Second Ebola Case in Dallas

[Matryoshka]

She used the word "much."  Much of the distrust and fear would be allayed.  There will always be extremists out there.  I don't think the other poster is referring to them.  What I am concerned with is with the people who through logic and reasonable concern are concluding that the CDC is making all kinds of serious missteps and has not been proactive, rather they are--for whatever reason--way behind the curve on something extremely dangerous.

 

I read somewhere that MSF who are knowledgeable and experienced and very cautious have already lost 9 out of 16 doctors in Sierra Leone.  As experienced and highly motivated as they were, I'm not going to assume any neglect or breach of protocol on their part.   Why then, would the CDC not have issued UNIVERSAL, ultimate protection guidelines for HCWs?  The lack of wisdom and common sense of "in case wear this, in another case wear that," or "these folks can travel, those can't."  just astounds me.  Even the 21 day guideline, when epidemiologists who have studied the outbreaks are reporting that in 15% of cases there is late onset of the disease.  Why, oh why, is the CDC not acting more cautiously?

 

In the absence of a Surgeon General, and as the head health guru in communicable disease, it is the CDC director's job to lead, and to overrule voices who are more timid or who are afraid of rocking boats, in the interest of protecting the public.  I'm am just not seeing the proper leadership. 

 

 

I'm not a government-hater.  I voted for Obama. 

 

Even before this happened, I thought they were downplaying the potential seriousness of this, and I thought there should long have been some kind of travel ban (though I think the WHO should have been suggesting this, not our gov't) which would have prevented this.  But even in my worst-case scenario, I thought a first case would get through, get directly to a hospital, and I thought they'd use proper protocols, isolate the patient, limit access, and do careful contact-tracking (as they kept saying they would), that would be a wake-up call, and we'd move on from there.

 

But this level of blundering, even I didn't see coming.  Contact-tracking?  And now one took a flight while sick, another's on a cruise with over 3500 people?  How are we going to track all them if that person gets sick?  And all their contacts?  We couldn't even properly manage tracking the people who came into contact with ONE patient.  Holy smokes.  They're screwing up as badly (or worse?) than FEMA after Katrina.  What are the qualifications of this CDC head?  Is he some political appointee (like the head of FEMA was?)  If not, what is the excuse for this level of sheer stupidity?  You don't even need a degree in anything to know what should be done, just a smidgen of common sense, but even the most basic common sense seems to be lacking. We know what level of protection is being used in Africa, just from looking at pictures on TV.  It's more than a gown and mask, for Pete's sake!  We kept saying that we had much better resources in Africa, so it wouldn't be a problem here.  But we're using less!!  Much less!!  I just can't fathom it.

 

I really never, never, thought the CDC could ever manage this level of incompetence.  This is really mind-blowing.

 

[Matryoshka]

I imagine that the government is operating - at least in part - with the notion that strict quarantine will have a negative effect on the economy, what with people staying home and not going about spending money, airline loads decreasing, etcetera. Quite shortsighted, IMO. Perhaps they are hoping to avoid panic, or to not have to fess up to the lack of preparedness, who knows. Despite the reasoning, they have failed not only in communication (for which I had been willing to cut them some slack), but also in policy making/execution (for which I am less apt to forgive - the CDC exists to study, develop, and pronounce infectious disease control measures, does it not?).

 

Too bad that current events poll on another thread didn't mention anything about a surgeon general. I was unaware that we lacked one.

 

Yeah, because shutting down all these hospitals and schools and airlines and cruises (and this after only three have sickened), that won't affect the economy.  Nor will letting it spread exponentially.  And that also won't cause panic and people to stay home. And fessing up to lack of preparedness would have been worse than actually showing us how unprepared they were?  Cause that's keeping everyone calmer??  It is insane how short-sighted they are.

 

it's like their entire plan was putting their fingers in their ears and singing "lalalalala".

 

[Pawz4me]

Obviously the CDC has dropped the ball on this.  Lots of balls.

 

But they're making things exponentially worse by not communicating well. They need a spokesperson. They need to stop doing interviews with various media outlets and start giving regularly scheduled press conferences (twice a day?).  They need to have a thorough, pre-written update statement to start off each press conference before taking questions. Such a statement could cover a LOT of the questions that would be asked, and answer them in a thorough manner.  Instead they launch right into taking questions, which really isn't an effective way to communicate facts.  Everything gets garbled.

[Seasider]

Yeah, because shutting down all these hospitals and schools and airlines and cruises (and this after only three have sickened), that won't affect the economy. Nor will letting it spread exponentially. And that also won't cause panic and people to stay home. And fessing up to lack of preparedness would have been worse than actually showing us how unprepared they were? Cause that's keeping everyone calmer?? It is insane how short-sighted they are.

