Ebola and the Competence Crisis. A Visit to Harlan

View 846 Wednesday, October 15, 2014

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

EBOLA OUTBREAK? Stock Market Plummets

A second health care worker who treated Mr. Duncan has now come down with Ebola. This has so concerned the President that he has cancelled a fund raiser and a golf game and will hold a cabinet meeting concerning public health.

Meanwhile, confidence in the competence of the government, which has repeatedly assured us that all the necessary protocols for preventing an Ebola outbreak in the United States are already in place, has collapsed and the stock market reflects that.

A ground swell of demand for sealing the borders against Ebola is developing, but no public official seems to be proposing that. Public officials are saying that we cannot refuse visas to those who wish to come to the United States. Of course those who come in through Mexico need no visa, but Ebola has a way of preventing vigorous travel. One can hope that the Texas, New Mexico, Arizona, and California National Guard could make that trip even more vigorous, but it is unlikely in California.

Whatever protocols are in place, they did not prevent someone well known to have been exposed to Ebola – she was treating a patient when he died from it – they did not include “monitoring” those known to be exposed to Ebola. We are repeatedly told about the competence of our meritocracy of unionized government workers.

Health care worker with Ebola flew on commercial flight a day before being diagnosed

The second health-care worker diagnosed with Ebola had a fever of 99.5 degrees Fahrenheit before boarding a passenger jet on Monday, a day before she reported symptoms of the virus and was tested, according to public health officials.

Even though there appeared to be little risk for the other people on that flight, she should not have traveled that way, Thomas Frieden, director of the Centers for Disease Control and Prevention, said during a news conference Wednesday.

“She should not have flown on a commercial airline,” Frieden said.

This health-care worker flew on a Frontier Airlines flight from Cleveland to Dallas-Fort Worth with more than 130 other passengers. She did not have nausea or vomit on the plane, so the risk to anyone around her is “extremely low,” Frieden said.

The health-care worker was not identified by public health officials, but family members told Reuters and the Dallas Morning News that her name is Amber Vinson, a nurse at Texas Health Presbyterian Hospital. She was part of a team that had cared for Thomas Eric Duncan, a Liberian man who flew to Texas and was diagnosed with Ebola last month, during his hospitalization in Dallas. Duncan died last week. Nina Pham, a nurse who also cared for Duncan, was diagnosed with Ebola on Sunday.

Vinson, who flew from Dallas to Cleveland on Friday, flew back to Texas on Monday, a day after Pham was diagnosed. She reported a fever on Tuesday and was isolated and tested for Ebola.

http://www.washingtonpost.com/news/post-nation/wp/2014/10/15/ebola-stricken-nurse-flew-on-a-passenger-plane-a-day-before-being-diagnosed/

It is now reported that Ms. Vinson had a low grade (99.8 F) fever on Monday when she took the commercial flight; there is argument over whether that is a symptom of Ebola, and whether or not she was contagious on Monday. One would assume this is a ‘breach of protocol”. And there is this:

Sorry to say this but it appears that our Government has been lying to us about Ebola once again.

In a recent report from WHO ( http://www.who.int/mediacentre/news/ebola/14-october-2014/en/ ) there is the little noted announcement that the 21 day incubation period is an error.

The REAL period appears to be much longer.

95% of the cases are under 21 days

3% of the cases are up to 42 days

2% fall in the other long period (something longer than 42 day)

Plus there appear to be infected individuals who never develop symptoms ( like Typhoid Mary ) but who are still infectious (that is possibly where the 2% comes from). That would be something to be feared — with 8000 cases that means there are 160 individuals walking around with no symptoms but who are spreading the disease. Just imagine one of them catching a flight to Europe and maybe on to America – nothing to identify them other than they came from West Africa. And they keep infecting those around them.

so it seem that areas of Nigeria that were declared cleared are having flare ups from the tail end of the sample curve that was over 21 days.

With 5% over the 21 day limit we have to be a lot more cautious than accepting the statistical 5% test. Our lives depend on it!

The problem with the Biological Sciences is that unlike Physics and Chemistry you end up with exceptions to just about any rule, and the data is never clear cut and definitive. Schrodinger achieved fame as a Physicist, if he were a Biologist he would be regarded as just another picky German who wanted a precise answer.

