Ebola Today 10/28

A Good News Day
OK, today we should lead with the best news. According to the The Washington Post, upon nurse Amber Vinson's recovery, and release from the hospital, there is only ONE patient left in the United States being treated for Ebola. That is to say, only one person of the 316 million people in the United States, has Ebola, at this time. Everyone else, except poor Thomas Eric Duncan, has recovered, and has been released.

More good news today
Although there is still a great need for international assistance, according to The New York Times, the spread of Ebola is slowing in Liberia. Health authorities in the region have come to that conclusion from the following facts:

• Liberia's health authorities are reporting lower numbers of new infections.
• Treatment centers in Liberia's capitol city of Monrovia, who were turning away victims for lack of space, are now reporting some unoccupied beds.
• The number of burials of victims has started to drop.

"Do we feel confident that the response is now getting an upper hand on the virus? Yes, in Liberia we are seeing a slowing rate of new cases, very definitely." ~~ Dr. Aylward, World Health Organization's Assistant Director-General in charge of WHO's operational response to the epidemic.

Bear in mind, nearly half of the total number of people infected have been infected in Liberia. Also note, about 5,000 of the almost 14,000 people infected, are reported to have died of the disease, and according to Dr. Aylward, in the three countries most affected, Guinea, Liberia, and Sierra Leone, there is still a 70% mortality rate. In the United States, of those who developed the virus while in the United States, our mortality rate is more like 20%. Of course, it looks like we know how to handle it better than we did when Thomas Eric Duncan showed up in Texas. And all of the cases after him in the United States have recovered. Just waiting for Dr. Craig Spencer to join that group. (There is some low level noise out there about Dr. Spencer lying about his whereabouts upon returning to the United States, but there are no accurate sources to back that one up. And no one else in New York has reported symptoms, including his girlfriend.)

That being said, there is still alot of scarem juice going around. If you pay attention to social media, the policy being suggested by the none scientific general public is to get your pitchforks, and guns, and take your country back from the Ebola Dictator Obama. It's Obama derangement syndrome on steroids. In the real world, however, Governor after Governor actually have to decide what is the best way to ensure the health and safety of their residents.

Under CDC guidelines that went into effect Monday, individuals at any risk of exposure to the virus should be actively monitored until 21 days after the last potential exposure, even if they show no symptoms of the disease. The guidelines are not mandatory.

Who's Being Monitored Now?
MICHIGAN ~~ Health officials are now monitoring ten people in Michigan for the Ebola virus, the Detroit Free Press reports. According to the health department spokesman, none of these people are believed to have had direct contact with anyone who has Ebola, and the Michigan Department of Community Health confirms none of the people being monitored have shown symptoms of the deadly disease. Nonetheless, the cases involve individuals who were in countries with widespread Ebola transmission within the last 21 days. MDCH is not releasing their identities or where they live out of respect for their privacy.

INDIANA ~~ Indiana was one of the first states to begin “direct active monitoring” of returning travelers. Gov. Mike Pence and the Indiana State Department of Health implemented the policy on Oct. 16. The local FOX affiliate in Indianapolis WXIN reports that state health officials are monitoring six people in Indiana for Ebola symptoms in accordance with guidelines from the Centers for Disease Control and Prevention. Two patients have completed the monitoring protocol while six others are currently under observation. They’re cooperating with the protocol, which lasts 21 days. State health officials aren’t releasing the names of the counties where travelers are being monitored in accordance with privacy laws.

All are considered low risk.

What Is Monitoring?
Monitoring includes twice-daily temperature and symptom checks by local health agencies. That's it. Hit a temperature of 100.4, you get packaged up, taken into a hospital for treatment, and, of course, quarantined. Until then, you just have to take your temperature.

The CDC’s new travel guidelines group people into four categories based on exposure to Ebola: high risk; some risk; low, but not zero risk; and no known risk.

