Ebola Arrives in Dallas. Policy and the Principle of the Objective; Update on Ebola in Dallas

View 844 Tuesday, September 30, 2014

Ebola has arrived

Ebola Diagnosed In U.S. For The First Time: CDC

http://www.huffingtonpost.com/2014/09/30/ebola-us-cdc_n_5909394.html

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

 

 

• Patient Quarantined In Dallas For Possible Ebola Infection
• Ebola Diagnosed In U.S. For The First Time: CDC

The Huffington Post  | By Alana Horowitz

A patient was diagnosed with Ebola in the United States for the first time, CNBC reported, citing the U.S. Centers for Disease Control and Prevention (CDC).

Until Tuesday, Ebola patients had only been treated in the U.S. after being diagnosed elsewhere.

The AP confirmed the news.
According to WFAA.com, the patient was being treated at a Dallas hospital.

Texas Health Presbyterian Hospital of Dallas announced on Monday that one its patients was being tested for Ebola. The patient was kept in isolation and CDC officials headed to Dallas to meet with doctors there.

Texas health officials told KDFW that the chances of an outbreak in the Dallas area are very low.

UPDATE [6:08 p.m. ET]:

The CDC gave more details about the case in a Tuesday press conference.

Dr. Thomas Frieden, Director of the CDC, reported that the infected patient was traveling from Liberia and left on September 19th, arrived in the U.S. on September 20th, but had no symptoms of the disease during that timeframe. On September 24th, the patient developed symptoms, and then sought care on September 26th. On September 28th, the patient was admitted to the hospital in Dallas. Frieden stated that he had "no doubt that we’ll stop this in its tracks in the U.S."

This is a developing story…

http://www.huffingtonpost.com/2014/09/30/ebola-us-cdc_n_5909394.html

Given our travel restriction policies, it was inevitable; and meanwhile the President says we are sending 3,000 troops into the plague area. Despite all precautions, there is a reasonable likelihood that one or another of them will bring home a case of Ebola (and others will bring home sexually transmitted diseases, unless the Army has changed a lot since I was a soldier). It is unclear what military troops will do in the plague area, but President Obama has high confidence that something good will come of sending them.

 

Update 1200 hours Wednesday, October 1, 2014 :  It is now reported that Patient Zero (who has not yet been identified publicly) is in critical condition.  His sister days he developed symptoms and went to the Emergency Room, where he told them that he was from Liberia.  The ER physicians did not recognize his condition as Ebola, and he was given antibiotics and sent home.  (Precisely what the antibiotics were to treat is not known; his symptoms were those of flu.) His symptoms got worse and he returned to the Emergency Room, where he was diagnosed as having Ebola and was quarantined.  There has been no published information on the identity or location of the sister (who is resident in America) but one presumes she is in quarantine.

In later developments, CDC officials said that Ebola could be contracted by contact, but later defined ‘contact’ as ‘close proximity’, which was later defined as being within one meter of a person with developed Ebola symptoms.  It is said that patient zero’s Ebola had not yet developed sufficiently to be contagious when he arrived at the Dallas airport. Investigators are trying to discover who may have been within close proximity after his symptoms became sufficiently developed.

It is reported that the ambulance crew that transported him to the hospital is now quarantined. Nothing has been said about the ER personnel who treated him.

 

 

The Principle of the Objective

It is a military maxim that you do not commit troops without some idea of the objective: an achievable goal. There may be exceptions, as with Winston Churchill’s speech to Parliament:

You ask, what is our policy? I will say: It is to wage war, by sea, land and air, with all our might and with all the strength that God can give us; to wage war against a monstrous tyranny, never surpassed in the dark and lamentable catalogue of human crime. That is our policy. You ask, what is our aim? I can answer in one word: victory; victory at all costs, victory in spite of all terror, victory, however long and hard the road may be; for without victory, there is no survival.

http://www.historyplace.com/speeches/churchill.htm

But that is hardly the situation of America in the Middle East.

Arming the Kurds

Jerry,

I was surprised by your suggestion of using US forces yet again in an effort to create an autonomous Kurdish region in Iraq and arming them in return for a portion of the oil revenue.

https://www.jerrypournelle.com/chaosmanor/

Are you really expecting Turkey to tolerate the existence of a Kurdish state on its border? There is considerable evidence that Turkey has with President Obama’s not so covert support been sponsoring ISIL as a proxy to not only overthrow Assad but subjugate the Kurds as well as the Shia of Iraq. You might recall that Turkey was so averse to the prospect of an independent Kurdish State or a Shia dominated Iraq that they steadfastly refused to allow a US Division to invade Iraq from the North through Turkey even when the international consensus was that Saddam did have WMD?

