Ebola and American Exceptionalism:

[PCIntern]

I just watched a Press Conference and this is what I have learned from it: As Americans, we cannot contract the ebola virus in its present form since we have the best healthcare in the world and we can track infected individuals and exposure because. We are very very safe because we are Americans. The patient is in extreme isolation in Dallas, Texas, home of the assassination of JFK and co-originators of the S&L Crisis, and thus we know that there can be no errors of judgement made because. The fact that this individual demonstrated symptoms of the virus for four days prior to his isolation is utterly irrelevant because he only came into contact with his family members and we know that this is true because. There is nothing to see here so just keep moving please. No worries. We are Americans and we are immune from this African Disease.
+++++++++++++++++++++++++++++++++++++++++++++++
Do you know where I last heard claptrap expressed in this manner? When I was a young clinician and the CDC and all the so-called Health Experts discussed GRID: Gay-Related Immune Disorder, since there was absolutely no evidence that the agent infected heterosexual individuals. Same tone of voice, same surety. We are just SO SPECIAL, are we not?

As my grandmother of blessed memory used to say loudly, "UH-HUH...!"

[YarnAddict]

1. Well, the guy

wasn't just presenting facts; he was doing his best to prevent a panic. At this point, there is nothing to be gained by leaving the door open for rampant speculation about possible danger to the public.

Can you imagine--our healthcare system would be totally overwhelmed with people flooding in, sure they had been exposed.

[PCIntern]

2. Of course he is...

so of course we had open borders and airports with no health screenings. Christ, in the old days they quarrantined people disembarking from ships for weeks and months if they thought they had smallpox or TB. If Stephen King had written The Stand now, he would have used this hypothesis.

[LiberalLoner]

10. CPT Tripp, all the way.

[CoffeeCat]

3. The CDC doesn't know what the future holds...

…and I'm not saying that millions in the US will end up infected with Ebola.

However, why is the CDC presenting such a farcical PR campaign?

They have NO IDEA what will happen with the Ebola virus. The latest WHO prediction models suggest that one million people will be infected in Africa alone.

Unless someone has a crystal ball, they should avoid painting rosy predictions regarding this unprecedented health situation. It's a health crisis that we have never seen before. The people saying, "Remain calm! All is well! Are just as bad as the people who are suggesting that this is the end of the planet.

The CDC should just stick to imparting facts. They don't need to tell us how and what to think about facts.

(edited for clarity)

[PCIntern]

4. I agree with your entire post with the exception

of the last sentence...

This IS how it works. Watch it in ACTION!

[Sopkoviak]

5. Every zombie/virus movie I've ever seen starts with a

"Don't worry, everything is under control" press conference.

And another thing about zombie/virus movies?

The first announced case is never the "only" case.

Of course then the military shows up with flame throwers, napalm and small tactical nuclear warheads.

Keep your eyes to the skys.

[longship]

11. You've been reading too much Scott Sigler.

Of course then the military shows up with flame throwers, napalm and small tactical nuclear warheads.

But then, at least,Scott Sigler's bug came from outer space, possibly requiring military intervention.

Ebola requires only infrastructure and quarantine, precisely the things which West Africa does not have which the USA does have. If fact, the big US military intervention in West Africa has been 3,000 troops to build clinics (infrastructure) and provide the necessary information to contain the outbreak (quarantine).

[davidn3600]

34. Until the virus mutates

http://www.dailymail.co.uk/health/article-2753421/Real-risk-Ebola-virus-mutate-AIRBORNE-disease-expert-warns.html

[longship]

36. Daily Mail? One guy?

When all the other experts say it is NOT likely to become airborne.

What they are saying is that it is more likely to become less deadly, which would also make it easier to transmit, but with less evolutionary change than that required to be airborne.

Apparently, being so deadly is not advantageous to transmission. However, even cadavers are infective (which is one reason why Ebola is such a problem in Africa which has burial practices which the virus can spread).

