Now we finally find out that 10 people in Dallas are in isolation

[TorchTheWitch]

Can that seriously not have gotten this reported correctly or have authorities been deliberately vague???

http://news.yahoo.com/dallas-hospital-u-ebola-patient-now-critical-condition-182714039.html
TEN PEOPLE REMAIN IN ISOLATION

On Friday, officials said the number of people placed under isolation in Dallas after possible exposure to Duncan had grown to at least 10, including four members of a family moved to an undisclosed house for close monitoring.

Initially, 100 people had been feared to have had direct or indirect contact. All those in isolation were cooperating with public health authorities by staying in quarantine voluntarily, according to Dallas city and county officials.

"There's no one under orders. There's no one that we perceive that needs to be under orders," Judge Clay Jenkins, Dallas County's top elected official, told a news conference late on Friday.

Authorities have said the individuals placed in isolation included the four members of a single family whose apartment Duncan was staying in when he fell ill after traveling to Dallas from Liberia on Sept. 19. The six others are health care workers, including those who transported Duncan by ambulance on his second trip to the hospital on Sept. 28.

------------

Well, I'm relieved to finally find out that the paramedics and probably the doctor and nurse that treated Mr. Duncan the first time he went to the hospital are under home quarantine yet now they're saying that NONE of them have been ordered to which includes Duncan's family who he had been staying with. What the hell??? Why in the world have these people not been ordered to remain in isolation? I'm also hoping that the two guys that power-washed the vomit from the pavement in front of the apartment complex days later and with no protection whatsoever are in isolation. And I still want to know if it ever got properly cleaned with chlorine.

Now, are they isolated at home alone or "isolated" at home with their non-infected families?

[uppityperson]

1. Weird, later in the article it says they were ordered. Maybe they mean the other people of the 100

"The woman with whom he was staying, publicly referred to by city officials by her first name only but identified in the media as Louise Troh, was later ordered to stay inside her apartment with her 13-year-old son and two adult nephews who lived there with her."

Bad writing and reporting there, confusing.

[TorchTheWitch]

6. that's what I mean

By saying can't they manage to even report this correctly. I could have sworn there was a judge's order for them to be quarantined at home until something like Oct. 19th. And the media always has to say that none of these people are showing symptoms in a way that makes it appear that they aren't going to. Considering the infection/symptoms window when they first started saying that it had only been a mere five days.

I'm particularly pissed off about the CDC being already here from the start and despite the family member calling the CDC about Mr. Duncan so that they knew he probably had Ebola the paramedics were still sent out for him without this knowledge and totally unprepared with hazmat suits, etc. They even did two more patient runs in that ambulance before they found out and the ambulance was isolated. For the life of me I couldn't figure out how on earth they would have isolated the ambulance but not the paramedics.

I think Louise Troh and her daughter may have been later ordered because they tried to leave... after being ignored for 24 hours with no food or other supplies being delivered.

I also can't stand that authorities have been saying they're isolated at home and being "constantly monitored"... how the heck can they be constantly monitored when no one is there constantly monitoring them? What if any of these people live alone, symptoms start and escalate immediately and they can't get to a phone to let anyone know they need help? I live alone, and I'd be horrified to be on my own without being ACTUALLY constantly monitored.

[kestrel91316]

34. The 4 (which include Louise and two minors and the nephew Weeks) are under armed guard in isolation

in that house because, after being told the voluntary isolation/stay home/no visitors rule, they immediately violated those rules, endangering the community.

If you can't obey isolation guidelines, they lock the door. Which is as it should be. The other 6 of the high risk contacts don't need this because they behaved responsibly and did not endanger the community. Homeless dude, while low risk, did endanger the community so I think he needs a nice room at the Hilton for the rest of the 21 days - locked and guarded.

[kestrel91316]

35. The "constant monitoring" consists of twice a day temperature checks (one self-administered and one

by a visiting PH person) PLUS a visual exam and conversation about how they are doing by said PH person. This is for the HIGH RISK contacts. They are told to stay at home and have no visitors for 21 days.

The LOW RISK contacts are handled differently. They are not told to stay home and have no visitors. They are told not to leave the area. They take their own temperature once a day IIRC and talk on the phone once a day with PH person for 21 days.

This system works, and works very well, as long as people do as they are told, don't get innovative or defiant or stupid.

There is no medical or legal rationale or justification for locking up every single contact no matter how low risk. Nor do we have the resources to do so.

PLEASE do yourself and DU a favor and read the chart at the bottom of this page which details protocols for each type of contact:

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html

[kestrel91316]

2. There's no confusion. After questioning people closely about their

level of contact with the victim, they have put 10 on the highest level of watchful waiting. These are the PLEASE stay home, don't go out, check your temperature once a day and CDC will come check it again later in the day too, for 21 days total. 4 of those are under armed guard because they left isolation repeatedly and cannot be trusted. The other 6 are presumably acting responsibly and doing as they are told.

Another 40 are being kept track of but they have a lower level of exposure/contact so I think they are just in the "don't leave town, take your temp daily and report in daily for 21 days" crowd.