 

it's like their entire plan was putting their fingers in their ears and singing "lalalalala".

 

I hear you! That's why I said that if they weren't instituting mandatory quarantines, perhaps due to economic impact, that they were being shortsighted.

 

Heck, my 9yo can foresee consequences farther out than what the CDC appears to have done.

[Seasider]

Obviously the CDC has dropped the ball on this. Lots of balls.

 

But they're making things exponentially worse by not communicating well. They need a spokesperson. They need to stop doing interviews with various media outlets and start giving regularly scheduled press conferences (twice a day?). They need to have a thorough, pre-written update statement to start off each press conference before taking questions. Such a statement could cover a LOT of the questions that would be asked, and answer them in a thorough manner. Instead they launch right into taking questions, which really isn't an effective way to communicate facts. Everything gets garbled.

Yes! Could you please forward this directly to the CDC?

[Pawz4me]

Yes! Could you please forward this directly to the CDC?

 

I'll get right on that.  I'm sure they'll heed my wise words. ;)

[Halftime Hope]

Dear CDC,  could you please instruct all healthcare offices and institutions to add another questions to their initial two: "Have you traveled on public transportation within the past three weeks?"  and authorize appropriate follow on questions as needed?

 

That is all.

 

 

[JoJosMom]

But, take heart, Americans!  We now have an "Ebola Czar."  Granted, his experience lies completely within the realm of politics and he has absolutely ZERO medical background but, seriously, who needs that? 

 

Having worked for a bureaucracy, I have never had the happy view that all would be well with this little Ebola thing and that the experts could handle it.  On the contrary, I tend to be (probably overly) cynical.  But even I am dumbfounded at the level of incompetence we are witnesses from our federal health care experts.

[WagsWife]

I'm not a government-hater. I voted for Obama.

 

Even before this happened, I thought they were downplaying the potential seriousness of this, and I thought there should long have been some kind of travel ban (though I think the WHO should have been suggesting this, not our gov't) which would have prevented this. But even in my worst-case scenario, I thought a first case would get through, get directly to a hospital, and I thought they'd use proper protocols, isolate the patient, limit access, and do careful contact-tracking (as they kept saying they would), that would be a wake-up call, and we'd move on from there.

 

But this level of blundering, even I didn't see coming. Contact-tracking? And now one took a flight while sick, another's on a cruise with over 3500 people? How are we going to track all them if that person gets sick? And all their contacts? We couldn't even properly manage tracking the people who came into contact with ONE patient. Holy smokes. They're screwing up as badly (or worse?) than FEMA after Katrina. What are the qualifications of this CDC head? Is he some political appointee (like the head of FEMA was?) If not, what is the excuse for this level of sheer stupidity? You don't even need a degree in anything to know what should be done, just a smidgen of common sense, but even the most basic common sense seems to be lacking. We know what level of protection is being used in Africa, just from looking at pictures on TV. It's more than a gown and mask, for Pete's sake! We kept saying that we had much better resources in Africa, so it wouldn't be a problem here. But we're using less!! Much less!! I just can't fathom it.

 

I really never, never, thought the CDC could ever manage this level of incompetence. This is really mind-blowing.

 

 

This!! A thousand times (except the voting for Obama part :) this!!! I am totally floored at the sheer incompetence on Every. Single. Level.

[Seasider]

I always said that if a team of home school parents participated on The Apprentice, they would kick it and Donald Trump would be impressed.

 

Now I can't help but think, if only WTMers ran the CDC.

 

We've got an epidemiologist, several doctors, a number of nurses, and apparently outweigh the current administration in common sense.

 

If only...

[HomeschoolMamaOfTwo]

So I heard something last night on CNN that Vinson's mother was in Dallas.  They mentioned she was there trying to visit Vinson.  I am wondering if this is accurate.  Is this the same mother (like not a step mother, etc) that she was visiting in OH?  If so, how did she get to Dallas from OH?  Wouldn't she also need to be in a quarantine?  Hopefully, I am just confused here.

[zoobie]

So I heard something last night on CNN that Vinson's mother was in Dallas. They mentioned she was there trying to visit Vinson. I am wondering if this is accurate. Is this the same mother (like not a step mother, etc) that she was visiting in OH? If so, how did she get to Dallas from OH? Wouldn't she also need to be in a quarantine? Hopefully, I am just confused here.

Vinson is in Atlanta at Emory.

 

The mother could drive her own car. They've asked people not to use public transportation. I don't believe anyone else is under mandatory quarantine at this time. (Mr. Duncan's family maybe?) That requires a judge's order.

[Sdel]

 

I really never, never, thought the CDC could ever manage this level of incompetence.  This is really mind-blowing.

