Second Ebola Case in Dallas

[Halftime Hope]

Those Liberians should build their own treatment centres. Africa really needs to pull itself up by the bootstraps.

 

If it's any consolation, I'm ashamed that my government has refused to send troops. At least the US can hold their heads up on this one. Your troops are doing a good, brave and worthy thing.

 

Sadie, I'm concerned that these countries are so poor, their infrastructure in such shambles from decades of civil war that they have no bootstraps. 

 

I would like to see some concern and investment from the other African nations that are able to help.  It's in their best interest, ya know?

[Starr]

I guess if Africa is supposed to solve this problem for themselves - the whole continent?- we should do the same. Lets quarantine and stop travel in and out of Texas. :D

[Carrie12345]

Those of you against US involvement, have you looked at the projected numbers for Africa if things continue as is?  They're flipping *exponential.  If one case came through at a few thousand, how many can come through at a hundred thousand?

 

HCWs here are getting scared, and rightfully so.  If their confidence continues to crumble, we're in big trouble from much more than this one virus.

[Laurie4b]

Those of you against US involvement, have you looked at the projected numbers for Africa if things continue as is?  They're flipping *exponential.  If one case came through at a few thousand, how many can come through at a hundred thousand?

 

HCWs here are getting scared, and rightfully so.  If their confidence continues to crumble, we're in big trouble from much more than this one virus.

 

What is an "HCW"?

 

[Carrie12345]

What is an "HCW"?

 

Health care worker

[TeenagerMom]

The local news reported that a patient who traveled thru Dallas had been admitted because they were afraid they have Ebola. Go figure one of my BFFs was their night caregiver (we work Psych but are on temp shutdown). She said she was given impermeable gowns & respirators, what went in the room did not come out down to an ink pen, etc. The patient does not have Ebola but my friend sure won't end up with the stomach bug! It sounds like we MAY have proper protocol under control. At least, from the sound of it they are providing better PPE than Texas Presb.

[Laurie4b]

http://www.washingtonpost.com/national/health-science/dallas-nurses-cite-sloppy-conditions-in-ebola-care/2014/10/15/1f0b9876-5423-11e4-b86d-184ac281388d_story.html  This story was linked previously, but I wanted to relink it because it has so much detailed info about how bad conditions were at the hospital.

 

http://www.breitbart.com/system/wire/ap_ab3cd5a9b32c450aa5a13e1a4a14c60e  Quote from the CDC director: "We could've sent a more robust hospital infection control team and been more hands-on with the hospital from day one about exactly how this should be managed," he said Tuesday.

 

Yes, and the fact that he didn't means that two women's lives are in danger. It gets harder to imagine it was a 1 time breach of protocol and easier to accept the anonymous reports from nurses that there was no protocol, proper protective equipment, sanitation, etc.

 

I hope the second worker has a blood type compatible with a donor. I hope the other medical providers escaped, but with poor working conditions, who knows?

 

Can Dr. Brantley give blood again so soon? I know there are a couple other people in the US who have also recovered who I assume would give blood if needed.

 

 

[maize]

Nm

[momacacia]

I don't understand how much more can come through to the US if we restrict flight in from infected countries. So far, one civilian flier (non-infectious at time of flight ) slipped in the country and has infected 2 people. Most central and South African countries have entry restrictions from ebola countries. I can see sending humanitarian aid and then very closely monitoring repatriotization of military and HCWs, but I just can't understand allowing in civilian travelers, eg Duncan, who are potentially infected to come in and potentially infect more Americans when our hospitals seem so ill prepared as it is.

[JustEm]

I had to take my ds to the children's hospital on Monday night because he broke his leg. I was surprised at their protocol. We essentially walked in the door and were immediately asked about our travel history and reason for our visit. This was an ER filled with children and the person asking the question was not at the front desk. They were specifically stationed so no one could get past them and into the ER without asking that info first. Then you went and signed in and got your hospital bracelet.

 

I asked an xray tech what they did when people came in with stomach issues and were previously traveling in Africa. He said they send someone out wearing a respirator and all gloved up to escort them into a private room immediately. He also said that the number of scared parents coming in suspecting Ebola even when their child has something as simple as a cough is starting to get out of control.

