Ebola and media coverage

Started by TaintedAndDelish, October 05, 2014, 06:45:23 PM

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TaintedAndDelish

I've been watching the news for information about the Ebola breakout in West Africa. It's been said numerous times that the news coverage of the outbreak is not giving the best picture. Some say that the number of people reported sick or dead is a bit lower - perhaps due to difficulty in counting or diagnosing.  Some say that disease outbreak itself is only part of the problem while quarantine, loss of farmers and stigma pose part of the overall problem too.

What I find more troubling is how the media is downplaying the threat of Ebola in the US - perhaps to prevent panic or stigma, but at the same time, it seems to be sensationalizing the story when speaking of the outbreak in Africa. Perhaps that's my own fault for watching CNN. We hear about medial workers in freaking space suits catching this disease, yet at the same time, the CDC is insisting that you won't catch Ebola by riding on a plane that an infected passenger has been on.

I'm certainly no expert on the subject, but I smell spin here.

As I understand:

"You can get Ebola though personal contact only. It's not airborne.", however, being sneezed on is considered personal contact, and a sneeze can travel pretty far. What about a sweaty handshake with someone who is symptomatic or lightly symptomatic? Or a handshake with someone shortly after they sneezed into their hand, or a sick food worker?

"Ebola is passed though personal contact only", however, there have been reports about people getting sick from riding in cabs, or touching personal items like bedsheets. I think I read that it can live on an inanimate surface for a matter of hours.

I suppose my concern is that either the health organizations and media are downplaying the threat  in order to curb panic, or perhaps the health agencies are just assuming that people will maintain an unrealistic/ideal level of hygiene.



lilhobbit37

#1
Ok let me just give a bit of information.

I work at the Rhode Island Department of Health. We have one of the largest percentage of Liberian residents (percentage of our population, not most people) in the US. Since day one, our department has been working with hospitals about what to do "WHEN" ebola comes to the US.

One thing you have to take into account on ebola and it's death rate in western Africa, is that there are many many things that are different there.

Sanitation is different. Medical care is different.

But most of all, the Liberian's have a very very different view of medicine and government. Many of them do not seek treatment until it is far too late. They also don't embalm the dead the same way we regulate in the United States. This means that the disease spreads more, faster, and is more difficult to squash out.

It also means that in the United States, while there are ways for it to spread, we have much more in place to deal with it, than in Liberia. We have hospitals ready to quarantine. And yes we have places like Texas that will make mistakes, because let's face it, this isn't an every day thing for many hospitals across the US. But overall, we do have what we need to keep it from spreading, and more importantly, the death rate is and will continue to be much lower in a place where people can get rapid treatment, access to the best medical care, and all the necessary medications and supplies to keep both them and their doctors safe.

So while yes, the media may be downplaying certain aspects of it, trust that the health officials across the country are hard at work to make sure that people here are safe, and that if/when people bring this into the country, we are prepared and able to handle it without it becoming the outbreak it is across the sea.

There is a lot of specifics I can't say, because I don't know for sure exactly, as my department doesn't work directly in that field, but we do get updates about everything going on in a general sense, and my boss goes to meetings daily where she learns what is happening. There isn't reason to panic. And yes, I'd hope that knowing what is going on, people will be a little more careful about hygiene, but for the most part, there really is no reason to panic.

Panicking will only lead to hospitals being overloaded with people who aren't really sick, who think they MUST have it, making it more difficult to determine the real actual cases.

Edit: It was pointed out to me that my statement came off as being an attack on Texas. I want to clarify that I have nothing against Texas, and just meant that they made a mistake there, and it may/probably will happen elsewhere, especially in places that don't have high Liberian populations, because they may not expect the cases. I certainly didn't mean it as an insult to Texas, and hope no one takes it as such.

Florence

Quote from: lilhobbit37 on October 06, 2014, 09:07:30 PM
Ok let me just give a bit of information.

I work at the Rhode Island Department of Health. We have one of the largest percentage of Liberian residents (percentage of our population, not most people) in the US. Since day one, our department has been working with hospitals about what to do "WHEN" ebola comes to the US.

One thing you have to take into account on ebola and it's death rate in western Africa, is that there are many many things that are different there.

Sanitation is different. Medical care is different.

But most of all, the Liberian's have a very very different view of medicine and government. Many of them do not seek treatment until it is far too late. They also don't embalm the dead the same way we regulate in the United States. This means that the disease spreads more, faster, and is more difficult to squash out.

It also means that in the United States, while there are ways for it to spread, we have much more in place to deal with it, than in Liberia. We have hospitals ready to quarantine. And yes we have places like Texas that will make mistakes, because let's face it, this isn't an every day thing for many hospitals across the US. But overall, we do have what we need to keep it from spreading, and more importantly, the death rate is and will continue to be much lower in a place where people can get rapid treatment, access to the best medical care, and all the necessary medications and supplies to keep both them and their doctors safe.

So while yes, the media may be downplaying certain aspects of it, trust that the health officials across the country are hard at work to make sure that people here are safe, and that if/when people bring this into the country, we are prepared and able to handle it without it becoming the outbreak it is across the sea.

There is a lot of specifics I can't say, because I don't know for sure exactly, as my department doesn't work directly in that field, but we do get updates about everything going on in a general sense, and my boss goes to meetings daily where she learns what is happening. There isn't reason to panic. And yes, I'd hope that knowing what is going on, people will be a little more careful about hygiene, but for the most part, there really is no reason to panic.

Panicking will only lead to hospitals being overloaded with people who aren't really sick, who think they MUST have it, making it more difficult to determine the real actual cases.

Edit: It was pointed out to me that my statement came off as being an attack on Texas. I want to clarify that I have nothing against Texas, and just meant that they made a mistake there, and it may/probably will happen elsewhere, especially in places that don't have high Liberian populations, because they may not expect the cases. I certainly didn't mean it as an insult to Texas, and hope no one takes it as such.

Thank you for this post, it was very reasonable in explaining the situation.

To the OP, I actually have a bit of a counterpoint. When I hear people accusing the medical community/government/etc. of downplaying it to avoid a panic, I have to as... what's your alternative?

We can only assume they're doing what they can, as they really don't have any motivation to do any less? I don't think anyone benefits from an Ebola pandemic. So if they're trying to avoid a panic, I'm not sure what the alternative people propose is...? Should we panic? As lilhobbit explained, panic only makes it worse.

Now, what was said on the matter already is pretty much what needs to be said. The factors that help Ebola spread so wildly over in the regions its ravaging are not entirely in play here. It doesn't mean we shouldn't be concerned, or shouldn't care, but we shouldn't panic. We're much better equipped to handle it with superior medical care, superior sanitation, and perhaps most importantly, superior education concerning germs and disease. It also doesn't help that some people in these regions apparently believe that Ebola is a US conspiracy. Poverty and general living conditions are a factor as well, as, from my understanding, Ebola's been spreading particularly bad in tightly-packed slums where people are brushing up against each-other all day.

I think its reasonable to expect we may get more cases in the US before this is over, but it won't become a major concern for public safety to the degree it is in Africa. BUT, even if it was a very real threat for becoming a major outbreak here, going into a panic and worrying over it wouldn't help. If you can do something about it, by all means, try to help out, but otherwise, I think the best thing most people can do is just keep on doing what they've been doing.

I mean, hell, we're all going to die eventually, no point freaking out over it if we can't help it.

Tl;dr: I think we're gonna be fine. Mind your basic hygiene and don't worry about it.
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TaintedAndDelish

Thanks lilhobbit37, your response pretty much answered everything.

Regarding the need to avoid panic, I agree, that's certainly important. I guess my concern was that the threat would be underestimated over here as a result of the media spin. It's been mentioned that we have better facilities and sanitation over here, but we also have a lot more mobility. ie. public and private transportation, massive community areas like restaurants, schools, work places, and so on. Anyway... we'll see what happens.

kylie

     As I understand it (drawing largely on the Guardian coverage, though I have read a few other media sources at times)...  The disease is currently mainly spread through body fluids.  There is some concern it is likely to mutate and that would be a different beast if it comes to that.  But for now, it isn't all that easy to catch.  The hypothetical sneeze would have to get "in" somehow through say, the eyes or the nose for example.  That sweat would have to be delivered from hands into eyes or mouth perhaps...  I wonder just how long the time frame is during which it is live after the sneeze, and how large a dose of fluid would have to be delivered precisely how for it to catch. 

     I do think crowded, closed environments like airplanes are potentially problematic.  But at the same time, by now there is at least some monitoring of people departing on flights from affected areas.  But populations sitting on porous borders in Africa (some early outbreak zones) can hardly be tracked, and the density of people in large Nigerian cities would compete with the airplane scenario horribly and on a large scale.  African resources and health system defenses are scant.  So for now it is much more damaging to Africa.   

    The frightening part is that it's now quite lethal -- so if one gets it, recovery is dubious.  Yet the bright side on a mass level is that, as long as it stays this lethal, it has very limited time to multiply and propagate from each host.  This means that a still more serious epidemic is relatively less likely than it would be if the carriers did not die this soon.  Particularly in countries with good response systems in place. 

    The thing about taxis:  Many of the African cases originated with corpses being taken home for funerals across national borders in public taxis.  It's more a cultural problem, but that does not help the response much.  I don't imagine many Western societies making the same sort of mistake.  The disease boomed in Africa because non-sterile needles have been used in many African hospitals.  There was also a terrible shortage of qualified doctors to begin with in some areas, after military conflicts, population displacement and so on.  Vastly different situation than in many Western countries.     
     

TheGlyphstone

Cracked's Quick Fix article today is about why Ebola's not as scary as people think. Granted, their whole shtick is sensationalism for the sake of comedy, so they're not a site you want to be directly quoting any more than Wikipedia, but they're funny and they back up the factual sources for their exaggerations pretty well.

http://www.cracked.com/quick-fixes/why-americans-need-to-calm-f234025-down-about-ebola/

Mathim

Quote from: TheGlyphstone on October 08, 2014, 12:40:15 PM
Cracked's Quick Fix article today is about why Ebola's not as scary as people think. Granted, their whole shtick is sensationalism for the sake of comedy, so they're not a site you want to be directly quoting any more than Wikipedia, but they're funny and they back up the factual sources for their exaggerations pretty well.

http://www.cracked.com/quick-fixes/why-americans-need-to-calm-f234025-down-about-ebola/

Yeah, thank heaven we can still give and receive handjobs from ebola carriers as long as we wash up afterwards.
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Iniquitous

It might be spreading.

A second person walked into a clinic exhibiting symptoms of ebola in Texas. Whether he has it or not is still up in the air, but the man claims he had contact with patient zero who passed away this morning.
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Mathim

Quote from: Iniquitous Opheliac on October 08, 2014, 03:13:05 PM
It might be spreading.

A second person walked into a clinic exhibiting symptoms of ebola in Texas. Whether he has it or not is still up in the air, but the man claims he had contact with patient zero who passed away this morning.

I just spoke to a woman who came into the office where I work and she seemed to be the kind of gullible worrywart the fearmongers prey upon. I tried to tell her this is nowhere near as bad as the media pump it up to be and she didn't believe me. Most everyone else I talk to has this whole thing (along with the ISIS crisis...haha, that rhymes) on the farthest back corner of their minds because they realize this sensationalism is just business as usual with no statistically significant ramifications, at least not for them.
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TheGlyphstone

Quote from: Mathim on October 08, 2014, 02:52:55 PM
Yeah, thank heaven we can still give and receive handjobs from ebola carriers as long as we wash up afterwards.

Hey, if you're into that kind of thing, I won't be the one to judge you...

Lilias

With Western medicine on hand (antibiotics, fluids, transfusions), an Ebola patient has good chances of making a full recovery. Africa doesn't have such luxuries... and precious time and resources have been lost because the attitude in the affected areas was for a long time like this.
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Scribbles

I just wanted to add a few points on why this is more devastating to a country like Liberia...

African communities tend to be very tight knit in the absence of any proper government, most don't even trust their leaders due to high levels of corruption. If you ever visit an African community, you'll learn that they not only rely on themselves for protection (mob justice) but they generally have a local witch doctor who provides remedies. As you can imagine, being part of such a close community coupled with "juju" as a source of healing isn't exactly the best environment to contain an outbreak. There have actually been reports of Ebola patients leaving hospitals to find their witch doctors...