More importantly; why is it in the US interest to expend yet more blood and treasure to create such a Kurdish state? ISIL is allegedly pumping $6 million per day worth of oil or about $2 Billion per year. This is about as much oil as the US uses every day, perhaps every few days if you factor in the black market discount that ISIS is granting it’s illicit customers. If the US were still on a downward spiral of declining energy production, this might make sense. However; President G W Bush revived the US petroleum industry and President Obama’s determined efforts to FUBAR energy policy have been unsuccessful. With the US on track to become the world’s biggest oil producer and perhaps even a net exporter, the additional oil supply from an independent Kurdish state is simply is not worth the expenditure of the blood and treasure.

Of course the real issue is long term grand strategy. You have been one of the few visionary people who questioned the population bomb mantra and you are aware of the ongoing demographic implosion of Europe. I believe that you are also aware of the massive immigration of Muslims to Europe. Europe is still decades away from becoming majority Muslim, but the time when the majority of the youth in many European countries is Muslim is at hand. Europe has already ceased to be a reliable US ally and will become increasingly hostile n the future. Will it serve US interests to have to support such a client state in an overwhelmingly hostile region going into the future?

Given the demise of the Bush strategy, a retreat to neo-isolationism is the only sane policy. As Colonel Ralph Peters wrote, we must become willing to observe genocide with equanimity.

James Crawford=

The answer is complex, and you must not confuse military strategy with policy. I have always said that the best US policy toward the Middle East is to develop US resources, build energy independence – which we could have done for the money expended in the Gulf Wars – and minimize involvement in that area. Just as we should not become involved in the border disputes of Europe, we should not become entangled in the border disputes of the Middle East.

That has not been our policy. For good or ill, we have chosen to intervene in Middle Eastern affairs and involve ourselves in the religions disputes of Sunni, Shia, Druze, Alawite, and various other Muslim factions.

We have already chosen to intervene in the Syrian civil war. Our intervention in Libya does not seem to have been beneficial to the Libyan people – to all of them or indeed to any single group of them; one suspects that an honest plebiscite in Libya would return the verdict that they were better off with Khadafy – and our intervention in Syria may not have even that much success.

As to Turkey, while Turkey was an ally of Israel we had no real choices in the matter. But today’s Turkey is not the old government backed by the successors to Ataturk. Its military has been divided against itself and greatly weakened. Turkey has chosen a new course of action, and the notion that Turkey is an ally needs to be questioned.

If we are to examine US policy in the Middle East we have to look at realities, and one reality is that we are there; we have spilled much blood and destroyed much treasure, and only a small fraction of those were American blood and treasure.

Bombardment with inevitable civilian casualties has the inevitable effect of generating hatred for America among survivors, particularly if they do not see that we gained anything from doing it. Is it that we are simply addicted to breaking things and killing people?

We seem determined to bomb someone in the Middle East. We seem to believe we cannot simply walk away, seal our borders, and get on with building the City on the Hill as an example to all mankind. A North American self-sufficient state was the goal of the old Howard Scott Technocracy movement that grew out of the writings of Bellamy and Thorstein Veblen. It is very likely that it could be built. (Not necessarily a technocracy, although that is not so unlikely as it once seemed: ask the people of Detroit if they would prefer democracy or a government that delivered the mail, generated electricity, paved the roads, and organized a working Fire Department.)

If we are going to break things and kill people, we should be doing it to accomplish something. Establishing a Kurdish Iraq as part of a confederacy with the rest of Iraq is an achievable objective, and greatly preferable to a policy of cut and run after killing over a hundred thousand people.

Are there better strategies and policies? Given the present situation I don’t think of any.

Note, incidentally, that what I proposed is a great deal more than “arming the Kurds.” 

Bombing people in company with other Arab states is not an objective in and of itself.  Killing selected people with drones is not an objective.  Cut and run is not in my judgment a desirable objective at this stage or our involvement.  I would be very pleased to debate competing objectives.

Objectives 

Jerry,

I’ve really been enjoying your discussions on our current mishandling of things in the Middle East. Your objections to getting into that mess are well noted and long standing. They go all the way back to G.W. Bush and questioned what could we hope to achieve in going to war in Iraq.

Afghanistan was understandable since they were shielding our enemies but once that was no longer true, you rightly concluded it was time to come home with the admonishment that we could easily come back.