[DawnM]

That is a very Western way of thinking and saying that to a country that is unable to do that is not going to help.

 

It is a tiny country in West Africa with very little in the way of resources since the Civil War outbreak.

 

 

 

Those Liberians should build their own treatment centres. Africa really needs to pull itself up by the bootstraps.

 

If it's any consolation, I'm ashamed that my government has refused to send troops. At least the US can hold their heads up on this one. Your troops are doing a good, brave and worthy thing.

 

[BlsdMama]

Sadie, I'm concerned that these countries are so poor, their infrastructure in such shambles from decades of civil war that they have no bootstraps. 

 

I would like to see some concern and investment from the other African nations that are able to help.  It's in their best interest, ya know?

 

I thought Sadie was being sarcastic about the bootstraps thing, yeah?

[maize]

That is a very Western way of thinking and saying that to a country that is unable to do that is not going to help.

 

It is a tiny country in West Africa with very little in the way of resources since the Civil War outbreak.

Sadie was being sarcastic.

[BlsdMama]

Those of you against US involvement, have you looked at the projected numbers for Africa if things continue as is?  They're flipping *exponential.  If one case came through at a few thousand, how many can come through at a hundred thousand?

 

HCWs here are getting scared, and rightfully so.  If their confidence continues to crumble, we're in big trouble from much more than this one virus.

 

There is now a second nurse confirmed.

http://www.cnn.com/2014/10/15/health/ebola-fears/index.html?hpt=hp_t1

 

CDC released yesterday that 10,000 new cases PER WEEK is expected in Africa by the end of the year.  They also released it is more deadly than first expected ( at 70% rather than 50%.)

 

There will be no way to stop it from being here IMO.  It is in our best interest to throw as many resources as we can afford and beyond to help them stem the tide.

[Jaybee]

I don't understand how much more can come through to the US if we restrict flight in from infected countries. So far, one civilian flier (non-infectious at time of flight ) slipped in the country and has infected 2 people. Most central and South African countries have entry restrictions from ebola countries. I can see sending humanitarian aid and then very closely monitoring repatriotization of military and HCWs, but I just can't understand allowing in civilian travelers, eg Duncan, who are potentially infected to come in and potentially infect more Americans when our hospitals seem so ill prepared as it is.

 

I have such conflicted feelings when I read posts like this. I mean, I understand it on one level, but I am an expat (not in Africa). So my mind trail goes: so what if this eventually spreads to where I live, where there is sub-optimal health care. What if we try to go home, but because we are coming from here, we are not allowed? Granted, I know that we would do everything we could to prevent infecting anyone else if we knew we had been exposed. But. . . I can carry it out to several different scenarios, and it's pretty sad to think through possible implications. Not sure there is really a good answer, either. :( 

[Katy]

I have such conflicted feelings when I read posts like this. I mean, I understand it on one level, but I am an expat (not in Africa). So my mind trail goes: so what if this eventually spreads to where I live, where there is sub-optimal health care. What if we try to go home, but because we are coming from here, we are not allowed? Granted, I know that we would do everything we could to prevent infecting anyone else if we knew we had been exposed. But. . . I can carry it out to several different scenarios, and it's pretty sad to think through possible implications. Not sure there is really a good answer, either. :(

 

Well there's a huge difference between banning American citizens from coming back, and stopping travel visas for citizens of those countries.  I haven't decided how I feel about it, but none of the people I've heard advocating that are arguing to stop ill Americans from coming home, they're all just arguing to stop visas.

[Matryoshka]

Travel restrictions isn't just about protecting us.  It's about how to best go about stamping this thing out once and for all.  We are obviously woefully unprepared to treat this.  Individual cases med-flighted into specialized hospitals, sure.  We got that.  But obviously not within the general populace or at regular hospitals.  How much capacity is there at the few specialized hospitals?  Expecting regional hospitals to all come up to snuff on an as-needed basis as a case comes up in their community is an obviously failed model. We are so cocky here because we're used to being able to cure everything, or if people die of sloppy protocols (and they do - all.the.time.), it usually is something like MRSA that actually isn't as communicable as this is, as it doesn't cause infected bodily fluids to flood the room.