[longship]

6. Uhhhh!

Last edited Tue Sep 30, 2014, 08:05 PM - Edit history (1)

The patient is in extreme isolation in Dallas, Texas, home of the assassination of JFK and co-originators of the S&L Crisis, and thus we know that there can be no errors of judgement made because.

What does that -- JFK and S&L crisis -- have to do with the price of tea in China? Let alone Ebola! Let alone American exceptionalism?

Can anybody say, non sequitur?

Huh?


on edit: clarification.

[Texasgal]

7. Right?

I was trying to understand that and didn't get it.

Presbyterian Hospital is an excellent facility that serves thousands of the city's poor people to boot. I am at a loss here. ???

[PCIntern]

9. Don't bother. Not worth it. Nt

[longship]

13. JFK and S&L crisis! Really?

I agree with TexasGal. I do not understand your argument.

It is a non sequitur.

[PCIntern]

14. All right...

Ok....
1. This guy is in Dallas
2. Dallas is known for JFK and some s and l shenanigans
3. Everything that we know about those involved screw ups
4. Ergo, what could possibly go wrong?

See, I told you it wasn't worth it. It was an aside. But it's ok. They said its safe and they also said that the WTC air was safe. But I digress....

[Texasgal]

15. Please pay no attention to the fact

Dallas Presbyterian is a world class institution that has an amazing program for the uninsured and poor communities. Nope... Nope. As a physician You should know this! Appalling and seriously strange on your part. Sorry.

[longship]

16. You do, indeed, digress, with totally irrelevant and unconnected facts.

That's why, although I often find your posts very good, this one is particularly cringeworthy.

I apologize if you take this wrong, but JFK and the Savings and Loan crisis have zero to do with an Ebola patient showing up in Dallas, and certainly has nothing whatsoever to do with the medical facilities' there ability to treat and contain it.

I do not object to your fears. I object to your non sequitur of invoking JFK and the S&L crisis, which are most certainly irrelevant to this issue.

[Texasgal]

18. I find it just plain

weird.

[PCIntern]

19. Ok so the irony of this being in

Dallas and the risk of it being mishandled since the guy WALKED AROUND FOR FOUR DAYS with symptoms is irrelevant and non sequiturs. Fine. I apologize.

[Texasgal]

20. Do you think that had he been anywhere else

it would have been different?

[PCIntern]

23. It was a joke of sorts

Sort of like how the joke goes that when somebof you guys when asked what country you're from say "Texas"

[PCIntern]

39. Wasn't this the hospital to which he first presented?

I don't personally give a damn about the reputation of a place. The individual practitioner is responsible for each of his or her patients. My building has a great reputation among lay people for medical and dental care. If they only knew what went on here...

[Dreamer Tatum]

44. Aren't you supposed to be some sort of health care provider?

If so, aren't you remotely aware of how disease and viruses can spread?

I'd think that if you were professional in the least, you'd be one of the first to get how dangerous
Ebola can be instead of knee-slapping and bullshitting about a place you don't seem to know or
understand.

I think you're in Philly, right? You really want people to bring up the stupid, irrelevant bullshit that
goes on in YOUR town?

Maybe you're right. Maybe the cops should have dropped bombs on the guy's house, like they do in Philly.

[PCIntern]

45. Nice post, thanks!

I don't know what you're talking about: I'm the one who is questioning the lack of care in allowing people in here who we KNOW have been in a zone, and not taking a thorough history.

You just brought that MOVE stuff up. There is no question that it occurred and we are still paying the price for it, in every sense.

[Dreamer Tatum]

47. You impugned Dallas, as if Dallas or Dallasites are responsible for such things. nt

[PCIntern]

48. Why you delicate flower...

I deeply and sincerely apologize to those from the home of Tom Landry of blessed memory.

On edit: it was supposed to be ironic, but such literary fashions are eschewed around here lately.

[Dreamer Tatum]

49. Irony works better when it's at least worth a titter or a knowing nod.

Just a bit of advice for you. And entre nous: I don't have the slightest bit of regard for Dallas, though
perhaps more than I do for that Philly shithole.

