There is a reason billions will be spent recalling faulty airbags when only four people are known to have died possibly due to their failure. Sometimes you exercise caution before people die.
I think I understand it, and it's apples and oranges, IMHO.People are willing to believe the safety experts regarding air bags, but ignore the medical experts and epidemiologists regarding Ebola. I don't understand that disconnect?
People are willing to believe the safety experts regarding air bags, but ignore the medical experts and epidemiologists regarding Ebola. I don't understand that disconnect?
I think I understand it, and it's apples and oranges, IMHO.
If the subset of experts in the anti-quarantine camp are wrong, the consequences could be exponentially horrific (if, by some chance, the virus "gets loose", thousands? millions?, who knows? will die).
If the anti-recall experts are wrong, it might mean we collect another couple of years worth of data and maybe a handful of people die, at most.
So the possible consequences of being conservative in the two cases are as different as night and day.
Physics, electronics, and vehicle accident rates= "hard" science. Experimental method = easily applied
Ebola, biological processes, societal responses to infection = "soft" science.
"Hard" science is more easily tested, more quantifiable, and more easily understood. Experimental method often requires retrospective analysis, time, and trying to control for variables that invariably reduce the faith we can have in the results.
It's clear that the situation is entirely different.
I wonder why someone returning from a high risk situation (treating ebola patients) is not simply automatically blood tested for the virus upon his return, rather than having him self-monitor and/or voluntarily quarantine for 21 days to see if symptoms develop?
The virus, like all viruses, has an incubation period. During that time, the virus is undetectable by any means, and the person is not contagious at all. The problem here is that we don 't have precise information about the minimum incubation period and if there is any contagiousness possible prior to onset of symptoms.
For example we know that with chicken pox, a susceptible person will start the rash 10-21 days after exposure, no more and no less. We also know that a person is contagious up to two days prior to onset of the rash, and it is spread by respiratory droplet-you can't get it at a significant distance, unlike measles, which is truly airborne. So a person exposed to chicken pox should be quarantined from immunocompromised people for 8-21 days. There is a defined period of contagiousness after the rash starts as well. 5-14 days, usually 8 or less.
With ebola, much less is known. I ran across a study from the last outbreak which makes me wonder how much our CDC folks know or bother to search. The paper suggested to reduce the risk to <1% one should use a maximum incubation of 25 days, not 21 days. And the authors failed to commit to a minimum incubation period--which is too bad.
That doctor in NYC was very foolish, going bowling and taking the subway.
Here is the article, though it's a difficult read:
Incubation Period of Ebola Hemorrhagic Virus Subtype Zaire
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Your link just takes me to a home page for the newspaper. I'm assuming this is the nurse that fought NJ's quarantine. It will be interesting what happens should this nurse develop symptoms later.Thanks, I suspected it was something like that. Here is an article about a nurse in Connecticut who seems to have done things the right way.
Tolland Nurse Just Back From Treating Patients With Ebola In W. Africa - Hartford Courant
Y I'm assuming this is the nurse that fought NJ's quarantine.
I've been watching the news a lot the past few days and I've noticed something. I think those who don't work in the medical profession don't understand how difficult it is to actually contract the Ebola virus.
Here is a list of all the people in America who were infected with Ebola virus disease:
Dr. Kent Brantly
Dr. Rick Sacra
Nancy Writebol
Eric Duncan
Nina Pham
Amber Vinson
There is one thing that all of these people have in common. They were in direct contact with the vomit and feces of someone who was in the later stages of infection with the Ebola virus. Dr Sacra contracted the disease after performing a c-section on a patient (in LIberia) who had not yet been diagnosed with the disease.
And, other than playing with infected bats and monkeys, that is the only way to get it.
But why has the Ebola virus killed thousands in African countries?
Because these are third-world countries. Most of the "hospitals" where their Ebola patients spend their last days don't have working sewer systems. They don't have disposable bedpans and advanced waste-management systems like we do in the US.
A little look into the relationship between a critically ill patient and their healthcare team will also be helpful. This is not for the weak of stomach.
When a patient is in the last stages of their battle with the Ebola virus, they produce a large amount of mucous, stool, vomit, and possibly blood. When a patient who is unable to sit up or get out of bed is stricken with these symptoms, I can assure you that these substances get EVERYWHERE. We're not talking a couple of bowel movements a day. We're talking about a constant flow of liquid stool coming from a patient who can only lie in the bed as it pools around them. And every time you change those sheets - which requires two people - you have piles of poop-covered sheets and gowns moved all around the room.