I am really not trying to sound overly pessimistic, but it is better for the truth to be told rather than live under government lies that will surely kill us.

Earl

See also this correspondent’s letter on the Ebola question in yesterday’s View; it is important. https://www.jerrypournelle.com/chaosmanor/questions-about-ebola-questions-about-an-essential-reading-list/

Re: Earl’s note (here: https://www.jerrypournelle.com/chaosmanor/questions-about-ebola-questions-about-an-essential-reading-list/)

I was struck by Earl’s analysis of preparation strategy.. namely using the survivors to care for the those coming down with the virus. That brought to mind stories that my father told about his time in the Navy in the early 50s. They sent the ship he was on back and forth between climate extremities, in part to achieve what he thought was an experiment in adaptability. The administration and the Navy department then had no problem experimenting with personnel for the ‘greater good’. It’s quite possible he and his shipmates were a part of the experiments that led to the establishment of ‘wind chill’ calculations that are now a standard adjunct to all weather reports.

Now take that philosophy in concert with the deployment of troops to ‘help’ with the Ebola outbreak in Africa. If the administration were worried about a massive outbreak here and needed to build up a cadre of immune, command-able individuals that could handle the sick, this would seem to be the perfect laboratory to incubate such a cadre. The possible loss of half the deployed troops could just be attributable to ‘bad luck’.

Yes, I am aware that this sounds like ‘black helicopter’ reasoning, and while I do suspect the current administration is more than capable of such a move, I doubt they have the cunning to pull off such a measure. Yet, they have demonstrated they have the hubris to attempt a great many underhanded things that were unthinkable with in past administrations. In any case, I think this is a line of thought worth keeping in mind.

Liberian Ebola Survivors Return to Help the Sick

Former Patients Like Salome Karwah, Who Lost Her Parents to the Virus, Offer Comfort and Counseling at Clinic

MONROVIA, Liberia—Six mornings a week, Salome Karwah gets up and goes to work at the Ebola treatment unit where she watched her parents wither and die just three days apart and where she almost died of Ebola as well.

Ms. Karwah, 26 years old, who had been a nurse’s assistant at a private clinic before the outbreak, recovered from the virus and was discharged on Sept. 5 as a patient from the Elwa treatment unit here. Less than a month later, she returned as one of seven Ebola survivors hired by the clinic, run by Doctors Without Borders, to counsel and comfort those suffering from the disease.

She and the other survivors are paid for their work at the Ebola unit, but few see it as a job. They are part of a select group that have withstood the virus here and they want to help.

(Update: Second health-care worker at Texas Hospital tests positive for Ebola).

http://online.wsj.com/articles/liberian-ebola-survivor-now-comforts-other-patients-1413301824

A collection of Ebola survivors trained in working with the disease would be valuable for many reasons including as a plasma supply, but it is unlikely that anyone has this intent.

This government seems more concerned with intentions than accomplishments.

Can All U.S. Hospitals Safely Treat Ebola?

http://mashable.com/2014/10/13/can-us-hospitals-treat-ebola/

ABC Chief Medical Expert: CDC Wrong, All US Hospitals Can’t Treat Ebola Safely

http://www.breitbart.com/Breitbart-Texas/2014/10/12/ABC-Chief-Medical-Expert-CDC-Wrong-All-US-Hospitals-Cant-Treat-Ebola-Safely

Dr. Richard Besser, the chief health and medical editor for ABC News, told WFAA-Dallas on Sunday that he found the second Texas Ebola case "very concerning." As reported by Breitbart Texas, the latest patient diagnosed with Ebola is a female nurse at the Texas Presbyterian Hospital who treated Thomas Eric Duncan before he died from the disease. Besser, having recently returned to the United States after visiting Ebola-stricken areas of Liberia, expressed sharp disagreement with the protocols being followed by the Centers for Disease Control and Prevention (CDC), dissatisfied with their admission that they needed to adopt enhanced protocols in a press conference Sunday.

Besser told WFAA that he had been anticipating the news of a second Ebola case. "I don’t find it surprising, but I find it very concerning," he said, continuing that it was necessary for health authorities to cast "a very wide net" to search for anyone who may have had even the most incidental contact with either Duncan or the nurse. The difficulty in containing the spread of the disease, according to Besser, is that it takes special training and experience to follow the isolation protocols and use the protective gear properly.