• People in the high risk category, such as a healthcare worker who treated an Ebola patient, should be monitored by a health official and avoid commercial travel and large gatherings.
• Those with some risk should be monitored by a doctor, and would be allowed to travel on a case-by-case basis.
• Travelers with low, but not zero, risk should watch for symptoms.
• Those with no known risk don’t have to monitor their health. Duh.

Schools And Parents Overreacting?
Maureen Downey of the The Atlanta Journal-Constitution took a stab at the issue. Parents with school aged children are getting concerned, and most local mayors and school boards aren't doing much to help assuage that fear.

We may see the issue of kids being barred from attending school addressed in Connecticut sooner than in other states. A lawsuit has been filed in the state after a school district refused to allow a third-grader to return to school after she attended a wedding in Nigeria, a country declared Ebola-free by the World Health Organization. Her father is suing the Milford district for banning the child from school, noting the family was never quarantined by the city after returning from Africa, the school system felt safe enough to send a tutor to the house, a doctor who examined the girl proclaimed her healthy, and she had no contact with, nor was anywhere near, any Ebola patients while in Nigeria. The family attorney suggested the ban had more to do with public concerns than real health concerns.

Civil Rights Versus Public Safety
“Normally one can’t be locked up without suspicion of a crime or conviction, but because we are dealing with infections, and because they can be spread by people who are not visibly sick, the state has the right to protect society from disastrous consequences by temporarily limiting someone’s liberties,” said Eugene Kontorovich, a constitutional law scholar at Northwestern University Law School in Chicago.

Of course, given all the available evidence, Ebola patients would definitely be visibly sick when they were infectious. They would be vomiting, and liquid would be coming from every part of them. It causes bleeding inside and outside the body.

Hickox is on the front lines of this dispute. Now that she is back home in Maine, and still asymptomatic, and still virus free according to repeated tests, Maine officials are seeking a court order to force her to self-quarantine at home. Acccording to NBC News, Hickox emerged from her home today, Wednesday, to tell reporters that she and her attorneys had been in negotiations all day with state officials, but that the impasse remained.

"They will not allow me to leave my house, and have any interaction with the public, even though I am completely healthy and symptom-free," Hickox said as her boyfriend stood beside her — and as a state trooper, who has her under surveillance, looked on.

We've been here before. Health officials in the U.S. have a long history of taking steps in the interest of public health, including closing schools and ordering large-scale quarantines, such as the one imposed during the 1918 influenza epidemic that was credited with limiting the spread of the disease. Of course, in 1918, we weren't able to treat, and cure, patients with plasma infusions.

Some public health experts say aggressive, widespread quarantines may be illegal, are not based on medical evidence, and can be counterproductive. Health officials have a certain ethic to uphold, but ordinary citizens might hide their potential exposure, or recent travel history, as a result. Most importantly, as we have mentioned in previous articles, this kind of government reaction, in the current environment, could also dissuade health care workers from volunteering to fight Ebola in West Africa, where the epidemic is just starting to get under control due to the caring and fearless work of those very same healthcare workers.

Unnecessary quarantines create unnecessary fear.

Feeling Helpless?
Well, there is only so much each of us, individually, can do to help out here. Unless you are a health hero putting yourself on the line helping patients in the United States heal, or jetting overseas to help on the front lines, what can you do?

Without saying any charity is helping more than any other, we offer one option of a place to donate. Unicef USA.

Stay with us daily as we report what we find, and vet what we can.

The Policy Geek

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Ebola Today: 10/27

One of the things that drives a Policy Geek crazy is, when it comes to Ebola, people irrationally blaming the President. Of course, one gets used to POTUS being blamed for everything. Benghazi, sure, Fast and Furious, yep, The IRS, ok, Immigration, yeah, it just goes on and on. But Ebola??? That one makes no sense at all.

In an effort to cut through the stupid, once again, we present: Ebola Today, 10/27.

