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Not-So-Hypothetical Ebola Question


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Hi, I'm coming out of lurking to get the boards' opinion on a personal situation. Let's say you had a health aide who came to your home for 12 hours 4 days a week to provide in-home care for a family member. This morning, said health aide (from Sierra Leone) mentions to you that he has visitors from same country who have been here 2 weeks and will be leaving in a week, so they'll know before they leave if they develop symptoms of ebola. He frequently has guests staying with him from Sierra Leone. With the new cases coming out in the news, this is obviously on everybody's minds. This health aide also relies on this income as his sole financial support.

 

How would you respond? Actually asked the pediatrician today because we were there for a well visit, and she said she'd get another health aide until he has been clear for 3 weeks (and impose the same quarantine any time he has visitors from back home). What would you do? I don't want to be ruled by fear, but I don't want to be foolish either!

Thanks for feedback!

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Yikes, that's a sticky situation!

 

On the one hand, the odds of catching ebola are very, very low.

 

On the other hand, if this person routinely houses people from a hot zone, then I think I would be cautious if I were you, and look for a fill-in. Bear in mind, if you do this, he may not tell you if/when he has visitors in the future.

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Personally I would follow the pedi's instructions. Being ruled by fear would be worrying about Ebola coming in from someone in an unaffected country, but I think taking precautions against something that is known to be a threat in the area where his visitors are coming from is protecting your family. I am 2 hours south of the current patient in the US. Currently I am not concerned, but if someone I know had come in contact with the man or his family, then I would keep my distance from them for 3 weeks. It comes down to risk assessment, and I think in your case the risk is high enough to warrent precautions. I do hope that the guy and his visitor do not get sick both for their sakes and for the rest of the population. The hard part will be finding someone to fill in for him that you trust and can have a good relationship with, because as you know both of those are so very important and sometimes hard to find.

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I would be quite confident that a Sierra Leonean health professional would be very aware of how to deal with this safely.  Even if he had been exposed (which is very unlikely even with Sierra Leonean visitors), he still couldn't transmit the disease unless he were symptomatic and I can't imagine he'd come go your house in that case.

 

I get why you're worried, and I don't think it's unreasonable to be worried, but I don't think it's necessary to keep him from working because of this.  

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I am listening right now to a talk radio show in Atlanta, and a caller whose wife is Liberian just said that he is making her relatives wait 21 days after they get to the US to visit his home. These are his in-laws, but he said,"I have kids." You are not overreacting, and your aid can close his home to visitors for a while.

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I would follow the pediatrician's advice.

Hi, I'm coming out of lurking to get the boards' opinion on a personal situation. Let's say you had a health aide who came to your home for 12 hours 4 days a week to provide in-home care for a family member. This morning, said health aide (from Sierra Leone) mentions to you that he has visitors from same country who have been here 2 weeks and will be leaving in a week, so they'll know before they leave if they develop symptoms of ebola. He frequently has guests staying with him from Sierra Leone. With the new cases coming out in the news, this is obviously on everybody's minds. This health aide also relies on this income as his sole financial support.

 

How would you respond? Actually asked the pediatrician today because we were there for a well visit, and she said she'd get another health aide until he has been clear for 3 weeks (and impose the same quarantine any time he has visitors from back home). What would you do? I don't want to be ruled by fear, but I don't want to be foolish either!

Thanks for feedback!

 

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Paediatrician is a health professional and aware of your families situation so I'd follow their advice. If you can't trust your health worker to be honest about the situation at home (hiding the fact they have visitors) I'd get a new health worker.

 

I do feel really sorry for them if this will cause hardship but I presume they are choosing to have the visitors in their home.

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I'd be more concerned that they frequently have visitors from there. It sounds like it's not just family, and you would need to have to go through this every time he has company.  I'd probably find a new aide rather than find a sub every time he has visitors.  I'm sure I'm overreacting but that's how I would handle it right now. 

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Thank you all for your responses, and for your understanding and compassion (for us and for our health aide). He actually doesn't work again until Tuesday because of the way the schedule works, so thankfully we have plenty of time to talk and process everything. I do hate the idea of letting him go, just to protect "us," but on the other hand he is making a decision to take a risk. I will post with a follow-up to let you know what happens!

 

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As usual, my rule is the safety and health of my children trumps the feelings or even income of an adult. My primary role is to protect them physically, emotionally, etc. I never want them to grow up and ask my why I failed to protect them or see them as a priority as children.

 

My answer is obvious. I would find a new aide.

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As usual, my rule is the safety and health of my children trumps the feelings or even income of an adult. My primary role is to protect them physically, emotionally, etc. I never want them to grow up and ask my why I failed to protect them or see them as a priority as children.

 

My answer is obvious. I would find a new aide.

We all see that as our role and see them as a priority and protect them.  But we can still come to different conclusions based on what we know of the risks.  

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Well, the CDC says there's absolutely nothing to worry about unless/until someone develops symptoms. So I guess I'd be as relaxed as people on three different plane flights have been. Do you trust the worker to mention anything, or stay home if they develop symptoms?

 

As people here are wont to say, "you're more likely to die of the flu."

 

Small comfort!

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I believe this is going to be a long term problem with the virus cropping up in different countries at different times. The home health aids in this country come from less stable countries (or have relatives/guests) where the virus is more apt to take root and stick around for awhile. I wouldn't want to switch health workers to the current safer flavor of the month.

 

And people from one country have friends and partners from other countries. You could have a Haitian worker with a girlfriend and family from another. If you are switching to the safer sounding flavor of the month worker and don't know them well, you could actually end out with a less safe worker, than the one you let go, without even knowing about it.

 

These people may have job protection and it might not be so easy to fire them just because they are from another country and have guests from that country.

 

It's not going to be so easy to escape risk by racial profiling.

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I wouldn't call it racial profiling. <eye roll> It's risk profiling. Everyone knows where the risk is coming from. It's not China, India or Switzerland. It's primarily 3 West African countries and this person had visitors from those countries in their home---increasing risk.

 

I'd find a new aid. Surely there is someone from a non-high risk country seeking employment in this field.

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 . This morning, said health aide (from Sierra Leone) mentions to you that he has visitors from same country who have been here 2 weeks and will be leaving in a week, so they'll know before they leave if they develop symptoms of ebola. He frequently has guests staying with him from Sierra Leone. With the new cases coming out in the news, this is obviously on everybody's minds. This health aide also relies on this income as his sole financial support.

 

 

 

For all you know, he could be renting out a room to travelers.  (One of my neighbors does this...he's got travelers coming and going all the time.)

 

I'm suspicious that he would even mention the part about the people staying for 3 weeks...long enough to know if they're going to come down with ebola.   Maybe he's got some kind of business and/or humanitarian arrangement with people from Sierra Leone...if they think they've been exposed, they can fly to the US and stay with a trained health worker until the incubation period is over.  Then they either get the best health care here, or they just fly back home.  

 

 

 

 

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