Ebola in America

Dr. Keith said:
It depends on where they are treated. In West Africa you may be approaching 90%, in a modern medical environment it looks like we will end up being well below 25% when this outbreak subsides.
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Given that we don't have an actual treatment for this disease, what makes the difference ?
 
I think the protocol in most if not all NHS hospitals is any patient with travel to Africa and presenting with fever is to treat the patient and sample with caution, but SCREEN THEM FOR MALARIA FIRST, as they are far more likely to have malaria than ebola.

As well, we have had a evidence based protocol in place, distributed to all staff and posted on the wall for about one month now, and I work in a hospital that is a 30 miles from London.

It is highly unlikely we will ever see a positive case, but we have had a few scared patients with 'query ebola' already. One was a potential case, two were children who had just returned from a holiday in Spain at the time the nurse with ebola had presented. There was absolutely no possibility the children had ebola, the parents were just terrified.

So far, the NHS is the only health care organisation that has treated an ebola patient and not transmitted it to a health care worker.

Just saying.
 
Belz... said:
Given that we don't have an actual treatment for this disease, what makes the difference ?
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From what I heard: very good supportive care.

The key is that it is very tough to administer without the caregivers being exposed, therefore it is less likely to be achieved in a struggling medical setting.
 
Tatyana said:
So far, the NHS is the only health care organisation that has treated an ebola patient and not transmitted it to a health care worker.

Just saying.
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This is not possible. The Dallas Ebola patient went to a private hospital. Another way to spell private is F-R-E-E-D-O-M. Private enterprise has the profit motive, which -- and I'll speak slowly so you socialists can understand -- means that if you or I were to contract Ebola, and Dallas Presbyterian had substandard protocols, then we can take our Ebola dollars elsewhere. Money talks! Free market FTW!!!

Conversely, this means that in a socialist hellhole like the UK, government bureaucrats make decisions, which is why Ebola will kill all of the Communists and why Stephen Hawking would be dead if he lived there.
 
Dr. Keith said:
"Fatigue" is also a known symptom of one of the primary diseases of the international traveler: jet lag. Going out for a run and trying to live a normal life sounds like a reasonable treatment plan.
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Normally I'd agree but this doctor was knowingly involved with contagious Ebola patients in West Africa. The CDC protocols called for self quarantine for 21 days after landing in the US and he knew it. Living a "Normal life" during those 21 days was not supposed to be an option and he knew that before he went off to West Africa. He violated those protocols in so many ways that it is well into the realm of irresponsible behavior. Riding public transportation, walking around crowed areas, eating in restaurants, and going bowling is in no way within the definition of "Self quarantine". Staying in your home and ordering take out or groceries for delivery is well within the realm of "Self quarantine". If he needed to exercise to wear himself out there are plenty of calisthenics that he could have done at home (jumping jacks for legs and cardio, pushups for upper body and so on).

He is an arrogant person who thought that the rules didn't apply to him and it doesn't matter one bit if he didn't infect anyone on his little jaunt about town. The protocols are there for a reason and it's well above his pay grade to challenge them.
 
Sam.I.Am said:
He is an arrogant person who thought that the rules didn't apply to him and it doesn't matter one bit if he didn't infect anyone on his little jaunt about town. The protocols are there for a reason and it's well above his pay grade to challenge them.
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The problem with quarantines is that they don't allow the volunteers to go out in public and tell everyone how wonderful they are for their selfless charity work.
 
wollclark said:
So this doctor gets back from working with ebola patients, starts feeling fatigued but decides to take public transport and go bowling in a highly populated, tourist heavy city anyway; he only decides to report the fact he's not feeling well when he finds he has a fever of 103.

And what do I hear from CNN? They keep repeating the lie that he was "asymptomatic" after just having stated that he was "feeling fatigued."

Then I heard that New York authorities aren't going to bother with sanitizing the elevator of his apartment building, nor the subway trains he took. If I'm remembering correctly, they also said they weren't going to bother with the taxi he took. There not even going to bother keeping in contact with the man who drove the taxi.

I hope these lazy, overly-confident actions (or inactions) taken by these officials don't end in more people getting sick. I hope they're right when they say the risk is "low" at this point in his illness that more can get sick, and they're not just saying that because it sounds nice and calming.
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Unless he was excreted blood and stool there's not a high risk of infection.
Until later stages set in he's not infectious. I'm more worried about the doctor himself right now.

Meadmaker said:
The virus can live for up to four hours outside of a host.

What point is there in disinfecting places that he hasn't been in the last four hours?

