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Old 10-31-2014, 11:29 PM   #101
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For an example of someone paralyzed by fear, and could afford to satisfy that fear, recall Howard Hughes.

Ebola is still exotic, auto crashes and heart disease are not. so the Ebola stands out. But we are all still more likely to die in an auto accident or from heart disease than anything else. In the 1990's, my best friend was buried in an empty part of a cemetery. Within 4 years, it was full of people aged between 19 and 30. Car accidents is the probable explanation, although I have no facts to back that up.

I also remember that sniper in Washington DC a while back. I work with many people who live in that area. As bad as that was, compared to car crashes and heart disease, the number of people killed was quite small. But everyone was focused on the sniper, as that was what was unusual.

If Ebola were to become endemic in the USA, it would become just another way to die, get put on a bar chart showing such, and not get the press it gets as an exotic disease. IMHO.
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Old 10-31-2014, 11:39 PM   #102
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I often hear the "let's stick to the science" appeal made by the same person, at the same time, as they extoll the "admirableness" of the health care workers as some sort of rationale for not imposing a quarantine. Either a quarantine is justified based on the scientific evidence (and the competing civil liberty/secuirty concerns) or it is not. The disease doesn't "care" about the wonderfullness of these people, and we're not talking about punishing them. Yes, let's stick to the evidence, avoid emotionalism, and recognize that biology/epidemiology has a lot more grey areas than "hard" sciences like engineering.

The executive branch of the US government has decided that a quarantine of their travelers (military personnel) who have been in the affected areas but not near Ebola patients is warranted. And the executive branch has also decided that a quarantine of other individuals who have directly been exposed to Ebola patients--their feces, blood, and vomit-- in these same countries is not required. Who is right, the executive branch or the executive branch?

It's easy and without constitutional consequences to tell a bunch of soldiers or Marines to go to quarantine. There would be no complaints from anyone just the usual bitching and moaning from them all (I was a Marine, I know the story). So when I heard Hagel make that speech I totally understood his move. His abundance of caution has no negative effects. On the other hand the other side of the executive branch does have constitutional concerns, and more than that, they would rather have the nurses and doctors flock to west Africa to fight Ebola on the front lines than not.

Believe me if every doctor and nurse gets ticked off with all the people over here demanding quarantine, and decide not to go there, we will be a thousand times worse off. Then it will definitely come here.


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Old 10-31-2014, 11:41 PM   #103
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But---it's not. We know that 12-15% of people who have Ebola and are capable of spreading it to others do >not< have a fever. That is based on many observations during the present epidemic as well as the previous ones.
Here's a direct explanation of this number from an interview with a medical aid worker and why it's a non-issue (Kelly is the interviewer, Sacra is the medial doctor):

Quote:
KELLY: Here's why people are concerned about her and other workers, I think. Because, first of all in 13 percent of an Ebola cases, you have no fever. So not having a fever isn't the end-all tell-all about whether you have Ebola, right?

SACRA: I think, you know, you can't take a statistic like that in the absence of context. Sometimes people with Ebola at the end of their lives will no longer be able to mount a fever because they're so weak. So when someone arrives at the tent for treatment in West Africa and they're about to die, they may not be having a fever.

Source: Ebola survivor says quarantine has negative consequences | Fox News
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Old 10-31-2014, 11:43 PM   #104
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Kaci Hickox must have had her sponsors lined up in advance

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I wouldn't have problems serving her -- I believe the science (even though I tend to be very cynical and skeptical). However, I don't think she would win a lawsuit over not being served. She is not under any of the protected classes for discrimination.

Actually, being female is a protected class. Look how she was treated, and she's not even sick, vs the NYC doctor who actually came down with the disease. Why is he forgiven and called a hero by the media, and the governor of her state took her to court for violation of what amounted to "a suggestion"? What is the difference other than gender?

This should be about a disease, but people complain about the Kaci Hickox's attitude, which will not affect the spread of the disease. No one has mentioned the attitude of the doctor in NYC who took the subway and went bowling with friends while incubating ebola. Talk about an cavalier attitude! That attitude is far more risky than Kaci's. I think she has every right to question the ridiculous way she is being treated. You 'd think a bike ride away from town was a dangerous thing, the way the governor treated it. What 's she going to do, infect the pine trees and the crickets with a disease she does not have?

A school district quarantined a 7 year old girl returning from Nigeria, a country that is free if ebola, unlike the U.S. Using that logic, we should place all children in the U.S. under quarantine. Nigeria had a total of 19 people infected in their outbreak, and has been disease free the required 42 days since October 20th. The U.S. Is not free of ebola.

Do go we quarantine all children? Or just black kids returning from ebola-free African countries? Do we allow a male physician exposed to ebola to ride NYC subways and dine in restaurants, while we tsk tsk a female nurse for taking a bike ride in the country, exposing nobody? And if she so contagious (with a disease she does not have), why are reporters allowed to camp out at her house and follow her everywhere she goes?Why are we so concerned about her "defiance" and not at all concerned about Dr. Spencer's lies and recklessness?

