outbreak

[Dmitri]

It's like when right after 9/11 anyone who "looked like an Arab" was an automatic terrorism suspect in the eyes of general public. But that was a bit more understandable (to me) since it was a national tragedy that hit too close to home. This one I just don't get. Oh well. People! What can you do.

[windwalker]

Dr. Ashish Jha, a professor at Harvard University’s School of Public Health, said there appeared to be “literally multiple failures” that led to Duncan’s release Sept. 25, only to be hospitalized three days later when his symptoms worsened.

http://www.bostonglobe.com/news/nation/ ... story.html

I find the fear, and confusion very understandable and expected in lite of the failure from the top of the CDC, lack of planing, overly confident position, and demonstrated results.
a very hard point to recover from.

[Steve James]

I find my fear, and confusion very understandable and expected

Fixed.

The demonstrated method of ebola transmission --and therefore the likelihood of infection and contamination-- have not changed one bit. All the people in the US who have contracted the virus have been health care workers who have directly come in contact with people who were contagious at the time --not who simply had the virus. IF ebola was like the flu or SARS or the common cold, and the outcome was inevitable death, THEN drastic measures would be required, especially if many people came down with the virus simultaneously. As it stands though, the people in the US who have been infected have survived.

Afa the NY/NJ actions concerning all people coming from affected countries --those who have had contact with infected persons (i.e., mostly health-care workers)-- may alleviate the fears of some people. Of course, those people with no faith in the health system in general will have no reason to change their opinions. They'll just change the reason for their fears. Their chances of getting the virus will not change. Also, NY/NJ is one of the designated places where people from affected regions must (are supposed to) land and can be screened.

Now, the news is saying that NYers don't need to fear riding the subways or going to the bowling alley where the doctor played. Anyway, there's also a poll asking which disease they fear most: ebola, the flu, or the enterovirus. Maybe I'll see the results of the poll; but, it'll be interesting. Any bets?

The risk of an "outbreak" of ebola in the US is slim, and the opportunities to successfully confront one if it did occur are at least as good as those of Nigeria.

[windwalker]

your funny

this thread was always about the inept leadership at the top that
predictably lead to what is happening now.

had they had a plan in place backed by actions when non scripted events happened
no one would even be paying attention to it.

you should try talking to health care workers, like people who work in, have dealt with patient care ect
and see how they feel.

granted its about perception, always was.
they F-up and now are trying to back track...

your pretty predictable,
"fixed" nice

I dont know about you, but I expect more out of those in charge.

what they are having to do now, is pretty much what was asked for in the beginning
would have been much easier,,,to implement, and explain.

[windwalker]

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that as a physician and scientist, he would have recommended against a quarantine.

http://news.yahoo.com/fauci-quarantine- ... itics.html

the same guy who felt that the US health care system was trained, equipped, and ready to deal with it.
All of which has so far proven false, by recent events, and questioned by those who work in the health care field here, staff and nurses.
self monitoring has been proven by events not really to be effective, as those returning if infected never know where or when
they will experience symptoms of it in its infectious stage.

recent events would suggest that they dont seem not understand this, instead of abiding by self quarantine,
they resume a normal life style despite the risks to others.


its not about fear, or panic, as some have suggested. It is about people in charge who seem to be out of touch with the realities on the ground that they
are supposed to be in expert in.

reminds me of

"Reports that say that something hasn't happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns -- the ones we don't know we don't know."

Donald Rumsfeld


The military, will automatically have some type of quarantine set up for those coming back in the military working in affected areas.
they understand the risk and perceptions and will seek to minimize both.

[Steve James]

Oops.

New York Gov. Andrew Cuomo admitted Saturday that the 21-day Ebola quarantine policy for health care workers returning from West Africa could be unenforceable.

The New York Daily News reported that the Democrat acknowledged that several contingencies had not yet been worked out by officials, including what would happen if someone refused to be quarantined or even where they would spend their time during the watch period.