Of course, history chose a different path. We broke Afghanistan slightly and then hung around to ensure it was completely broken. We’ve lost lives there that should not have been lost; ours and theirs. Iraq was a complete fiasco. We broke it; broke it terribly, then sent in the horrid Bremer to ensure it would stay broken for decades. In both countries we did just about everything we could to ensure the local population not only hated us, they would continue to hate us for generations to come. Then President Obama pleads surprise that Iraq hated us enough to band together to destroy anything and everything we had tried to accomplish. The same will happen in Afghanistan once we leave and Barack will plead ignorance of why and how we underestimated the opposition yet again.

Through all of this you have been correct simply because you recognized one simple thing – we have no goal. Peace, democracy, even oil are nice concepts but they are not goals. Goals are measurable.

Topple the Taliban rule in Afghanistan, kill Osama bin Laden, capture or kill Saddam Hussein – these are measurable and once done can be demonstrated so that we know we are done and can bring our troops home.

In short, our goal should always be to accomplish something measurable and then come home. Part of any objective must be to identify when we are done.

To that end, I would contend that James Crawford is missing the point or perhaps has moved past it to the point where he is just ready to cut and leave as we did in Vietnam. You’ve also commented multiple times on how we had met the objectives in Vietnam, then gave it away. Mr.

Crawford, it appears, would want to do the same in the Middle East.

Isolationism is no longer an option. When 5 guys in shirt sleeves with box cutters can capture a plane and fly it into a building you can truly no longer be isolationist.

The overall objective, of course, is national security but that is an abstract and not measurable. In terms of the Middle East, what national security goals could our government implement that would be measurable and give some indication of when this will end? I would submit that the first should be the destruction of ISIS ability to finance itself. That is measurable since most of their funding is coming from oil. It does appear our military and perhaps even the president understand this and are sending our planes at the refineries to do just that. Another source would be financial support from governments. It is hoped our government is working to destroy that source of funding as well. Should both of these succeed in any large way, ISIS source of munitions would begin to dwindle. With air support taking out stockpiles of these munitions, the Kurds and Iraqi forces would have more success at defeating them.

The steps they take to do this should be left to them, however. The UN and the U.S. should not wag the finger of displeasure at the methods used however distasteful they are to our sensibilities, ethics, and media. It is the Kurds and Iraqis that must live with how they win their war and the steps they use to ensure ISIS or something like it does not rise again. The UN and our only other option is to send in ground troops to do the same job and then live with what we had to do to accomplish this part of our objective.

Braxton Cook

The goal in Viet Nam was to bring the ARVN up to the point that it could resist an armored invasion from the North with no US ground troops, but massive US air support including bombing the holy hell out of Hanoi and various North Viet Nam targets.  We achieved that goal as witness the 1973 invasion from the North with a full armored army: 150,000 came south and were resisted by ARVN with US air support.  The result was that fewer than 40,000 of the 150,000 invaders, and none of their armor, returned to North Viet Nam after a full defeat with fewer than 500 American casualties.  We won in Viet Nam but did not go on to victory, dictating peace terms in Hanoi.  By 1975 the Democrats were able to limit support of ARVN to 20 cartridges and two hand grenades per man, and withdraw American air support.  The North sent in another armored army with as much armor as the Wehrmacht had in the invasion of Russia.  ARVN had no American support on the ground or from the air, and Saigon became Ho Chi Minh city. See http://www.jerrypournelle.com/archives2/archives2view/view349.html 

Our goal in Viet Nam was to allow the south to defend itself with American air support.  We achieved it, but then withdrew the air support.  I say this as a reminder that we should carefully choose our goals.

Understand that there may be a place for ISIS in this world.  It is not my business to determine that.  It is the business of the United States to pursue its interests.  We have interests in the Middle East, and we have allies there.  Building up a survivable Kurdish Iraq is a feasible and obtainable goal.  Bombing hell out of ISIS in Syria and Iraq with no actual purpose gives them more reason to hate us, but it is not certain what else it accomplishes.

 

r.e. Some principles of a Middle East Strategy 

Dear Jerry,

"Fortunately the Kurds claim and can hold a land pipeline path from the Iraqi oilfields to Turkey. Of course the Kurds may need a bit of help: and that is the rub. Holding land is primarily the business of those living on it, but holding it against foreign invaders armed and supplied by a major outside power"

Possibly. There are two major proposed pipeline projects from the Gulf area and Iran going to Turkey. One is promoted by a Shiite bloc including Iran, al Maliki’s former portion of Iraq and that part of Syria still ruled by Assad. The other pipeline project is favored by Sunni Arabs including the Saudis and others. This pipeline competition reflects the roughly 50-50 division in the Gulf area between Shiite and Sunni natural gas reserves.

NATO and the EU have a broad interest in Choice C, both projects. Meanwhile Vladimir Putin’s selection is Choice D, None Of The Above. Coincidentally enough the entity now called ISIS is presently operating on top of necessary segments of both routes. The question is whether this is by strategic design or the result of faulty strategic analysis by the ISIS leadership and its veiled backers.