 

The reason I say travel restrictions are just as much about saving lives over in Africa, is that how much are we going to be able to help if we're panicked here?  Playing whack-a-mole with these onesie-twosie, oops now it's four, oops now it's eight cases coming over on planes? How many beds are there at these specialized hospitals  (if Duncan had been sent to one of those right away, would there be two infected health care workers - so far)?  And I'm not just talking about the US, but about all the other countries that will end up playing whack-a-mole and spending time and resources at home instead of sending them to snuff this out at the source.

[kiana]

I don't understand how much more can come through to the US if we restrict flight in from infected countries. So far, one civilian flier (non-infectious at time of flight ) slipped in the country and has infected 2 people. Most central and South African countries have entry restrictions from ebola countries. I can see sending humanitarian aid and then very closely monitoring repatriotization of military and HCWs, but I just can't understand allowing in civilian travelers, eg Duncan, who are potentially infected to come in and potentially infect more Americans when our hospitals seem so ill prepared as it is.

 

We don't have any direct flights iirc -- they're all passing through other countries. If we imposed a ban, we'd have to do so unilaterally, as these other countries haven't stopped flights. If there were an international agreement, it might be possible. 

 

Unilaterally, it might stop some people -- it might indeed! But other people who have passports from elsewhere but have been in infected countries may very well conceal their status and slip in anyway. In that case, they'd be very reluctant to go to the hospital and more likely to stay home until deathly ill, infecting their family and neighbors.

 

It may very well cause much MORE Ebola in the US to stop 9/10 potentially infected people but drive the 10th into hiding -- especially since frequently immigrants live in crowded apartments with multiple family members and many crowded apartments nearby.  

[Katy]

We don't have any direct flights iirc -- they're all passing through other countries. If we imposed a ban, we'd have to do so unilaterally, as these other countries haven't stopped flights. If there were an international agreement, it might be possible. 

 

Unilaterally, it might stop some people -- it might indeed! But other people who have passports from elsewhere but have been in infected countries may very well conceal their status and slip in anyway. In that case, they'd be very reluctant to go to the hospital and more likely to stay home until deathly ill, infecting their family and neighbors.

 

It may very well cause much MORE Ebola in the US to stop 9/10 potentially infected people but drive the 10th into hiding -- especially since frequently immigrants live in crowded apartments with multiple family members and many crowded apartments nearby.  

 

Ummm, I'm pretty sure last week a few countries in Europe did ban direct flights, so I don't think this is accurate.  Don't have a link for you though.

[songsparrow]

Although the news that continues to come out about the handling of Mr. Duncan's case is abysmal, I think the current state of affairs is much more hopeful:

 

* So far, no people who were exposed to Mr. Duncan during the four days from the time he began showing symptoms until he was hospitalized have contracted Ebola.  We are 4 days away from the end of their 21-day quarantine period.  Assuming that they do not show signs of the disease in the next 4 days, this will suggest that the disease is not highly contagious even during the early stages of symptoms.  This gives strong hope that the the disease can be well controlled from spreading among the general population using the techniques of monitoring possible contacts for symptoms and hospitalizing them when they show the first symptoms.

 

 * Although the response to Mr. Duncan and his family was exceedingly poor, officials do seem to be handling the subsequent cases in a much better manner.  Hazmat teams were quickly dispatched to clean their apartments; their contacts have been quickly identified, monitored and even isolated in some cases.  Collateral issues (such as the dog) have been identified and addressed promptly.

 

* It appears that the greatest risk may be to the HCWs who care for the patients during the late stages of their disease.  The CDC seems to be ready to respond much more aggressively to prepare and protect those HCWs.  My thoughts are with the HCWs who heroically helped Mr. Duncan as they wait through the next 2 weeks.  

[melmichigan]

OK, based on what several of you who have worked in hospitals have said, maybe it is possible, or perhaps you worked in hospitals like others I've seen?  I *would* believe that kind of bad decision-making about the hospital in my suburb and the one two suburbs over, based on what I have personally seen in those two hospitals from family members admitted.