It isn't "lazy" to avoid actions that have no benefit.
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I read that it can last up to three three days in normal conditions, something like six in ideal conditions.
Belz... said:
Not sure about that last part, however. The fatality rate seems pretty high once you've got it.
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With treatment it's fairly survivable, but still risky. In the US with access to health care you have a good chance to survive.
 
I'm am significantly less than impressed with the actions of this doctor. He should have self-quarantined upon his return. Some things, like traversing the airport and transportation in order to get home naturally would've been unavoidable; but after that he should have had the self-control not to leave his home for 21 days.

An improperly-trained nurse flying to see relatives can be forgiven; but this guy is not only a doctor, he's spent the last while at ground zero treating this disease specifically. In every meaningful way, he knew better than to do what he did. For his sake, I hope nobody in NYC that he contacted gets sick.
 
If anyone here has ever read And The Band Played On or The Demon In The Freezer they would know that the CDC is generally only organized to identify and catalog diseases not think up responses to them. They can, usually, come up with a response to a specific new disease but it is a painful process since it outside of their normal job description.
 
Travis said:
If anyone here has ever read And The Band Played On or The Demon In The Freezer they would know that the CDC is generally only organized to identify and catalog diseases not think up responses to them. They can, usually, come up with a response to a specific new disease but it is a painful process since it outside of their normal job description.
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The public seems to assume the CDC gives orders, but all they really give is advice. They do not have the authority to take over care of a patient, they have to be invited.
 
I see that New York and New Jersey have made mandatory a 21 day quarantine for anyone returning from a place where they were in direct contact with Ebola patients.

I will again appeal to my own ignorance in stating my opinion about whether or not this is a good idea. However, let us assume, for the sake of argument, that it is indeed a good idea. If that is the case, then it can only be the case because the disease can be transmitted from one individual to another in the ordinary course of human interaction. Right? Let's be clear about what I'm saying. The only reason to quarantine someone would be if they could be spreading disease as they go about their daily business. Furthermore, it would have to be the case that lesser measures, such as self monitoring and trusting them to report symptoms when they arise, would not be adequate. If the quarantines are a good idea, it must be that those people represent a real danger, and lesser measures cannot counteract that danger.

If that is the case, then there is a real risk to the American people, even if we institute the quarantines. The world being what it is today, with ease of travel, we cannot catch all the people who are carrying the virus. Some will get through. Some will lie about where they have been. Some will unknowingly make contact with an Ebola victim. It's inevitable. The disease will spread.

If that is the case, then it seems to me that there is no way to keep Americans completely safe from Ebola, but there is one clear way to maximize our safety. We must very aggressively and with substantial effort, which implies substantial cost, work to keep Africans safe from Ebola. If we can reduce the number of African victims, then we reduce the possible number of disease vectors into our country.

President Obama should then be commended for the work he has done to set up health care facilities in Africa, but it is not nearly enough. We should be writing our congressmen telling them that we must do everything we can to protect Africans from this disease, so that we can minimize the risk to the American people.
 
Ziggurat said:
Risk assessment is a question of facts. Risk tolerance is not. It is a subjective evaluation. Dr. Keith's risk tolerance for ebola is no more based on rationality than mine. And the fact that my opinion about risk tolerance is popular is very much relevant to what our government should be doing.
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What should the government be doing that it isn't? What does the popularity of an idea have to do with it's effectiveness?
 
Travis said:
If anyone here has ever read And The Band Played On or The Demon In The Freezer they would know that the CDC is generally only organized to identify and catalog diseases not think up responses to them. They can, usually, come up with a response to a specific new disease but it is a painful process since it outside of their normal job description.
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Then they are poorly named, "Center for Disease Control" pretty much says that they are there to help CONTROL diseases which is a pretty specific job description. Their name pretty much describes what their primary mission should be. That, to me anyway, means that they are there to come up with responses to things like this as well as help develop vaccines and other cures.

The Health Department (from the Surgeon General on down) are there to implement the recommendations of the CDC and others, by force if needed (that's why health department officials are officially considered the equivalent of officers in the military just so they can give legal orders).

If you meant that there has been mission creep from controlling disease into other areas at the expense of their primary mission I wouldn't disagree but to say that it's not in their normal job description I would have to disagree.
 
Sam.I.Am said:
Then they are poorly named, "Center for Disease Control" pretty much says that they are there to help CONTROL diseases which is a pretty specific job description. Their name pretty much describes what their primary mission should be. That, to me anyway, means that they are there to come up with responses to things like this as well as help develop vaccines and other cures.
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Bureaucracy 101: Claim dire need for government role, funding, etc. based on threat of scary event. Then, when faced with actual event, do everything possible to minimize government responsibility, expectations, etc.
 
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