People are going crazy about every detail of this PR nightmare. We call it a PR nightmare, because if everyone was just reacting to facts, this wouldn’t even be more than a blip on page 4 of any newspaper, a 2 minute segment at most on the Evening News. But no, we have a bunch of nonsense coming from all directions.

The Sign Language Guy
New York City Mayor De Blasio, in a press conference on Ebola, was accompanied by a man to the side of him who was translating for the deaf. CBS New York claimed the sign language interpreter for Oct. 24th press conference was “faking it.” There is video, and speculation. Tweets said he was signing song lyrics. Blogs written quoting CBS, etc. So is that true?

Of course, not. That poor guy is signing his ass off. The message is important, and deaf signers say he was getting that across, accurately. Here is a perfect example of what we are talking about. Here is a meaningful press conference, being given by a caring Mayor, being interpreted by a devoted sign language guy, with information people need to hear, and the only take away is that the CDC is “faking it.”

This is particularly troubling, the part where it is assumed that the CDC and the NIH are lying to us, or making things up. For instance, when Thomas Eric Duncan’s Texas nurse Amber Joy Vinson flew in and out of Texas, before being diagnosed with Ebola, there were reports that she had called the CDC about a fever before flying back from Akron to Dallas, and been given the go ahead. News stations were shocked. How could she have been contagious with Ebola, and have been cleared by the CDC to fly? Not surprisingly, that’s not exactly how it happened. Amber was contacted by Texas Presbyterian while in Akron, and asked how she was doing, which is standard protocol. She had a temperature of 99.5. The healthcare worker at Texas Presbyterian called that info into the CDC, who said she was cleared for travel, and that info was relayed to Amber. According to the CDC, a 100.4 temperature is symptomatic of Ebola. When she arrived back in Texas, she recorded a higher fever, immediately called it in, and sought treatment and quarantine.

The Poor French Speaking Children from Senegal
According to The Root, NBC New York, and Buzz Feed, last Friday, Oct. 24th, two Senegalese-American middle school students, 11 and 13-year-old brothers, were taken to the hospital on Friday after suffering a beating at the hands of their classmates, while the attackers chanted “Ebola! Ebola! Ebola!” The beatings were apparently motivated by some sort of fear of the Ebola virus, but local lawmakers are saying it is a hate crime. These bullies haven’t been taught any better, but whose fault is that? Where were the administrators? Where was the supervision?

Monday press conference at Harlem headquarters
of Association of Senegalese in America

Ousmane Drame, the boys’ father, explained that the children were born in the United States, but had been sent to Senegal to learn French. The boys arrived in the The Bronx three weeks ago (the proverbial 21 days), and were initially welcomed by their classmates. But as misinformation about the Ebola virus spread over the last two weeks, Drame said his sons had been cruelly harassed repeatedly leading up to the group attack.

“If they go to the gym, they don’t want them touching the ball – ‘Oh, you have Ebola, don’t play with us,'” Drame said.

Then, on Friday at lunchtime, a large group of students approached Abdou, the younger brother, and began the chanting, Ebola! Ebola! The group then attacked the boy, the father said, kicking and punching him in the face. When Amedou came to help his younger brother, he was also beaten. It must have been so frightening, and so unexpected. But are these children just reflecting their parents paranoia?

Should those middle school bullies living in The Bronx be scared of people from Senegal? Should we all be afraid?

The truth is only one case has been documented in Senegal, the country of origin of the children that were regularly bullied, and then attacked. That one Senegal case was reported almost two months ago, so on Oct. 18th the World Health Organization declared the nation of Senegal to be free of Ebola. No new cases have been documented in the 51 days since, more than twice the virus’s incubation period. Needless to say, these children weren’t anywhere near the one patient reported in Senegal at any time. But that doesn’t stop the hate, or the fear, or the ignorance, from spreading.

NY State Senator Bill Perkins was appalled, saying,
Already Ebola is a bullying crisis in our public schools, and in our charter schools. Our mayor needs to take some steps so that children in our public schools know what Ebola really is, and don’t go out and attack their fellow students.