One of the other concerns I heard from Liberia was that some of the populace didn't actually believe there was an Ebola outbreak, they thought their president was trying to scam the international community into donating. LACC is having a hard enough time trying to convince the population that officials aren't pocketing aid. Corruption is actually one of the main causes that the government is having such a hard time containing the outbreak. They've lost so much money to buying overpriced medical supplies and equipment (officials get kickbacks), increasing the wages of senior officials, appointing unqualified officials, and so on and so forth. By the time Ebola hit the big city, Health was caught with its pants around its ankles.

For good reason, many refuse to visit their local hospitals out of fear that they too will catch the disease, and they're probably right. Public hospitals can be scary things in most African countries, not even government health officials use them, unless they're old and dying and need a new kidney and then they're bumped to the top of the list.

Also, as was already mentioned, the lack of hygiene isn't exactly helping the case. Many communities still lack water, meaning you can have hundreds of people sharing toilets, baths, etc, or simply going without cleaning themselves for days on end...
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Drake Valentine

I find the Ebola panic going around in media amusing, more so in how much the U.S is stretching it in some cases. I don't find Ebola itself entertaining, such a tragic thing that is.

Though in all honestly, the Flu kills more people than Ebola ever will in the U.S(yearly), but you don't hear people stretching pandemics about the common cold or other viruses that spread and claim lives. Furthermore, Flu/Viruses are Airborne, so far Ebola is only through contact.

In fact: 2010 U.S -
Influenza and Pneumonia: 53,826 Deaths

Source - http://www.cdc.gov/nchs/fastats/deaths.htm

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Beguile's Mistress

Several people here at work were talking about a news report on television this morning stating that the nurse who flew in from Cleveland to Dallas and was hospitalized on Tuesday may have been contagious for longer than was originally thought.  I found the following article that talked about her two flights and the increase in the number of people who may come into contact with the virus.

http://www.cnn.com/2014/10/16/health/us-ebola/index.html

There is a quite a bit of information in the article.

gaggedLouise

#14
It's not contagious through air before the illness has gone far (and become obviously visible) in an affected person. When she flew she was infected, but not showing any symptoms. So those who shared the same airplane cabin really wouldn't be at any substantial risk as long as they were not, like, using the same unwashed glass as her, directly shaking her hand or picking up one of her paper hankies etc. From what I've heard, things like reading the same free magazine as an infected person had read, on the next flight, or sitting in the same seat a few hours later, would not be a viable path of contagion either.

Ebola seems to have the unpleasant side that the further down the path towards death a patient gets, the more contagious he/she becomes (bubonic plague, as during the Black Death, has something of that too, I think).

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Retribution

Okay call me paranoid, archaic, whatever, but this all seems kind of crazy to me. So ebola is supposedly hard to catch, but why court danger? Just to be safe why not have things like quarantines and so on? Hell, professionally when working in a lab we were always taught to be over the top with caution so why is ebola being treated differently? I find this simple fact utterly baffling and that is with freely accepting that the media blows things out of proportion for self serving reasons. But heck if this had been say three mass shootings as opposed to three cases of ebola there would be a rush for more gun control. So why have not been what seems like pretty basic steps taken to contain it?

Zakharra

Quote from: Retribution on October 17, 2014, 08:55:41 AM
Okay call me paranoid, archaic, whatever, but this all seems kind of crazy to me. So ebola is supposedly hard to catch, but why court danger? Just to be safe why not have things like quarantines and so on? Hell, professionally when working in a lab we were always taught to be over the top with caution so why is ebola being treated differently? I find this simple fact utterly baffling and that is with freely accepting that the media blows things out of proportion for self serving reasons. But heck if this had been say three mass shootings as opposed to three cases of ebola there would be a rush for more gun control. So why have not been what seems like pretty basic steps taken to contain it?

The Administration and the CDC say that putting up an air quarantine would only help spread the disease to the US because we wouldn't know who was coming in.  /eyeroll   Yes, they have really said that, so no quarantine.

Retribution

I know they said that, and to say I find it idiotic from people I otherwise consider relatively intelligent would be a massive understatement of my disbelief. Ignoring ugly facts just because they are inconvenient does not change that they are facts. Quarantines have a long history as a means of controlling spread of disease, not always effective but it is a step that can be taken. It mystifies me that it has not been taken, I see no overt harm in taking such a basic step despite arguments to the contrary.

I know many of the people who have contracted the disease did so while helping others. That is a notable and noble thing, but it does not mean we should spread the disease around. It does not mean we should fail to take very basic steps for fear of being perceived as insensitive or mean.

Drake Valentine

#18
Meh.

'Merica will only really worry about it when it upgrades from epidemic to pandemic or becomes epidemic in the U.S itself. (Cold truth)

So far.

Reported Cases / Deaths (as of 14 October 2014)
Total: 8,998 / 4,493
Liberia: 4,249 / 2,458 (as of 12 October 2014)[2]
Sierra Leone: 3,252 / 1,183 (as of 12 October 2014)[2]
Guinea: 1,472 / 843 (as of 12 October 2014)[2]
Nigeria: 20 / 8 (as of 7 October 2014)[3]
United States: 3 / 1 (as of 15 October 2014)[4][5]
Senegal: 1 / 0 (as of 7 October 2014)[3]
Spain: 1 / 0 (as of 7 October 2014)[3]

Source - http://en.wikipedia.org/wiki/Ebola_virus_epidemic_in_West_Africa


I still say the common cold / flu kills more people yearly.  Besides, the only one that has the worse odds so far in deaths is Guinea, everyone else has been at half or less ratio of fatality rate.

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TheGlyphstone

Reposting from the What's In The News thread -

A nifty web app/website someone created that tells you how far away the closest Ebola case is from your home.

http://ebolanear.me/


Drake Valentine

Quote from: TheGlyphstone on October 17, 2014, 10:50:13 AM
Reposting from the What's In The News thread -

A nifty web app/website someone created that tells you how far away the closest Ebola case is from your home.

http://ebolanear.me/

Yay, Ebola is roughly 200 miles from me. ^_^

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Retribution

The flu does kill more, but being devil's advocate here, I actually work with another illness that is often in the news. West Nile (I happen to be an expert on mosquitoes) is established in the US, but the flu kills far more.

http://www.cdc.gov/westnile/

I linked CDC for reference, but we throw great heaping piles of money at West Nile.  heck, I am part of the great heaping piles of money thrown at it lol. But why is something like ebola not given the same attention?

TheGlyphstone

Quote from: Drake Valentine on October 17, 2014, 10:57:26 AM
Yay, Ebola is roughly 200 miles from me. ^_^

Only 119 miles here! And it was something like 600 miles yesterday! PANIC! ;D

Ephiral

Quote from: Zakharra on October 17, 2014, 10:07:40 AM
The Administration and the CDC say that putting up an air quarantine would only help spread the disease to the US because we wouldn't know who was coming in.  /eyeroll   Yes, they have really said that, so no quarantine.

It makes sense from a security perspective. An outright ban on travel from the afflicted areas provides an entirely false sense of security. It doesn't prevent anyone from travelling if they really want to, just adds another leg to their trip - and erases them as possible carriers. And since we know a ban is in place, we don't need to worry about (and can't justify to the public) screening people, right?

Drake Valentine

Quote from: Retribution on October 17, 2014, 11:07:08 AM
The flu does kill more, but being devil's advocate here, I actually work with another illness that is often in the news. West Nile (I happen to be an expert on mosquitoes) is established in the US, but the flu kills far more.

http://www.cdc.gov/westnile/

I linked CDC for reference, but we throw great heaping piles of money at West Nile.  heck, I am part of the great heaping piles of money thrown at it lol. But why is something like ebola not given the same attention?

*Shrug* My theory is, because it isn't that widespread in the U.S or other countries- presently at least. Of course at this point, it is starting to cause some paranoia in the U.S, given the media coverage from a few existing cases.

Also, Mark Zuckerberg donated like 25 Million dollars a few days ago to health care facilities on fighting Ebola. Of course, 25 million is like chump change to him, but some people are donating, his was a pretty big case of chumps of money.

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Retribution

Quote from: Ephiral on October 17, 2014, 04:53:16 PM
It makes sense from a security perspective. An outright ban on travel from the afflicted areas provides an entirely false sense of security. It doesn't prevent anyone from travelling if they really want to, just adds another leg to their trip - and erases them as possible carriers. And since we know a ban is in place, we don't need to worry about (and can't justify to the public) screening people, right?

I think we all agree that at least at this point in time the threat from ebola is minimal. Having said that in reference to your point Ephiral I seriously hope someone is monitoring things like pass ports and immigration a bit more intently than that. If all one has to do to evade detection is fly to another country first I fear there are much larger issues at hand than ebola.

Caehlim

Honestly, my perspective is that if you're concerned about your personal safety, drive more carefully next time you're in a car. It'll do much more for you than thinking about Ebola. So far the only contaminations that have occurred within the US are two healthcare professionals who treated a misdiagnosed patient. Similar cases of misdiagnosis are extraordinarily unlikely at the moment, with the current levels of awareness and the CDC running ongoing investigations. Future ones should be handled correctly.

America, despite the problems of its healthcare system, is not in the same situation as the countries in which outbreaks have occurred. The affected countries simply do not have the ability to treat these diseases, they have insufficient beds for the numbers of patients meaning that many infected are not being housed correctly resulting in further spreading.

Medical research is continuing on the disease and being fast-tracked because of the severity of the African outbreak. The vaccine has already been made by Glaxosmithkline, it's just currently being tested for approval but they're confident enough to have prepared large batches of it ready to be sent to Africa once it is approved.

You've had one incident with three people affected. There is an organization with 15,000 people and a 7 billion dollar budget currently taking care of the situation. I think you're going to be okay.

Quote from: TheGlyphstone on October 17, 2014, 10:50:13 AMA nifty web app/website someone created that tells you how far away the closest Ebola case is from your home.

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Ephiral

Quote from: Retribution on October 17, 2014, 08:09:11 PM
I think we all agree that at least at this point in time the threat from ebola is minimal. Having said that in reference to your point Ephiral I seriously hope someone is monitoring things like pass ports and immigration a bit more intently than that. If all one has to do to evade detection is fly to another country first I fear there are much larger issues at hand than ebola.
The only way this supposition holds is if all potential carriers are citizens of the afflicted countries, travelling via normal means, and/or the borders of the afflicted nations are 100% secure and non-porous. It's a very bad idea to make your security depend on someone who is completely outside your control doing everything right.

Retribution

I am not saying I think there is perfection, but like I said I really hope someone is watching a tad more closely than the assumption your are offering up implies. Because to hell with ebola  I am worried about the fellow with methel ethel death in his suitcase and a plan for mass murder.

Ephiral

My assumptions are merely that people don't like the government wasting resources on screening for things they already think they're safe against, and that not all ebola carriers will necessarily be easily traceable to the affected areas. Those are... pretty basic assumptions, all things considered.

lilhobbit37

A few fun facts we were given at work:

Ebola is not contagious until you have developed symptoms.

For the first 3 days after symptoms develop, the virus is relatively weak and it is still difficult to contract the virus.

After 3 days, the virus grows exponentially in strength.

The virus survives on surfaces for hours.

It survives in the bodily fluids for days.

It survives in the body (including the corpse) for weeks.

It survives in the semen after recovery for 2-3 months.

Just some fun facts to think about, and think about how hard it actually is for an everyday joe to contract the virus outside of the hot zones.

Zakharra

Quote from: Ephiral on October 17, 2014, 08:13:34 PM
The only way this supposition holds is if all potential carriers are citizens of the afflicted countries, travelling via normal means, and/or the borders of the afflicted nations are 100% secure and non-porous. It's a very bad idea to make your security depend on someone who is completely outside your control doing everything right.

Quarantining5 the affected regions is still a prudent step to take by cutting down on one way to stop possible infected from coming here.

TaintedAndDelish


I think more attention needs to be paid to ensuring that medical staff and those who clean up are fully protected. The virus will no doubt make it past our defences no matter what we do, and when it does, we are going to be depending on the medical community. If they start dying off or leaving their professions for safer jobs ( ones that pay the same but without the risk of dying),  then we're going to have a major problem and few to help combat it.




Retribution

Well, taking steps for medical staff is a good idea. As for the argument that there should not be action taken to quarantine we have a saying in the hills that applies to my feelings about that assertion. That dog wont hunt.

Zakharra

Quote from: TaintedAndDelish on October 18, 2014, 01:35:59 AM
I think more attention needs to be paid to ensuring that medical staff and those who clean up are fully protected. The virus will no doubt make it past our defences no matter what we do, and when it does, we are going to be depending on the medical community. If they start dying off or leaving their professions for safer jobs ( ones that pay the same but without the risk of dying),  then we're going to have a major problem and few to help combat it.

