Ebola in The USA

Snyderman should be required to make up the maid's lost salary. It's a total overreaction by the folks who fired the maid, but it's still on Snyderman, imo.

That maid should never have been fired. And I think a couple of days in a county lockup would have a salutary effect on Snyderman's arrogance and sense of entitlement. The maid performed a public service.

Kicking down and kissing up

Last edited Thu Oct 16, 2014, 09:08 AM - Edit history (1)
There is a common misconception about authoritarians, they want to rule everyone. In fact a classic authoritarian is obsequious and servile to those perceived to be of a higher social status or possible utility while at the same time being extremely harsh and strict with anyone they judge to be their social inferior and of no utility to them.

Watching the reactions in the M$M to this Ebola story has been interesting, every time there has been a screwup their first reaction is to blame the lowest status person they can find (unless they can somehow make it Obama's fault, they do have another agenda).

First it was the triage nurse did not pass on that Mr Duncan had been in Liberia, it took a couple of days for that to be shot down. But notice that the fact the doctor who signed him out missed it too has been entirely dropped like it never happened. Notice also that the the fact the doctor treated what he diagnosed as a viral condition with antibiotics has been dropped from the conversation.

Next it was nurse Pham, she had "breached protocols", again it took a few days for them to get slammed upside the head with the fact that for all practical purposes there were no protocols for some time after Mr Duncan was returned to the hospital. They implicitly believed the management story and did not bother to do any investigation with lower level employees.

Now it's nurse Vinson, the authoritarians exploded with rage at nurse Vinson for traveling but when it is revealed later the same day that the CDC was consulted and assented to the travel their rage was instantly muted rather than directed at the perceived social superior.

Watch for this reaction, if someone's first instinct is to believe that some little person screwed up hugely and the institution is blameless there's a decent chance you are witnessing an authoritarian in action.

Totally irrelevant to reducing and/or halting this dangerous disease and a curious artifact of the predictable imperfections built into the system of hospital administration,. Furthermore, there's the usual media distortion and over-hype.

When the smoke clears, the dead will be just as dead, and those that became infected will most likely be just as at risk. What matters most is the actions taken to limit or (hopefully) eliminate ... preventing a further outbreak.

Results are what matters here - not morbid curiosity about who is blaming whom.

What makes me a bit wonder is that only four hospitals around the USA are set up to deal with high-risk germs, but nearly everyone seems to think that all U.S. hospitals may be able to safely treat Ebola patients. (We have seven hospitals in Germany for the treatment of Ebola.)

The nurse flew to see her mother and another relative, as well as her boy friend, who's the one she is planning on marrying. If she is infected, the boy friend ( husband -to-be) is also infected.

What You Need To Know: The Chances Of Contracting Ebola
By Aaron Pero
Wed Oct 15th, 2014 4:03pm America/Los_Angeles


WASHINGTON (AP) — How come nurses wearing protective gear can catch Ebola from a patient, but health officials keep saying you almost certainly won’t get it from someone sitting next to you on a plane?