"Could you have a hostile person who doesn’t want to be quarantined?" Cuomo said during a campaign appearance in the New York City borough of Queens Saturday. "I suppose you could. But that hasn’t been the case yet." The governor added that officials had not determined whether those refusing to be quarantined could face arrest or prosecution, saying "It's nothing that we've discussed, no." When asked by the News where the quarantined people would be held, Cuomo even seemed unclear on that point, saying "Some people could be quarantined in a hospital if they wanted to be."

On Friday, Cuomo and his New Jersey counterpart, Chris Christie, imposed a mandatory quarantine of 21 days — the incubation period of the deadly virus — on travelers who have had contact with Ebola patients in the countries ravaged by Ebola — Liberia, Guinea and Sierra Leone. A similar measure was announced in Illinois, where officials say such travelers could be quarantined at home.

Doctors Without Borders executive director Sophie Delaunay complained Saturday about the "notable lack of clarity" from state officials about the quarantine policies, and an American Civil Liberties Union official in New Jersey said the state must provide more information on how it determined that mandatory quarantines were necessary.

"Coercive measures like mandatory quarantine of people exhibiting no symptoms of Ebola and when not medically necessary raise serious constitutional concerns about the state abusing its powers," said Udi Ofer, executive director of the ACLU of New Jersey.

Health officials in all three states with quarantine policies did not return messages from The Associated Press seeking details about enforcement Saturday.

Meanwhile, Kaci Hickox, the first traveler quarantined under Ebola watches in New Jersey and New York, wrote the first-person account for the Dallas Morning News, which was posted on the paper's website Saturday. Her preliminary tests for Ebola came back negative.

"This is not a situation I would wish on anyone, and I am scared for those who will follow me," Hickox wrote of her quarantine. "I am scared about how health care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa. I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine"

"One after another, people asked me questions," Hickox continued. "Some introduced themselves, some didn’t. One man who must have been an immigration officer because he was wearing a weapon belt that I could see protruding from his white coveralls barked questions at me as if I was a criminal ... The U.S. must treat returning health care workers with dignity and humanity."

Doctors Without Borders said Hickox has not been issued an order of quarantine specifying how long she must be isolated and is being kept in an unheated tent. It urged the "fair and reasonable treatment" of health workers fighting the Ebola outbreak.

"We are attempting to clarify the details of the protocols with each state's departments of health to gain a full understanding of their requirements and implications," Delaunay said in a statement.

Christie, campaigning Saturday in Iowa for a fellow Republican, said he sympathizes for Hickox but said he has to do what he can to ensure public health safety.

"My heart goes out to her," the governor said, while also noting that state and local health officials would make sure quarantine rules are enforced. He said the New Jersey State Police won't be involved.

The quarantine measures were announced after a New York physician, Craig Spencer, working for Doctors Without Borders returned from Guinea was admitted to Manhattan's Bellevue Hospital Center earlier this week to be treated for Ebola.

A senior White House official said Saturday that how to treat health care workers returning from the affected West African countries continues to be discussed at meetings on Ebola as the administration continues to take a "careful look" at its policies.

The Associated Press contributed to this report.

Anyway,

The military, will automatically have some type of quarantine set up for those coming back in the military working in affected areas.

Sure. They already quarantine people before returning them to the US from the ME. Some like the time in Kuwait, though. Of course, the Army has facilities for quarantining thousands. We don't, and we won't. We'll have to allow people to self-quarantine OR we'll have to set up camps. Now, if any of those people decided to leave, what would be the solution? What would be their punishment if they escaped? If we get lots of people together, what happens if they start to infect each other, and then escape? Not to mention, what if one of the quarantined needs to have heart surgery? What if that person is refused the surgery because of the risk, and then dies without ever having ebola? Have they thought those things through?

[Steve James]

Oh, and let's not forget that ALL the US ebola patients either self-reported by going to the hospital or self-quarantined themselves. Gov. Christie argues that we can't depend on that. Yet, it's been the ONLY dependable mechanism that has accomplished anything.

Oops, one last thing. What if the virus mutates so that the Maximum Observed incubation time becomes 22 days?

Kill ebola in Africa, and it's killed here.

