twa Posted October 30, 2014 Share Posted October 30, 2014 And explain why these types of drastic measures have not been enacted with the importation of other hemhorragic fevers to the US that we've successfully dealt with? You talking Reston?....hardly comparable Link to comment Share on other sites More sharing options...
Bonez3 Posted October 30, 2014 Share Posted October 30, 2014 We don't have even thousands of cases to evidence, so caution should be the default position. Prior hemmorhagic viruses didn't have sustainability either. Why not 'good on paper monitoring', because Spencer, Pham, Hickox. Look, at this point, when we here are way underprepared (trust me, or don't), exercising extreme caution is prudent. And the staggeringly low number of individuals that would actually be affected by this... 47 + 150, yeah, it's worth it. Oh yea, and that flight ban, so Peter's hypothetical of passenger not seeking help (or seeking help and being misdiagnosed ie Duncan). This will beyond cripple this health care system. It can be prevented from becoming more prevalent in US. The lying, irresponsible doctor should only serve as a warning shot across the bow. Link to comment Share on other sites More sharing options...
Special K Posted October 30, 2014 Share Posted October 30, 2014 You talking Reston?....hardly comparable No, I am not talking about Reston. That is isn't even pathogenic to humans. I'm talking about Marburg (which is nearly identical to Ebola) and Lassa Fever cases that have been imported into the United States. Link to comment Share on other sites More sharing options...
bcl05 Posted October 30, 2014 Share Posted October 30, 2014 There is so much disinformation out there, so much panic, and so much BS from non-scientific sources. I'm not sure where I want to begin. First - Ebola is contagious in the late stages of the illness. It is not VERY contagious. In Africa sterile precautions and protective equipment are not possible and corpses are typically closely handled by multiple members of the family (in most traditions in the area). There, in Africa, an average of 1.7 additional people are infected by each patient. (That's the R0 - or reproduction number). That's not trivial, but its significantly less than HIV, SARS, mumps, measles (highest - estimated at 18-23), whooping cough, flu - really most other infectious diseases. The reasons aren't entirely known, but most evidence suggests that the virus is not present in transmissible fluids (saliva, semen, vomit, blood) until the very end stages of the disease (when it does appear in large quantities). The virus is also not stable when exposed to air, so that it rapidly degrades. In other words, you can't get it from a toilet seat, or a door handle, or a park bench. Someone needs to be dying from ebola right in front of you for you to be at risk. You need to get wet exposure to your mucous membranes to be at risk. Even with that, the risk (while definitely not zero), is not that high. There is no reason to think that people who aren't symptomatic, or who are in the very early stages of the disease, are contagious to the public at large. The benefits of quarantining asymptomatic people travelling from west Africa are purely political. There are many diseases that are far more infectious that will kill many more people in the US this year that aren't being suggested as quarantine targets. People talking about how a 21 day quarantine is no big deal are nuts. As I've said earlier, I do medical volunteer work in Africa every year. We go to treat babies/kids with heart malformations. Every day I take there is vacation time, and my job doesn't pay me or support the work. (They don't get in the way, and do help with some logistics, but since it isn't in their financial interest, it doesn't change my patient quotas/etc at home). If I (or any of the dozen or so docs that go as a part of this project) had to miss even one additional week of work at home, I think the project would fall apart. Many kids we save there would die because of the lack of care. No one would fill the gap. The project I'm a part of has saved hundreds of lives there. There are thousands of kids we would love to serve there but can't get to because we don't have the time/manpower. Most die. I'm most bothered by the blaming or demonizing the health care workers who are coming back from west Africa. These people are portrayed as selfish because they come back from a harrowing trip and try to regain some normalcy. I can't imagine how grueling and exhausting it must be working in the Ebola treatment centers there. We should be celebrating them as heroes. If I could meet them now, I'd give them a hug and a thanks. Link to comment Share on other sites More sharing options...
twa Posted October 30, 2014 Share Posted October 30, 2014 No, I am not talking about Reston. That is isn't even pathogenic to humans. I'm talking about Marburg (which is nearly identical to Ebola) and Lassa Fever cases that have been imported into the United States. well Lassa is a arenavirus and harder to transfer ad less deadly you suggest we do what we did for the Marburg case? .....that was ........get lucky Link to comment Share on other sites More sharing options...
Special K Posted October 30, 2014 Share Posted October 30, 2014 We don't have even thousands of cases to evidence, so caution should be the default position. Prior hemmorhagic viruses didn't have sustainability either. This will beyond cripple this health care system. It can be prevented from becoming more prevalent in US. The lying, irresponsible doctor should only serve as a warning shot across the bow. I agree that caution should be the default position. Where we do not agree is on the definition of "reasonable" when it comes to caution. Link to comment Share on other sites More sharing options...