First, the odds of an Ebola-infected seatmate in the U.S. remain tiny, even after the news that a nurse coming down with the disease flew commercial across the Midwest this week.
Then there’s the extra screening that’s begun on airline passengers arriving from West Africa.
But even if you were to draw that unlucky spot next to a traveler with a yet-unknown infection, the disease experts would consider you at little or no risk.
Here’s why:
___
THAT PERSON ON THE BUS OR PLANE MIGHT NOT BE CONTAGIOUS YET
People infected with Ebola aren’t contagious until they start getting symptoms, such as fever, body aches or stomach pain, research shows.
So far, two infected travelers are known to have flown U.S. commercial airlines:
—The Liberian man who died in a Dallas hospital Oct. 8 wasn’t ill when he flew to the United States, according to the U.S. Centers for Disease Control and Prevention. So passengers on his United Airlines flights aren’t considered at risk.
—The nurse who flew Frontier Airlines from Ohio back to Dallas on Monday night wasn’t experiencing symptoms, either, the CDC said. But by Tuesday morning she had a fever.
Because her temperature rose so soon after traveling, everyone on her flight will be interviewed by health officials, and passengers determined to be potentially at risk will be monitored. CDC Director Tom Frieden says that’s for “an extra margin of safety.”
“We think there is an extremely low likelihood that anyone traveling on this plane would have been exposed,” Frieden said Wednesday.
He also said the nurse shouldn’t have taken a commercial flight because she was among the hospital workers being monitored after potential exposure to the Liberian patient.
___
BUT WHAT IF THAT GUY ON THE PLANE IS SICK?
Even if a traveler is already feeling sick, Ebola germs don’t spread through the air the way flu does.
Ebola is transmitted through direct contact with bodily fluid, such as getting an infected person’s blood or vomit into your eyes or through a cut in the skin, experts say.
What if a sick person’s wet sneeze hits your hand and then you absentmindedly rub your eyes? Could that do it?
Asked about such scenarios recently, Frieden allowed that, theoretically, “it would not be impossible” to catch the virus that way. But it’s considered highly unlikely. No such case has been documented.
“Should you be worried you might have gotten it by sitting next to someone?” he said Wednesday. “The answer to that is no.”
Frieden said “what actually happens in the real world” — and he cited four decades of dealing with Ebola in Africa — is that the disease is spread through much more direct contact with a sick person.
The World Health Organization says the same thing, and notes that few studies have found Ebola in an infected person’s saliva, generally in patients who were severely ill.
Still, the CDC identifies someone who spends a prolonged period within 3 feet of a person who is sick with Ebola as a “contact” who should be watched for signs of catching it for 21 days, just in case.
Pity the poor guy who’s prone to air sickness — will other fliers suspect it’s Ebola?
___
NURSES, ON THE OTHER HAND, WORK WITH PATIENTS AT THEIR MOST CONTAGIOUS
As Ebola patients get sicker, they become more and more infectious.
The amount of virus in their bodily fluids climbs, and the disease progresses to projectile vomiting and extreme diarrhea, and sometimes bleeding.
All the while, hospital workers are drawing blood, inserting IVs, changing diapers, wiping up.
Doctors, nurses and family caretakers have suffered an especially heavy toll in the West African nations where Ebola is spreading out of control, and where there isn’t enough protective equipment or help.
So far, the three people in this outbreak known to have caught Ebola outside of West Africa — two in Dallas and one in Spain — all are hospital workers.
All three tended fatal Ebola cases, in hospitals where health care workers were supposed to be safeguarded by their protective equipment.
___
USING THE PROTECTIVE GEAR IS TRICKY
Putting on a gown, gloves, hospital mask and clear face shield might not sound that hard.
But once the equipment is contaminated, the steps for carefully removing each piece without infecting yourself are painstaking. It’s easy to slip up.
Spain’s health authorities suspect the assistant nurse in Madrid was infected after touching her gloved hand to her face while taking off her gear.
U.S. officials are still investigating what went wrong in Dallas. Frieden acknowledged that the CDC did too little to help the hospital train and protect its staff when they were confronted with the first Ebola case diagnosed in the U.S.
___
WHO’S MOST AT RISK NOW?
More than 70 other workers who might have been exposed while treating the Liberian patient, Thomas Eric Duncan, at Texas Health Presbyterian are being monitored for symptoms of Ebola.
Meanwhile, Frieden offers optimism about the people in Dallas who interacted freely with Duncan before he was hospitalized.
There are 48 people being watched because of their potential exposure, including the family he was staying with when he got sick. They have passed symptom-free through the time period when infected people most often come down with the illness.
As they approach the ends of their various 21-day incubation periods, Frieden said, “it’s decreasingly likely any will develop Ebola.”

Why are so many Germans infected with the Ebola virus?

You read this where, please?

I mean, we do have quite some hundred aid workers and doctors in the African Ebola regions, but I didn't notice that one or more there or here have been infected.

Obviously you know more then we here.