 

As far as our soldiers, I heard on the news yesterday that one soldier was part of a mission delivering supplies to Sierra Leone has been tested and is being watched for ebola.  I pray it is something else!

A Sierra Leone soldier who is not a peacekeeper, who hasn't had any contact with those deploying to Somalia, is reported to have tested positive for ebola.

[songsparrow]

Unilaterally, it might stop some people -- it might indeed! But other people who have passports from elsewhere but have been in infected countries may very well conceal their status and slip in anyway. In that case, they'd be very reluctant to go to the hospital and more likely to stay home until deathly ill, infecting their family and neighbors. 

 

This doesn't seem credible to me.  I think it's pretty well known at this point that your best chances at surviving are to get medical assistance at the earliest signs of the disease.  The whole premise of the idea of people sneaking out of the affected countries is that they want to get away from the disease so they don't contract it and die - or that, if they think they may have been exposed, they want to get to countries with superior health care so they have a better chance of surviving.  It makes no sense that if they began to show symptoms, they wouldn't promptly seek medical help.  

[unsinkable]

Travel restrictions isn't just about protecting us. It's about how to best go about stamping this thing out once and for all. We are obviously woefully unprepared to treat this. Individual cases med-flighted into specialized hospitals, sure. We got that. But obviously not within the general populace or at regular hospitals. How much capacity is there at the few specialized hospitals? Expecting regional hospitals to all come up to snuff on an as-needed basis as a case comes up in their community is an obviously failed model. We are so cocky here because we're used to being able to cure everything, or if people die of sloppy protocols (and they do - all.the.time.), it usually is something like MRSA that actually isn't as communicable as this is, as it doesn't cause infected bodily fluids to flood the room.

 

The reason I say travel restrictions are just as much about saving lives over in Africa, is that how much are we going to be able to help if we're panicked here? Playing whack-a-mole with these onesie-twosie, oops now it's four, oops now it's eight cases coming over on planes? How many beds are there at these specialized hospitals (if Duncan had been sent to one of those right away, would there be two infected health care workers - so far)? And I'm not just talking about the US, but about all the other countries that will end up playing whack-a-mole and spending time and resources at home instead of sending them to snuff this out at the source.

Capacity at the four specialized hospitals: total of 8 to 13 patients:

 

 

"Altogether, those four hospitals can accommodate just 8-13 patients, said Phil Smith, medical director of the biocontainment unit at Nebraska Medical Center in Omaha, which has treated a U.S. missionary and is treating a television news cameraman, both of whom contracted the virus in West Africa. He said Nebraska has 1-2 Ebola beds, Emory 2 beds, St. Patrick Hospital in Montana 1-2 beds and the National Institutes of Health in Maryland 4-7 beds. "But I don't know if they (NIH) have the staffing," he said."

 

http://www.usatoday.com/story/news/nation/2014/10/14/us-hospitals-prepare-for-ebola/17221077/

[Matryoshka]

We don't have any direct flights iirc -- they're all passing through other countries. If we imposed a ban, we'd have to do so unilaterally, as these other countries haven't stopped flights. If there were an international agreement, it might be possible.

 

Yeesh.  No we wouldn't.  Been on an international flight coming into the US lately?  Everyone has to go through passport control.  It would be very easy to check passports to see who'd originated from one of those countries, and at the very least take their names and addresses in the US and check in on them, if we're not going to say 'don't come here'.  If that's "too much work" or "costs too much", it's still waaaay less cost in money and lives than it would cost to do what we're doing now - nothing (and taking someone's temperature when they got off the plane?  Worthless.  They're already taking the temps of everyone getting on in Africa.  It would only catch someone if they became symptomatic in the few hours on the flight.  It would not have caught Duncan.  Let's get real here.)  Sure, if someone is so bound and determined to get here that they can falsify documents, they might be able to get around this, but it I'm guessing the people with those resources are not the vast majority of people coming.

 

If we're worried about US citizens coming back, we should start chartering flights for returning volunteers, missionaries, aid workers, etc, bring them into a centralized place and maybe put them up in a nice, cushy place for 21 days (for free, with good food. Again, comparing to the cost of another Duncan).  Who else has some great, burning need to travel to and from those places right now?  Businessmen?  Use Skype.  Tourists?  Who???