 

 

I did.  We are a HCW family and we've been talking and planning about whens not ifs.  My DH is a supervisor at a hospital and he's already making his game plan for when the first case shows up in the ER.  *hint hint*  It involves calling the local military depot down the way and demanding several of their hazmat suits not relying on gloves, gown, and face mask.  Those were laughable precautions.

 

Stefanie

[HomeschoolMamaOfTwo]

Vinson is in Atlanta at Emory.

 

The mother could drive her own car. They've asked people not to use public transportation. I don't believe anyone else is under mandatory quarantine at this time. (Mr. Duncan's family maybe?) That requires a judge's order.

 

I know Vinson is in Atlanta but I think the implication was that the mother had gone to Dallas before the decision was made to move Vinson to ATL so that she could visit her while she was in Dallas.  I'm not sure as it was just something mentioned on CNN quickly, confirmed that she was there, and then they moved on.  I hope you are right about the car!  I was thinking time wise that wouldn't work, but maybe it would.  

[Momof3littles]

I thought I heard this on GMA this morning but now they have it up in print.

 

http://abcnews.go.com/Health/ebola-nurse-nina-pham-fair-condition-trip-dallas/story?id=26266763

 

Vinson did not directly call federal health officials for permission to board a passenger flight Monday, instead talking to a team of Texas health officials who relayed her symptoms to the Centers for Disease Control and Prevention, her uncle told ABC News.

 

"They called Amber back and told her, ‘The CDC is OK with it. You can travel,†Lawrence Vinson said today.

 

I wonder what she was told by the CDC about calling them vs. calling into the team in Texas.  This is assuming the uncle's report is accurate. 

 

edited to add:  Why would the CDC want to hear it through another party and not speak with her directly?  Anytime you layer in more people, the message is more likely to be distorted IME.  I wonder if this was how the plan for her communication was set up, or whether there was no real plan about who to call if an issue arose (other than the CDC required "self monitoring" from her), or whether she deviated from a plan that was set up.  Did they just tell her to call if she had a temp but didn't specify who she should call?

[Halftime Hope]

Oh, never mind--czar, schmar and Mama Vinson.

 

 

 

 I just need to pull a rock over my head.

 

 

 

[Seasider]

I thought I heard this on GMA this morning but now they have it up in print.

 

http://abcnews.go.com/Health/ebola-nurse-nina-pham-fair-condition-trip-dallas/story?id=26266763

 

Vinson did not directly call federal health officials for permission to board a passenger flight Monday, instead talking to a team of Texas health officials who relayed her symptoms to the Centers for Disease Control and Prevention, her uncle told ABC News.

 

"They called Amber back and told her, ‘The CDC is OK with it. You can travel,†Lawrence Vinson said today.

 

I wonder what she was told by the CDC about calling them vs. calling into the team in Texas. This is assuming the uncle's report is accurate.

 

edited to add: Why would the CDC want to hear it through another party and not speak with her directly? Anytime you layer in more people, the message is more likely to be distorted IME. I wonder if this was how the plan for her communication was set up, or whether there was no real plan about who to call if an issue arose (other than the CDC required "self monitoring" from her), or whether she deviated from a plan that was set up. Did they just tell her to call if she had a temp but didn't specify who she should call?

 

I am starting to think that CDC has IRS written all over it.

[Joanne]

I essentially work in an ER (psychiatric) in Harris County, Texas. We have 2 sides of admits - voluntary and involuntary. The involuntaries come from law enforcement. There has been "precautionary measures" taken for a current inmate:

 

http://www.khou.com/story/news/local/2014/10/17/harris-county-inmate-considered-low-risk-for-ebola-transported-to-hospital/17422289/

 

We've gotten 2 emails today regarding Ebola. My facility is next to the busiest hospital for indigents.

 

I am *not* usually worried about these things. But I am on an elevated concern level for this one, especially so since I believe that what we've been told about transmission and what is the truth about transmission don't add up.

[Seasider]

Take care, Joanne. I am curious about just why this person is even considered at risk.

[swimmermom3]

This morning, I read on FoxNews.com that the Colombian government has banned entry of people who have been in one of  5 countries in Africa, during the past 4 weeks.  That the 2nd Nurse was permitted by the CDC to travel on civil turbojet aircraft within the U.S.A. is astonishing to us. I hope and pray the CDC and the U.S. Government will begin take Ebola much more seriously.  We flew back to Cali Tuesday afternoon and the idea of someone like the 2nd Nurse being in an aircraft with us is not comforting to us. Apparently if one is within 3 feet of someone like the 2nd Nurse, they can catch Ebola and in an aircraft that distance is quite possible, especially when boarding or deplaning. To say nothing of sitting near someone like that...