I applaud her standing up to the idiocy of the governors of NJ and Maine. It certainly shows that there is a double standard that is applied to men vs. women, and maybe to doctors and nurses, as well as whites and blacks as in the case of the 7 year old girl in CT.


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Old 11-01-2014, 03:17 AM   #105
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While she was in Africa, Ms Hickox had a roommate who apparently caught Ebola, according to the State of Maine. The roommate didn't know how that happened.

This seems to happen a lot.

People might have more faith in the opinions of health care experts about how to protect ourselves from Ebola if so many health care experts weren't becoming infected themselves. There's either a gap in our knowledge of how the disease is spread or negligence/carelessness in applying this knowledge. None of those available options increases public confidence.
To be more precise the Maine DA alleged that her roommate had signs of Ebola. Having a fever or diarrhea are both signs of Ebola, yet even in West Africa many times more people have signs of Ebola without actually having the disease. This would fall into one of those neat prosecutorial misdirections.

The reason that I'm particularly suspicious of this claim, is I have been following the Doctors without borders website since early summer. They have been regular updating the staff who've been infect by Ebola. The current number is 3 international and 21 locals out of almost 3,000 (meaning roughly 1% of the staff who work with Ebola get infected.)
I've seen no reference to Kaci's roommate. Obviously the judge did not seem to think it was critical either.
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Old 11-01-2014, 06:05 AM   #106
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It's easy and without constitutional consequences to tell a bunch of soldiers or Marines to go to quarantine. There would be no complaints from anyone just the usual bitching and moaning from them all (I was a Marine, I know the story).
I understand all of this. But, politics and constitutional arguments aside, should we believe that a quarantine is a medically effective and required action to prevent the spread of Ebola from Africa to the US? The clear and unequivocal position of the USG is apparently "definitely yes" and "definitely no".
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Old 11-01-2014, 08:21 AM   #107
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It is interesting that only the Maine CDC which went to court against Hickox has evidence that her roommate was treated for ebola. All the other sources for this information picked it up from the Maine CDC's court papers. I would think that would be a pretty big story, but there are no other souces for it?
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Old 11-01-2014, 08:40 AM   #108
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Goodwin's or Arkens law?
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Old 11-01-2014, 08:50 AM   #109
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Believe me if every doctor and nurse gets ticked off with all the people over here demanding quarantine, and decide not to go there, we will be a thousand times worse off. Then it will definitely come here.

To imply that a 21 day home quarantine here in the U.S. is somehow going to discourage people from volunteering is just not believable. These people are medical professionals who volunteer to work and live in deplorable conditions to provide care and comfort to others suffering from this terrible disease.

The treatment of the Hickox woman in N.J. was certainly not well executed for a variety of reasons. Her reaction to it was understandable in part because she was probably unaware of what was going to happen and in part because she was anxious to see her family and boyfriend.

Going forward, I believe the CDC needs to develop new guidelines and procedures that everyone will be aware of and comply with.
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Old 11-01-2014, 09:38 AM   #110
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More food for thought:
Ebola Aerostable for 50 days?
The Story Changes: Ebola Is Now ‘Aerostable’ And Can Remain On Surfaces For 50 Days
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Old 11-01-2014, 10:21 AM   #111
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Maybe we need an ERF survey on this subject:

- I am nervous and concerned about a major Ebola outbreak in the US since there is too much we do not know about Ebola and the US Gov't is doing a poor job in handling cases thus far

- I am not nervous and concerned of an Ebola outbreak because there is enough evidence to mitigate my concern

For me, I am in the not concerned category, at least until there is enough evidence to prove otherwise.
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Old 11-01-2014, 10:23 AM   #112
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Maybe we need an ERF survey on this subject:

- I am nervous and concerned about a major Ebola outbreak in the US since there is too much we do not know about Ebola and the US Gov't is doing a poor job in handling cases thus far

- I am not nervous and concerned of an Ebola outbreak because there is enough evidence to mitigate my concern

For me, I am in the not concerned category, at least until there is enough evidence to prove otherwise.
I am not concerned either.
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Old 11-01-2014, 12:30 PM   #113
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I wonder how the nurse feels when patients don't follow her instructions. Just saying
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Old 11-01-2014, 12:43 PM   #114
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That "article" seemed pretty hyperbolic. I'm not disputing it - just commenting on the style of writing and some of the links it sites for sources.

We know that transmission can handle from body fluids of infected people. That isn't new. In fact the camera man from Snyderman's team appears to have gotten it from his tennis shoes. He didn't wash them with bleach, just hosed them off after being in an ebola ward. So it was a transfer contact.

60 minutes had a piece interviewing the Dallas medical staff (minus Pham and Vinsen). They talked about how every surface had to be cleaned with bleach and the used cleaning supplies treated as hazardous waste. So this isn't really news.
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Old 11-01-2014, 01:21 PM   #115
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I understand all of this. But, politics and constitutional arguments aside, should we believe that a quarantine is a medically effective and required action to prevent the spread of Ebola from Africa to the US? The clear and unequivocal position of the USG is apparently "definitely yes" and "definitely no".