[PCIntern]

50. Wow...two nice posts in a day!

I really appreciate your sensitivities in this matter and will keep you in mind for further discussions.

[Dreamer Tatum]

52. Likewise. I mean, not every city can be as clean and disease-free as Philly.

I mean, can you IMAGINE anyone with any sort of contagious disease walking around in public places in PHILLY? I sure can't. Dallas sure has a lot to learn, by gum. Anyplace that hosts the deadly communicable disease known that the [bS&L Crisis pretty much needs to be burned down and rebuilt. Rebuilt, mind you, with the same disease-free aesthetic as...PHILADELPHIA.

[longship]

22. But that he was released IS an issue, as you posted.

The CDC needs to get the word out to inquire of a person's recent travels when certain symptoms show up.

However, we are coming up on influenza season, which has many of the same symptoms as Ebola. But influenza is much, much more contagious than Ebola. Flu is transmitted by air and Ebola is not. That is a huge difference. And it is why a person who is hospitalized for flu but has Ebola will not likely spread the disease as quarantine procedures would likely be the same.

BTW, both influenza and Ebola are deadly. And although a higher proportion of those afflicted with Ebola die, than flu, the flu kills tens of thousands every year, much, much higher than Ebola.

Ebola is its worst enemy.

1. It kills so quickly and effectively that the patient has little time to transmit the virus.

2. It is not easily transmitted. It is not transmitted until symptoms appear and only through direct contact with body fluids.

In other words, although it is a horrible disease, it is a very inefficient one. (Except when it finds its way into countries with no medical infrastructure and broken cultural and political systems.

[PCIntern]

24. Yes

When someone else has the disease it is inefficient. When you have the disease it's an irrevocable tragedy. I'm trying to remember my public health 101.

[longship]

12. Edited for more clarity. nt

[tularetom]

8. Remain calm!

[Bluenorthwest]

17. There were over 20,000 dead Americans before the government officially said anything about AIDS

There were an additional 50,000 infected. Cases had spread to 113 countries. Through all of this, Americans as a whole paid no attention, did nothing, said nothing and continued to vote for the Republicans who were ignoring this health crisis.
Perspective.

[AverageJoe90]

70. The truth is, though, this is a rather different scenario. In many ways.

AIDS didn't really spread all that much outside the LGBT and African-American population, and certainly wasn't nearly as horribly nasty or as virulent as Ebola, either. Those two things alone accounted for most(perhaps something on the order of 90%) of that problem.

OTOH, we're already seeing a much better initial response with Ebola than we did with AIDS, so yes, there's no reason to panic just yet.....even Nigeria's gotten their own problems under control at this point.

[951-Riverside]

21. We're stupid.

We continue to allow free travel in and out of these affected countries so was bound to happen.

[uppityperson]

25. Every healthcare provider I worked with knew HTLV would affect anyone, regardless of sexual

orientation. It was showing up and being diagnosed among young gay men, but we knew that was only where it was being noticed, not wherenit only was.

There was lots of "wtf is going on" but maybe I was just lucky to work with people who saw the broader picture.


And as far as ebola goes, some of us are able to see there is a wide area between OMG.PANIC and meh.

[PCIntern]

26. Exactly. Nt

[kestrel91316]

28. + 1 000 000 000 000 000

Nobody is taking into account the ability of this virus to spread via sweat and fomites.

Nobody is taking into account the proven tendency for victims and contacts, many of whom are ignorant, superstitious, or mistrusting of government, to LIE and lie outrageously to public health investigators.

I know about that last one personally. It caused a delay in locating a rabid cat that could have cost my life as one of the exposed.