 

I still think the WHO should have long suggested suspending commercial flights in and out of those countries.  Not aid flights, not chartered flights, not cargo planes, just commercial passenger flights.  This is a problem that affects the whole world, and that's the level it should be dealt with at.  That's what the WHO is for, I thought.  This is not something that should be dealt with country-by-country.

[mommymilkies]

Sadie, I'm concerned that these countries are so poor, their infrastructure in such shambles from decades of civil war that they have no bootstraps. 

 

I would like to see some concern and investment from the other African nations that are able to help.  It's in their best interest, ya know?

She was being sarcastic. :) We need a sarcasm font.

[Perry]

The report about the hospital makes what CDC head Frieden said more clear.  He was blamed for criticizing the nurse, but I don't think he was ever blaming her.  He probably learned immediately of the hospital's poor handling of the situation, and was addressing that, without coming right out and saying "the hospital screwed up."

 

"I think the fact that we don't know of a breach in protocol is concerning, because clearly there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients.

...

Unfortunately, it is possible in the coming days that we will see additional cases of Ebola. This is because the healthcare workers who cared for this individual may have had a breach of the same nature of the individual who appears now to have a preliminary positive test,†Frieden said."

 

 

[Twolittleboys]

While I do understand the concern I really don't think people "sneaking" in from West Africa pose a huge threat. First of all the number of people that can even afford this (i.e. pay for a ticket) and have the ability to get a visa (as I assume there are various restrictions) should be pretty small, I think. Secondly (and in my opinion of more importance) it really now seems that ebola is not very contagious until the later stages. I would assume that anyone leaving West Africa hoping to escape the disease/get better care would get to the nearest hospital at the first sign of a fever/as soon as they get here. So the chance of infecting the general population is fairly small. By the time they become highly infectious they are so sick that I don't think it very likely that one could meet them in public without noticing anything.

 

I think the most important steps now would be to a) ensure that hospitals can handle cases like this better and b) help Africa to stop this disease. I have to admit that my knowledge of Africa is very lacking. Not sure how close the affected countries are the neighboring countries - well, obviously, they are right next to them but not sure whether there are mountains/uninhabited land between - and how connected these countries are. Maybe someone can shed some light on this? The newly projected numbers for future cases are indeed very concerning. If ebola started to spread from country to country like the ripples a stone makes when you throw it in a pond - that would be the point to really worry about it spreading in Europe/America.

 

I can see how restricting flights can make people feel safer but I don't think it would stop more than a handful of cases. On the other hand it might make people more hesitant to aggressively help the affected countries and that could really lead to disaster.

[Carrie12345]

Although the news that continues to come out about the handling of Mr. Duncan's case is abysmal, I think the current state of affairs is much more hopeful:

 

* So far, no people who were exposed to Mr. Duncan during the four days from the time he began showing symptoms until he was hospitalized have contracted Ebola.  We are 4 days away from the end of their 21-day quarantine period.  Assuming that they do not show signs of the disease in the next 4 days, this will suggest that the disease is not highly contagious even during the early stages of symptoms.  This gives strong hope that the the disease can be well controlled from spreading among the general population using the techniques of monitoring possible contacts for symptoms and hospitalizing them when they show the first symptoms.

 

 * Although the response to Mr. Duncan and his family was exceedingly poor, officials do seem to be handling the subsequent cases in a much better manner.  Hazmat teams were quickly dispatched to clean their apartments; their contacts have been quickly identified, monitored and even isolated in some cases.  Collateral issues (such as the dog) have been identified and addressed promptly.

 

* It appears that the greatest risk may be to the HCWs who care for the patients during the late stages of their disease.  The CDC seems to be ready to respond much more aggressively to prepare and protect those HCWs.  My thoughts are with the HCWs who heroically helped Mr. Duncan as they wait through the next 2 weeks.  

 

I do hope this (ETA in case it gets quoted, THIS, being the post I am quoting) all holds to be true as time goes on.