That can be done with an air quarantine. It doesn't have to be one or the other. Both can easily be done.

Oniya

Quote from: Zakharra on October 18, 2014, 01:41:39 PM
That can be done with an air quarantine. It doesn't have to be one or the other. Both can easily be done.

*nods*  Many methods that would help with containment are mutually beneficial, rather than being mutually exclusive.
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Drake Valentine

Not to stray a bit off topic.

But, wasn't there a movie that came out a few years ago something like this? I mean, I am sure the movie wasn't about the 'Ebola' virus, but it was about some sort of deadly virus that had spread everywhere which had surviving citizens in fear of their lives of things they may touch. >.>

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Oniya

There was a novel called 'The Hot Zone', which detailed events (mostly accurate) around the discovery of the Reston variety of Ebola.  I actually worked in a call center not-too-far from the site several years after the event.  It's purportedly being made into a TV miniseries.  (Which seems like an utterly brilliant idea.  Novels rarely survive the transition to film.)

There was a movie in 1995 called Outbreak, which features a virus somewhat similar to Ebola, but after a little more looking, you're probably thinking of the move 'Contagion' from 2011.
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Apple of Eris

The ebola coverage isn't even about science, it's about ratings and in some cases scoring political points. People in the media, and politicians especially, should STFU and do what medical professionals are saying, which is increase preparedness, not close borders, etc etc.
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TaintedAndDelish


I found a few interesting videos that give a glimpse into what life life is like in Monrovia Liberia. I thought it would be interesting to get a better idea of the differences between these areas and the US just to help put things into perspective.

The first video is about 18 mins long and covers topics such as sanitation, bush meat, and prostitution.
http://youtu.be/XasTcDsDfMg


The second one shows an escaped Ebola patient walking through a crowded area in Monrovia. What's interesting about this clip is that it shows that not everyone in Liberia is oblivious to Ebola as the media sometimes seems to portray. Some news reports have depicted the people there as dirty and ignorant. While the city is clearly lacking resources, you can see that the people in this video are properly dressed and clearly aware and concerned about the threat that this patient poses.

Also, the struggle to get the patient back into the van poses much more risk of physical contact than just changing a pair of contaminated gloves and gown as in the Dallas incident. Towards the end, you see the medial workers literally forcing him into the back of their truck, then climbing in - presumably to keep him from getting out again.

http://youtu.be/F-JZEaeOmfE


Caehlim

Here's a rather nice photo I came across recently.

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Caehlim

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Drake Valentine

Quote from: Oniya on October 19, 2014, 11:22:25 AM
There was a novel called 'The Hot Zone', which detailed events (mostly accurate) around the discovery of the Reston variety of Ebola.  I actually worked in a call center not-too-far from the site several years after the event.  It's purportedly being made into a TV miniseries.  (Which seems like an utterly brilliant idea.  Novels rarely survive the transition to film.)

There was a movie in 1995 called Outbreak, which features a virus somewhat similar to Ebola, but after a little more looking, you're probably thinking of the move 'Contagion' from 2011.

Yussssh, Contagion, was it. Great movie. ^^ Time to refresh and watch up on it.

But in other news.

I find this
portion

   Avoid direct contact with sick patients as the virus is spread through contaminated body fluids
    Wear protective cover for eyes
    Clothing and clinical waste should be incinerated and any medical equipment that needs to be kept should be decontaminated
    People who recover from Ebola should abstain from sex or use condoms for three months

Because we all know condoms will keep you safe from catching Ebola during intimacy with possible contagious people.  ::)
of that news page amusing.




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Oniya

That's because you may still have viral load after recovery, according to what I was reading.
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TheGlyphstone

#46
Quote from: Drake Valentine on October 23, 2014, 01:48:56 AM
Yea, but Ebola has a 42 day incubation period.

http://mobile.wnd.com/2014/10/who-report-ebola-has-42-day-incubation-period/
That link leads to an article on NaturalNews - you're basically quoting the Daily Mail of health websites.

http://en.wikipedia.org/wiki/NaturalNews

Note the bit where they're promoting homeopathic herbal treatments as an effective means of curing Ebola. The quote they've based that article on is probably horrifically out of context.

Cassandra LeMay

#47
Quote from: Drake Valentine on October 23, 2014, 01:48:56 AM
Yea, but Ebola has a 42 day incubation period.

As the WHO website states:

QuoteRecent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval.

First of all, the 42 days comes from the WHO guideline that a country can be declared free of Ebola if no new case has been registered within the last 42 day. That does not mean that the maximum incubation period is actually 42 days. In almost all cases the incubation period happens to be 21 days or shorter. Doubling that strikes me as a "safety margin" that does not, in itself, say anything about the maximum incubation periode. If the WHO actually assumed that the incubation periode could be as long as 42 days that would not leave any margin for error or late reporting of new cases when declaring a country Ebola-free after 42 days with no new infections. I find it difficult to believe that the WHO would do that.

Second, the three percentage points more in the 1-42 days range would be just as true if those extra three percent of cases had an incubation periode of 22 or 23 days. Statistics can be funny like that, and a small variance to the generally accepted 21 days as the maximum incubation periode seems reasonable and natural to me, as it might be very difficult to narrow down when someone actually caught the disease. Unless you constantly monitor someone day-in, day-out, determining when an infection actually happened could boil down to educated guesses, especially in cases where someone has been around carriers for several days. Did he catch it on the first day, the second, the third of his contact with infected people? If you assume it was the first day and he falls sick 23 days later you would assume a 23 day incubation periode. But perhaps he got it only on the third day and you would be back to the 21 day range most cases fall into.
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Oniya

Looking at the specific percentages that they give, I'm thinking those are simply the 2- and 3- standard deviation ranges.  As in 95% of all cases fall within 2 standard deviations of the mean.  The 42 day case is almost certainly outlier data.
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Florence

Quote from: Oniya on October 22, 2014, 07:50:32 AM
That's because you may still have viral load after recovery, according to what I was reading.

Is it immature that, given the context, my first thought was to make a viral 'load' joke?
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Cassandra LeMay

Quote from: Florence on October 24, 2014, 03:58:24 AM
Is it immature that, given the context, my first thought was to make a viral 'load' joke?
I am not sure, but I think any laughter you may get out of that joke would not be very contagious.
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Drake Valentine

Quote from: Cassandra LeMay on October 24, 2014, 04:00:25 AM
I am not sure, but I think any laughter you may get out of that joke would not be very contagious.

Lols.

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Cycle

Presidential candidate Chris Christie thinks people who come back from countries with Ebola should be locked up in a tent with no heating and no showers and a port-a-potty for three weeks.

Way to panic, governor.


TaintedAndDelish


Call it insensitive, but I would rather see a few folks inconvenienced, lonely and discouraged, than to see people get sick and die.

I haven't heard anyone talking about the possibility of legal action in the event that neglecting to properly isolate a person causes another to die from exposure to the virus. I have to wonder who could be held responsible in such a situation ( both the positive patient and medical staff? ) and what might the legal consequences be? ( ie. fine, prison time, civil suits, death penalty (lol), etc.. )


Beguile's Mistress

I was thinking about that when I heard they let the nurse in New Jersey return to Maine.  I don't know that I would want her to move back in if she lived next to me.  At least, I wouldn't want to see her there for the minimum three weeks of the incubation period.  If there is even a slim chance you could be infected but not show it you could be a walking time bomb.

Cycle

Did I neglect to mention that she tested negative for Ebola?

Yep.  She tested negative.

Oh, so did the gentleman up in Connecticut. 

Course, he really shouldn't complain since they let him stay where there is heat and a toilet.  The armed police officer won't let him out, of course.  So everyone is safe.  Assuming you ignore the fact that he is allowed out at night into the common area to use the washing machines.

Yeah.  Let's hear it for well thought out responses by politicians pandering to the base!


TaintedAndDelish

Unless I am mistaken, "tested negative" is not necessarily the same as "not infected."

A few things that can go wrong here:

1. The patient decides to "live it up" just in case he or she is infected. While out and about, they become symptomatic and infect someone on the way home.  For example, he or she passes out after binge drinking and wakes up the next day sick as a dog. They might then throw up or piss themselves as some folks do.

2. The patient is feeling sick but is in denial about it. As a result, they end up reporting themselves later than they should or making excuses for why their temperature is high.

3. The patient becomes symptomatic while in a very inopportune place - like aboard an plane or ship or in a very crowded place where they cannot easily leave.

4. The person in question gets into some sort of an accident and is cut badly causing blood leakage or splattering.

While these folks are "medical professionals" and should know better, they are also humans, and are subject to making mistakes and having bouts of poor judgement. ( Like the nurse from Dallas who boarded a plane, our friend from NY who decided to live it up while feeling a little crappy, and the other person who decided that it would be a good idea to board a cruise ship. )

I'm not necessarily saying that premature isolation is the right thing, but undermining the risks and consequences is not the way to go. When the stakes are "death", even low risk becomes intolerable. If the stakes were just a runny nose and a case of the shits, then a much higher level of risk would be tolerable.

Cycle

*shrugs*  I don't think our fear of the unknown should allow a governor to deprive the people who tried to help stamp out this disease of a shower, a real toilet and heat.  Here.  Christie for President 2016 posters:


I also think we should bear in mind that the total number of people infected by Thomas Eric Duncan outside the hospital is zero.  From all indications, the total number of people infected from the plane flight, the cruise, and that trip to the bowling alley is also zero.

As for the tests, well, it may not show that they won't possibly, ever develop Ebola later, but it does show they don't have it now.  So that should be considered when we decide how much we want to deprive these individuals.  Otherwise, why are we bothering to test them at all?  Just assume they're all infected for 21 days! 

Oh wait.  That's precisely what that governor was doing...


Beguile's Mistress

They get tested because they are coming from an area where they may have been exposed and may already have an active virus in their system.  There is a 21-day incubation period for a reason.  Some cases have presented with symptoms within the 21-day period from exposure, therefore, a person who is not symptomatic now could develop the virus sometime during that 3-week period.  Also, even though quarantine standards may be primitive at the moment, do we really say to the public we aren't going to quarantine anyone until we have upgraded our quarantine facilities?  Maybe we could find a building that has heat and lavatories.  Or we could empty a hospital and use that for quarantine putting other sick patients at risk while we spend hundreds of thousands of dollars to move and re-house them.

There is not good answer to the problem but when the need for quarantine is brushed off because someone may be inconvenienced the chances of that one sick person getting out and communicating the disease to others is much much greater.  Ebola is a deadly disease.  Most of the people contracting it die.  Pregnant women have a 100% chance of dying.  A few people who have been diagnosed early and have had intensive treatment have recovered.  I'd like to see people caring more about keeping the numbers down than worrying about their own comfort. 

I have nothing but praise and appreciation for the people who have volunteered to work in the highly infected areas and don't look for parades when they come home but when they do come back to some of the most highly and densely populated areas in our country we need to be cautious.  People who are concerned about the living standards of the quarantined people should do something about that and help those patients.

TaintedAndDelish

One thing that I think would complicate this is the number of infections. With only one or two people infected, its easy enough to give them their own little tent. If the number of infections grows to the point where individual private tents are no longer feasible and the risk of spreading the disease from one patient to another is a bit higher, then putting a negative person into a quarantine facility with lots of positive people could be a very bad thing.



Florence

Quote from: TaintedAndDelish on October 28, 2014, 09:24:05 PM
Call it insensitive, but I would rather see a few folks inconvenienced, lonely and discouraged, than to see people get sick and die.

I haven't heard anyone talking about the possibility of legal action in the event that neglecting to properly isolate a person causes another to die from exposure to the virus. I have to wonder who could be held responsible in such a situation ( both the positive patient and medical staff? ) and what might the legal consequences be? ( ie. fine, prison time, civil suits, death penalty (lol), etc.. )

I'm on the fence about the idea of quarantine in general. I mean, I'm not a health expert, I don't know what the best way to handle an outbreak like this is.

However, it seems unacceptable to me to simply throw them in a tent with horrendous living conditions and basically being like "Good luck, hope you don't die."

I mean, that's a hell of a way to thank someone for heroically putting their lives on the line to save others.