"The idea that this could be done by any American hospital that has an isolation room and can be done safely, I was skeptical about that," said Besser, in a clear departure from recent statements by the CDC that any American hospital can safely care for Ebola patients. Besser mentioned the highly specialized biocontainment equipment and advanced training available at at Emory University Hospital in Atlanta, where Fort Worth doctor Kent Brantly was successfully treated for Ebola exposure, and the Nebraska Medical Center in Omaha, where an NBC photographer is currently getting treatment.

Besser agreed with Dr. Tom Frieden, the CDC head, who had said that the new Ebola case was caused by a "breach in protocol." "You cannot get sick without a breach in protocol, [however] you can’t implement that protocol without training and practice. It’s very difficult to take off the protective gear in such a manner that you don’t potentially contaminate yourself." Besser cited this new Dallas case and the case of a nurse in Spain who had contracted Ebola from a patient, and the fact that health care workers at the Emory and Nebraska facilities had not gotten sick, as illustrative of the vital difference that the training can make.

Ebola Is Coming. A Travel Ban Won’t Stop Outbreaks

J V Chamary

Ebola has officially gone global.

The World Health Organization recently confirmed that a Spanish nurse was the first case of transmission outside Africa. Now it seems the first patient diagnosed in the United States transmitted the disease before he died.

More outbreaks are on their way.

While nations struggle to contain the epidemic in West Africa, other countries are discussing how to protect their own citizens, with governments and health authorities repeatedly asked the same question:

Why don’t we just ban flights from Africa?

The idea seems logical. Prevent sick people entering the country, keep your loved ones safe. It’s selfish, but understandable. A survey of over 1000 people by NBC News found that the majority of Americans (58%) support a ban on flights from countries where the Ebola virus has broken out.

Dr Tom Frieden, director of the US Centers for Disease Control and Prevention, has tried to explain why he doesn’t support a travel ban:

Importantly, isolating countries won’t keep Ebola contained and away from American shores. Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries, and that we will have more patients who develop Ebola in the US. People will move between countries, even when governments restrict travel and trade. And that kind of travel becomes almost impossible to track.

Simply put: you can’t seal the country. If you blocked air travel, it would force desperate individuals to use alternative routes – over land and sea – to escape the epidemic. They’ll still end up in the US, except you won’t know where.

An attempted travel ban would be like locking yourself in a cabin on a sinking ship and praying the flood doesn’t seep through the gaps, and that the water pressure won’t be enough to burst through the door.

http://www.forbes.com/sites/jvchamary/2014/10/13/ebola-travel/

I would not have thought it impossible to quarantine those from plague ridden areas, and to refuse them visas to the United States, but I am not familiar with the current Department of State protocols. I suspect that the Joint Chiefs of Staff could devise a way.

Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much. How to subscribe is described here: PAYING FOR THIS PLACE.

Who says Ebola isn’t airborne

Tuesday, September 23, 2014 by: Ethan A. Huff, staff writer

"The fact of the matter is that Ebola has never been proven not to transmit through the air, which is reason enough to assume that it does for the safety of workers on the ground. The two doctors explain that, scientifically speaking, Ebola currently has "unclear modes of transmission," meaning nobody truly knows all the ways that infections can emerge. "

"We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators <http://www.naturalnews.com/respirators.html> , not facemasks," they wrote, citing an earlier paper Dr. Brosseau published in the American Journal of Infection Control".

http://www.naturalnews.com/046986_Ebola_airborne_transmission_respirators.html

In November 2012, they say it is airborne!!!!

http://healthmap.org/site/diseasedaily/article/pigs-monkeys-ebola-goes-airborne-112112

http://www.naturalnews.com/046986_Ebola_airborne_transmission_respirators.html

And, YOU don’t think Obama isn’t playing the typical game of total deceit keeping the people from panicking? If the cold virus is airborne, logic and common sense mandates that ANY virus can be airborne. Why don’t they tell why this virus isn’t airborne while all others are? ASSUME IT IS!!!!!