 

One of my sons is a TSA officer and they are in constant conversation and training with regards to Ebola.  TSA officers that are doing the security screenings are often unwillingly in contact with bodily fluids whether it's from being sneezed on or peed on. Gloves don't quite cut it for protection.

 

[Just Kate]

I essentially work in an ER (psychiatric) in Harris County, Texas. We have 2 sides of admits - voluntary and involuntary. The involuntaries come from law enforcement. There has been "precautionary measures" taken for a current inmate:

 

http://www.khou.com/story/news/local/2014/10/17/harris-county-inmate-considered-low-risk-for-ebola-transported-to-hospital/17422289/

 

We've gotten 2 emails today regarding Ebola. My facility is next to the busiest hospital for indigents.

 

I am *not* usually worried about these things. But I am on an elevated concern level for this one, especially so since I believe that what we've been told about transmission and what is the truth about transmission don't add up.

 

That is scary! I'm sure you are being more cautious and alert.

 

As for the transmission, what are your thoughts here? Do you think that ebola is more easily transmitted than what we are being told? If so, I wonder why Mr. Duncan's family didn't get it.

[Katy]

That is scary! I'm sure you are being more cautious and alert.

 

As for the transmission, what are your thoughts here? Do you think that ebola is more easily transmitted than what we are being told? If so, I wonder why Mr. Duncan's family didn't get it.

 

It's undeniably more easily transmitted than earlier strains - that's why it's now all over the world instead of isolated to 2-5 villages.

 

It's possible they stayed away from him when he was feeling ill.  Since most of them were from Liberia it's possible they are some of the people with natural immunity that we don't yet understand the source of.  It's absolutely true that it's more contagious later in the illness, when the nurses were exposed not the family.

[Callie]

It's undeniably more easily transmitted than earlier strains - that's why it's now all over the world instead of isolated to 2-5 villages.

 

It's possible they stayed away from him when he was feeling ill.  Since most of them were from Liberia it's possible they are some of the people with natural immunity that we don't yet understand the source of.  It's absolutely true that it's more contagious later in the illness, when the nurses were exposed not the family.

I've been thinking about the natural immunity angle for days and wondering why no one "in charge" had considered that was why his family had not become ill.

[PeachyDoodle]

GMA showed a video of the first nurse, Nina Pham, in her hospital room this morning. She looks considerably better than I would have expected:

 

http://abcnews.go.com/GMA/video/ebola-infected-nurses-treated-experimental-drugs-26266159

 

Also, Breitbart is reporting that the government began expediting visa extensions for travelers from Guinea, Liberia and Sierra Leone in August. From what I can tell, these rules only apply to travelers who are already in the US, presumably to keep them from having to go back home during the epidemic. Just thought it was interesting in light of the current debate over travel restrictions.

 

http://www.breitbart.com/Breitbart-Texas/2014/10/17/DHS-Started-Expediting-Visa-Extensions-From-Ebola-Countries-in-August

[Carrie12345]

That is scary! I'm sure you are being more cautious and alert.

 

As for the transmission, what are your thoughts here? Do you think that ebola is more easily transmitted than what we are being told? If so, I wonder why Mr. Duncan's family didn't get it.

 

Different immunities, different exposures...and, frankly, there are people who wonder about their current health status.  I want to believe they're fine, but they're certainly being "handled" as far as communication goes.  I mean, come on. *Someone* managed to shut Jesse Jackson up!

 

I still don't believe ebola is easy to catch.  I do think it's easy to mishandle. And no one seems to know how not to mishandle it.  :tongue_smilie:

[Lolly]

Different immunities, different exposures...and, frankly, there are people who wonder about their current health status.  I want to believe they're fine, but they're certainly being "handled" as far as communication goes.  I mean, come on. *Someone* managed to shut Jesse Jackson up!

 

I still don't believe ebola is easy to catch.  I do think it's easy to mishandle. And no one seems to know how not to mishandle it.  :tongue_smilie:

 

Which could be considered not only a miracle, but a first in history.

[momto10blessings]

Well said. A lot of my friends who were very confident that ebola would not become a problem in the US are now on edge.

 

I agree to a point. Some people will never trust what is said. There's not much you can do to convince them otherwise.

 

But I think the majority of us WANT to have confidence in our government's ability to handle this situation. Unfortunately, the questionable decisions/actions to date by a variety of entities--the hospital, individual patients (like the second nurse), government agencies, and the CDC--have left people feeling that nobody has a handle on it.

 

When people see what looks like blatantly foolish decisions being made and people being unnecessarily put at risk, you can't blame some of the public for not trusting. The CDC and local governments need to work extra hard at this point, I believe, to restore that trust. That starts with being upfront and available for comment when things happen such as that man dying on a plane.