Bonez3 Posted October 30, 2014 Share Posted October 30, 2014 Sorry BCL... I'm not demonizing anyone, and I know you didn't direct that statement purely to me. But Spencer's 'reported' actions (which seem to have been corroborated by him) were negligent, irresponsible and DANGEROUS. I commend you and you're work, but it's not really relevant to Ebola unless that's where your cases are. And in that case, simply might not be best time for that... UNFORTUNATELY. Regardless of transmission rate, the potential for catastrophic outcomes likely exceeds Influenza, MERS, Measles, HIV combined. We simply don't know what would transpire if true outbreak occurred. Nobody has shown to me 'scientific evidence' that flight bans and quarantines won't protect US citizens best. All I've heard has been that people wouldn't go help... All 190 of them And I said in prior posts, these people are Heros IMO. Normalcy is a luxury that may need 21 days (or longer). I will reiterate paid positions that I think would get many applications. Ebola doesn't require the worlds top physicians. In fact, nurses and above all capable. Link to comment Share on other sites More sharing options...
Special K Posted October 30, 2014 Share Posted October 30, 2014 well Lassa is a arenavirus and harder to transfer ad less deadly you suggest we do what we did for the Marburg case? .....that was ........get lucky No, I'm suggesting we combine scientific evidence and reasonable caution. Like Bcl05 said, like what Peter and I have been saying: 1. a mandatory quarantine is not a "minor" inconvenience and 2. enactment of such quarantines is purely political and a waste of resources. Link to comment Share on other sites More sharing options...
ABQCOWBOY Posted October 30, 2014 Share Posted October 30, 2014 No, I'm suggesting we combine scientific evidence and reasonable caution. Like Bcl05 said, like what Peter and I have been saying: 1. a mandatory quarantine is not a "minor" inconvenience and 2. enactment of such quarantines is purely political and a waste of resources. How is it political? There is support for this on both sides of the isle. Link to comment Share on other sites More sharing options...
Bonez3 Posted October 30, 2014 Share Posted October 30, 2014 I think it's short sighted to say its purely political to support quarantines, and frankly insulting. TWA already sourced 2 very well respected members of the scientific community. And I have no dog in the fight. So, please, I feel it's trivializing the matter. I think we need to listen to all our points. I respect everyone in this thread for even voicing opinion and respect BCL, Peter and K. But I won't go there to prove a point. I see the political angles, but chose to not introduce it into discussion. Because we are trying to find solution and there is no clear consensus Link to comment Share on other sites More sharing options...
twa Posted October 30, 2014 Share Posted October 30, 2014 No, I'm suggesting we combine scientific evidence and reasonable caution. Like Bcl05 said, like what Peter and I have been saying: 1. a mandatory quarantine is not a "minor" inconvenience and 2. enactment of such quarantines is purely political and a waste of resources. it was recommended here by medical experts, I do agree some flexibility and judgement in implementing it is best... that is what is being done in my state and yours of course better choices made by others would reduce the need and justification for imposing them the consensus seems set add would those opposing quarantine be comfortable with a ebola researcher taking a small vial of it home and about town? the risk is minimal Link to comment Share on other sites More sharing options...
Predicto Posted October 30, 2014 Share Posted October 30, 2014 How is it political? There is support for this on both sides of the isle. It's political because it is catering to the fears of the most ignorant and scared voters - regardless of which party does it, or whether both parties are doing it. Political in this context means: "public officials doing things to appease voters rather than doing what is right, necessary, reasonable or effective." note - I'm not opining on the need for quarantines here - just explaining what Special K meant when she call these actions "political." Link to comment Share on other sites More sharing options...
Bonez3 Posted October 30, 2014 Share Posted October 30, 2014 Politicians are being politicians... Nuff said. But the debate is not clearly on political lines. Link to comment Share on other sites More sharing options...
Larry Posted October 30, 2014 Share Posted October 30, 2014 How is it political? There is support for this on both sides of the isle. Pointing out that just because politicians of both parties are making decisions based on polling data over scientists doesn't make something non-political. Link to comment Share on other sites More sharing options...
bcl05 Posted October 30, 2014 Share Posted October 30, 2014 Political, not partisan. Link to comment Share on other sites More sharing options...
twa Posted October 30, 2014 Share Posted October 30, 2014 Political, not partisan. hard not to be when the politicians hold the power, maybe we should elect scientists instead of lawyers Link to comment Share on other sites More sharing options...