Ignoring it gets you this:

Rep. Louie Gohmert: Nurses Infected With Ebola Are Part Of The Democrats 'War On Women’
Source: The Raw Story



Rep. Louie Gohmert (R-TX) declared on Thursday that Center for Disease Control (CDC) Director Tom Frieden was in charge of “the Democrats war on women nurses.”

Speaking on Glenn Beck’s radio program, Gohmert — who represents Texas, where one Ebola patient has died and two nurses have been infected — said he was “okay, but do any of us really know for sure.”

“You know, it’s a shame that the CDC head, Frieden, is apparently the commander of the Democrats’ new war on women nurses,” Gohmert opined. “Because, goodnight, they set them up, and then they throw them under the bus.”

“The idiot comes out and says that clearly she had violated protocol,” the Texas congressman continued. “At least in football, they have to tell you what you violated.”

http://www.rawstory.com/rs/2014/10/louie-gohmert-nurses-infected-with-ebola-are-part-of-the-democrats-war-on-women/

Both nurses who contracted Ebola from Mr Duncan have now been transferred out of Texas; one to Emery in Atlanta and the other to the NIH in Bethesda MD. Whether this is a slap to the local hosp in Dallas or not remains to be seen, but it's fairly clear that they are not yet ready to care for high level bio-contagious patients.

It was a bit puzzling to read about the transfers. Each country seems to have such a different take on how to approach care in cases like this.

Following SARS, Canada developed a protocol of special teams going to where the contagious patients are - there is a belief here that there is less danger of bio-contagion by moving the teams rather than attempting to move the patients.

The CDC was onsite in Dallas earlier this week. I have no idea how the decision came about to transfer both nurses, but it's obvious that the decision was made to transport both of them to higher level bio-facilities. It doesn't bode well for the "every hospital in the US should be prepared for an Ebola case" mantra.

Which leads to the question of why Mr. Duncan wasn't immediately moved to one of the two hospitals (In Georgia and Nebraska) that have proven they can properly handle Ebola patients.

Call me cynical, but I suspect that it was because the White House political hacks didn't want to upset the narrative laid out by their boss that America's healthcare system is entirely prepared to handle any and all Ebola patients.

The same dynamic came into play when Administration officials fell all over themselves denying that the Benghazi attack was committed by Islamist terrorists. To do so would have taken some of the wind out of the "Bin Laden Is Dead and Al Qaida Is on the Run" campaign slogan.

This White House is all politics; all the time. While Republican politicians may have tried to make some hay out of moving Mr. Duncan to Emory, they would have looked bad doing so, doing so would have instilled more confidence in the American people that the government was right on top of this crisis, It probably would have reduced the current number of Ebola patient by two (the two nurses).

This off course has nothing to do with the medical "experts'" understanding of the disease and how to treat it, which is something folks like max want to endlessly trumpet. It has everything to do with the way that government run operations actually pan out because of administrative incompetence and political considerations trumping the technical.

I wouldn't be surprised to learn that someone in CDC recommended that Duncan be moved to a proven facility, but was shot down by a superior.

Max blithely dismisses the CDC mistake of allowing the second nurse to fly from Cleveland to Dallas as simply "dumb." It's dumb mistakes that can turn a well-managed crisis into one that is out of control.

The CDC is part of the government, and while the first and foremost responsibility of the government in this crisis is to protect the American public from contracting Ebola, there is also a major responsibility involving making sure that the people who do contract the disease receive the best possible care. If anyone can form an opinion on whether or not Mr. Duncan would have received better care at a facility with experience with treating the disease we're not likely to hear about it for some time, if ever. Knowing that the Dallas Hospital has bungled certain aspects of the Duncan case certainly doesn't instill confidence in the American people, which leads us to a third major responsibility of the American government.

It wouldn’t have taken a psychic to realize that if Ebola reached our shores that the American public would experience a fairly high level of anxiety. For years now, the American media has portrayed the disease as one of the world worst Viral Bogeymen, concentrating on the horrific last stages during which patients bleed out from their every orifice while their internal organs literally liquefy. We have all been told it has an extremely high kill rate and led to believe (somewhat correctly) that contracting the disease is a death sentence.