 

They need to be more proactive in keeping at-risk people from traveling and potentially spreading illness. (How many more families are now dealing with unnecessary fear, anxiety, and hardship because that nurse wasn't told to stay in Dallas from the start.) I read an article yesterday by a psychologist (I'll try to remember where) who said people will start to panic when they feel they can't trust those in charge to handle the situation. He also suggested that we're not all that far from that tipping point.

 

I think people get that this outbreak caught everyone by surprise although it shouldn't have. It's the repeated blunders that are so astounding and which damage credibility so much.

[Ethel Mertz]

Here's an article by a hazmat trained hospital worker that is interesting with regard to the donning and doffing of PPE.

[Supertechmom]

Im a nurse and I am on edge.   We absolutely without a doubt can NOT handle an ebola epidemic.   CAN NOT.  just staffing and equipment needs are problems.  Thinking for one minute that the hospital system can handle ebola is a scary from a resource material management view and human resource view.  

 

We need to open up a couple of closed army bases and house everyone with the potential to even develop ebola.

 

Stopping this is the only effective way.  Trying to treat and contain is only going to continue with blunders.  Given how costly those blunders could be........   Quarantine is the only route. 

 

I'm boggled forced quarantine isn't already in operation on a massive scale..  

[Katy]

Im a nurse and I am on edge.   We absolutely without a doubt can NOT handle an ebola epidemic.   CAN NOT.  just staffing and equipment needs are problems.  Thinking for one minute that the hospital system can handle ebola is a scary from a resource material management view and human resource view.  

 

We need to open up a couple of closed army bases and house everyone with the potential to even develop ebola.

 

Stopping this is the only effective way.  Trying to treat and contain is only going to continue with blunders.  Given how costly those blunders could be........   Quarantine is the only route. 

 

I'm boggled forced quarantine isn't already in operation on a massive scale..  

 

A couple of years ago Jesse Ventura had some weird tv show about conspiracy theories.  It left me under the impression we already have quarantine centers prepared. Of course, that assumes a level of competence not actually demonstrated.

[jelbe5]

That is scary! I'm sure you are being more cautious and alert.

 

As for the transmission, what are your thoughts here? Do you think that ebola is more easily transmitted than what we are being told? If so, I wonder why Mr. Duncan's family didn't get it.

 

I have been wondering the same thing.  I do not consider myself to be a paranoid person, but I tend to be a realist.  So I have a couple of thoughts on this for what it is worth:

 

1)  Mr. Duncan's family did not contract ebola because it really is not easy to contract in the very early stages but only in the later stages.  I am praying for this to be truth and it would explain why the nurses contracted it since he was in the final stages of the disease at the height of contagion.

 

2)  Mr. Duncan's family is quite ill (or worse) and we are not being told about this.  I believe in patient privacy, etc.  But I feel this situation is beginning to reach a level where people are becoming quite concerned.  If Mr. Duncan's family is not ill, wouldn't the powers that be want the rest of us to "see" that as reassurance?  Wouldn't you think that the family members would be talking to other family members and friends who would be relaying information on their condition to the media, etc.?  It seems as though the family members have dropped off the face of the earth.  If they were moved into a "gated community" wouldn't you think, in this day and age of cell phones, instant messaging, twitter, Facebook, digital video, etc. that their location would have been posted somewhere for all the world to see by nervous members of that community?  I doubt that type of activity could be easily kept from the public eye but maybe I am mistaken.  I think back to the play-by-play that happened when police moved in on the Boston Marathon bomber.  People in that community were panicking and tweeting every detail.  But it seems as though Duncan's family has disappeared . . . unless I am missing something.  And that makes me nervous.

[Supertechmom]

Here's an article by a hazmat trained hospital worker that is interesting with regard to the donning and doffing of PPE.

 

 

I would say that article completely sums up why treating this after people catch it is the problem.  How long do you think it takes to don and then take off such equipment?   Two staff members tied up in taking off and putting on hazmats.  Which every nurse who says they will take care of EBola patient in my hospital has said they will insist on with that very level of caution in the article. (we are a fema trained center as well)

 

While two are doing that, what do you think is happening to the patient? How well do you think you can put in an iv or give meds or even clean up in that get up?  

 

I'm becoming worried that we are letting this get beyond the ability of our system.

[trulycrabby]

I am not impressed with the new Ebola Czar. :ack2: I understand the administration wanted a communicator, but the person should have been an M.D., IMO. To me, without the medical credentials, he is just a spin doctor with the ability to greatly influence policy and the economy.

[Mrs Mungo]

I'm boggled forced quarantine isn't already in operation on a massive scale..