I don't understand why this confuses people. There are charts on the CDC website in their guidelines that are in plain English and not at all difficult to understand and apply to the situation.

[morningfog]

5. Since none are showing any symptoms there is no

basis for armed guards or isolation.

Obviously they need to be monitored so immediate action can be take. Is thy do how symptoms, but there is currently no need for isolation if anyone other than Duncan.

[bobGandolf]

11. There is a wide window during which symptoms can start.

It doesn't make sense to isolate AFTER they become infectious.

[morningfog]

13. Of course it makes sense to isolate upon symptoms.

As soon as a fever is shown is plenty son enough. It takes time for the virus to build up.

[kestrel91316]

20. Once symptoms start, the patient goes into a HOSPITAL ISOLATION WARD

for TREATMENT.

Prior to that, to be safe, people who might at any moment start shedding virus must limit their contacts to stop secondary cases.

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html#modalIdString_exposure-table

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html

By all means, call the CDC and Texas health authorities and inform that they are doing it all wrong and you have the correct procedures.

[kestrel91316]

19. Apparently it does if you are a Know Nothing.

Jesus. These people who don't understand epidemiology are terrifying in their ignorance.

Failing to limit contacts from the very SECOND people become contagious is exactly how we have wound up with the West Africa disaster.

[kestrel91316]

18. You aren't the epidemiologic expert in this picture and you have

no expertise by which you can make these calls. THANK GOD. Because you'd get people killed.

The 4 who are under armed guard agreed to isolate and then immediately and repeatedly broke isolation.

The level of isolation and monitoring is based on the level of exposure. There are firm, explicit federal guidelines for this.

If you don't like this, go live in Somalia. Or Liberia.

[TorchTheWitch]

8. people here kept repeating that only the four family members

were in isolation since I had thought from the beginning the most obvious ones (paramedics, etc.) would also be in quarantine at home. And until now I'd read nothing that made it clear who was and how many those people were. The media has been shit about reporting this correctly from the outset, and with the CDC's bungling yet being there from the beginning I wouldn't have thought they'd have anything specific on their website.

So, lovely, at least some of these people may start having symptoms while quarantined at home with their non-infected family members or roommates. No way would I agree to be quarantined with my non-infected family members. It's cruel to do that to both the people needing to be quarantined and their non-infected family members.

It reminds me so much of when my parents used to make us all share our bad illnesses (flu, chickenpox, mumps, colds, etc.) so we'd all be sick at the same time instead of one after the other for weeks and weeks. Especially since some of us might never had gotten infected at all (namely me since I would have been basically hiding in my room away from the sick ones, using my own roll of toilet paper, swabbing down the potty before using it, brushing my teeth with baking soda so as to not have the use the family tube of toothpaste, etc.).

And those are all diseases kids recover from whereas Ebola will likely kill you. I can't imagine how those non-infected family members must feel terrified symptoms will start with their exposed loved one being quarantined with them and that they might also get infected. Especially young kids that can't be relied on to not hug daddy if he starts having symptoms or use the toilet after he just vomited it in or missed and got some on the floor, etc.

[Bluenorthwest]

15. Why do you assume that family members will remain in quarantine with infected people?

Quarantines historically separated the ill from their families. My own mother as a child was separated from her ill mother. The story goes that grandma thought Mom had died, so they had to bundle her up and show her at the window.
But you assume they'd lock them all inside together? Why do you assume this?

[morningfog]

3. There is no reason for anyone to be in ordered isolation

since no one is showing any symptoms.

Having said that, it was stupid to shutter the family in the home where Duncan had been sweating and puking.

[Quixote1818]

7. Agree. nt

[kestrel91316]

21. Where did you get your PhD in Epidemiology, and

how long have you worked as an epidemiologist specializing in reportable infectious diseases?

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html#modalIdString_exposure-table

[Warren DeMontague]

4. we're ready! we've got it under control! Nothin' to worry about!

No problem!

[LisaL]

9. Give it a few days.

8-10 days is the most common period for symptoms to start showing.
If Duncan infected people, they will start showing symptoms soon enough.

[Warren DeMontague]

10. I forgot the sarcasm thingy.

[HereSince1628]

12. Why...have these people not been ordered to remain in isolation? Perhaps,

because of a strangely unexpected behavior called co-operation?

I remember the 50's, when quarantines were pretty common and fear of polio was much like fear of ebola. People generally cooperated with officials.

Do we have to act out "The Living Dead"?

I don't think we need militarized police wrapping suspected exposures in duct tape and plastic tarps, placing seals on doors and sitting in MRAPS with mini-guns trained on the craniums seen through any window.

[kestrel91316]

22. Here's how it works:

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html

http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html#modalIdString_exposure-table

[TorchTheWitch]

36. nobody said anything about military and duct tape

Is there something you aren't getting about Ebola being deadly? These people that volunteered to remain quarantined in their homes may get fed up and try to leave (Mr. Duncan's family members did that almost right away which is why they were ordered to remain in quarantine), may infect their homes and the non-infected family members that live with them should they become infected themselves. And some of them will be infected and at some point start to have symptoms.