I get that life isn't always fair, but shouldn't we at least TRY to treat these people with some respect and dignity?
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Cassandra LeMay

#61
Quote from: TaintedAndDelish on October 28, 2014, 11:18:39 PM
While these folks are "medical professionals" and should know better, they are also humans, and are subject to making mistakes and having bouts of poor judgement. ( Like the nurse from Dallas who boarded a plane, our friend from NY who decided to live it up while feeling a little crappy, and the other person who decided that it would be a good idea to board a cruise ship. )
I see no reason to use quotation marks around 'medical professional' in this case, because they are professionals - just not all trained to the same level, for the same situations. Comparing the nurse from Dallas with someone who worked in West Africa with Doctors Without Borders (MSF) strikes me as unfair, as the former may know very little about Ebola, while the latter probably knows a whole lot more about this disease.

And where did you find that "...who decided to live it up while feeling a little crappy..."? From everything I read the doctor in New York stayed at home from the moment he detected he had a fever, informed the relevant authorities, and kept himself away from other people till he was transported to hospital.

Everyone working with MSF has strict orders to check their temperature twice a day for three weeks after returning home from working with Ebola patients, and they are paid a salary during that 21 day self-monitoring phase so they do not have to go back to work, lowering the risk of them infecting anyone if they should actually come down with Ebola. That is far different from the situation of the nurse in Dallas.

And even if the first symptoms show, chances might be slim to none that someone actually infects someone during the first few hours (perhaps even the first few days). Ebola can only be spread by contact with bodily fluids, and that only gets really nasty when diarrhea and vomitting set in - which doesn't happen immediately. During the first few days of infection virus RNA levels are so low in humans that they are almost undetectable. Even if someone starts showing the first symptoms it may be a while before their ... "viral load" is high enough to infect anyone. Even sharing a home with someone may not be enough to spread the disease, according to the CDC:

QuoteSeveral investigations have also demonstrated that persons residing in confined, shared spaces (e.g., homes), but who had no direct physical contact with these cases did not develop EVD


Quote from: Beguile's Mistress on October 29, 2014, 12:18:02 AM... Most of the people contracting it die.  Pregnant women have a 100% chance of dying.  A few people who have been diagnosed early and have had intensive treatment have recovered.  I'd like to see people caring more about keeping the numbers down than worrying about their own comfort.
BM, may I ask where you found that 100% mortality rate for pregnant women? I haven't heard that before so I would like to read up on it.

Also, intensive treatment is not always necessary for recovery - or maybe it is and we just define "intensive treatment" differently. One of the aspects of Ebola that kills a lot of people is organ failure from massive fluid loss. Just keeping a patient hydrated and providing them with the nutrients they might lose through diarrhea and vomitting can bring the mortality rate down from somewhere between 70% and 90% to about 50%.  That is still a lot, and it may take constant attention on the part of doctors or nurses, but but for a trained healthcare provider it's not rocket science and it can help a lot.

* * * * *

Edit: I'll add in a bit more, concerning the point I made above about the risks of contagion: The European Centre for Disease Prevention an Control gives the following examples for "low-risk exposure" in their guidelines for contact management:
Quote> Casual or physical contact with a feverish but ambulant and self-caring EVD case (e.g. sharing a seating area or public transportation, including airplane transport; receptionist tasks; etc.)
> Close, face-to-face or physical contact with a case who is not coughing or vomiting.
> Household, classroom or office contact.

For those cases the only recommendation they make is self-monitoring twice a day for fever and other symptoms, with self-isolation and immediate notification of health authorities only if potential symptoms are detected. That very much seems to be the consensus between European health bodies, the CDC, and MSF as adequate for those who have only had casual contact with a patient.
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Caehlim

This is a little bit of a sidetrack, but I'm posting this here because it might be of interest to people involved in the discussion.

http://www.abc.net.au/news/2014-10-28/nz-researchers-develop-device-for-quick-ebola-detection/5849270

A really cool new invention that's coming out of New Zealand looks like it'll be able to identify ebola quickly out in the field.
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Cassandra LeMay

Quote from: Caehlim on October 29, 2014, 04:23:57 AM
This is a little bit of a sidetrack, but I'm posting this here because it might be of interest to people involved in the discussion.

http://www.abc.net.au/news/2014-10-28/nz-researchers-develop-device-for-quick-ebola-detection/5849270

A really cool new invention that's coming out of New Zealand looks like it'll be able to identify ebola quickly out in the field.
I'll believe it when it has been proven under field conditions. Also
Quote"Pretty much we can have a test result in an hour and a half - that's from a blood sample," Dr Stanton said.
is not that spectacular an improvement in detection time when you consider that a modern lab can deal with it in 3 to 5 hours, part of which is taken up by just careful handling of the samples (which will be necessary with this new device also, as we are talking about blood samples here, i.e. a high infection risk). Of course it would be great if there was a simple one-step diagnostic process that didn't require a full-blown lab, but even if this gizmo works, to prevent new outbreaks of Ebola what is needed is a solid healthcare infrastructure and public awareness, together with a lot of soul-searching on part of the WHO. It may be a step in the right direction, but it's not enough by a long shot.
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Florence

Quote from: Cassandra LeMay on October 29, 2014, 05:51:04 AM
is not that spectacular an improvement in detection time when you consider that a modern lab can deal with it in 3 to 5 hours, part of which is taken up by just careful handling of the samples (which will be necessary with this new device also, as we are talking about blood samples here, i.e. a high infection risk). Of course it would be great if there was a simple one-step diagnostic process that didn't require a full-blown lab, but even if this gizmo works, to prevent new outbreaks of Ebola what is needed is a solid healthcare infrastructure and public awareness, together with a lot of soul-searching on part of the WHO. It may be a step in the right direction, but it's not enough by a long shot.

So a portable device can get results quicker than a full laboratory and you don't consider that impressive?

I get doubting it until its proven in the field, but if it IS proven to work, I fail to see how that's NOT impressive and helpful.
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Cycle

Quote from: Beguile's Mistress on October 29, 2014, 12:18:02 AM
They get tested because they are coming from an area where they may have been exposed and may already have an active virus in their system.

I don't believe this is correct.  Hickox was tested because she had a fever.  Boyko was tested because he had a fever and diarrhea.  That is, in both cases, the test was applied after the individual developed a symptom, to see if the symptoms they had was caused by Ebola or any one of a number of other reasons:  e.g., the flu, a bad burrito, being interrogated for two hours, etc.  They were not tested simply because they flew in from Guinea, Liberia, or Sierra Leone.

QuoteAlso, even though quarantine standards may be primitive at the moment, do we really say to the public we aren't going to quarantine anyone until we have upgraded our quarantine facilities?

No, what we do is get better facilities in place before we launch a State-wide blanket program to start quarantining people.  Cart, horse, which one goes first again, governor?  It isn't like New Jersey doesn't have a single portable heating unit or a shower somewhere in the State.  And it wouldn't have been all that hard to get one of those in place beforehand.

QuotePeople who are concerned about the living standards of the quarantined people should do something about that and help those patients.

People are.  By spreading the word that fear should not override science.  And by threatening to sue these governors into oblivion.  And at least in Hickox's case, Christie caved.  As he should.  Because what he did was wrong.


Oniya

Quote from: Cycle on October 29, 2014, 08:36:31 AM
No, what we do is get better facilities in place before we launch a State-wide blanket program to start quarantining people.  Cart, horse, which one goes first again, governor?  It isn't like New Jersey doesn't have a single portable heating unit or a shower somewhere in the State.  And it wouldn't have been all that hard to get one of those in place beforehand.

For $115 at Target - not even one of those swanky outdoorsman shops - you can get a portable heated shower.  Depending on your power source, portable space heaters can be just as cheap or cheaper, and we're getting into the season when those are also available in everything from Walmart to Home Depot.  (I'd probably go with the electric type, since a quarantine area might have problems venting fumes.)  The point being that both these items are easily accessible, and could possibly have even been requisitioned at the time that the quarantine was imposed.
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Cassandra LeMay

Quote from: Florence on October 29, 2014, 07:37:03 AM
So a portable device can get results quicker than a full laboratory and you don't consider that impressive?

I get doubting it until its proven in the field, but if it IS proven to work, I fail to see how that's NOT impressive and helpful.
I don't know how much this device will really speed up the process, provided it works. If the "hour and a half" figure is the time a blood sample needs to be in the device, how much time is needed befpr and after that when it is employed in the field? How does that compare to a full lab test? It's pretty much impossible to say, given what little information we have. That's part of why I am somewhat sceptical about this being such a big improvement, provided it works as advertised. Plus, if you have a decent healt infrastructure with well-eqiped laboratories at hand it makes little difference. Once someone comes down with what might be Ebola they should be isolated while the lab test is run. If it takes one hour or eight hours for the results to arrive makes only one difference: Someone has to stare at the wall of an isolation ward for a few more hours. Is that really that much of an important difference?

Another reason why I am somewhat sceptical about tests like this (even if they work as advertised) is what I would like to call the "blinded by science" factor. What if this gizmo works? Would donors in the West invest millions and more millions to provide these diagnostic kits to every country in Africa? If they did, how long would it take for ... "diagnosis fatigue" (for lack of a better words on my part) to set in? The early stages of Ebola share a lot of symptoms with many more common diseases (e.g. malaria). How long would it take for people to just ignore these tests because they would too often come up negative? And could a test kit like this not become a cop out for Western nations who will spend their aid money on what they see as a "magic bullet" in the fight against Ebola, instead of spending their money on what is really needed - and will do a lot more than just help against Ebola - i.e. a good health infrastructure and health education in African countries? A test in a lab may take longer - and cost more - but a well-equipped lab can do a lot more than just help diagnose Ebola. In so far I see a good solid lab as the better alternative to what strikes me as a "one trick wonder pony".
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Retribution

Quote from: Cycle on October 29, 2014, 08:36:31 AM
No, what we do is get better facilities in place before we launch a State-wide blanket program to start quarantining people.  Cart, horse, which one goes first again, governor?  It isn't like New Jersey doesn't have a single portable heating unit or a shower somewhere in the State.  And it wouldn't have been all that hard to get one of those in place beforehand.

Great plan! Lets make sure it is spread while we are establishing these facilities. That way we really need the facilities to combat epidemic. Both governors Christie and Cumo took similar action. A liberal democrat and a conservative republican. Opposing sides of the political spectrum. So what I see here is -responsible- action. I know it might put those in quarantine out. Tough luck.

There is a lot that is not known about the disease and taking basic, proven, steps is reasonable. I have no idea why the left leaning find this so distasteful. Sure, it puts some inconvenience out there for those affected, but to use the same argument that is tossed out when it comes to gun control "is not saving lives worth a little inconvenience?"

Oniya

I'm not sure how requisitioning a heater and shower would cause an excessive delay in quarantining someone.  Depending on traffic, the person sent to get it could be back and have it set up before the plane landed.
"Language was invented for one reason, boys - to woo women.~*~*~Don't think it's all been done before
And in that endeavor, laziness will not do." ~*~*~*~*~*~*~*~*~*~*~Don't think we're never gonna win this war
Robin Williams-Dead Poets Society ~*~*~*~*~*~*~*~*~*~*~*~*~*~Don't think your world's gonna fall apart
I do have a cause, though.  It's obscenity.  I'm for it.  - Tom Lehrer~*~All you need is your beautiful heart
O/O's Updated 5/11/21 - A/A's - Current Status! - Writing a novel - all draws for Fool of Fire up!
Requests updated March 17

Retribution

Quote from: Oniya on October 29, 2014, 09:02:34 AM
I'm not sure how requisitioning a heater and shower would cause an excessive delay in quarantining someone.  Depending on traffic, the person sent to get it could be back and have it set up before the plane landed.

No argument on that Oniya, it is just that is not what I am hearing in this whole angle of argument. What I am hearing is we need to construct extensive facilities........yada, yada.

Cassandra LeMay

Quote from: Retribution on October 29, 2014, 08:54:54 AM
Great plan! Lets make sure it is spread while we are establishing these facilities. That way we really need the facilities to combat epidemic. Both governors Christie and Cumo took similar action. A liberal democrat and a conservative republican. Opposing sides of the political spectrum. So what I see here is -responsible- action. I know it might put those in quarantine out. Tough luck.
The current Ebola outbreak has been going on for months. Doctors and nurses from western countries (including the U.S.) have been working in West Africa for months to help fight this disease. Both are facts and could have been known to the authorities in New York and New Jersey for a while. If they had wanted to they could have put adequate facilities in place weeks ago, taking all the time they needed. Instead they acted only when that case in New York happened. What's happening now is not responsible action. It's shooting from the hip, pure actionism that serves more to spread fear than contain any virus. That people from different sides of the political spectrum fall into the same trap does not make their actions more justified, logical, or based on scientific facts.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Beguile's Mistress

Dr. Spencer, the infected Ebola patient in New York lied about his activities when he supposedly self-quarantined himself and now all the places he visited are being "scrubbed" to forestall the possibility he could have spread the disease.