Any proposed resolution of "ISIS" that favors only one of the pipelines will be inherently unstable. A settlement that includes both pipelines is a potential regional compromise acceptable to both blocs. This means resolving relations with Iran. This settlement will then require protection from meddling by evilly disposed external influences (insert Vladimir Putin & Sergei Lavrov pictures here).

The ISIS epic is another chapter in the emerging interconnected natural gas grid linking most of Africa, Europe and Asia. This has been steadily growing for 15 years. Seaborne Liquified Natural Gas (LNG) exports/imports will function to set marginal spot prices and level out regional discrepancies to a more uniform global price such as we see with oil. This will incidentally reduce Gazprom’s extreme regional profit margins in Europe towards a lower global price.

Growing US LNG exports will also sharply raise presently low US domestic n-g prices toward the same global price. Dow Chemical among others have been opposing LNG exports for precisely this reason. This will be one "price of empire" for the hoi polloi outside of Manhattan and a few other select zip codes.

LNG Exports plus Obama’s War On Domestic Coal guarantees American serfdom will be worse off in the immediate future than before the shale gas bonanza.

Best Wishes,

Anon

The casualties of drone warfare

Dear Dr. Pournelle,

Seen in the Daily Mail — a study has concluded that our drone strikes are killing 49 innocents for every terrorist killed.

http://www.dailymail.co.uk/news/article-2208307/Americas-deadly-double-tap-drone-attacks-killing-49-people-known-terrorist-Pakistan.html

While that’s certainly an improvement over the mass bombings of World War II, I’m curious as to how this war can be prosecuted more effectively. I suspect that drone strikes *by themselves* aren’t terribly effective. If you blow up an AQ commander , his second in command will take over . The network will be degraded, but so long as they have the capacity to replace manpower, talent and expertise there will be little lasting effect.

I don’t, at this point, see any alternatives. We do not have an American Foreign Legion. What we have is air supremacy. So tit-for-tat targeting of terrorist cells from the air — something which allows us to say we’re "doing something" but is unlikely to permanently destroy the terror network — seems to be about all we’ve got. Would welcome alternatives.

Respectfully,

Brian P.

Wednesday, 1 October, 2014  1200 hours:

 

http://www.bloomberg.com/news/2014-09-30/first-ebola-case-is-diagnosed-in-the-u-s-cdc-reports.html <http://www.bloomberg.com/news/2014-09-30/first-ebola-case-is-diagnosed-in-the-u-s-cdc-reports.html <–the hospital gave him drugs for his symptoms and sent him home 2 days before admitting him> <–the hospital ER gave him drugs for his symptoms and sent him home 2 days before admitting him; 12-18 people are believed to have come in contact during this time

http://abcnews.go.com/Health/us-ebola-patient-exposed-school-age-children-governor/story?id=25885934 <–5 school-aged children may have been exposed to the patient during the 2 days between the first patient’s ER visits, attended school (but are not presenting symptoms)

http://www.wfaa.com/story/news/health/2014/10/01/thompson-dallas-county-ebola-patient-cases/16524303/ <–district schools identified: 2 elementary, 1 middle, 1 high; original patient is not a USA citizen

http://www.usatoday.com/story/news/nation/2014/10/01/hospital-ebola-patient/16527143/ <–ER triage nurse asked for, was given, his travel history, recorded it; information failed to get to the rest of the ER team

http://www.dailymail.co.uk/news/article-2775608/CDC-confirms-Dallas-patient-isolation-testing-returning-region-plagued-Ebola-HAS-deadly-virus.html <–began presenting symptoms 2 days before his first ER visit; this means he was exposing people for 4 days before being admitted & quarantined; Dallas Co. Health Dept. denying a second patient is being monitored

Also if you do the arithmetic for death rates in Liberia from the graphic in that UK article, it is quite possible that the strain presenting in Liberia is the stronger strain: the known death rate in Liberia is just over 86%. The weaker strain has a 60% death rate, whereas the stronger strain has a 90% death rate. However, Sierra Leone and Nigeria are indicative of how proper care can change that, because they both have death rates between 30-40%.

http://www.latimes.com/nation/nationnow/la-na-ebola-texas-20141001-story.html <– original case upgraded to "serious (but stable);" where are his contacts?

http://www.usatoday.com/story/news/nation/2014/10/01/texas-ebola-patient/16525649/ <–second possible case

And this, folks, is how a pandemic can get started.

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

 

Freedom is not free. Free men are not equal. Equal men are not free.