We're being told they're being constantly monitored but they aren't. There isn't anyone there constantly monitoring them. What if one or more of these people live alone, become symptomatic and are unable to call for help? Why are they being quarantined in their homes with non-infected family members?

The whole point of isolation is just that - to be ISOLATED from non-infected people. Quarantine is not isolation and it certainly isn't when those people are NOT isolated from non-infected people. Instead the family members or roommates in the homes with the quarantined possibly infected people are being put at risk to also become infected once any of the possibly infected become symptomatic. Young children especially can't be trusted to not come into contact with the symptomatic family member.

The CDC's own protocols call for ISOLATION of these people but they're ignoring their own protocols by not isolating them and only quarantining them in their own homes where they aren't being constantly monitored despite they're saying they are and with unprotected non-infected family members or roommates forced to be at risk of becoming infected once any of these people start having symptoms. This isn't polio, it's a very DEADLY and horrible disease.

No disease can be contained by not ISOLATING possibly infected people and instead putting them into quarantine with non-infected family members or roommates putting those non-infected people at risk.

[Bluenorthwest]

14. No offense, but do you understand that most power washers have a tank in which one can place

say, chlorine bleach or detergents or whatever? Are you simply assuming that only water was used to clean that sidewalk? Or is that something you know somehow?
I assumed that power washer was loaded with bleach at the least. I do believe you assumed it was hooked up to a hose and the city tap. Neither assumption amounts to fact.

[TorchTheWitch]

27. Of course I know how power washers work

And since they didn't bother to suit up the men that were doing it why should I assume they also were using bleach or enough of it?

I didn't say anything about fact. That's the whole problem here... we aren't getting facts. Why were those guys doing the power washing not suited up appropriately, what were they using to clean the pavement, and why on earth did it take so long for that infected vomit to get appropriately cleaned up to begin with?

[MineralMan]

16. Quarantine, not Isolation.

There is a difference.

[alcibiades_mystery]

17. I wonder what the reaction here will be if nobody else in the Duncan contact circle is infected

Obviously, we will have to wait, but it will be interesting to note the responses.

[kestrel91316]

23. HUGE sigh of relief from me. I have firsthand experience with how

badly things can go wrong with reportable zoonoses, and how hard everybody has to hold their breath. In my case, nobody got to sigh with relief for 6 months.

With Ebola it's 42 days from the last official unprotected contact with a victim.

[Avalux]

24. Ebola is not contagious until the person is symptomatic.

So until one of these individuals becomes sick and is spewing body fluids, they can't spread the disease.

[TorchTheWitch]

25. yes, I know that

What's your point?

[Avalux]

26. From reading your post, you seem to be upset all those people aren't in isolation.

Isolation without symptoms is not warranted. That's my point. The media gets the words quarantine and isolation mixed up; they don't mean the same thing.

[LisaL]

29. And if they are out in public when their symptoms show up?

Too bad, so sad? For whoever is around them?

[Avalux]

30. Anyone who had direct contact with the patient or his body fluids should be in quarantine.

It's not the same as isolation, in medical terms.

[kestrel91316]

33. High risk contacts must stay home (the 10). Low risk contacts are asked to limit their travels

and check in daily (the 40). Everybody gets their temperatures monitored daily - high risk twice a day. High risk contacts get daily visits by PH personnel, low risk contacts get phone checks.

One thing people need to realize (and I now do) is that fever doesn't not mean that patient is immediately highly infectious. Appearance of virus in bodily fluids increases over time, with corpses having the highest levels and people on Day One of disease the lowest.

THAT is why people with no symptoms do not require total isolation. Once they get sick, they go into individual isolation in a hospital bed, no unprotected physical contact with another soul. Period.

[kestrel91316]

31. Spewing is not necessary. HOWEVER, as soon as they get a fever, all of their

bodily fluids/secretions are considered highly infectious. And that continues until they are proven to either not have ebola (fever from something else, multiple ebola tests negative), or have fully recovered from it.

Standard procedure as outlined in CDC guidelines.

[Avalux]

32. Yes, and that's why they're screening travelers by taking temps.

Once the virus load is high enough, symptoms start and the person is infectious.

[kestrel91316]

37. Yep. If they get sick on the plane, that planeload of contacts is all together and easy to do the

initial investigation on. As we saw with Newark.

i would actually much prefer an Ebola patient got sick on a flight and snagged right there rather than wandering all over some city being sick like Duncan did.

[kestrel91316]

28. CDC is handling contacts appropriately. Journalists get confused and often themselves contribute to

confusion by sloppy reportage.

I don't get what you are upset at public health officials for.

I knew about the 10 versus the 40 (actually 38) versus the initial approximately 100 yesterday. These investigations take time, deciding how to handle each contact takes time, putting together a press conference takes time.

Sheesh. Calm down.

[BillZBubb]

38. Exactly! "Sheesh. Calm down." is the correct advice.

[cwydro]

39. I think

there's lots we don't know.

[Logical]

40. This WHOLE COUNTRY needs to calm the FUCK DOWN! Panic Paranoia! nt