Retribution

#73
*pinches his brow* okay last comment here because I cannot get my mind around the whole mindset. Sure I agree action -should- have been taken months and months ago. It utterly baffles me that none was taken as I have said here multiple times. But since action was not taken in a timely fashion therefore no action should be taken? To say I find this silly would be an understatement of massive proportions. I have found it silly for months and months because as Beguile's just pointed out some people including this fellow lie.

Now, I am probably more likely to get struck by lightening than catch ebola. I acknowledge that openly, but being a bit facetious I see no reason why we should be starting the zombie apocalypse just because some people might be inconvenienced.

Zakharra

  Those coming back from those affected nations, especially if working with infected people, should be quarantined for awhile to make sure they are not infected if said contact has been within 21 days. Then they can be released into the general population. They should NOT be allowed to walk around free and potentially infected.  Yes it inconveniences them a lot, but considering the disease in question, it would be irresponsible to not quarantine them to make absolutely sure they are not carriers. They should understand that after seeing the disease in action.

Better safe than sorry. Take no chances and be sure there are no infected coming back.

Cassandra LeMay

Quote from: Retribution on October 29, 2014, 09:40:27 AM
*pinches his brow* okay last comment here because I cannot get my mind around the whole mindset. Sure I agree action -should- have been taken months and months ago. It utterly baffles me that none was taken as I have said here multiple times. But since action was not taken in a timely fashion therefore no action should be taken?
I am not trying to say that no action at all should be taken. What I am trying to say is that what is happening right now is not, as you called it, (quote) responsible action (unquote). From where I sit it is overreaction based on fear - and that will only increase fear. What this situation warrants is a calm, meassured, and reasonable response and that is not what I see in the responses from NY and NJ governments. Fear and panic help no one. Acting in a timely fashion is one thing, acting with undue haste is another, and I see the latter here.

Also, it does not matter one little bit if Dr. Spencer was telling the truth about his movements or not, as long he told the full truth about his movements after he developed the first symptoms. The few pieces of news I have gathered so far do not mention any time frame or state that he moved around while he could have infected anyone.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Zakharra

Quote from: Cassandra LeMay on October 29, 2014, 10:02:09 AM

Also, it does not matter one little bit if Dr. Spencer was telling the truth about his movements or not, as long he told the full truth about his movements after he developed the first symptoms. The few pieces of news I have gathered so far do not mention any time frame or state that he moved around while he could have infected anyone.

He should have been in quarantine before that when he came back to the US. As it is, because he wasn't, he has put people in danger because he was actually infected.  It's a hell of a lot better to inconvenience some people just as a safety precaution, to make sure, than let potentially infected people walk around spreading the disease. And the doctors and nurses who are a part of the Doctors without Borders should understand that. Do they want to infect people in the US?

Beguile's Mistress

Quote from: Cassandra LeMay on October 29, 2014, 10:02:09 AM
Also, it does not matter one little bit if Dr. Spencer was telling the truth about his movements or not, as long he told the full truth about his movements after he developed the first symptoms. The few pieces of news I have gathered so far do not mention any time frame or state that he moved around while he could have infected anyone.

New York City is a major metropolitan area that is densely populated.  I think I'd be really irritated if I learned that I had come in contact with him somewhere, like the restaurant where he ate, touched utensils and dishes, left behind napkins he used to wipe his mouth and touched a table and chair with those hands he had on his mouth and where he may have sneezed or coughed while he was infected.  I would be more than irritated if he was somewhere a child of mine needed to be.  It would matter quite a bit if there was even a 1% chance of him infecting anyone.  All it takes is one person, one irresponsible, unthinking, selfish, arrogant, egoistical, uncaring and careless person who doesn't want to be inconvenienced, to pass the disease on and possibly kill someone.  As long as the possibility of contagion exists the need for caution must exist and the caution must equal the severity of the disease.

Maybe he did tell the full truth in the end or maybe he lied again or "forgot" to be accurate.  He wouldn't have said anything if the police hadn't investigated his activities using his Metro Card and credit cards to gather evidence.  Even the officer who interviewed him did so by phone rather than come into contact with him. 

Cassandra LeMay

Quote from: Zakharra on October 29, 2014, 10:14:05 AM
He should have been in quarantine before that when he came back to the US. As it is, because he wasn't, he has put people in danger because he was actually infected.  It's a hell of a lot better to inconvenience some people just as a safety precaution, to make sure, than let potentially infected people walk around spreading the disease. And the doctors and nurses who are a part of the Doctors without Borders should understand that. Do they want to infect people in the US?
At the chance of repeating myself: As long as you do not show any symptoms you can not spread Ebola. Even if you show the first symptoms, chances of spreading Ebola may be slim to none for a day or two.

Carrying the virus in your body does not mean you are "spreading" this disease if you haven't developed any symptoms yet, no matter how much you walk around or interact with other people. Being infected does not automatically put the people around you in any danger. You can be a carrier of Ebola without spreading the disease one little bit. During the incubation stage Ebola is not contagious.

All major health institutes and experts around the world agree on that. It's a proven fact. If Dr. Spencer had spit on everyone in Times Square before he developed any symptoms he would not have done more than aggrevate and piss off a lot of people. Going bowling or eating out while you are a carrier without any symptoms of the actual disease is not a risk to public health.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Retribution


Cassandra LeMay

#80
Quote from: Beguile's Mistress on October 29, 2014, 10:27:20 AM
All it takes is one person, one irresponsible, unthinking, selfish, arrogant, egoistical, uncaring and careless person who doesn't want to be inconvenienced, to pass the disease on and possibly kill someone.
Just so I don't misunderstand you: Are you accusing Craig Spencer of all/some/one of those character traits?

Quote from: Beguile's Mistress on October 29, 2014, 10:27:20 AMEven the officer who interviewed him did so by phone rather than come into contact with him.
Maybe that's because Spencer is in isolation and not allowed visitors? I don't see how the fact that he was questioned by phone makes any difference. Now that Mr. Spencer has come down with Ebola not having any more direct contact with him is, of course, a prudent choice, but I fail to see how that is relevant to his movements before he came down with Ebola, his personal activities, or quarantine protocols for those who may be (non-infectious) carriers.

---------------------------------------

Quote from: Retribution on October 29, 2014, 10:37:13 AM
*sighs* http://en.wikipedia.org/wiki/Mutation
*sighs too*

Frankly, I think that is completely irrelevant to the debate about the justification for quarantine meassures. If you worry about that you might as well quarantine everyone because no one knows what dastardly mutation to the common cold any one of us might soon breed. I can see no justification whatsoever for taking half-assed meassures that ignore scientific fact, and I see even less justification for them when we drift into the realm of maybe-one-day instead of dealing with the facts on the ground and basing rational, appropriate meassures on what is known and proven.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Beguile's Mistress

Quote from: Cassandra LeMay on October 29, 2014, 10:45:51 AM
Just so I don't misunderstand you: Are you accusing Craig Spencer of all/some/one of those character traits?
Yes.  Any of them that apply.  Unless you are constantly testing your blood you don't know for sure you aren't contagious.  Hence the need for quarantine.  When people start thinking they know better everyone else the become a danger to us all.  This is the reason the places the good doctor visited are being bio-scrubbed.  How do we know he wasn't contagious?

QuoteMaybe that's because Spencer is in isolation and not allowed visitors? I don't see how the fact that he was questioned by phone makes any difference. Now that Mr. Spencer has come down with Ebola not having any more direct contact with him is, of course, a prudent choice, but I fail to see how that is relevant to his movements before he came down with Ebola, his personal activities, or quarantine protocols for those who may be (non-infectious) carriers.
As I said who knows when he became contagious?  Him?  Yes he finally got around to reporting his condition when he needed medical care.  By then he was contagious and he was still in the public sector and a source of infection.  He's really no better than those parents who send children with measles and chicken pox off to school because all the other kids are going to get sick anyway.   

Zakharra

Quote from: Cassandra LeMay on October 29, 2014, 10:31:45 AM
At the chance of repeating myself: As long as you do not show any symptoms you can not spread Ebola. Even if you show the first symptoms, chances of spreading Ebola may be slim to none for a day or two.

Carrying the virus in your body does not mean you are "spreading" this disease if you haven't developed any symptoms yet, no matter how much you walk around or interact with other people. Being infected does not automatically put the people around you in any danger. You can be a carrier of Ebola without spreading the disease one little bit. During the incubation stage Ebola is not contagious.

All major health institutes and experts around the world agree on that. It's a proven fact. If Dr. Spencer had spit on everyone in Times Square before he developed any symptoms he would not have done more than aggrevate and piss off a lot of people. Going bowling or eating out while you are a carrier without any symptoms of the actual disease is not a risk to public health.

  That's irrelevant They can still carry the disease and it can manifest later in a place that there isn't any proper medical care, or the person ends up still going out and either deceiving themselves, or just flat out lying about it like the one doctor.  This is Ebola, the doctors and nurses should expect to be quarantined to make sure they are 100% free of the disease and outside of the 21 day potential infection/symptoms range. People are wonderful as deceiving themselves that they aren't sick or ill or having any problem at all.

As we have seen at least one person has come back and then developed symptoms, so the 21 day quarantine only makes sense. To let them roam free is irresponsible and bluntly, stupid as hell. With an infectious disease like this, you don't take chances. So better they be inconvenienced for 3 weeks than potentially spread a very nasty disease all over the place. But if you don't want to quarantine them for awhile, how about sending the next few doctors or nurses coming back to live with you for 3 weeks. Would you feel safe then? I wouldn't and I wouldn't put my family at risk until -after- the 21 days had passed.

It honestly seems like you're saying that we should not error on the side of safety in this matter, that we should let people who can be infected even if they are not showing symptoms, to roam around free and only quarantine them if they show symptoms, but I again point out that people are masters at self deception or would just flat out lie like the doctor did when he knew he was spreading it..  It seems like you would rather put everyone else at risk than take just one additional step to make 100% sure they are clear and free of the disease.


Oniya

There seems to be a lot of 'false dilemma' arguing going on here:

Quote from: Vekseid on November 18, 2008, 11:56:35 AM
False Dilemma 'Black & White Thinking' - wherein two options are presented and one is discredited when three or more options are in fact available. "We can't drink the sour milk, so we'll have to have orange juice today." When there is a perfectly good water faucet nearby, for example. The third option needs to be present in order for this to be a fallacy - you can either have read this paragraph or you haven't, but see also the excluded middle.

As far as I could see, Cycle was not advocating the elimination of quarantine.  Rather, simply providing the simple and humane additions of heat and hygiene - additions that would have been easily procured with minimal cost or delay.  (Possibly even no delay.)  Prudent measures - not panic measures should be the order of business.

On the mutation front:  This might be worthwhile reading.  To summarize it, mutations are random, and just as likely to be disadvantageous to the virus as they are advantageous.  Changing means of transmission involves a multitude of alterations to the viral RNA, not just a single faulty copy.  Also, the last time an Ebolavirus went airborne (at a research lab in Reston, Virginia, I might add), it was accompanied by a profound loss of lethality to humans.
"Language was invented for one reason, boys - to woo women.~*~*~Don't think it's all been done before
And in that endeavor, laziness will not do." ~*~*~*~*~*~*~*~*~*~*~Don't think we're never gonna win this war
Robin Williams-Dead Poets Society ~*~*~*~*~*~*~*~*~*~*~*~*~*~Don't think your world's gonna fall apart
I do have a cause, though.  It's obscenity.  I'm for it.  - Tom Lehrer~*~All you need is your beautiful heart
O/O's Updated 5/11/21 - A/A's - Current Status! - Writing a novel - all draws for Fool of Fire up!
Requests updated March 17

Cassandra LeMay

Quote from: Beguile's Mistress on October 29, 2014, 11:07:55 AM
Yes.  Any of them that apply.  Unless you are constantly testing your blood you don't know for sure you aren't contagious.  Hence the need for quarantine.  When people start thinking they know better everyone else the become a danger to us all.  This is the reason the places the good doctor visited are being bio-scrubbed.  How do we know he wasn't contagious?
Unless you have some close, personal knowledge of Craig Spencer all I can see here are assumptions about his character based on a few sketchy news pieces. That is not a solid basis for a debate. Making assumptions about someone's character without knowing the person in question is nothing I can possibly argue against, however much scientific facts I throw into the ring. Neither does the fact that the places he went to are being "bio-scrubbed" (whatever that means) argue against my point that the authorities are overreacting. I see nothing here that proves that this "bio-scrubbing" isn't anything more than panic and political actionism.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Zakharra

Quote from: Oniya on October 29, 2014, 11:39:00 AM
There seems to be a lot of 'false dilemma' arguing going on here:

As far as I could see, Cycle was not advocating the elimination of quarantine.  Rather, simply providing the simple and humane additions of heat and hygiene - additions that would have been easily procured with minimal cost or delay.  (Possibly even no delay.)  Prudent measures - not panic measures should be the order of business.