On several occasions during my career as an ICU nurse, I have found myself asking the question, "How in the hell did poop get THERE?"
And if the actual virus is IN the poop, then you're getting that virus on EVERYTHING.
And all these people in ties and skirts have never been at the bedside cleaning these messes. They do not understand the situation that these caregivers are in any more than a fish knows what it's like to sneeze. So when they get in front of a camera yack about Ebola, you need to take it with a grain of salt and check the facts for yourself.
My point is this: Although the Ebola virus disease IS a serious illness, the media is seriously exaggerating the actual danger to you and your family. Unless you are literally cleaning up the poop or vomit of someone who is dying from Ebola virus disease, you're safe.
Will someone please answer the question of how the American journalist covering the Ebola outbreak came down with the disease when he said he exercised caution while filming?
Did he have sex with monkeys or clean his camera lens with infected poop?
It just doesn't sound like he was doing C-sections or cleaning bedpans, or even licking corpses.
The point I'm making does not involve nuanced differences of the subject matter, but the cafeteria style approach as to which 'experts' people believe. The disconnect I'm seeing is that the same overarching scientific establishment (scientific industrial complex?) that created our modern civilization - vaccines, penicillin, computers, space exploration, heart transplants - is only believed when people 'feel' like they agree with the scientific determination. It turns out Ebola is one of those scientific determinations that people just 'feel' is wrong, for whatever reason, without any actual proof for their skepticism. That's the disconnect I see.
Your link just takes me to a home page for the newspaper. I'm assuming this is the nurse that fought NJ's quarantine. It will be interesting what happens should this nurse develop symptoms later.
I'm sure there have been many dozens of heathcare workers that came back from West Africa without issues. Unfortunately, we've just seen one that didn't.
He apparently told his father he was spraying his shoes with a hose to clean them off after being in the medical area (his father said he told him that but he hasn't mentioned it himself to the press), and some of the contaminated water splashed on his bare skin.
He apparently told his father he was spraying his shoes with a hose to clean them off after being in the medical area (his father said he told him that but he hasn't mentioned it himself to the press), and some of the contaminated water splashed on his bare skin.
It somewhat reminds of the hysteria, when AIDs first hit the scene. People with HIV were fired, kids weren't allowed to go to school, lots of bans were proposed with respect to gays. The panic was understandable in many ways, a highly lethal disease with no cure and no treatment. AIDs actually is lot scary than Ebola even today. It appears with prompt medical help in a Western hospital you are very likely to survive Ebola and after a few weeks are pretty healthy again.
The ultimate solution with HIV/AIDs was education, not knee jerk reactions.
Therefore, an asymptomatic health care worker returning from treating patients with Ebola, even if he or she were infected, would not be contagious. Furthermore, we now know that fever precedes the contagious stage, allowing workers who are unknowingly infected to identify themselves before they become a threat to their community. This understanding is based on more than clinical observation: the sensitive blood polymerase-chain-reaction (PCR) test for Ebola is often negative on the day when fever or other symptoms begin and only becomes reliably positive 2 to 3 days after symptom onset. This point is supported by the fact that of the nurses caring for Thomas Eric Duncan, the man who died from Ebola virus disease in Texas in October, only those who cared for him at the end of his life, when the number of virions he was shedding was likely to be very high, became infected. Notably, Duncan's family members who were living in the same household for days as he was at the start of his illness did not become infected.
A cynic would say that all these “facts” are derived from observation and that it pays to be 100% safe and to isolate anyone with a remote chance of carrying the virus. What harm can that approach do besides inconveniencing a few health care workers? We strongly disagree. Hundreds of years of experience show that to stop an epidemic of this type requires controlling it at its source. Médecins sans Frontières, the World Health Organization, the U.S. Agency for International Development (USAID), and many other organizations say we need tens of thousands of additional volunteers to control the epidemic. We are far short of that goal, so the need for workers on the ground is great. These responsible, skilled health care workers who are risking their lives to help others are also helping by stemming the epidemic at its source. If we add barriers making it harder for volunteers to return to their community, we are hurting ourselves.
Interesting editorial on the quarantine in the New England Journal of Medicine:
NEJM Editorially link