The sensationalist way the media has covered this disease is not the government's fault, but it, obviously, set the stage for when a case came to our shores, and the psychological impact it would have should have been known and should have been planned for.

It appears clear that the government's plan for dealing with public reaction has been to make broad and at times overstated assurances while implying that only idiots are frightened by Ebola.

You can tell someone "Look, you're an idiot for worrying. We have this completely under control, and none of your fears will be realized, so just shut up and go about your business," but you then had better be perfectly correct, because the first reaction to a screw-up will be "Hey big-shot, you said we didn't have to worry, that nothing like this would happen. What else have you been wrong about and why should we trust you to do what you said you'll do?"

Crisis Management Experts all agree that Johnson & Johnson did a masterful job at reacting to the Tylenol tampering incidents back 1982. First and foremost they understood and took seriously the concerns of consumers. Although each one was an individual tragedy, in relative numbers, the seven people who died were statistically insignificant. At the time, there were 31 million bottles of Tylenol on the shelves of stores throughout the US. I don’t know if the probability of dying from contaminated Tylenol in 1982 was the same as dying from Ebola in 2014, but it’s certainly in the same ball park. What J&J did not do, is tell the public they had nothing to worry about and try to minimize their concerns by telling them how they had a much greater chance of dying from double lightning strikes, terrorist attacks, or driving in their car to their local supermarket. They didn’t simply tell them they had a plan they clearly demonstrated it and in a near flawless manner. What they did do was to immediately warn consumers not to buy their product and then recalled all 31 million bottles. Furthermore they reintroduced their product into the market in tamper-proof containers that were a break-through in consumer safety and actually helped solve a bigger problem than product tampering: Child access to adult medicines.

The CDC doesn’t have a product to recall, and there probably isn’t some equally dramatic and effective means to protect the public, but they can still learn from J&J by taking the public’s concerns seriously, communicate fully, honestly and without condescension, and remain focused on the goal and not allow secondary concerns like whether or not the president’s statement are backed up or contradicted to interfere with correct decision making.

Of course J&J had millions of dollars at stake, and, indeed their company itself. Tylenol represented 17% of the company’s income, and 37% of the $1.2 billion analgesic market. Whether their Chairman actually believed that the company needed to put people over profit or it was simply part of the PR plan, Tylenol was motivated to implement a plan that not only worked in terms of safeguarding the public it resulted in their restoring their market share from a low of 7% immediately after the deaths to 30% in less than a year, and they made a significant contribution to product safety in the process. Not bad for a soulless corporation run by unfettered capitalists.

I don't need to know any more about Ebola than I already do. nor do I need to know any more about government officials and medical experts than I already do.

Some brilliant medical experts at the CDC told the second nurse to be found to have contracted the disease that it was OK for her to board a commercial airliner when she had a fever. I give that nurse a hell of a lot more credit that the experts with whom she spoke. The people she spoke with who cleared her to fly, I'm sure know more about Ebola than I do, but there being experts on the virus obviously didn't mean much when it came to advising the nurse on the proper course of action. Her temperature wasn't high enough to hit the magic zone they all have written down on some check-list and so they told her to go ahead and fly. Classic beaurocratic behavior.

Something that does nothing is not counter-productive to anything. I'm sure there's a mathematical concept underlying that fact so I have to wonder why math-genius max doesn't understand it. And I don't know how many times I have to tell you that I don't believe there is a significant risk of a widespread Ebola epidemic. There are people calling for an air travel ban, and although in this they don't agree with you, it doesn't mean they are ignorant fools blinded by panic. Your reasoning for opposing the ban is as vacuous as that coming from the experts. Actually it's more so because at least they are not arguing that because something does nothing it is counter-productive.

They have absolutely not presented the reasons why a travel ban is a bad idea, and neither have you, but if you think you have, please, by all means, reiterate them. It's only what I've been asking for over the last two or three posts.