  I got no problem with making sure they are comfortable while in quarantine, but I do think it would be prudent to make sure they are 100% past the incubation period.

Cassandra LeMay

#86
Quote from: Zakharra on October 29, 2014, 11:35:10 AM... but I again point out that people are masters at self deception or would just flat out lie like the doctor did when he knew he was spreading it.
I would have been willing to argue all the points you made and explain my point of view on this matter until this point.

What you are saying here boils down to accusing Craig Spencer of knowingly spreading Ebola to the population of New York and I can see absolutely not one single basis in fact for a claim like that.

From all I know making such a claim is nothing more than .... Bravo Sierra. In fact, accusing Craig Spencer of knowingly spreading Ebola could be grounds for an accusation of defamation.

I am sorry if I am sounding a bit tired and aggressive here, but I am both.

I will repeat myself one more time: Self-monitoring and reporting yourself to health providers within a few hours of the onset of possible symptoms is a reasonable and effective measure to stem the spread of Ebola. If the health authorities are worried they can very well send people home and put them under "house arrest" with monitoring once or twice a day. When in doubt put a monitoring device on them to track their movements. Isolation and quarantine for someone who does not show any symptoms of Ebola are not necessary.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Zakharra

Quote from: Cassandra LeMay on October 29, 2014, 12:15:09 PM
I would have been willing to argue all the points you made and explain my point of view on this matter until this point.

What you are saying here boils down to accusing Craig Spencer of knowingly spreading Ebola to the population of New York and I can see absolutely not one single basis in fact for a claim like that.

From all I know making such a claim is nothing more than .... Bravo Sierra. In fact, accusing Craig Spencer of knowingly spreading Ebola could be grounds for an accusation of defamation.

I am sorry if I am sounding a bit tired and aggressive here, but I am both.

I will repeat myself one more time: Self-monitoring and reporting yourself to health providers within a few hours of the onset of possible symptoms is a reasonable and effective measure to stem the spread of Ebola. If the health authorities are worried they can very well send people home and put them under "house arrest" with monitoring once or twice a day. When in doubt put a monitoring device on them to track their movements. Isolation and quarantine for someone who does not show any symptoms of Ebola are not necessary.


  I don;t believe that's an acceptable option and should be ignored in this regard. We have one doctor who is infected who flat out lied about it and only contacted, or was contacted by authorities -after- he was showing symptoms, and he had been out in public while showing symptoms. And as far as I know, he admits it. I am listening on the radio to audio of the nurse who was quarantined and she is flat out -refusing- to self quarantine herself because she doesn't want to be inconvenienced, not because she think s she is safe, but mostly because she thinks she is being inconvenienced. She has 6 days or so left on her 21 day period since last contact (as I understand it).

I fail to see why you don;t think it would be a prudent safety issue to just do the quarantine. 21 days isn't that long, especially compared to the time they have likely already been over there. That 21 days can provide proof they -aren't- infected and contagious. It's a simple step and hardly invasive or bothersome since they can leave after the 21 days is over. Hell. We and other nations keep animals in a 6 month quarantine (I believe) just to check for such things, 21 days? That's nothing. I'd think they would agree just to be on the safe side and for peace of mind for everyone.

Cycle

Quote from: Retribution on October 29, 2014, 09:10:52 AM
No argument on that Oniya, it is just that is not what I am hearing in this whole angle of argument. What I am hearing is we need to construct extensive facilities........yada, yada.

Really?  Huh.  I'm pretty sure I was pointing out that the poor woman didn't have heat, a shower, and a real toilet and suggesting that the government should think about putting such things into the tent before they toss people in them for three weeks... 

And I don't know why you think my posts are leftist-leaning.  Maybe you didn't notice but I'm critical of both New Jersey and Connecticut's quarantine plans?  (Malloy up in Connecticut is a Democrat and his plan is to lock Boyko up but let him have free use of the apartment washing machine.  Nice logic there!)




As for the more general discussion of whether we should quarantine all the travelers from that region for three weeks, I have to go with what medical science tells us:  transmission requires contact with the bodily fluids of a symptomatic individual.  Duncan's fiancee doesn't have Ebola.  Or those people on the plane or the cruise ship.  And I can't believe that none of those people had any casual contacts with the infected/possibly infected individuals.

So maybe medical science knows something about Ebola and we should consider what they have to say?


Cassandra LeMay

#89
Quote from: Zakharra on October 29, 2014, 12:58:19 PM
  I don;t believe that's an acceptable option and should be ignored in this regard.
That is for you to decide.

Me, I would rather base my opinion on facts, not believes.

If Craig Spencer knew he could spread Ebola and lied about it I am with you in villifying him, but the news I have seen on that are not very clear. I would prefer to keep an open mind and give people the benefit of the doubt until proven otherwise, instead of making rock-solid statements just yet. If you have any good, reliable sources, please state them. A single radio station is not a solid source in my book, given all the fear-mongering surrounding Ebola right now.  If you have any definite information on this, please cite your sources and link to them.

If the best counter argument to the facts I provide is "I do not believe you, therefore I will ignore your facts" I am out of this topic. All I can see here now is half-baked information about a single individual useed to support meassures that affect a whole lot of people and stir up panic where no panic is warranted, given the whole science behind this disease.
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)


Cassandra LeMay

Quote from: Retribution on October 29, 2014, 01:42:14 PM
http://nypost.com/2014/10/29/ebola-doctor-lied-about-his-nyc-travels-police/

http://www.foxnews.com/health/2014/10/29/new-york-city-doctor-with-ebola-reportedly-lied-about-his-movements-in-city/

http://twitchy.com/2014/10/29/report-hero-ebola-doctor-lied-to-the-nypd-said-hed-self-quarantined/

http://www.libertynews.com/2014/10/bombshell-nycs-1st-ebola-patient-dr-craig-spencer-initially-lied-about-his-movements-around-the-city/

http://www.cnbc.com/id/102132467
The number of sources quoted alone means very little when all of them reference the same NYPost article as their source. And that article is darn scant on details. A strong number of links does not make for a strong arguments if all the links point to one single source that comes with very little detail and pretty much no facts at all. No matter how many links there are, that number alone does not make a source reliable if all the links point to the same - unproven - source.

Even Fox News (in a video coming with the article you linked) admits that Dr. Spencer took his temperature every few hours. Where they go completely wrong is adding to that "yet despite the risk".

There was no risk.

If he took his temperature every few hours and acted on those readings - as he did, from all we know - There Was No Risk!
ONs, OFFs, and writing samples | Oath of the Drake

You can not value dreams according to the odds of their becoming true.
(Sonia Sotomayor)

Retribution

This is where I say once again that dog won't hunt and have a nice day.

Zakharra

Quote from: Cassandra LeMay on October 29, 2014, 01:35:20 PM
That is for you to decide.

Me, I would rather base my opinion on facts, not believes.

If Craig Spencer knew he could spread Ebola and lied about it I am with you in villifying him, but the news I have seen on that are not very clear. I would prefer to keep an open mind and give people the benefit of the doubt until proven otherwise, instead of making rock-solid statements just yet. If you have any good, reliable sources, please state them. A single radio station is not a solid source in my book, given all the fear-mongering surrounding Ebola right now.  If you have any definite information on this, please cite your sources and link to them.

If the best counter argument to the facts I provide is "I do not believe you, therefore I will ignore your facts" I am out of this topic. All I can see here now is half-baked information about a single individual useed to support meassures that affect a whole lot of people and stir up panic where no panic is warranted, given the whole science behind this disease.

  From what you're saying, they should be able to walk off the plane and test themselves. No hospital or other people, but just them doing their own checks and that is good enough for you. From what I understand, by the time you start showing symptoms, you're already contagious. It sounds kind of a little late at that time to start worrying about not infecting people by then.

I can't accept that as viable. There is a good chance they could be infected. The doctor was infected, and contagious. I fail to see why it's not reasonable to have them wait 3 bloody weeks to make 100% sure they are clean of the disease.  That eliminates any doubt of the matter. It's also prudent and eases the fears or possible fears of the public and officials.


However I think we're going to have to agree to disagree on this. I'm for mandatory quarantining for 21 days from possible last contact of people from those areas of Africa to remove any doubt in the matter. You are not, so agree to disagree.

Caehlim

Quote from: Cassandra LeMay on October 29, 2014, 08:50:19 AMAnother reason why I am somewhat sceptical about tests like this (even if they work as advertised) is what I would like to call the "blinded by science" factor. What if this gizmo works? Would donors in the West invest millions and more millions to provide these diagnostic kits to every country in Africa? If they did, how long would it take for ... "diagnosis fatigue" (for lack of a better words on my part) to set in? The early stages of Ebola share a lot of symptoms with many more common diseases (e.g. malaria). How long would it take for people to just ignore these tests because they would too often come up negative? And could a test kit like this not become a cop out for Western nations who will spend their aid money on what they see as a "magic bullet" in the fight against Ebola, instead of spending their money on what is really needed - and will do a lot more than just help against Ebola - i.e. a good health infrastructure and health education in African countries? A test in a lab may take longer - and cost more - but a well-equipped lab can do a lot more than just help diagnose Ebola. In so far I see a good solid lab as the better alternative to what strikes me as a "one trick wonder pony".

I have to admit that I'm not particularly familiar with the various countries in Africa, so there's a lot of supposition in my post here. However even within my own country, most pathology labs are within the main cities with outlying areas being forced to transport samples to and from outlying regional and rural districts. I expect the utility of these devices to be in remote communities, where due to a lack of infrastructure it may take a day or two to actually get these samples to where they need to be. However a positive identification of Ebola on site by a simple portable device such as this, could allow for the local government to justify the use of resources and begin investigation and quarantine precautions earlier.

I think that the concerns you identify are definitely important ones, but I think there's also a risk of applying centralized western models to other countries which may lack the infrastructure to use them in the same fashion we do. Also Africa (if I can generalize to an entire continent like this) tends to have a more rural population with less urban concentration, relying more heavily on labour intensive agriculture. From what I've seen in terms of the aid in Ethiopia, providing equipment with portability and field use can be vital for jumping the gap between the well established technological areas and the more remote, agricultural ones that are separated from infrastructure.
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Drake Valentine

Wow, I go away and come back to see all this talk about isolation tents.

No offense, but ya'll make it sound like secluding people in 'concentration camps.'  Which I already lost respect in Fox News when they made a similar suggestion.

As for mutation, it is doubtful Ebola will go airborne. There have been no contact viruses documented as of yet of going airborne and vice-versa.

http://www.theguardian.com/world/2014/oct/03/ebola-answering-10-basic-questions

It has also almost been a month and not many other new cases have been rising of victims, only those assumed to be infected. Ebola can only spread after the incubation period and most mutations that may happen will often weaken a virus of its initial ability when it may adapt new ones.

And I still say the common yearly flu kills more people a year worldly.