[840high]

30. Info

ow long does Ebola live outside the body? No definite information is available because it has not been researched; the best hypothesis is 3 to 10 days. Fomites, if Ebola can live on a door handle for 3 to 10 days. How many people visit a public restroom in a day (entrance door handle and then touch your face)?

http://wiki.answers.com/Q/How_many_times_does_a_person_touch_their_face_daily

The incubation period of Ebola is 2 to 21 days. The method of transmission is direct contact with secretions. If a person survives the Ebola virus the person may be able to transmit the virus through sexual contact for up to 2 months.

http://en.wikipedia.org/wiki/Ebola
- See more at: http://www.thomhartmann.com/users/pkrause12249/blog/2014/07/urban-setting-ebola-perpetual-ebola-will-never-burnout-professionals#sthash.uluJmjLK.dpuf

[kestrel91316]

54. Stop spamming my comments and these boards with the identical post, dude.

[840high]

55. wtf is your problem? I posted twice.

[kestrel91316]

56. You posted that a lot more than twice.

[FourScore]

29. It's the same claptrap they've been spouting since

the disease began to spread in early summer: Not a problem...will stay contained...almost impossible to catch...won't make it to the US...Meanwhile, Doctors Without Borders was screaming for help as the disease spread like wildfire, killing thousands (soon to be millions)...and now? It's in friggin' TX!!

CDC: "Wowzie! How'd that happen???"

[AverageJoe90]

58. "Soon to be millions"? I don't think so, FourScore.

Even the Bubonic Plague didn't evolve that quickly.....and it was a one-in-a-million occurence. And right now, we have no solid evidence that Ebola is at risk of killing millions either......

[FourScore]

65. Guardian headline: "Up to 1.4m people could be infected with Ebola by January, CDC warns"

That's just by January and it has a 70% kill rate. They've also told us it will be an illness to contend with in our society in the future. Will it spread like the plague? Not unless it goes airborne, which it could. Hopefully won't. But, do the math. Unless you think it will magically disappear after January, there are many, many deaths ahead.

http://www.theguardian.com/society/2014/sep/23/ebola-cdc-millions-infected-quarantine-africa-epidemic

[AverageJoe90]

69. Yes, but that was only a worst-case scenario, however.

Also, where do some of you guys keep hearing that this is (supposedly inevitably) going to be a recurring problem for the U.S. in the future(feel free to correct me if I read that wrong, however)? Because I've been paying pretty close attention to this and I can't recall ONE (reliable) mainstream source that has made that claim.

[magical thyme]

31. +1,000,000,000. and I totally got the Dallas references

unlike "Ignored" (who's comments I saw at work).

From the moment I read the 1st article I saw this morning, I knew this patient had tested positive. None of the announcements about it were like prior patients. I've pretty much been waiting for this. It seems more of a clusterfuck than I was expecting, though.

What was frightening to me was to learn that he was symptomatic for 4 days or so prior to being isolated, and that he was misdiagnosed on his 1st ED visit.

I wonder if they neglected to ask him about recent travel, or if he lied about it. I hope the exposed health care workers are ok, and any people exposed in the ED waiting room during his 1st visit are ok.

[suffragette]

35. Possibly also the pharmacy there

Since he was apparently prescribed antibiotics at his first visit.
Not sure how it works there, but at medical centers I've been to, you usually wait in one area, the have to wait again to pick up your prescription.
So, possibly two waiting areas and two different groups of people waiting.
I also wonder about surfaces and magazines, etc.
Sweat or mucus could be transferred to these easily.
Would these be contagious and for how long?

[magical thyme]

38. there haven't been any studies to date re: transmission via fomites

the pig study in Canada suggests 3 possible routes of transmission. The most likely of the 3 are large droplet and fomite.

Since the virus is encased in membrane, it most likely needs fluid to remain viable, so I don't expect surfaces to remain contagious for long. Usually membrane encased organisms die once they dry out. That is how alcohol works to disinfect; it dehydrates the surface membrane of the gram negs.

But that is pure speculation based on bacteria, which are living, not viruses, which are not really alive.

[suffragette]

43. That's good to know

Hope that is the case.
And now I know what fomites means.

[Barack_America]

32. Nigeria.

No new cases since 8/31 after tracing and isolating contacts.