 

"On the morning of Oct. 14, the second healthcare worker reported to the hospital with a low-grade fever and was isolated. The Centers for Disease Control and Prevention confirms that the second healthcare worker who tested positive last night for Ebola traveled by air Oct. 13, the day before she reported symptoms."

[kiana]

Ummm, I'm pretty sure last week a few countries in Europe did ban direct flights, so I don't think this is accurate.  Don't have a link for you though.

 

What, exactly, is inaccurate? 

 

Any flights out are not coming through us, but are being staged through other countries. In order for a travel ban to be effective, we'd need all the countries to agree. 

[Trish]

Now they are reporting that the 2nd nurse had traveled from Cleveland to Dallas via air the night before  her diagnosis.

 

How closely are exposed health care workers being "monitored?"

[kiana]

Yeesh.  No we wouldn't.  Been on an international flight coming into the US lately?  Everyone has to go through passport control.  It would be very easy to check passports to see who'd originated from one of those countries, and at the very least take their names and addresses in the US and check in on them, if we're not going to say 'don't come here'.  If that's "too much work" or "costs too much", it's still waaaay less cost in money and lives than it would cost to do what we're doing now - nothing (and taking someone's temperature when they got off the plane?  Worthless.  They're already taking the temps of everyone getting on in Africa.  It would only catch someone if they became symptomatic in the few hours on the flight.  It would not have caught Duncan.  Let's get real here.)  Sure, if someone is so bound and determined to get here that they can falsify documents, they might be able to get around this, but it I'm guessing the people with those resources are not the vast majority of people coming.

 

If we're worried about US citizens coming back, we should start chartering flights for returning volunteers, missionaries, aid workers, etc, bring them into a centralized place and maybe put them up in a nice, cushy place for 21 days (for free, with good food. Again, comparing to the cost of another Duncan).  Who else has some great, burning need to travel to and from those places right now?  Businessmen?  Use Skype.  Tourists?  Who???

 

I still think the WHO should have long suggested suspending commercial flights in and out of those countries.  Not aid flights, not chartered flights, not cargo planes, just commercial passenger flights.  This is a problem that affects the whole world, and that's the level it should be dealt with at.  That's what the WHO is for, I thought.  This is not something that should be dealt with country-by-country.

 

Having a passport from there? Sure. But just passed through? It's pretty easy to miss a stamp or for someone to avoid getting stamped.

 

I would certainly agree with taking names and addresses and requiring checkups (at no charge) at the local hospital for the first couple of weeks. 

[Matryoshka]

What, exactly, is inaccurate? 

 

Any flights out are not coming through us, but are being staged through other countries. In order for a travel ban to be effective, we'd need all the countries to agree. 

 

The most effective travel ban would be if the countries themselves imposed it.

 

But it's quite easy to see where someone's traveled recently, even if they came through other countries, by just looking at their passport.  Which are always looked at anyway, for every person coming in on every flight.  Not even an extra step.  Just make sure to check.  This is not rocket science.  This does not require multilateral agreements.

[songsparrow]

Here's a current article about the current state of air service into and out of the effected countries.   "There’s no central decision-making body overseeing airline service into Ebola-ravaged areas. The airlines have made their own decisions."  According to the article, only two major airlines have maintained service to the effected countries: Brussels Airlines from Belgium and Royal Air Maroc from Casablanca. Air France has also kept its flight from Paris to Guinea. British Airways has suspended service to Sierra Lione and Liberia at least through March.  Emirates has stopped flights to Guinea's capital.  Britain refused to allow an African-based carrier to resume flying into London from Sierra Lione.  

 

Interesting article about a reporter's experience flying out of Liberia (it's 4 days old).  She had her temperature taken twice and had to wash her hands in chlorinated water twice, plus fill out a questionnaire (and I assume that the medical people were also observing her for other signs of illness), before she could even get into the airport terminal, and her temperature was taken again before she boarded the flight.

[Trish]

Also the fact that these nurses were taking care of OTHER PATIENTS while also caring for Mr. Duncan.

 

I think the "not nervous" crowd on this board is not nervous because they are "not in the Dallas area."

 

Too bad the CDC didn't consider "over-reacting" to the news of ebola in this country.

[Seasider]

I do hope this (ETA in case it gets quoted, THIS, being the post I am quoting) all holds to be true as time goes on.

