Ebola in The USA

Yeah, and so far it's not even with early symptoms - just end stage symptoms of projectile vomiting and explosive diarrhea.

It should be easy to deal with these patients. It is scandalous how poor the infection control protocols used in Dallas were.

'K, thanks.

Beg pardon - it wasn't a boy at the school who was on the plane (also not the same flight) but an adult employee - I miss remembered. True that they closed the school and did disinfecting procedures.

http://cleveland.cbslocal.com/2014/10/16/ohio-school-district-takes-ebola-precautions/

Ebola crisis: Nigeria declared free of virus
Source: BBC

Nigeria has been declared officially free of Ebola after six weeks with no new cases, the World Health Organization (WHO) says.

WHO representative Rui Gama Vaz, speaking in the capital Abuja, said it was a "spectacular success story".

Nigeria won praise for its swift response after a Liberian diplomat brought the disease there in July.

The outbreak has killed more than 4,500 people in West Africa, mostly in Liberia, Guinea, and Sierra Leone.

Read more: http://www.bbc.co.uk/news/world-africa-29685127

Personally, I'm finding it more and more difficult to trust that the safety protocols that we have in place are secure enough. Multiple people have come in from West Africa, bringing the threat of Ebola into our cities. Dallas and Houston Texas are some of the most recent (that I've heard of) to have an Ebola outbreak scare. This is troubling that these people could get through without questioning or any kind of medical attention until they're contagious. Shouldn't they be checked before and/or after they get on/off the plane, at least while there's such an impending concern?

I don't think the practical learning we have had to do in this area is either a sign of inability or failure. Some practical clinical learning was inevitable in the case of an unfamiliar, highly contagious disease with such high mortality. All of this was largely predictable. Unforunately our inept President didn't understand that, and , instead of focusing on what had to be done, he fed us all a lot of empty reassurances, working, as it seems he always does, from a politics-only perspective. As his empty reassurances were repeatedly proved wrong, public confidence fell - as it should have done.

This is a thread about Ebola (which is will understood and is not very contagious at all).

Which disease are you talking about?

Tell that to the people of West Africa idiot.

That's not exactly true. It is highly contagious in the right circumstances. The virus wants a host. Once the disease overwhelms an immune system and the current host is near death it becomes a "fluid producer" causing large amounts of fluid to be exuded from that host. These fluids are highly contagious with very high virus loads. The corpse is also highly contagious to those who come in contact with its fluids. Patients who reach this state also have a very high mortality. Getting early care is extremely important, as is avoiding close contact with someone with end-stage disease or an ebola-ridden corpse. We don't know yet at just what stage a symptomatic patient becomes contagious. It's encouraging that none of Mr Duncan's public contacts, nor any of the care providers prior to his isolation became infected. It's unlikely that anyone who came in contact with nurse Vinson during her travel will become ill, but the truth is we won't really know for another two weeks. It remains to be seen how the morbidity and mortality of this disease in the developed world will compare to that in rural West Africa.

Ebola is not very contagious (in West Africa or here). It isn't transmitted by people without symptoms. It isn't easily transmitted to people around you. It isn't transmitted by mosquitos.

In West Africa the problem is that people are caring for the sick and dead without protection. This doesn't change the fact the disease is very hard to get in any casual public interaction. This is a tragedy. But it doesn't change the basic scientific facts.

This is why the mass hysteria here is ridiculous.

No it doesn't remain to be seen. People who understand the science already know what will happen. This is a well known disease. The transmission rate is very low. The R0 for ebola is 2, for measles the R0.

A couple of dozen people in the US may die. Each case is tragic, but more people will die of the flu this year than ebola.

This isn't magic. This virus is well understood by science.

Again, try and sell that idea in West Africa. Eubola is a very serious disease with high infection rates and unusually high mortality.

It is becoming increasingly obvious that you pretend levels of knowledge and understanding that you don't actually have.

It's lower than that for the US, actually. Current numbers I'm seeing are closer to 1.5 here vs 2.0 elsewhere. That's still an estimate, obviously, since there are only 3 cases to go on. I'm thinking it will actually be less than 1.0, but there's no large-scale data to back that up. But, still, any r_zero greater than 1 will ultimately result in an epidemic if it isn't controlled/stopped.

It is a very serious disease. But the hysteria and overreaction isn't warranted.

We know exactly why it is spreading in West Africa. We also know why it won't spread here.

There is science here.

So what? The truth or falsity of a factual proposition is independent of whether people buy it.* And it's a well-established fact that Ebola is far less contagious than, say, influenza or malaria.


Max does, however, spell the name of the disease correctly, which is a higher level of expertise than you just demonstrated in your post.

___________
* Max, being a relativist, may not buy the proposition that facts are facts independent of who buys them. Tough titties! This proposition of mine is true true, just as his about Ebola.

...is 18.

Okay, thanks for that. After googling "R0" I think I'm a convert to the "let's not worry" camp. (Although, we should worry for ethical reasons, because it's irresponsible and racist to let this disease decimate West Africa.)

Maybe people have already linked to this article, I don't know, but anyone who hasn't read it and is freaking out about ebola probably should read it:
http://www.npr.org/blogs/health/2014/10/02/352983774/no-seriously-how-contagious-is-ebola

On a side note, this article also sheds some light on why measles vaccination on a massive scale is so important. If even a ninth of the population aren't vaccinated against measles, measles is still as likely to be transmitted as ebola.

