Ebola in The USA

@JPB,

JPB wrote:

georgeob1 wrote:
The basic argument has been that because travel restrictions aren't a perfect protection, they shouldn't be used.

That's not the basic argument I've been hearing. Who said that? That's ridiculous, if true.

You are correct in that some have also said that if we ban flights to/from epidemic areas we won't be able to send or retrieve emergency health care workers to/from epidemic areas. That argument is so laughably specious that I left it out entirely - getting the occasional dedicated charter/military flight for such emergencies is no issue at all.

Beyond that the rationalizations offered by our government officials, including the President, were exactly what I wrote. If you have heard a more intelligent argument offered, I would be pleased to hear ot it.

JPB wrote:

Let me ask you, though. Now that Ebola IS here, Patient 0 has died, Patient 1 is in the hospital. In your opinion, what N do we need to reach before folks here think that travel restrictions on no/low risk residents of Dallas/FW are a good idea?

Eubola is epidemic in Liberia and Serra Leone with thousands of cases now and (according to the chief of the WHO ) locally exponential growth rates for new infections. I believe that is a far different situation from what obtains in this country or Spain today. Containment and isolation have long been the most effective methods for previous outbreaks of this disease within Africa, and everywhere else for epidemics of this nature. If we also get to the point of thousands of cases with exponential growth rates of new infections, I can assure you that other countries will seek to isolate us.

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@JPB,

JPB wrote:

Let me ask you, though. Now that Ebola IS here, Patient 0 has died, Patient 1 is in the hospital. In your opinion, what N do we need to reach before folks here think that travel restrictions on no/low risk residents of Dallas/FW are a good idea?

The issue isn't the number (although if it hits 100 I will not only be very surprised, I will also start to worry).

The issue is the type of growth. If patient zero infects patients one, two and three there isn't much risk of an epidemic.

However if patient zero infects patient one who then infects patients two and three... that would be exponential growth (and would be quite scary).

The reason I am confident is that with a modern public health system, patients will be isolated. You will never have a patient infected in the US infecting another person.

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CNN is headlining a story on five ways the CDC has already screwed up on Ebola. The scary thing is if we got hit with Ebola we would need to count on our government to get something done correctly, and let's face it, the governments record on doing its important work right over recent years is not good. We are also going to be relying on our medical system, which we know is deeply broken.

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@maxdancona,

maxdancona wrote:

You will never have a patient infected in the US infecting another person.

never?

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Hopefully the ( Canadian ) vaccine which is going into human clinical trials in the US this week will prove successful.

http://www.thestar.com/news/gta/2014/10/13/canadianmade_ebola_vaccine_to_start_clinical_trials_in_humans.html

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https://cmgajcluckovich.files.wordpress.com/2014/10/100914-toon-luckovich-ed.jpg

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@georgeob1,

I think Finn was much closer to the actual rationale than the idea that it wouldn't be perfect so therefore not necessary. I think it's a cost/benefit analysis on the value of a handful of Americans over the economies of the airlines and the national economies of the endemic areas. Everything that I've read is a) Ebola will arrive to our shores (check) and the spread of Ebola will be contained once here (oops, although it can still be defined as "contained"). The cost of shutting down the airlines and the economies of multiple countries is deemed too high given that our containment procedures are supposed to be effective in containing the spread of the illness. Keep in mind, that containing the spread means keeping it local. It doesn't mean that (unlike Max hopes) that there will never be person-to-person contact here by someone who contracts it here.

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@JPB,

Nods.

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Quote:

"We have to rethink the way we address Ebola infection control. Even a single infection is unacceptable," Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, told reporters. "The care of Ebola is hard. We're working to make it safer and easier.

http://www.reuters.com/article/2014/10/13/us-health-ebola-idUSKCN0I21M020141013

http://izquotes.com/quotes-pictures/quote-you-can-always-count-on-americans-to-do-the-right-thing-after-they-ve-tried-everything-else-winston-churchill-37296.jpg

The truth is that in the past containing this bug has been pretty straightforward and successful. Not this time though.

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@JPB,

The point I am trying to make is this, The danger is exponential growth, something that won't happen with this disease in the US.

If one person infects 3 people and then each of the 3 people infect 3 more people who infect 3 more people... you get to big numbers rather quickly. The series would be 1, 3, 9, 27, 81, 243... and so on. That is what has been happening in West Africa.

In the US, that won't happen. We have modern hospitals, a functional public health system and a culture without barriers to medical care.

When we have a patient with Ebola, she is not only isolated... we also search out and check each of their contacts. This prevents spread from people to people to people.

The exponential growth won't happen.

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http://www.addictinginfo.org/wp-content/uploads/2014/10/Public-Health-Funding.0.png

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Dickensian US Working Conditions Almost Guarantee Ebola Catastrophe
Why is the US freaking out about Ebola while the rest of the world seems to be taking it stride? Damn good question.