 

"On the morning of Oct. 14, the second healthcare worker reported to the hospital with a low-grade fever and was isolated. The Centers for Disease Control and Prevention confirms that the second healthcare worker who tested positive last night for Ebola traveled by air Oct. 13, the day before she reported symptoms."

So much for others exposed being quarantined. Totally reckless.

[Matryoshka]

Having a passport from there? Sure. But just passed through? It's pretty easy to miss a stamp or for someone to avoid getting stamped.

 

I would certainly agree with taking names and addresses and requiring checkups (at no charge) at the local hospital for the first couple of weeks. 

 

Then maybe we need to direct the passport control people to check extra-special careful.  Really, it's an easy step that doesn't require an extra cent or any extra resources.  It's less work than the silly temperature-taking.  Maybe for super-worldwide travellers with kabillions of stamps it's easy to miss.  Is that who these people are coming in?  They have kazillions of stamps?  I've travelled quite a bit, my passport isn't close to full.  I'd guess most people travelling from there are not jet-setters with hyper-stamped passports.  If they travel a lot between here and there, then there would just be a lot of stamps from there - actually even harder to miss.

 

I'm kinda doubting the high-flying travellers with kazillions of stamps from all over are cavalierly risking their lives by taking in the sights of Monrovia just about now.  I think most frequent-fliers (mostly rich people, I'd think), are vacationing elsewhere, and are not fond of risking their wealthy posteriors by visiting countries with Ebola.  I'm not particularly worried about that kind of traveller.

[ddcrook]

Also the fact that these nurses were taking care of OTHER PATIENTS while also caring for Mr. Duncan.

 

I think the "not nervous" crowd on this board is not nervous because they are "not in the Dallas area."

 

Too bad the CDC didn't consider "over-reacting" to the news of ebola in this country.

I'm in the Dallas area and I'm part of the "not nervous" crowd.  I am saddened by the illness of these two young nurses.  I am concerned for the health of the others that cared for Mr. Duncan.  I am hoping that we will soon hear that the Mr. Duncan's family is healthy and out of quarantine.  But I am not nervous that this will spread and infect many others. 

[Lisbeth]

There is now a second nurse confirmed.

http://www.cnn.com/2014/10/15/health/ebola-fears/index.html?hpt=hp_t1

 

CDC released yesterday that 10,000 new cases PER WEEK is expected in Africa by the end of the year. They also released it is more deadly than first expected ( at 70% rather than 50%.)

 

There will be no way to stop it from being here IMO. It is in our best interest to throw as many resources as we can afford and beyond to help them stem the tide.

IMO, there *is* a way tp keep it out. Our political leaders just don't have the will to take those measures.

[ChocolateReignRemix]

Also the fact that these nurses were taking care of OTHER PATIENTS while also caring for Mr. Duncan.

 

I think the "not nervous" crowd on this board is not nervous because they are "not in the Dallas area."

 

Too bad the CDC didn't consider "over-reacting" to the news of ebola in this country.

 

I wouldn't be nervous if I was in Dallas.  DH has numerous coworkers in Dallas and this isn't even on the radar for them.

[ChocolateReignRemix]

IMO, there *is* a way tp keep it out. Our political leaders just don't have the will to take those measures.

 

Which is...?

[Wildiris]

Did anyone realize that the 2nd nurse took a flight within the US one day before reporting symptoms? 132 people were on board that flight. This seems a lot like the game Plague.

[Seasider]

I'd reckon your passport isn't full because it's not getting stamped at every transit point. My passport is the same, in fact, I've asked for it to be stamped because when I first travelled internationally, I wanted my passport marked up!

 

Visas are a different matter. They must be present in/with your passport. I haven't traveled internationally in a while but it seems like suspending/canceling visas for at-risk subjects might work. However, I think for the rich, clever and lucky-born-or-wed, there are ways around everything. Bribery of customs agents is not rare. One would hope something like Ebola would make everyone want to follow the rules, but I don't believe we will fine that so.

 

ETA my point in saying this is that we need to be fully prepared to engage Ebola HERE.