 

What would this look like, in your opinion?

 

 

A couple of years ago Jesse Ventura had some weird tv show about conspiracy theories.  It left me under the impression we already have quarantine centers prepared. Of course, that assumes a level of competence not actually demonstrated.

I wouldn't rely upon a conspiracy theory show for actual information.

 

I would believe that the government has *plans* for a wide scale outbreak because they have plans for *lots* of things that the military works on in conjunction with think tanks (we know a lot of people who do those jobs). But, that's not at all the same as preparing a "quarantine center" (whatever that means).

 

The reason that they make such plans (in theory) is that the plan can be dusted off, tweaked and put into place. However, it is important to remember that the military had plans for invasion of Iraq that were nearly totally ignored, resulting in chaos that continues over ten years later. And some plans are considered far fetched enough that nothing physical is prepared ahead of time.

[Valley Girl]

 

 

We need to open up a couple of closed army bases and house everyone with the potential to even develop ebola.

 

Stopping this is the only effective way.  Trying to treat and contain is only going to continue with blunders.  Given how costly those blunders could be........   Quarantine is the only route. 

 

I'm boggled forced quarantine isn't already in operation on a massive scale..  

 

But then how do you protect those at-risk people who otherwise would not have gone on to develop the actual illness if they're housed with people whose exposure was greater and who do actually get sick? (This is a real question. I'm honestly not trying to nit-pick your post, Supertechmom. I truly appreciate the valuable insights people who work in the healthcare field are offering on this subject.)

[Katy]

But then how do you protect those at-risk people who otherwise would not have gone on to develop the actual illness if they're housed with people whose exposure was greater and who do actually get sick? (This is a real question. I'm honestly not trying to nit-pick your post, Supertechmom. I truly appreciate the valuable insights people who work in the healthcare field are offering on this subject.)

 

They have to be isolated from each other too.

[Pen]

I have been wondering the same thing.  I do not consider myself to be a paranoid person, but I tend to be a realist.  So I have a couple of thoughts on this for what it is worth:

 

1)  Mr. Duncan's family did not contract ebola because it really is not easy to contract in the very early stages but only in the later stages.  I am praying for this to be truth and it would explain why the nurses contracted it since he was in the final stages of the disease at the height of contagion.

 

2)  Mr. Duncan's family is quite ill (or worse) and we are not being told about this.  I believe in patient privacy, etc.  But I feel this situation is beginning to reach a level where people are becoming quite concerned.  If Mr. Duncan's family is not ill, wouldn't the powers that be want the rest of us to "see" that as reassurance?  Wouldn't you think that the family members would be talking to other family members and friends who would be relaying information on their condition to the media, etc.?  It seems as though the family members have dropped off the face of the earth.  If they were moved into a "gated community" wouldn't you think, in this day and age of cell phones, instant messaging, twitter, Facebook, digital video, etc. that their location would have been posted somewhere for all the world to see by nervous members of that community?  I doubt that type of activity could be easily kept from the public eye but maybe I am mistaken.  I think back to the play-by-play that happened when police moved in on the Boston Marathon bomber.  People in that community were panicking and tweeting every detail.  But it seems as though Duncan's family has disappeared . . . unless I am missing something.  And that makes me nervous.

 

 

Ebola infections with no symptoms are possible. And they could help fight the West Africa epidemic.

Washington Post - 23 hours ago

 

In Dallas, Ebola patient family struggles with isolation amid fears

Chicago Tribune - 1 day ago

[Valley Girl]

They have to be isolated from each other too.

 

I understand what you're saying. Given the current track record of the various decision-makers so far, I don't know that I'd put much faith in their ability to do that, honestly. I think a lot of people would be very skeptical, which brings its own set of problems. What a mess.

[songsparrow]

 

 

In Dallas, Ebola patient family struggles with isolation amid fears

Chicago Tribune - 1 day ago

 

 

The article says:

 

"The four aren't allowed to touch one another, or anyone else. As a replacement, Mason wraps his arm around himself and makes eye contact with family members when he visits. They mimic the motion. It's the closest they can come to hugging, he said."

 

But why would the four people in quarantine not be allowed to touch one another?  The CDC has maintained that the virus cannot be transmitted in the absence of symptoms.  They are checking their temperatures twice a day and I'm sure they're monitoring how they're feeling.  If they're asymptomatic, they cannot spread the disease.  

[Katy]

The article says:

 

"The four aren't allowed to touch one another, or anyone else. As a replacement, Mason wraps his arm around himself and makes eye contact with family members when he visits. They mimic the motion. It's the closest they can come to hugging, he said."