Google the Internet for more :<Ebola is airborne>

http://www.endalldisease.com/cdc-caught-lying-airborne-transmission-of-ebola-confirmed/

There’s nothing hidden about that fact. But the records don’t show that any humans grew ill from the Reston strain. Might be the cowpox version of Ebola. In which case maybe it’s what the researchers need to concentrate on for a vaccine.

Stephanie Osborn

Rommel And Ebola

Jerry,

The German general Erwin Rommel famously said that Americans knew less but learned faster than any other opponents he’d faced. This was, of course, shortly after the first major WW II battle between US and German troops, at a place called Kasserine Pass – a fiasco for the US.

We can only hope our current medical leaders still learn fast. I made the (apparently common) error over the last couple of months of assuming that the West Africans’ growing problem with Ebola killing off their medical personnel was a matter of primitive conditions, scarce protective gear, and sloppy procedures. Perhaps so – but the second Dallas hospital worker diagnosed (so far) tells me we are not near as much better than them as we thought.

Our government’s position that any decent US hospital is intrinsically able to handle Ebola seems to have been abandoned overnight. I now see signs that our new government policy will be massively centralized, and resource-intensive to the point where if there are any significant number of cases the resources will quickly run out.

One of the immediate results of the Kasserine disaster was that heads rolled among the US leaders responsible. It’s probably too much to hope for here in 2014; we don’t seem to do that anymore.

I do hope that local medical people around the country are now seriously planning how to at least keep the transmission rate below 1.0 with resources at hand as outbreaks occur. I do not see any way we will escape this thing unscathed, but we should still be able to prevent epidemic spread here.

good luck to us all

Porkypine

Meanwhile in the Middle East

Subject: RE: Gruesome photos may show ISIS using chemical weapons …

Date: Mon, 13 Oct 2014 21:52:03 -0400

Chemical weapons are quick relative to what else is going on…

http://www.foxnews.com/story/2009/08/17/human-rights-watch-gay-men-systematically-tortured-and-killed-in-iraq/

http://themuslimissue.wordpress.com/2013/10/14/punishing-gays-rectums-are-glued-shut-and-they-are-force-fed-petrol-and-set-alight/

Stephanie Osborn

Interstellar Woman of Mystery

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

We continue to break things and kill people, but without apparent objectives.

Ebola in columns and talk shows today

http://www.anncoulter.com/columns/2014-10-15.html

http://www.breitbart.com/Big-Government/2014/10/11/Michael-Savage-on-Ebola-Third-World-African-Dictators-are-Smarter-than-Barack-Obama

http://www.marklevinshow.com/common/page.php?pt=2nd+Ebola+Nurse+Called+CDC+Before+Boarding+Plane%2C+CDC+OK%27ed+It&id=11423&is_corp=0

http://www.rushlimbaugh.com/daily/2014/10/15/obama_s_deadly_ebola_failure

I have read your thoughts on Ebola with interest. Indeed, why not restrict travel from places where Ebola is endemic? At first glance it surely seems like politically-correct insanity. But here is another view on the topic…

http://globuspallidusxi.blogspot.com/2014/10/obama-is-letting-diseases-enter-united.html

John De Chancie and I are working on a space opera, and he came over for lunch, after which the two of us went to the hospital to see Harlan Ellison, As reported yesterday he had a stroke last week and is in recovery. We called his wife first to be sure it would be appropriate, Harlan is in a Catholic hospital, and at his request the nurses – he hasn’t seen any Sisters yet – covered the crucifix in his room. One of them with a sense of humor used the standard pain estimation instructions as the cover. John and I both went to Catholic schools in our youth so we have a somewhat different set of expectations…

Harlan looks good.

He’s sitting up in a wheelchair, with a hospital table in front of him. I pointed out that there’s a 20% Federal excise tax on all medical equipment including his chair and that table and any other stuff they have to use in his physical therapy sessions.

He is recovering the use of his right arm and leg, and it looks as if all the neurological pathways are intact so it’s a matter of practice to get back full function. Nothing wrong with his head. He can still dominate a conversation for two hours, with me in the room, and that’s a rather large feat. David Gerrold was there when we got there, and we had a fine afternoon talking about everything from the old days and taking Robert Silverberg to dinner to comparatively modern times.