I disagree. It depends on the people going into quarantine. The medical professionals probably don't need it. The military possibly do. Remember that the brave guys that fight our wars are mostly just a bunch of kids. The "mature" ones are in their early 20s. The rest are younger. They do stupid stuff at that age. I know we did. I'm assuming that the medical pros won't. That's my reasoning. Hagel is doing it cos he knows he has a bunch of kids in that group he's sending and because "he can".


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Old 11-01-2014, 01:32 PM   #116
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Originally from WND.com as embellished by the noted medical news reporting site endoftheamericandream.com

If one works their way back to the original source material, a WHO report, one finds:
Quote:
“Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus – over a short distance – to another nearby person."
So, I suppose that projectile vomiting could be described as airborne transmission.
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Old 11-01-2014, 01:58 PM   #117
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The original paper says it may remain aerostable (not in the dictionary BTW) in an enclosed environment in the dark (without more specifics), and on glass surfaces at low temperatures for up to 3 weeks. Droplets and airborne are not exactly the same thing.

The site you sent us to misquoted the paper and appears to have an alarmist agenda. Not a trustworthy source of information. It only took me about 3 minutes to find errors.

This stuff has been known about ebola for a long time. It is dangerous. It has a high mortality rate. HIV infection has a 100% mortality rate if untreated. It's just more indolent, with a very long asymptomatic period, allowing more widespread disease. It's easier to get ebola than HIV, but it 's much easier to get the flu or measles than ebola.

The best protection we have against such diseases is if a vaccine is developed. A number of companies have developed ebola vaccines and trials are already underway.


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Old 11-01-2014, 03:00 PM   #118
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Remember that the brave guys that fight our wars are mostly just a bunch of kids.
We're going to have to disagree on this point. I will not cede that a returning U.S. servicemember is less likely to behave responsibly than a random traveler entering the US from Africa.
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Old 11-01-2014, 03:23 PM   #119
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We're going to have to disagree on this point. I will not cede that a returning U.S. servicemember is less likely to behave responsibly than a random traveler entering the US from Africa.
Agree. If soldiers were as sloppy about following protocol as doctors are, they would all be dead.

The sole reason the military is alone in requiring quarantine is they are the sole group that won't start an avalanche of Kaci type acting out.

The typical US citizen is as disciplined as a flea on a hound dog's butt.

Ha
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Old 11-01-2014, 05:02 PM   #120
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To imply that a 21 day home quarantine here in the U.S. is somehow going to discourage people from volunteering is just not believable. These people are medical professionals who volunteer to work and live in deplorable conditions to provide care and comfort to others suffering from this terrible disease.

The treatment of the Hickox woman in N.J. was certainly not well executed for a variety of reasons. Her reaction to it was understandable in part because she was probably unaware of what was going to happen and in part because she was anxious to see her family and boyfriend.

Going forward, I believe the CDC needs to develop new guidelines and procedures that everyone will be aware of and comply with.
Here is Doctors without Borders (DWB) statement on the quarantine

Quote:
Forced quarantine of asymptomatic health workers returning from fighting the Ebola outbreak in West Africa is not grounded on scientific evidence and could undermine efforts to curb the epidemic at its source, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) said today. Diligent health monitoring of returnees from Ebola-affected countries is preferable to coercive isolation of asymptomatic individuals.
“There are other ways to adequately address both public anxiety and health imperatives, and the response to Ebola must not be guided primarily by panic in countries not overly affected by the epidemic,” said Sophie Delaunay, executive director of MSF-USA. “Any regulation not based on scientific medical grounds, which would isolate healthy aid workers, will very likely serve as a disincentive to others to combat the epidemic at its source, in West Africa.”
International MSF staff members commit to burdensome four-to-six week assignments in the Ebola-affected countries. The risk of being quarantined for 21 days upon completion of their work has already prompted some people to reduce their length of time in the field. Others will be less inclined to volunteer in the first place. This will present significant operational disruptions at the field level for MSF and other organizations, and lead to an overall shortage of desperately needed health workers, precisely when the Ebola outbreak is as out of control as ever.
As it is, MSF draws on a small pool of people with highly specific skill sets required in an Ebola setting. Further restricting access to that group of aid workers could have devastating consequences. Since March, MSF has sent more than 700 international staff to West Africa as part of its Ebola response.
Enhanced restrictions on returned aid workers in the United States could lead to similar measures being adopted in other countries, leading to an even greater impact on the ability to fight the outbreak in West Africa.
"We need to be guided by science and not political agendas," said Dr. Joanne Liu, international president of MSF. "The best way to reduce the risk of Ebola spreading outside West Africa is to fight it there. Policies that undermine this course of action, or deter skilled personnel from offering their help, are short-sighted. We need to look beyond our own borders to stem this epidemic."
So instead of 6 weeks working in the field and 1 week R&R we are now adding 3 week of quarantine which depending on how it is implemented may also be stressful. Roughly cutting the staff effectiveness by a 1/3.

DWB rejects 80% of those who volunteer and even higher percentage of those who volunteer for Ebola. This is the type of illness that you want experienced doctors treating not somebody fresh out of med school.

I am curious what part of their statement do you find unbelievable.
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