 

But why would the four people in quarantine not be allowed to touch one another?  The CDC has maintained that the virus cannot be transmitted in the absence of symptoms.  They are checking their temperatures twice a day and I'm sure they're monitoring how they're feeling.  If they're asymptomatic, they cannot spread the disease.  

 

My guess?  This is either another example of the CDC telling the public one thing to calm us down, and telling those who have been exposed something completely different OR the daughter that's a nurse's aide told them to do so and to ignore CDC recommendations.

[Pen]

  If they're asymptomatic, they cannot spread the disease.  

 

We do not know that for sure. 

 

 

[mathnerd]

I have seen what happens when massive catastrophe strikes this country - 9/11 and Katrina. I believe that Ebola is on that scale or even greater. I am no government hater - but, I think that this country does not know what it is dealing with when it comes to Ebola. My personal belief is that the CDC thinks that it knows how this virus spreads, but in reality, this virus is defying all their protocols. The gross underestimation of the ability of this virus to spread is why we are seeing so much incompetence in directing treatment for ebola patients, setting standards for caregivers, handling of infected caregivers, setting standards and facilities for disposing of infected waste from patients etc. Some senators were demanding the resignation of the CDC chief because it is not right that the disease spread to caregivers (maybe many more?) and there were no standing instructions for them to isolate themselves after caring for Mr Duncan.

 

What we need is more of out top infectious disease scientists moved to Ebola research and more funding (millions or billions) poured into companies like Mapp pharma that produces the ZMapp in the hopes that there is a fast turnaround of a preventive medicine or cure. 

 

I shudder to think of what would happen if this disease spreads to third world countries with millions living in urban slums with open sewers and flies and insects and poor sanitation.

[Supertechmom]

But then how do you protect those at-risk people who otherwise would not have gone on to develop the actual illness if they're housed with people whose exposure was greater and who do actually get sick? (This is a real question. I'm honestly not trying to nit-pick your post, Supertechmom. I truly appreciate the valuable insights people who work in the healthcare field are offering on this subject.)

 

That is going to take quite a bit of detailing.  I seriously hope that somewhere in our gov and military there is a detailed massive quarantine plan that somebody is reviewing right now for just in case.  Off the cuff, I would think it could be set up on base to have sectors.  Those that have highest potential to develop the disease in one sector, those with minimal in another, those with the lowest risk  in another.   If need be separate the bases out to those with the highest potential, etc... Keep each sector separate with proper decon procedures between.  in each sector, people would have to isolate themselves from each other. Little mini isolation units inside larger ones.

 

It would be a nightmare. It would be a huge  deal and I am sure laws would need to be passed to protect those people financially and to protect their belongings.  I am not saying this would be an easy feat or easily snap your fingers and it is done type of operation.  It would require  a lot of thought, input from many sources, and way more patience than most have. And somebody with some serious attention to detail to oversee it. But we do have reports of HCW in Dallas sleeping in their car for lack of a better method because some of them didn't want to take the chance of taking it home to their families.

 

 I'm sure my state is like all the rest and are pulling their state Ebola response together.  Wards are being identified,set up, material requested, staff getting trained. The system is being put into place for all the non Ebola hospitals to identify and transport Ebola patients to these special wards.  I'm sure it is going to work well because the front line workers don't want to get sick and are taking more precautions than the CDC recommends.

 

 But there is only a limited number of beds and staff trained.   Not just any worker and not just any hospital can handle this. And the supplies and materials and staff are only for a handful of beds.  I believe my state is preparing 12 beds across the state. Which is a lot, until it is not.  My family would take up half of the beds.  

 

Where is the tipping point between "we can handle it and are prepared to take care of patients" and " we don't have enough beds and staff and materials"

 

What is the plan to keep us from that  tipping point? Is there another method outside of some type of quarantine?

[Perry]

 My personal belief is that the CDC thinks that it knows how this virus spreads, but in reality, this virus is defying all their protocols. The gross underestimation of the ability of this virus to spread...

 

 

So far we have two cases, both in HCW who were inappropriately protected and had massive exposures to a patient in the end stages of disease. 

 

What am I missing here?

[mathnerd]

So far we have two cases, both in HCW who were inappropriately protected and had massive exposures to a patient in the end stages of disease. 

 

What am I missing here?

CDC chief went on record to state that nurse Nina Pham did not get infected because of a breach of protocol. So, what does that mean? To me it means that the protocol was designed with poor understanding of what it takes. Which further means that there is lack of knowledge in designing the protocols.

[Perry]

CDC chief went on record to state that nurse Nina Pham did not get infected because of a breach of protocol. So, what does that mean? To me it means that the protocol was designed with poor understanding of what it takes. Which further means that there is lack of knowledge in designing the protocols.