Yea, Ebola did a nice wiping overseas, but you also have to think that the people over there do not have the same amount of medical facilities or proper nutrition as those over here in the States. Therefore it makes treating and maintaining that disease that much harder.

http://www.cnn.com/2014/10/29/health/ebola-us-recovery/index.html




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Cassandra LeMay

Quote from: Drake Valentine on October 29, 2014, 08:17:23 PM
Yea, Ebola did a nice wiping overseas, but you also have to think that the people over there do not have the same amount of medical facilities or proper nutrition as those over here in the States. Therefore it makes treating and maintaining that disease that much harder.
And lets not forget that West Africa was unprepared for an Ebola outbreak because all other major outbreaks of the past happened in Central Africa. The current outbreak is as far from previously known cases as... I would guess about as far as Miami is from Maine, in a part of the world where most people do not travel beyond the very local area. While there is one strain of Ebola native to West Africa, the Ivory Coast (or Tai Forest) strain, that made its last appearance in 1994 among the local chimpanzees, with a grand total of exactly one human infection (someone who performed an autopsy on the dead animals and who made a full recovery).
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TaintedAndDelish

I don't know for a fact, but I imagine that if Ebola hit London instead of the US, there would be a proportional about of alarm in London. The same would go for any other country with access to up to date news and electronic communication. Yes, news about Ebola hitting America is far more concerning to Americans than news about Ebola hitting some under developed country in Africa (where we don't exactly of swarms of news reporters who can just drive over and interview someone ). To suggest that this makes us self absorbed is pushing it a little. At least, that's the impression that I got from the article. We care about this because it is on OUR doorstep and it has the potential to sour OUR lives. Who else wouldn't feel the same way if it was on their own doorstep?

There was some suggestion too that Duncan got less attention because he was black, and that the news media ( the same folks covering the Ferguson riots) are not really interested in black people.  I disagree with this. Up until Duncan died, the CDC was making it sound like everything was under control, and that Ebola in the US was no big deal. It was somewhere around that time that he died and two nurses who claimed to be following protocol got sick, that eyebrows were raised. From my perspective, it seemed likely that the CDC was downplaying the story in order to placate us. This contraction put their credibility in question.

There have been numerous comments both here and in the news media about the mayor's decisions to mandate a quarantine not being based on science. While the decision to quarantine is very aggressive, it makes logical sense. If you separate the people who might have the disease form the rest of the population for that 21 day period, then you greatly reduce the chances of them contaminating someone *should they have the virus*.

Is this "not based on science" because politicians made this decision and not doctors? Do only the decisions and ideas of doctors count as being "based on science? "  The decision on whether or not to quarantine has more to do with risk management than anything else. Those politicians who made this call were not comfortable with the same level of risk that the CDC was comfortable with and took a step to curb that risk to a more desirable level. It could very well be that the folks are the CDC have much bigger balls when it comes to dealing with diseases. That does not mean that the rest of the world must accept the same level of risk.

As for my earlier comment about the doctor in NY who felt "tired", but decided to go out bowling and whatnot only to be feverish the next day, here's my source. I agree that I should have said "tired" instead of "crappy", but given the context, I think he should have known better and should have erred on the side of caution. There is no shame in adding a margin of error.

http://www.nytimes.com/2014/10/24/nyregion/craig-spencer-is-tested-for-ebola-virus-at-bellevue-hospital-in-new-york-city.html?_r=0

From the article: ( bold emphasis my own )

QuoteDr. Spencer began to feel sluggish on Tuesday but did not develop a fever until Thursday morning, he told the authorities. At 11 a.m., he found that he had a 100.3-degree temperature and alerted the staff of Doctors Without Borders, according to the official.

QuoteDr. Spencer, 33, had traveled on the A and L subway lines Wednesday night, visited a bowling alley in Williamsburg, and then took a taxi back to Manhattan.

I agree, Dr. Spencer could not spread the disease if he was not symptomatic, but by having the virus in his body and being out in public, he introduce risk.

* What if something happened to him while out in public that delayed him from getting home for a few days?
* Or if he got mugged and stabbed
* Or what if he was a less than responsible person and got so drunk that he blacked out, woke up the next morning and started puking and having the shits?

While he may be a responsible, upstanding citizen, the decision on how to manage this risk needs to take into account the fact that not everyone will be responsible and act wisely.

MHaji

QuoteI can't accept that as viable. There is a good chance they could be infected. The doctor was infected, and contagious. I fail to see why it's not reasonable to have them wait 3 bloody weeks to make 100% sure they are clean of the disease.  That eliminates any doubt of the matter. It's also prudent and eases the fears or possible fears of the public and officials.

This does a lot of harm in the name of "easing fear." It creates a disincentive for any doctor or nurse who has the training to go to Sierra Leone and fight the disease, or even briefly consult for hospitals there. There's a huge need for doctors and nurses in affected countries, and effectively telling doctors that "When you get home, we'll lock you up for a few weeks even if you're 100% asymptomatic just in case, on the basis of political posturing rather than scientific advice" is a good way to get people not to go.

The tremendous media fearmongering around Ebola is absolutely unconscionable.
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Cassandra LeMay

Quote from: TaintedAndDelish on October 31, 2014, 04:49:27 AM
Is this "not based on science" because politicians made this decision and not doctors? Do only the decisions and ideas of doctors count as being "based on science? "  The decision on whether or not to quarantine has more to do with risk management than anything else. Those politicians who made this call were not comfortable with the same level of risk that the CDC was comfortable with and took a step to curb that risk to a more desirable level. It could very well be that the folks are the CDC have much bigger balls when it comes to dealing with diseases. That does not mean that the rest of the world must accept the same level of risk.
I can not look into the heads of governors Christie and Cuomo, but I suspect they made their decision at least in part for political positioning and to alley public fears. If not, why would they ignore the advice of the CDC, who have all the known facts about Ebola on their hands? But by advocating a quarantine they are actually helping to create fear, because people can easily start to think that the CDC is lying to them. After all, that train of thought might run, if the CDC were telling the truth and no quarantine was necessary politicians wouldn't advocate a quarantine. But as the politicians want a quarantine we can not trust the CDC.

But mistrust in the health authorities will help create fear, because it makes people doubt the facts of the matter. Something that is known "mutates" into something unknown in the imagination and fears of people. And the less people trust solid, scientific facts, the easier misinformation spreads. As fear and misinformation spread, how many African children will be banned from their schools for no good reason at all? How long before people start giving everyone arriving from Africa a wide berth, no matter where on the continent they come from? How long before the first doctors and nurses arriving back home after risking life and limb to care for the sick and dying receive death threats from some idiot who believes they are part of a secret plot to wipe out America via biological warfare? All this and more could well be consequences of fear and misinformation. Is that really a desirable outcome for something that may be completely unnecessary?

The best way to fight an epidemic of fear and misinformation is to keep calm and stick with the facts. Calling for a quarantine after just one single case has come to light is not keeping calm.
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Cycle

#101
Quote from: TaintedAndDelish on October 31, 2014, 04:49:27 AMIs this "not based on science" because politicians made this decision and not doctors?

No, the fact a politician makes a decision does not mean it is not based on science--a decision made not based on science is a decision made not based on science.  The fact that a politician made it simply means the bad decision can hurt far more people than if it was just an ordinary citizen making the bad decision.

Now, let's look at the science.

Quote from: TaintedAndDelish on October 31, 2014, 04:49:27 AM
There have been numerous comments both here and in the news media about the mayor's decisions to mandate a quarantine not being based on science. While the decision to quarantine is very aggressive, it makes logical sense.

See, this is where the logic falls apart.  First, let's consider why one thinks quarantine is a valid response to control certain infections:  because medical science tells us this is the case right?  Quarantine were not invented by, say, a professional baseball player.  It was invented by medial science.  So, when someone advocates for a quarantine, they are following the advice of medical science.

So far so good.

Now, we also know you do not quarantine everyone for anything.  We know this is true because we don't quarantine people who have diabetes, for example.  Or gonorrhea.  Why?  Because medical science tells us that quarantines are not the right tool to address the transmission of such diseases.  So, when we decide not to advocate for the blanket quarantine of everyone with a stomach flu, we are following the advice of medical science once again.

Now let's turn to Ebola.  What does medical science say we should do about quarantining everyone who flies in from West Africa?  Hmm?  It says we don't need to do that.  It says we shouldn't do that.

And yet, we have people who because they are caught in the grip of fear--or are maneuvering for political advantage--advocating for the blanket quarantine of everyone who comes from West Africa.

Thus, we see that this particular application of the quarantine is no longer following the advice of medical science.  And this is why people like me say the reactions of certain politicians are not based on science.  Because it isn't.


TaintedAndDelish

#102
Quote from: Cassandra LeMay on October 31, 2014, 11:40:23 AM
I can not look into the heads of governors Christie and Cuomo, but I suspect they made their decision at least in part for political positioning and to alley public fears. If not, why would they ignore the advice of the CDC, who have all the known facts about Ebola on their hands?

I agree, there may be political positioning involved here. CNN reported that a poll that they did suggested that something like 80% of the people polled were in favor of quarantine. I don't have a link, but if assuming their poll is accurate, this would support the argument that the decision was politically motivated - at least in part.

QuoteBut by advocating a quarantine they are actually helping to create fear, because people can easily start to think that the CDC is lying to them. After all, that train of thought might run, if the CDC were telling the truth and no quarantine was necessary politicians wouldn't advocate a quarantine. But as the politicians want a quarantine we can not trust the CDC.

OK, I see truth to both sides on this. Yes, the mandated quarantine undermined the CDC's authority, but at this point, I don't think the CDC's assurances that Ebola was not a significant threat were having the fear quelling effect that they had prior to the Dallas incident.


QuoteBut mistrust in the health authorities will help create fear, because it makes people doubt the facts of the matter. Something that is known "mutates" into something unknown in the imagination and fears of people. And the less people trust solid, scientific facts, the easier misinformation spreads.

I don't think people are doubting scientific facts here. What is in being doubted is thoroughness of the CDC's recommendations. From the news about the allegedly insufficient protective garments that the folks in Dallas were recommended to use, it seems pretty clear that there is something lacking in their equation. Perhaps they are assuming the workers will follow their procedures flawlessly?


Quote
The best way to fight an epidemic of fear and misinformation is to keep calm and stick with the facts. Calling for a quarantine after just one single case has come to light is not keeping calm.

One single case?
I admit, my recollection of the exact time line is blurry, but I don't think is was in reaction to one single case.

Quote from: cycle
First, let's consider why one thinks quarantine is a valid response to control certain infections:  because medical science tells us this is the case right?  Quarantine were not invented by, say, a professional baseball player.  It was invented by medial science.  So, when someone advocates for a quarantine, they are following the advice of medical science.

No, it's an effective plan because it makes logical sense. You cut off the bad part before it infects the rest. It doesn't matter if this idea came from a doctor or some peasant who was trying to minimize the rot on his food.

Quote
Now, we also know you do not quarantine everyone for anything.  We know this is true because we don't quarantine people who have diabetes, for example.  Or gonorrhea.  Why?  Because medical science tells us that quarantines are not the right tool to address the transmission of such diseases.  So, when we decide not to advocate for the blanket quarantine of everyone with a stomach flu, we are following the advice of medical science once again.

Were talking about quarantining those few who are at risk of being infected with a contagious and deadly disease in order to minimize the risk. The fact that a person has been working directly with sick Ebola patients in an highly infected part of the world, puts them at some level of risk. The method for assessing that risk has been based on science. We learned from the CDC about the 21 day window and about what symptoms to look for.  What is in debate is what threshhold of risk is acceptable.

Quote
Now let's turn to Ebola.  What does medical science say we should do about quarantining everyone who flies in from West Africa?  Hmm?  It says we don't need to do that.  It says we shouldn't do that.

Quarantining people who have been caring for sick patients and quarantining everyone who flies in are two different things. I think you need a separate policy for each group since the factors that introduce risk are different. Fortunately for us, the folks in West Africa have reason to prevent sick people from leaving the country.


Caehlim

Quote from: TaintedAndDelish on October 31, 2014, 02:18:44 PMOK, I see truth to both sides on this. Yes, the mandated quarantine undermined the CDC's authority, but at this point, I don't think the CDC's assurances that Ebola was not a significant threat were having the fear quelling effect that they had prior to the Dallas incident.

More people have married Kim Kardashian in America than have died of Ebola. It's not a significant threat (the Ebola, I won't comment on the risks of marrying Kim Kardashian).

QuoteOne single case?
I admit, my recollection of the exact time line is blurry, but I don't think is was in reaction to one single case.

This was in reaction to a single case. The Connecticut quarantine laws were signed on the 7th October. At this stage only Thomas Eric Duncan had been infected. Nina Pham was diagnosed on the 10th October, Amber Vinson on the 14th.

QuoteQuarantining people who have been caring for sick patients and quarantining everyone who flies in are two different things. I think you need a separate policy for each group since the factors that introduce risk are different. Fortunately for us, the folks in West Africa have reason to prevent sick people from leaving the country.

The only person so far who has infected others, Thomas Eric Duncan, was not identified originally because they either lied about coming into contact with a sick patient or were unaware of it (depending upon whose story you believe).
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Cycle

Quote from: TaintedAndDelish on October 31, 2014, 02:18:44 PM
No, it's an effective plan because it makes logical sense.