[bailewen]

http://www.iflscience.com/health-and-me ... d-backfire

[windwalker]

http://www.iflscience.com/health-and-medicine/why-bans-flights-ebola-hotzones-would-backfire

As Dr. Kamran Khan at St. Michael’s Hospital in Toronto said, “Decreasing the number of infections in the source area is the most important way to decrease the spread.”

from your link.
so where was the good doctor when this first started?
where is he announcing this from, oh yes "toronto" seems like he should get his happy ass over there where he can do some good.
indeed where were any of them?

they talk about over there, while being safely here.
makes sense.

let me understand this, we can have no fly list that people dont understand how they got on.
we issue the travel visas to come here
but some how its not possible to control people coming in through legitimate means and be on the look out
for others who try other wise...

my main point was that this from the beginning was handled wrong.
lack of leader ship, they could have enacted all that was or is being enacted now, and then scaled back
as the public's perception that things are being handled and their safety concerns were being met.

The strength of the U.S. health care system "would make it extraordinarily unlikely that we would have an outbreak" in this country, Fauci said.

as it was, the head of the CDC seem to basically say, don't worry about it, our system can handle it, and we are prepared.
all of which proved untrue with an unscripted event.


hell, its still untrue as they are now having to come up with things that should have been in place from day one.
wonder why the good doc. is out in public saying what he says, instead of helping the situation, he's out backpedaling
trying to justify his lack of leadership, preparedness, and total failure in his assigned role.

Meanwhile, the economies of the countries included in the ban will be badly damaged

this is happening anyway within the affected areas.

no one seems to question the speed of the development of a vaccine or treatment
maybe this will help to spur the development of for other things that dont seem to get the attention they need.
after all this time, until it, hits home.

[windwalker]

"From a public health perspective, we would not feel that isolation is appropriate," said Dr. Jeff Duchin, Washington State epidemiologist and chairman of the public health committee of the Infectious Diseases Society of America.

Still, the Army's decision to isolate its soldiers reflects growing anxiety in the United States about the potential spread of the illness. That, in turn, is magnifying fears in West Africa that such steps might discourage health care workers from volunteering, and undermine efforts to contain Ebola.

So far, the Army is the only U.S. military service to order isolation, which also applies to dozens of other soldiers due back at Vicenza later this week. But the military is weighing a similar measure across the armed forces, officials said.

http://news.yahoo.com/u-isolates-soldie ... 21671.html

That includes Major General Darryl Williams, the commander of U.S. Army Africa, who oversaw the military's initial response to the Ebola outbreak in West Africa.
Williams said the move was precautionary, adding: "There's anxiety out there and we want to take care of our soldiers and their families."

a true leader, leading by example

he understands and gets it

this was to be expected, Its simple, and provides an assurance that has been set as a standard for understanding whether one has contracted it or not.

we would not feel that isolation is appropriate

Right , your'er a commander with 4k plus troops on the ground dealing with a known class 4, bio agent.
your troops may or may not come into direct contact with it.
you make the call?

[chud]

Hmmm, let's check the news and see how other countries are handling the Ebola outbreak:

While the debate continues in the US as to how best to protect Americans from a potential spread of Ebola, Australia has made a decision on a comprehensive policy. They will issue no new travel visas for people in Ebola-impacted nations in western Africa, and will require travelers from those countries on permanent visas or Australian passports to undergo a mandatory 21-day quarantine prior to entering the country. That applies to health-care professionals returning to Australia after serving in Guinea, Liberia, and Sierra Leone: In the fight against Ebola, Australia has said: No thanks.Immigration Minister Scott Morrison announced “strong controls” on arrivals from West African countries affected by cases of the deadly disease....

Common sense...

[Steve James]

to undergo a mandatory 21-day quarantine prior to entering the country.

I.e., 21 days quarantine in Africa before they leave? or 21 days after they arrive at the airport? after coming off the plane (and after potentially infecting everyone on the plane, including staff and pilots?) Why wouldn't all the passengers (and the plane) be included?