 

Nurses were told by their supervisors to wear tape around their necks, to cover exposed skin, which is not protocol anywhere, ever.  There is no possible way to remove tape without contaminating yourself. 

 

CDC had nothing to do with that. It was a hare-brained idea and I have no idea what the supervisors were thinking. 

 

If the nurses had actually stuck with the CDC guidelines they might well have not got sick. 

[warneral]

Why didn't the CDC rush over a plethora of supplies?

[trulycrabby]

I think the folks here are very knowledeable about airborne versus aerosol transmission, but this is still a very interesting article discussing ebola virus transmission:

 

Hat tip to Gert van der Hoek of flutrackers:

http://www.virology.ws/2014/09/27/transmission-of-ebola-virus/

[Pen]

That is going to take quite a bit of detailing.  I seriously hope that somewhere in our gov and military there is a detailed massive quarantine plan that somebody is reviewing right now for just in case.  Off the cuff, I would think it could be set up on base to have sectors.  Those that have highest potential to develop the disease in one sector, those with minimal in another, those with the lowest risk  in another.   If need be separate the bases out to those with the highest potential, etc... Keep each sector separate with proper decon procedures between.  in each sector, people would have to isolate themselves from each other. Little mini isolation units inside larger ones.

 

It would be a nightmare. It would be a huge  deal and I am sure laws would need to be passed to protect those people financially and to protect their belongings.  I am not saying this would be an easy feat or easily snap your fingers and it is done type of operation.  It would require  a lot of thought, input from many sources, and way more patience than most have. And somebody with some serious attention to detail to oversee it. But we do have reports of HCW in Dallas sleeping in their car for lack of a better method because some of them didn't want to take the chance of taking it home to their families.

 

 I'm sure my state is like all the rest and are pulling their state Ebola response together.  Wards are being identified,set up, material requested, staff getting trained. The system is being put into place for all the non Ebola hospitals to identify and transport Ebola patients to these special wards.  I'm sure it is going to work well because the front line workers don't want to get sick and are taking more precautions than the CDC recommends.

 

 But there is only a limited number of beds and staff trained.   Not just any worker and not just any hospital can handle this. And the supplies and materials and staff are only for a handful of beds.  I believe my state is preparing 12 beds across the state. Which is a lot, until it is not.  My family would take up half of the beds.  

 

Where is the tipping point between "we can handle it and are prepared to take care of patients" and " we don't have enough beds and staff and materials"

 

What is the plan to keep us from that  tipping point? Is there another method outside of some type of quarantine?

 

 

So far as I can tell, what we have  in terms of prepared facility and staff, is what might be able to handle cases that might come in, as they have already, from overseas HCW who get sick, and a few more that come despite absolute best efforts to not have that happen, and absolute best efforts to use top level containment, contact tracing, protective gear, etc. etc., to care for what there is.  We are having a really hard time with just a few cases at a time. If it goes into several hundred...?  I think our system, good as it supposedly is, would be rapidly overwhelmed, and we like Liberia would be in the situation of this rapidly spinning out of control.   So it really has got to be properly dealt with. Now. Well, yesterday, and also 6 months to a year ago as it was rising in West Africa, but that is already too late.

 

We cannot handle what is happening and will continue to happen from what appears to be a serious downplaying of the seriousness and contagiousness of the illness along with an overestimation of capacity and preparedness, and a failure to properly do all the quarantine and other precautions that could and should be done. 

 

Otherwise we have something like the keystone cops, except that the situation is in too serious an area for it to be funny.

 

I mean, honestly, if it weren't for the potential seriousness, the announcement that an HCW is on a cruise ship sounded like it must be from Saturday Night Live or some such thing. It took me a bit to realize that it was real and not a joke.

 

 I think we need someone in charge with significant ebola experience--such as someone with an MD and who has been with MSF. Not a politician, not someone who majored in public health and possibly has never or hardly ever dealt with real ebola (or perhaps any) patients. For the USA, someone with actual experience in many different USA hospitals and in many capacities, not just perhaps some top level facility in the country, would also help.  Maybe it would take a team to get the requisite experience.

[KingM]

On the one hand, it's great to see people acting a little more seriously about this. On the other, it shows how an epidemic can spread exponentially if we're not careful.

 

 

 

As of Friday, a pool of about 1,000 people are being watched for symptoms, have been asked to monitor themselves or have been urged to check with a counselor at the Centers for Disease Control and Prevention. The group includes a handful of people who have been ordered into quarantine, a larger group that is being closely watched with temperatures taken at least daily and a much larger group of travelers who may haven flown on a Frontier Airlines jetliner used at some point by an Ebola patient traveling with a low-grade fever.

 

http://www.latimes.com/nation/la-na-ebola-fear-monitoring-20141017-story.html