Senegal. No new cases after isolating man who presented ill.

Nigerian and Senegalese exceptionalism too?

[PCIntern]

37. Possible answers:

1. That you know of.
2. Failing (1), a ruthless subjecting of anyone entering the country routinely to questioning, testing, and/or quarantining. No one here or anywhere else has the 'civil right' to infect anyone else.

[magical thyme]

40. they have not yet reached 2 consecutive 21 day periods

The WHO prematurely declared the current epidemic over once before, months ago. And then, just 1 day before their 42 day requirement of no new cases, it flared up and turned into the current conflagration.

Frieden's presentation was clearly aimed at averting panic, rather than informing. Personally, I'm concerned about how the patient came to be released on 9/26. Those are the types of mistakes that lead to outbreaks.

And I'm concerned that while they've announced that the ambulance workers have been quarantined, they haven't mentioned the health care workers that treated him on 9/26.

[ecstatic]

59. There are reports that entire cities are being quarantined at gunpoint

That will never happen here, so you can't really compare the US to Nigeria/Senegal.

[AverageJoe90]

71. That's true.

And if even Senegal and Nigeria can get this under control, than we should definitely be able to as well.

[HeiressofBickworth]

33. On the guy's FIRST visit to ER, one question

would have served to contain any additional exposures: "Have you been in Africa recently?" If no, then it would be reasonable to assume a flu of some kind. However, if YES, then isolation and testing immediately would have reduced any other exposures. Or did the ER staff buy into the American Exceptionalism that it can't happen here?

[magical thyme]

41. Or did they ask the question and get lied to? nt

[Hekate]

62. He told them straight out. The nurse wrote it down. The doc ignored her notes.

The patient did not lie -- he knew he had been exposed.

[magical thyme]

66. I've seen that since posting this, other than doc ignoring her notes...

do you have a link to that? Was it really the doctor that ignored (or missed) her notes?

[Hekate]

68. Don't have a link; saw it here

As for it being the doctor, that was just an assumption of mine based on the usual chain of events in a hierarchical organization. Notes were taken by an intake nurse -- then notes were somehow overlooked by the person or persons who saw him next and then discharged him.

[randome]

42. The only way to protect yourself is to not get vaccinated and to stay away from chemtrails.

Or:


[hr][font color="blue"][center]I'm always right. When I'm wrong I admit it.
So then I'm right about being wrong.[/center][/font][hr]

[Erose999]

46. US hospitals are 3-0 against ebola right now.

[magical thyme]

51. those 3 patients were treated in isolation wards designed specifically for Biohazard Level 4

pathogens by staff specifically trained for Biohazard Level 4 pathogens.

And the 3 survivors received either Zmapp (Writebol), anti-body rich plasma from recovered patients (Sacra), or both (Brantly).

There has been no update on the condition of the 4th patient who was flown to Emory back on Sept. 9 (believed to be somebody from the WHO).

This will be the 1st patient treated in a regular hospital.

[Erose999]

53. They do have him in an isolation ward, just not one like the specially Level 4 ward at Emory.

[AverageJoe90]

57. Sorry, but AIDS and Ebola aren't the same thing.....and the circumstances are different, too. nt

[PCIntern]

60. Really. I had not observed that.

Now I had been referring to the response of the Establishment to the pathologies. Narrow focus, platitudes, wishful thinking, denials. But my job is not shilling for TPTB so maybe I'm a cynic. Thank you for setting me straight.

[AverageJoe90]

61. It's okay to be cynical.

Our private healthcare definitely isn't in the best of shape, so I'm afraid we can't rule out the possibility that Ebola *may* eventually become a significant problem here in the States. Which is one reason why I've supported socialized medicine for a long time.

[PCIntern]

64. Yes…I agree.

I treated victims of the Establishment's refusal to acknowledge the severity and etiology of what later became known as AIDS. It was the most frustrating clinical situation of my lifetime.

[Hekate]

63. Yeah. You I'll listen to. KnR