And are there any suggestions as to when the quarantining process would end? The eradication of ebola? Who do "we" trust to know when it is safe?

[Steve James]

For those of ya'll planning to visit Europe though, be prepared that representatives of some countries have suggested that visitors from the U.S. be quarantined because of the outbreak here. Since we have more ebola cases than most other countries, "common sense" would demand such a quarantine. No?

[windwalker]

World Bank chief Jim Yong Kim echoed the warning in an apparent swipe at developed countries which have not sent medical teams to the region, saying Ebola was "not an African crisis... it is a global crisis".

"We'll need a steady state of at least 5,000 health workers from outside the region... those health workers cannot work continuously -- there needs to be a rotation," he told reporters.

Kim said medics should remember their vocation and their professional oath to save lives, and not shy away from going to a problem areas.

http://news.yahoo.com/huge-drop-ebola-b ... 33510.html

Kim said medics should remember their vocation and their professional oath to save lives, and not shy away from going to a problem areas

I like how they make it everyone else s problem, while they themselves or countries they represent
do very little.

The team of at least 10 Korean medical personnel, including doctors and nurses, is expected to cooperate with American, European and non-governmental workers already deployed in the region, according to health authorities

http://crofsblogs.typepad.com/h5n1/2014 ... ebola.html
wow, 10 Korean medical personnel, thats a good start.
another "leader" setting the example

the better idea would be to set up training centers to train the people within the region, its more sustainable,
provides a good knowledge base for the their over all med system, and provides jobs that directly impact the areas.

the guy is dreaming if he or anyone feels that 5k med. trained personal are going to rotate in and out from other areas.

"not an African crisis... it is a global crisis".

ahh beg to differ, only until recently was it an African crisis, that not many cared about.
its still an African crisis, and will remain so as other countries take the prudent measures that those in "the region" already have.

its only "common sense"

[windwalker]

Dr. Beutler, an American medical doctor and researcher, won the Nobel Prize for Medicine and Physiology in 2011 for his work researching the cellular subsystem of the body’s overall immune system — the part of it that defends the body from infection by other organisms, like Ebola.

“It may not be absolutely true that those without symptoms can’t transmit the disease, because we don’t have the numbers to back that up,” said Beutler, “It could be people develop significant viremia [where viruses enter the bloodstream and gain access to the rest of the body], and become able to transmit the disease before they have a fever, even. People may have said that without symptoms you can’t transmit Ebola. I’m not sure about that being 100 percent true. There’s a lot of variation with viruses.”

In fact, in a study published online in late September by the New England Journal of Medicine and backed by the World Health Organization, 3,343 confirmed and 667 probable cases of Ebola were analyzed, and nearly 13 percent of the time, those infected with Ebola exhibited no fever at all.

Why, then, does he think the CDC would so emphasize Ebola is not communicable in patients without symptoms?

“There’s some imperative to prevent panic among the public,” says Dr. Beutler, “But to be honest, people have not examined that with transmissibility in mind. I don’t completely trust people who’d say that as dogma.”

As such, allowing home confinement for medical workers exposed to Ebola but currently without symptoms was, as Beutler put it, “a move away from goodness,’ as an engineer might say.”

“Even if someone is asymptomatic you cannot rely on people to report themselves if they get a fever,” said Dr. Beutler, adding, “You can’t just depend on the goodwill of people to confine the disease like that – even healthcare workers. They behave very irresponsibly.”

http://www.nj.com/politics/index.ssf/20 ... e_win.html



which we have seen from the current health care workers returning from the affected areas.
they dont seem to have to much "common sense"

nearly 13 percent of the time, those infected with Ebola exhibited no fever at all.

its ok, according to some "the strength of our health care system" should be able to handle it

“I know at times that you all would like to make things a heck of a lot more complicated than they are,” said Christie, “In home quarantine means: In-home. Quarantine. If they are asymptomatic, they can be quarantined in their home.”

Beutler disagrees with this, saying “the ideal scenario is where a patient is isolated from all family members,” preferably in an specialized hospital ward, not in a home.

who you gonna call?