Wait, I thought we were discussing whether a decision was made based on science.  So we're done with that discussion?  It is agreed that this "just quarantine them all" plan--the effectiveness which I will address shortly--is not based on science?  Good.

QuoteYou cut off the bad part before it infects the rest. It doesn't matter if this idea came from a doctor or some peasant who was trying to minimize the rot on his food.

There is a skipped step here.  Science tells us the "infects the rest" part requires contact with the bodily fluids of a symptomatic individual.  So if we want to do something to limit infection, let's also consider how infection takes place.

Take HIV.  It is very dangerous and can easily be lethal.  But do we quarantine everyone that has it?  No.  Because we know how it is transmitted, and we take steps to stop the transmission, based on the method of transmission:  e.g., do not have contact with bodily fluids of individuals with HIV. 

This is the step that those politicians are skipping:  consideration for how Ebola is transmitted. 

And this matters.  Look at Duncan's fiancee and all those passengers on the plane and cruise ship.  They didn't get infected?  Blind luck?  Or maybe they didn't come in contact with the bodily fluids of a symptomatic individual?


Zakharra

Quote from: Cycle on October 31, 2014, 03:56:32 PM

There is a skipped step here.  Science tells us the "infects the rest" part requires contact with the bodily fluids of a symptomatic individual.  So if we want to do something to limit infection, let's also consider how infection takes place.

Take HIV.  It is very dangerous and can easily be lethal.  But do we quarantine everyone that has it?  No.  Because we know how it is transmitted, and we take steps to stop the transmission, based on the method of transmission:  e.g., do not have contact with bodily fluids of individuals with HIV. 

This is the step that those politicians are skipping:  consideration for how Ebola is transmitted. 

And this matters.  Look at Duncan's fiancee and all those passengers on the plane and cruise ship.  They didn't get infected?  Blind luck?  Or maybe they didn't come in contact with the bodily fluids of a symptomatic individual?

Do you think those people would have wanted to be around a possible carrier of Ebola if they had known who he was? I can bet the answer would be a very resounding 'No!' from almost all of them.

Caehlim

Quote from: Zakharra on October 31, 2014, 05:55:53 PMDo you think those people would have wanted to be around a possible carrier of Ebola if they had known who he was? I can bet the answer would be a very resounding 'No!' from almost all of them.

I don't see what that has to do with anything, people are terrible at assessing risks.
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Of course, what we are seeing here are the opinions we hold about quarantine and adequate precautions regarding a deadly disease.  We've also seen to medical professionals, one fighting the disease and one fighting the government, who basically thumbed their noses at us.  After spending the day at my doctor's office and the hospital lab for some tests I got an earful from the people in the business who have a really low opinion of both the doctor and the nurse, the way the government is handling things and people who are brushing off the danger of an Ebola infection as something not worth mentioning.

Cycle

Quote from: Zakharra on October 31, 2014, 05:55:53 PM
Do you think those people would have wanted to be around a possible carrier of Ebola if they had known who he was? I can bet the answer would be a very resounding 'No!' from almost all of them.

See, this is actually one of the reasons I am so critical of the politicians' behavior.

They feed the fear. 

A responsible leader should try to protect the welfare of the community, not use fear to advance their own personal status.  Quarantining someone simply because they worked in a region with Ebola is irrational.  But politicians do it because it sounds good.  And I am sad to see that it working for them.

If we apply reason to the situation, as well as medical science, we will see that what the governors are doing is irrational.  I've already tried the HIV example.  I've repeatedly pointed out how science says Ebola is transmitted--and pointed to situations that confirm medical science's analysis to be correct:  i.e., contact with bodily fluids is required, and casual contact by hundred of people on an airplane did not infect anyone with Ebola.  Now I will try this:  look up how the number of the Emory or Nebraska Medical Center treating doctors and nurses who have been quarantined.  Then look up the people who handle their medical waste disposal to see how many of them are sitting in a tent for 21 days.  Then look the number of techs who did blood tests for Ebola to see if any of them are under armed guard to stay in their apartment for three weeks.

Big fat goose egg, right?

See the problem?

We don't quarantine people who are in the U.S. treating individuals we know are infected with Ebola, but we do quarantine people who might have possibly shared common space with someone outside the U.S. who may have had Ebola, but we don't know for sure?

This is rational?  This is logical?  This is "good science"?  No.  No.  No.

But saying that you're instituting a quarantine plan to fight Ebola from entering the country sure gets people riled up and thinking you're a aggressive leader.

I hate to see folks fall for this kind of manipulation.  But there it is.  Sigh.


TaintedAndDelish

#109
Quote from: Cycle on October 31, 2014, 03:56:32 PM
Wait, I thought we were discussing whether a decision was made based on science.  So we're done with that discussion?  It is agreed that this "just quarantine them all" plan--the effectiveness which I will address shortly--is not based on science?  Good.

No, I was disagreeing with a portion of this statement which I had quoted. Quarantine makes sense not because of who invented it or who suggested it, but because it makes logical sense. From what I recall, the CDC's objection to closing the border or quarantining everyone who flew in from west Africa was that people would then circumvent this control measure which in turn would make it harder to track those who might be sick. Likewise, those who developed symptoms afterwards might be hesitant to get help and consequently admit that they circumvented the system.

As stated earlier, I don't think that medical professionals and the general public should be treated the same exact way. Those who are known to have had exposure with sick patients whether they are doctors or regular citizens are going to have a higher chance of having the disease than those who have had no contact at all. Likewise, those who had contact with sick individuals and were wearing protection and were medically trained will have a different probability of being infected than those who were in contact with sick people and had no protection and were not medically trained.

With regard to the requirements to transmit the disease, I agree that while a person is not symptomatic, they cannot transmit it. There is still the risk though, they they will become symptomatic while in public and then transmit the disease at that point. While this sort of worsening may not be possible during the course of one day, an uncontrollable circumstance could leave a potentially sick person out in public for more than one or two days. ( Based on the NY doctor's case, it looks as if this could happen within a few days, but I really don't know. )

QuoteTake HIV.  It is very dangerous and can easily be lethal.  But do we quarantine everyone that has it?  No.  Because we know how it is transmitted, and we take steps to stop the transmission, based on the method of transmission:  e.g., do not have contact with bodily fluids of individuals with HIV. 

There's a difference though in how Ebola and HIV are transmitted. HIV is not transmitted though urine, sweat, vomit, feces and tears It is primarily transmitted through blood, semen and vaginal fluids. It exists in saliva, but in a very weak concentration. ( I think you would need to drink something like a quart of saliva to be at risk of getting it. )  As I understand, medical professionals who work with HIV patients will wear plain latex gloves and maybe a cover over their mouth and nose. They do not need to don biohazard suits and get hosed down before taking them off. HIV can also go undetected for long periods of time and thus can be spread by seemingly well people. Unless I am mistaken, someone with Ebola will be done in a matter of days without treatment once the virus ramps up in their system.

While HIV has a higher basic reproduction number than Ebola (2-5 vs 1-2 ), I don't think you are as likely to get HIV from normal non-sexual contact with a patient as with someone who has Ebola -  given the types of fluids through which it spreads.

Some links that I thought were rather interesting:

http://www.businessinsider.com/what-makes-ebola-virus-so-deadly-2014-10
http://en.wikipedia.org/wiki/Basic_reproduction_number
http://www.everydayhealth.com/hiv-aids/protect-yourself-as-hiv-caregiver.aspx
http://www.webmd.com/news/20140806/ebola-virus-how-contagious?page=2

edit: spelling correction

Cassandra LeMay

#110
Quote from: TaintedAndDelish on October 31, 2014, 02:18:44 PM
One single case?
I admit, my recollection of the exact time line is blurry, but I don't think is was in reaction to one single case.
I was referring to the quarantines in N.Y. and N.J. as they have garnered the most media attention lately and are the ones I am most aware of. Those - as far as I can tell - were a direct reaction to the case of Dr. Craig Spencer. They weren't put in place because of cases in some other states. They were only put in place when that one single case happened on their doorstep. One more reason for me to believe it was mostly politically motivated. If governors Christy and Cuomo were so concerned about Ebola, why not call for a quarantine earlier, when the first case in the US came to light? It had to happen to them before they sprang into action.

Edit, to address another point you raised:
Quote from: TaintedAndDelish on October 31, 2014, 02:18:44 PM
OK, I see truth to both sides on this. Yes, the mandated quarantine undermined the CDC's authority, but at this point, I don't think the CDC's assurances that Ebola was not a significant threat were having the fear quelling effect that they had prior to the Dallas incident.
...

I don't think people are doubting scientific facts here. What is in being doubted is thoroughness of the CDC's recommendations. From the news about the allegedly insufficient protective garments that the folks in Dallas were recommended to use, it seems pretty clear that there is something lacking in their equation. Perhaps they are assuming the workers will follow their procedures flawlessly?
Handling the Dallas case could certainly have gone better, as far as communication by the CDC and local Health Services are concerned. For example, I bet hardly anyone is aware that the two nurses who became infected were caring for Mr. Duncan at the very last stages of his illness, when viral loads can be expected to be extremely high. No one who cared for him during the earlier stages caught Ebola from him. That is (in my opinion) a slightly different picture than what many people might believe happened, i.e. that everyone who cared for him was at risk at any moment. (Source: New England Journal of Medicine)

As for following procedures flawlessly, I can't imagine many people on the planet who would be more likely to follow protocol and procedures to the letter than the doctors and nurses who have treated the sick any dying in West Africa. They have seen first hand what can happen, what Ebola does. Perhaps the same can not be said for every single doctor or nurse in each and every hospital in the US, but the people who have been to West Africa should be trusted to have a very thorough knowledge of Ebola and what to do - or not do - if and when they detect the first signs that they may pose a risk to public health.
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Quote from: TaintedAndDelish on October 31, 2014, 11:29:31 PM
HIV is not transmitted though urine, sweat, vomit, feces and tears It is primarily transmitted through blood, semen and vaginal fluids. It exists in saliva, but in a very weak concentration. ( I think you would need to drink something like a quart of saliva to be at risk of getting it. )  As I understand, medical professionals who work with HIV patients will wear plain latex gloves and maybe a cover over their mouth and nose. They do not need to don biohazard suits and get hosed down before taking them off. HIV can also go undetected for long periods of time and thus can be spread by seemingly well people. Unless I am mistaken, someone with Ebola will be done in a matter of days without treatment once the virus ramps up in their system.

Bingo.  See, this is an analysis how we respond to a disease based on its characteristics--specifically, how it is transmitted. 

And such an analysis should dictate how we respond to Ebola.  Now, given that medical science tells us Ebola cannot be transmitted until:

  (a) someone is symptomatic;
  (b) they expel bodily fluids; and
  (c) someone touches said bodily fluids

Following the same approach used with HIV means we should be considering the quarantine of people based on their level of infection, not solely because of who they treated or where they were or because they happen to have a fever.

Again, I point to how we are treating the medical staff in Emory.  And the Nebraska Medical Center.  They touched symptomatic Ebola patients' bodily fluids.  They were not all quarantined for 21 days thereafter.  And no one complained one wit. 

I also again point to the hundreds of people on the plane and the cruise ship who have not come down with Ebola even though they sat near or dined with someone who had or could have had Ebola.

Quarantine shouldn't be tossed around haphazardly.  It should be used when it will do some good, not just because a handful of people are panicking--or worse, pandering.  And when government does quarantine someone, than please, be smart enough to think of details like:  they need food, water, heat, sanitation and waste removal for the entire period of the quarantine!


lilhobbit37

Another thing to keep in mind when discussing what should be done about doctors and nurses who worked overseas:

Doctors without borders is aware of how dangerous this disease to the doctors and nurses who are working with patients dying of ebola.

So they assign someone who is a "Watcher" who makes sure they follow procedure to the letter to significantly reduce mistakes that may happen while treating a patient.

Things like making sure they remove all their gear in the correct order, make sure they do nothing out of protocol, etc.

This did not happen in the US in Texas, and perhaps had there been someone there to make sure everything went 100% to code, no one would have been infected.

But this greatly reduces the risk that a doctor overseas will get infected, as they have extra safety measures in place to ensure the safety of the brave men and women who are volunteering to go and help.

And as it has been pointed out, it is easier to catch the flu and the common cold, and more people in the US have died each year of that. Yet we don't quarantine these diseases.