Special K Posted October 30, 2014 Share Posted October 30, 2014 I think it's short sighted to say its purely political to support quarantines, and frankly insulting. My apologies. I wasn't intending to insult you or others supporting mandatory quarantines. It was more of a statement about how this issue has been completely politicized and politicians are capitalizing on the public's fear and ignorance about this disease. Link to comment Share on other sites More sharing options...
Bonez3 Posted October 30, 2014 Share Posted October 30, 2014 Like I said, politicians are going to be politicians. Just wouldn't want to discredit one side or other because of political innuendos. I'm not really insulted, but think this thread should avoid derailments if not completely necessary. I know none of us are the Ebola Czar, but all the same Link to comment Share on other sites More sharing options...
Larry Posted October 30, 2014 Share Posted October 30, 2014 I know none of us are the Ebola Czar, but all the same Just a personal opinion, but at least with me, Peter has vastly more credibility on the subject that anybody else I'm aware of. But I don't think that's what you're talking about. Link to comment Share on other sites More sharing options...
Bonez3 Posted October 30, 2014 Share Posted October 30, 2014 I def agree. And I tried not to post in this thread for a while, but read for months. I know K (i think he stated his life changed when he first read about it decades ago. this is probably like his super bowl) and Peter have extensive knowledge and insight. Frankly, agree with proposed monitoring. But, having seen the oversights, simply feel different at this moment in time. To me, it's a dynamic stance that can change with the change to the landscape as it pertains to therapies and vaccines and most importantly preparedness. Link to comment Share on other sites More sharing options...
Bonez3 Posted October 31, 2014 Share Posted October 31, 2014 "The government had quarantined the 275,000 people in Bumba Zone — no commercial planes or boats could land there, and citizens were told not to leave their villages or allow strangers to enter. People lacked basic commodities and were fearful and agitated. We explained to them that we knew what caused the outbreak and showed authorities the electron micrograph. People along the road from the town of Bumba to Yambuku were relieved when we said we'd come to stop the disease's spread, treat patients, and meet their families." This is from editorial from the New England Journal if Medicine this week. It chronicled the first outbreak in 1976. Pretty cool, but they went all in in quarantine. In fairness, same publication has editorial discrediting NY/NJ quarantine. Stating it will discourage the needed manpower to fight EVD. But they admit they need tens of thousands and are far short (like tens of thousands).... Soooo Sorry can't embed since I got from App Link to comment Share on other sites More sharing options...
visionary Posted October 31, 2014 Author Share Posted October 31, 2014 http://www.washingtonpost.com/opinions/christopher-coons-those-who-help-ebola-patients-should-be-honored-not-punished/2014/10/29/57321d58-5ee4-11e4-9f3a-7e28799e0549_story.html Those who help Ebola patients should be honored, not punished The best way to protect Americans from Ebola is by stopping the virus at its source. That’s why President Obama has committed up to 4,000 U.S. military engineers, logistics specialists and public health trainers and $1 billion in funding to help eradicate the virus in West Africa. That’s why philanthropist Paul Allen pledged $100 million in support last week and why Samantha Power, the U.S. ambassador to the United Nations, visited the affected countries this week. We cannot protect Americans at home without sending Americans to Liberia, Guinea or Sierra Leone. Instead of demonizing those who volunteer for service, through stigmatizing mandatory quarantines or the imposition of a travel ban, we should be honoring them. There’s a simple way to do that: The president should guarantee that all U.S. citizens who travel to West Africa to help fight Ebola will be allowed to return to the United States, that any medical care they need as a result of their trip will be provided free of charge and that wages lost to any government-imposed quarantine will be reimbursed. That’s the least we can do for the volunteers, missionaries and military personnel working to end this outbreak. Doctors Without Borders, Samaritan’s Purse, the Red Cross and other humanitarian organizations deployed medical personnel to West Africa months before the virus started making headlines in the United States. These groups and their personnel should be celebrated and thanked for their service. Link to comment Share on other sites More sharing options...
ABQCOWBOY Posted October 31, 2014 Share Posted October 31, 2014 Pointing out that just because politicians of both parties are making decisions based on polling data over scientists doesn't make something non-political. Fair enough. What do you see as political on the issue of Quarantine Policy on Ebola? Link to comment Share on other sites More sharing options...
Larry Posted October 31, 2014 Share Posted October 31, 2014 Fair enough. What do you see as political on the issue of Quarantine Policy on Ebola? How about, for starters, whether a quarantine (for people who are not contagious) is a good idea in the first place? Link to comment Share on other sites More sharing options...
ABQCOWBOY Posted October 31, 2014 Share Posted October 31, 2014 How about, for starters, whether a quarantine (for people who are not contagious) is a good idea in the first place? I don't really see that as political. I see it as the responsibility of our Government/Healthcare to safeguard the American Public. Link to comment Share on other sites More sharing options...
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