[Whereneverever]

Well, and where are all of those people now? I started really non alarmist with this but I am getting more concerned.

[Seasider]

Did anyone realize that the 2nd nurse took a flight within the US one day before reporting symptoms? 132 people were on board that flight. This seems a lot like the game Plague.

Plague, just what I was thinking!

 

Seriously, the more I consider this the more incredulous I become. You'd think those being monitored would have been given a list of restrictions, sort of a Horatio Caine, "Don't go far." As health care workers, you'd think they would understand this.

 

I believe we will learn that people aren't willing enough to live with self-control and sacrifice to totally contain this thing. I am not a doomsayer, I just mean there will surely be a plethora of cases that should have been preventable.

[maize]

I've passed through immigration in many countries without a passport stamp, this is just not something that is universally done these days.

[ChocolateReignRemix]

Did anyone realize that the 2nd nurse took a flight within the US one day before reporting symptoms? 132 people were on board that flight. This seems a lot like the game Plague.

 

Which unless she was exchanging body fluids with those passengers means the chance of infection is extremely small (and by extremely small I mean almost nonexistent.)

[kitten18]

Well, I was enjoying this thread but I'm going to have to stop reading now because the hysteria is getting out of control.

[Thia7278]

Add me to the worried group.  I am appalled (and angry) that this nurse flew when she should have been, at the very least, self quaranteened.  How selfish and stupid to endanger the lives of others to jet of for whatever.  Nothing was so important as to take this risk.  It's stupidity like that which will spread this more than anything else. 

 

I'm really mindful of how dirty people and our behaviors are.  On my last trip to the store I saw coughing all over without covering or coughing into hand/arm, then brushing against something which the next person in the isle picks up and puts into the cart (which they bring home and put on their dining table or kitchen counter), constantly rubbing of faces, public bathrooms that see a (questionably clean) rag once a day, kids (being kids) touching everything and putting their fingers in their mouths, passing around of debit cards, cash, bought goods etc.  I just feel like the spread of this is inevitable. 

 

I wish I had never read The Stand.

[Matryoshka]

I've passed through immigration in many countries without a passport stamp, this is just not something that is universally done these days.

 

Most European countries don't bother, 'tis true, but that isn't an issue.  The only question, is do those three African countries stamp?  Are there other countries we're worried about?  I've been through other countries (Iceland) that are a bit obsessive about it.  In my admittedly very limited experience, poorer/ less powerful countries tend to stamp more rather than less.  I'd kind of hope they'd be stamping these days, but who knows?

 

[duckabell]

I'm very surprised there aren't travel restrictions in place for those who have had contact with ebola patients. Hopefully if other areas in the US run into Ebola patients they will have learned from the mistakes of Dallas and be more vigilant in tracking contacts and making sure those under watch don't travel, especially on airplanes.  

 

One thing I've thought about protecting health care workers is minimizing pregnant health care workers from interacting with ebola patients. From what I've read, ebola is even more deadly to pregnant women and their babies since it causes the babies to miscarry and then it's hard to stop the mothers from bleeding out. I don't know if you can make that recommendation or not, but if I was pregnant I would be concerned about working with ebola patients, even with PPE.

 

I also have to wonder when in the future you can start to use robots and other technology to minimize human to human interactions and still provide proper care. Obviously that's way not here now, and it would be extremely expensive, but sometime in the future that may help deal with infectious diseases. 

 

Speaking of technology (and just pondering things here), I wonder if you could have some sort of temperature type device like a watch that you give to contacts to monitor their temperature and alerts public officials if their temperature goes up. You could also do the same to people who come in the country from affected areas. To make it actually work you would probably have to make it non-removable and have a GPS tracker which runs into a host of privacy and freedom issues. Obviously not something anyone would recommend right now, but would it be something to consider if there was a real pandemic sometime in the future?

 

I also think if there are more cases if it would make more sense to have screenings and such done off site from a hospital where you're not exposing the public to the virus. There were conflicting articles that said the second exposed health worker was isolated right away and another report said she was isolated after 90 minutes at the hospital. I wonder why if you knew this health care worker had contact with Duncan that you wouldn't have them call a separate number and then provide transportation that isolates them right away.