Your assertion that my reaction to the outbreak is evidence of panic is precisely what I expected from you: Any questioning of the CDC's competency in handling this crisis, or an insistence on their providing us with a medical reason for why the travel ban should be enacted is, in your pompous mind, an indication of out-of-control, irrational fear. No doubt you've been wanting to call me and anyone else who disagrees with you or who questions, in any way, the CDC's decisions and actions panicked yahoos for some time now.

I have given you plenty of evidence in my posts as to what resources I've been relying on to form my opinions on this matter and yet your utterly predictable, reflexive response is to yammer about yahoos at Fox. Yes, Fox is one of my sources for news, but it is only one and I'm not about to apologize for using it. If you had any idea what the folks at Fox have been saying about this matter, you would know that they are not all calling for the travel ban or demanding that Frieden resign, and they are certainly not exhibiting any behaviors that can qualify as panic.

Fox also has a number of doctors who contribute to their discussions and who are all saying pretty much the same thing the CDC is about the mode of transmission and how very unlikely a widespread epidemic in the US actually is. Sheppard Smith, who you have such a high regard for, is just like you, copping a superior attitude and referring to questioning of the CDC's competency as mad panic. It a habit of his and one which I suspect doesn't endear him to his colleagues.

One only had to watch Obama impromptu press conference yesterday to realize that, apparently, he finally has caught on that his Administration has been botching this crisis, but I suppose you consider what he had to say either bowing to the panicked cries of yahoos or that he’s become one of the yahoos himself.

We are damned lucky that it’s Ebola that broken out and not a far more virulent virus that can make use of airborne transmission to spread.

actually the truth seems to be even more bizarre....it appears that the medical scientists believe that there is no chance of infection with a low grade ebola fever, that she was cleared to fly because it was ok to fly. The boss of the outfit however seems to not know the science or his staffs professional opinion but he is out there running his mouth anyways, and apparently The Professor( who has a long record of horrible judgment) believed without examination the idea that the boss of the CDC was telling the factual truth.

The experts knew just fine if this is what happened, it was The professors political appointees who were not in touch with reality and who completely fucked up doing the basics of their job( which means that the poor judgement of The Professor fucks us over yet again)

Finn,

Stop being so obtuse. Medical scientists have explained why a ban on air travel isn't necessary or a good idea. I have explained why a ban on air travel isn't necessary. You can scroll up a few pages and read it, or you can google it yourself, or if you really insist I will type it again.

Your position is anti-science and it really is ridiculous.

The proper response to an infectious disease is to make reasoned decisions based on medical expertise. You have the people with the training and experience who have done the research and have access to the data and scientific expertise on infectious disease come up with the best public policy based on facts.

Of course these medical doctors and researchers should explain their conclusions to government officials. And they are explaining their conclusions (which is why I understand them). They aren't the problem, you are. It is not the fault of medical doctors and researchers that you are listening.

The alternative is to come up with a bullshit, reactionary policy run by public emotion instead of science. Banning air travel (against the advice of the medical doctors and researchers who actually understand the disease) is a perfect example of that.

You are completely wrong in this Finn. A reasoned scientific response based on facts and research that ignores public irrational emotion is really the best response for any infectious disease.

Your final jab at science, implying that they would be unable to handle an airborne virus is also bullshit. The science community had a much different response when confronted with H1N1. The advantage of a science-based logical approach is that it adapts to find an appropriate response to whatever the facts of the specific crisis are.

A knee-jerk, emotion driven, reactionary policy doesn't have that advantage.

the one and only objection that I have heard from the infection experts on travel bans that if staff cant trust that they can come home when they want to they will never go to hotspots. this is easy to work into a ban, just exempt medical professionals. The objections to travel bans seem to come from representatives of the tourism industry first, global firms and their advocates second.

Do you know different?

EDIT: Actually there is a second argument....that government could never effectively conduct a travel ban, any effort would fail due to incompetence, so dont even try.

http://lmgtfy.com/?q=why+banning+air+travel+won%27t+work#