it can move quickly to the second stage of clinical trials if the first ones are successful. Information on those first-phase trials will be available early next year.
The second-phase trials will include “high risk populations, such as front-line health workers,” and should begin in 2015, she said. In the meantime, GlaxoSmithKline is trying to speed up preparations for “manufacturing at an industrial scale so that if the trials are successful, we will be in position to significantly ramp up production to help combat this or future Ebola outbreaks.”
posted by mediareport at 4:13 PM on October 17, 2014
GENEVA — The Ebola crisis took new twists Friday, with another somber update from the World Health Organization on the outbreak in West Africa and a bleak warning from a major drug manufacturer that a safe vaccine likely won’t be ready before the current epidemic has passed. Dr. Ripley Ballou, head of Ebola research for Great Britain’s GlaxoSmithKline, told the BBC that full data on a vaccine’s safety and efficacy won’t be ready until late 2015, and full-scale production for general use won’t happen until well into 2016.
The World Health Organization had said a month ago that it hoped data from clinical trials on two vaccines would be available by next month, and the vaccines would be available for use by health care workers by January.
GlaxoSmithKline’s Ebola CAd3 vaccine was one of the two vaccines. The other was the VSV vaccine, made by NewLink Genetics Corp., which is headquartered in Ames, Iowa. The GlaxoSmithKline vaccine has been developed in collaboration with the U.S. National Institute of Allergy and Infectious Diseases.
Ballou’s assessment alarmed experts at the the medical charity Doctors without Borders, which has more than 3,000 staff members fighting the epidemic in the three most affected countries, Liberia, Sierra Leone and Guinea. The organization, at least 16 of whose workers have contracted the disease, urged GlaxoSmithKline to step up its efforts.
“This is a disaster scenario,” the organization’s executive director for drug access, Manica Balasegaram, told McClatchy. “We want to see serious acceleration. We need to be more ambitious. It’s worrying to hear timelines into 2016. We have got to accelerate. The situation on the ground is a catastrophe.”
...Catherine Hartley, a GlaxoSmithKline spokewoman, told McClatchy the drug company is working as fast as it can. She said the company already has begun manufacturing 10,000 doses of the vaccine so that it can move quickly to the second stage of clinical trials if the first ones are successful. Information on those first-phase trials will be available early next year.
The second-phase trials will include “high risk populations, such as front-line health workers,” and should begin in 2015, she said. In the meantime, GlaxoSmithKline is trying to speed up preparations for “manufacturing at an industrial scale so that if the trials are successful, we will be in position to significantly ramp up production to help combat this or future Ebola outbreaks.”
posted by mediareport at 4:13 PM on October 17, 2014
Yes. We'll "seal the borders," create an international panic, and scatter it everywhere. The CDC does actually think these things through.
The same CDC that told the Cleveland nurse she could board a plane? That CDC? If that's thinking it through, I want to build a time machine, go back to Olduvai Gorge and shoot Lucy in the head.
posted by Renoroc at 4:55 PM on October 17, 2014 [1 favorite]
The same CDC that told the Cleveland nurse she could board a plane? That CDC? If that's thinking it through, I want to build a time machine, go back to Olduvai Gorge and shoot Lucy in the head.
posted by Renoroc at 4:55 PM on October 17, 2014 [1 favorite]
Actually, it does.
Not all of the countries in the graph that are overperforming the US are truly public systems though. France and Japan has mixture of public and private, for example.
posted by Nevin at 6:34 PM on October 17, 2014 [1 favorite]
Not all of the countries in the graph that are overperforming the US are truly public systems though. France and Japan has mixture of public and private, for example.
posted by Nevin at 6:34 PM on October 17, 2014 [1 favorite]
A doctor in NYC has tested positive for Ebola after returning from Africa.
posted by Justinian at 6:03 PM on October 23, 2014 [1 favorite]
posted by Justinian at 6:03 PM on October 23, 2014 [1 favorite]
The doctor, Craig Spencer, had been treating ebola patients in Guinea with Doctors Without Borders, and had a 103-degree fever Thursday morning, 9 days after he arrived home.
It emerged that he traveled from Manhattan to Brooklyn on the subway on Wednesday night, when he went to a bowling alley, and then took a taxi home. The next morning, he reported having a temperature of 103 degrees, raising questions about his health while he was out in public...
[Spencer] told the authorities that he did not believe the protective gear he wore while working with Ebola patients had been breached but had been monitoring his own health. Doctors Without Borders, in a statement, said it provides guidelines for its staff members on their return from Ebola assignments, but did not elaborate on those protocols...
Dr. Spencer began to feel sluggish on Tuesday but did not develop a fever until Thursday morning...A health care worker at the hospital said that Dr. Spencer seemed very sick, and it was unclear to the medical staff why he had not gone to the hospital earlier, since his fever was high.
Since there's no reliable test for ebola before symptoms appear, I bet this case gets groups like Doctors Without Borders to re-emphasize and/or tighten their guidelines for returning health professionals going out in public.
posted by mediareport at 8:11 PM on October 23, 2014 [1 favorite]
It emerged that he traveled from Manhattan to Brooklyn on the subway on Wednesday night, when he went to a bowling alley, and then took a taxi home. The next morning, he reported having a temperature of 103 degrees, raising questions about his health while he was out in public...
[Spencer] told the authorities that he did not believe the protective gear he wore while working with Ebola patients had been breached but had been monitoring his own health. Doctors Without Borders, in a statement, said it provides guidelines for its staff members on their return from Ebola assignments, but did not elaborate on those protocols...
Dr. Spencer began to feel sluggish on Tuesday but did not develop a fever until Thursday morning...A health care worker at the hospital said that Dr. Spencer seemed very sick, and it was unclear to the medical staff why he had not gone to the hospital earlier, since his fever was high.
Since there's no reliable test for ebola before symptoms appear, I bet this case gets groups like Doctors Without Borders to re-emphasize and/or tighten their guidelines for returning health professionals going out in public.
posted by mediareport at 8:11 PM on October 23, 2014 [1 favorite]
Living in NYC, I'm not any more worried about personally contracting ebola today than I was yesterday, but I just know my news feed today is gonna blow up with people convinced They're Next.
posted by showbiz_liz at 4:18 AM on October 24, 2014
posted by showbiz_liz at 4:18 AM on October 24, 2014
Mod note: Comment deleted. I now have the dubious honour of saying "please don't wish Ebola on people, even as a joke."
posted by goodnewsfortheinsane (staff) at 5:09 AM on October 24, 2014 [1 favorite]
posted by goodnewsfortheinsane (staff) at 5:09 AM on October 24, 2014 [1 favorite]
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posted by oceanjesse at 5:41 PM on October 10, 2014 [1 favorite]