Dickensian US Working Conditions Almost Guarantee Ebola Catastrophe

http://thiscantbehappening.net/node/2505

(snip)

One reason Europeans are not in a state of hysteria about Ebola the way the US public is, besides the confidence Europeans have in their universal health care systems, is that they know that waiters, maids and housekeepers have a right to paid sick leave, so they are not going to be on the job infecting others if they get the disease. They'll be availing themselves of free or next-to-free healthcare and getting tested and if necessary, treated.

Europeans also know that low-income workers are not going to send sick children off to day care or school. Unlike in the US, where many poor working parents have to choose between leaving small children home alone when they’re sick, or sending them to school anyway, so that their parents can keep their jobs, European parents in countries like Finland, where I spent some time last summer, and most other parts of the EU, have the right to paid leave so they can stay home and care for a sick child. Their schools also have nurses, unlike in the US, where impoverished school districts like Philadlephia have cut their school nurses from the payroll.

These programs are humane and just and have been won through years of labor movement struggle in Europe, but they are also beneficial to all the other people in a country -- the middle and upper classes for whom things like health insurance and paid sick days are simply expected.

Not so in the US, where a Darwinian philosophy prevails that argues that the poor do not deserve “handouts” like sick pay or health benefits.

PAID SICK DAYS IN US COMPARED TO REST OF WORLD

http://elitedaily.com/wp-content/uploads/2012/12/vacations-by-country-elite-daily.jpg

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@maxdancona,

maxdancona wrote:

We have modern hospitals, a functional public health system and a culture without barriers to medical care.

Say, what?!?!?!

For the record, I don't think it will happen either but it's not because there are no barriers to health care.

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@bobsal u1553115,

Not sure what to make of this

Quote:

National Nurses United, the largest union of registered nurses in the country, said that more than 80 percent of nurses the union surveyed report they have not been given adequate training on Ebola.

Thirty-six percent say their hospitals do not have sufficient supplies — including face shields and fluid-resistant gowns — to care for an Ebola patient, according the report by National Nurses United, which surveyed more than 1,900 nurses in more than 750 facilities in 46 states.

Seventy-six percent of nurses surveyed report their hospitals have not issued adequate policies on how to deal with patients who might be infected with Ebola.

“We are seeing that hospitals are not prepared,” said Bonnie Castillo, director of Registered Nurse Response Network, which is part of National Nurses United. “They are not doing active drilling and education they need to be doing.”

Castillo said most of the nurses surveyed reported they have received only single pages of information about Ebola that refers them to a Web site.

“That is woefully insufficient,” Castillo said. “We have to continue to sound the alarm. There is the potential for many more Dallases if hospitals are not mandated and do not commit to more vigorous standards. We see potential gaping holes for this to spread.”

http://www.washingtonpost.com/news/post-nation/wp/2014/10/12/national-nurses-united-says-most-hospitals-are-not-prepared-for-ebola/

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@JPB,

I am comparing it to the cultural practices in West Africa where people are hiding their sick family members. This is something that would never happen in America.

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@hawkeye10,

Its happening now, I bet!

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@maxdancona,

Or wash our dead, or even care for our deathly sick.

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@maxdancona,

I suggest you read bobsal's article above (http://able2know.org/topic/251020-18#post-5787526). Do you really think that a mother of a sick child is "never" going to send that child to school because she has to go to work? Or that a man who works as a day laborer without benefits isn't going to work a shift if he's sick? I think your "never happen here" assumption is pretty naive.

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@bobsal u1553115,

bobsal u1553115 wrote:

Dickensian US Working Conditions Almost Guarantee Ebola Catastrophe
Why is the US freaking out about Ebola while the rest of the world seems to be taking it stride? Damn good question.

What is your evidence for the proposition that "the U.S. is freaking out, while the rest of the world seems to be taking it in stride"??? Please provide some evidence of both parts. Several other nations have already imposed travel bans to/from countries with Ebola epidemics. Are they freaking out or taking it in stride?

I notice your table indicates that U.S. workers get zero paid sick days off and zero paid holidays. What is the source if this data? The great majority of employers provide at least nine holidays and 14 paid sick days. Increasingly companies are combining these categories and making them interchangable - i.e. vacation plus sick days plus holidays,

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@JPB,

The point is that there are big cultural and economic difference between the US and West Africa. I don't think that this is naive at all.

In these African countries, particularly in the countryside, people are getting very sick and dying without ever going to a hospital. Even worse, when health workers come to ask about their dying family members, they are hiding them.

I don't think it is naive to point out how different life is in America to life in rural Western Africa. There is no comparison. Bobsal's article (which is an interesting comment on modern Western culture) is completely meaningless in a Western African rural context (I don't think the typical person living in these villages even knows what a sick day is).

Life in West Africa, where this epidemic is centered and is growing exponentially, couldn't be any more different to American life.

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Ebola in The USA

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