The only people from Africa who will bring the disease into our cities are the one who have it. As I see it, there are three soft spots in our safety protocols regarding their arrival in this country

1) Are our TSA agents up to the task of screening for passengers who might have the disease? As I previously wrote, I heard a doctor from Samaritan's Purse on the radio the other night describe a reassuringly thorough process at Atlanta-Hartfield. Whether or not that process is being duplicated in all the other airports where screening has been implemented, I can't say, and whether with time it will remain as diligent as it now may be, remains to be seen.

I do a lot of travelling to a lot of different cities and the level of TSA screening for terrorists varies greatly from airport to airport. I have seen evidence of excellent work and evidence of sloppy work. I imagine that the same will play out with screening for Ebola or any disease. It would be foolish to think that TSA agents will catch each and every case of infected passengers who are symptomatic. This isn't wholesale criticism of the TSA, just common sense. If the US healthcare system (including the CDC) has made mistakes with only three patients on whom just about everyone in the country is focused, it defies credibility to suggest that TSA agents will be error free when it comes to hundreds and thousands of airline passengers.

2) A person can be infected but still be asymptomatic when they deplane at an American airport. All the information we now have tells us these people are not contagious at this time and so the people they came into contact on the plane and in the airport should have nothing to worry about, but if these people remain in the country for any length of time, they will eventually have symptoms and become contagious. I don't know how TSA agents are supposed to identify these people during the screening process. I don't know if the virus would show up in a blood sample, but taking blood is not part of the screening process anyway, and if they are relying on asking the passengers questions to determine if they pose a risk, this is only as solid as the honesty of the passengers. The first man to bring the virus into the US (Mr. Duncan) lied to TSA agents and I suspect that this will be the case with many passengers who wish to be allowed in.

3) All the airports that receive passengers from the affected nations of West Africa are not included in the enhanced screening program. I think the airports without extra screening account for something like 6% of the traffic which is obviously low, but with time, a lot of passengers will have come to the US through these airports and the chances that one or more of them are infected will increase. Statistically it may not be a great threat, but it remains a soft spot.

The best way to insure that most of the people who have been in the infected regions do not enter the general populace here (no means will be perfect) is not only to ban commercial flights to and from these countries, but to put a freeze on the issuance of US travel visas to citizens of the affected nations.

I haven't yet scrolled back far enough to see if max has come up with a medical reason not to do this, but it's already been discussed that these bans need not put an end to US efforts to help these countries gain control over the disease. Special charter flights can be arranged for those who need to travel to Liberia, Sierre Leone et all for the purpose of providing assistance in these nations' battles with the disease.

Since more and more Democrats are now calling for the banning of flights and visas I think there is a strong possibility that they will be put in place, and I think it's almost a certainty that they will if another Ebola patient from one of these countries makes it to US streets.

Of course max and others are correct that there is no reason to panic, but then there never is, no matter what the threat. Panic won't solve any problems and will likely exacerbate them. Now what max describes as a panicked reaction and what I do are very different, and there is absolutely nothing wrong with being concerned about the disease.

No matter what is done, I think it's important for everyone to realize that there is no perfect course of action. Despite what anyone tells us they can't guarantee that no more Ebola patients will materialize, either from one or more West African country or because they were infected by one of the three Ebola patients associated with and including Mr. Duncan.

They also can't guarantee us that we won't get hit by a truck or drown in our bathtubs so there is need to keep the risk in perspective, and to weigh the cost (not only in terms of money) of precautions taken against the scope of the risk they are intended to mitigate. The problem, again as I see it, is that our government hasn't been able to adequately explain the cost of the bans, and that it is not adequately considering the level of public anxiety in the cost benefit equation.

This discussion will probably be moot if another Ebola patient turns up in America and particularly if he or she is identified before the elections in a couple of weeks. Let's just hope for everyone's sake that no more do make it in. Your chances of being infected with the virus may be, indeed, very slim, but it's a horrible disease and anyone who catches it isn't going to take any great solace from the fact that it was a very rare event.

Whatever, the donations are almost non existent, from governments and individuals. We have been hearing about and seeing images on tv of calamity in Africa our whole lives. Then we have their offspring, the blacks in America, who are perpetual victims according to them. Then there was that recent business of the most recent calamity to befall Haiti, another never ending disaster no matter what we do.

almost 5000 africans dead, maybe 5000 a week by Christmas? Ya, whatever the thinking goes. Africa all fucked up, situation normal.

You're probably right that the airlines don't want a ban. I'm not so sure that they can cancel any and all routes they please without getting flack from the government, but I doubt they want to. None of them will come close to going out of business if the ban is enacted though.

Your explanation of why there is no medical reason for a ban is pretty simplistic and short of the mark. Mr. Duncan had the disease, but was certainly fit to travel since he made it from Liberia to Dallas. If he wasn't symptomatic when he arrived at a US airport, he certainly became so after a period of time in this country and as we know, he did infect at least two other individuals. It certainly does appear that he didn't infect any non-medical people with whom he came into contact, but despite the difficulties presented to transmission there is nothing to say that a new infected passenger will not receive the same sort of close contact care from family members that allows for transmission in West Africa.

You are correct though that a reason for enacting the bans (should they be enacted) will be to alleviate fear. Unfortunately this is what can happen when you assure everyone there's nothing to worry about and then your own mistakes prove you wrong.

Contrary to popular liberal belief, only an extremely few "free market types" believe there is no role for the government to play in our lives and that everything should be dictated by the market. In addition, there are more and more Democrats calling for the bans so it's no longer a Republican "thing."