If you ask us, Mayors everywhere need to hold public health meetings, as well as school assemblies, to talk about the truth, and hammer home the point that really, there is nothing to fear but fear itself. A teachable moment.

Can You Get Ebola When Someone Sneezes?
When your body first starts fighting Ebola, the body reacts by causing a fever. To be infectious with this virus you must have a really high number of copies of the virus in your blood. At that point, all of your blood vessels are spiderwebbing, practically disappearing, a process that can not be reversed. To be safe, if you have been exposed, and you develop a fever, call your local hospital. But running a low fever does not mean that there is enough of the virus in your blood to actually be able to infect anybody. Since all but one of the current Ebola patients in the United States are health officials, we need to have a certain amount of trust that they will sequester themselves the moment they show any fever. Again, those flying on the planes with the patients we are treating in the United States have not come down with it, and they were in a closed environment for hours and hours with those who are actually infected.

President Barack Obama gives a hug to Dallas nurse Nina Pham in the Oval Office

As for Thomas Eric Duncan, apparently you need a great deal of exposure, and exposure from a patient who is in the highly contagious stage, to catch the virus. That means exposed to feces, vomit, blood, etc. Duncan caught it while in Liberia helping a poor pregnant woman who was very ill. You can imagine the fluids there. When a person is in the later stages of the disease, as Mr. Duncan was when treated in Texas, liquid comes out of every part of them, and alot of it. That’s how Duncan caught it. Unfortunately, poorly trained staff in Texas allowed Duncan to go home, and then didn’t diagnose him immediately when he returned to the emergency room. That’s how his nurses got it. Bear in mind, Duncan is the only one that has died in the United States. He did not receive any plasma from a previously recovered Ebola patient, and he died. He’s the only patient treated in the United States for Ebola that did not receive that type of plasma infusion.

So feces from an Ebola patient, bad, and plasma from a recovered Ebola patient, good. A recovered Ebola patient can not get the virus again. So their plasma, once shared, is saving lives. This is very important. That’s why Obama made a point of inviting Nina Pham, that nurse from Texas who has recovered, to the oval office for a hug. She’s a hero. We can’t say that enough. And as of the writing of this article, both of Duncan’s nurses, Amber Joy Vinson and Nina Pham, have recovered, and have been released from hospital.

What we have to keep in mind, today, of all days, on Jonas Salk’s birthday, is we have a treatment. So as long as we have protocols, and those exposed monitor themselves for a fever, immediately quarantining themselves if they have one, we should be o.k. (Jonas Edward Salk was the American medical researcher and virologist, from New York City, who discovered and developed the first successful inactivated polio vaccine. Happy Birthday, Jonas.)

But We Hear That These Workers Took Precautions And Caught It Anyway
We have to remember that the process of medical care means that you are literally touching patients, regularly, and in that respect, it’s very difficult to come away with something like this. In fact, Thomas Eric Duncan’s family, who took care of him at home for a bit, have not contracted the disease. And those who spent time with Dr. Craig Spencer in New York, also have not shown any symptoms. So simply touching a patient, or sitting next to one, doesn’t do it.

So, again, how did the health workers catch it? We have to remember our doctors are rapping themselves with a lot of protective gear. That gear is very difficult to put on and off, as Dr. Gupta demonstrated recently on CNN. Especially, if you are trying to do it by yourself, without a partner, or without training. Some of these challenges can lead to unfortunate infections, but that’s what happens when people put themselves in harm’s way, and are willing to take care of patients with this disease. Health care workers are human too, and there are no reports of them having done all of the protocols perfectly. Although, if you listen to people on the street, they all say, “She did everything, and she still caught it. Time to freak out!! Ahhhhgggggg!!!”

Obama and recovered Dallas nurse Nina Pham in the Oval Office

The hysteria is building, and the worst thing we can do is start to attack each other over, what?, 5 cases of Ebola in the United States. Really? More people report seeing UFO’s every day in the U.S. What we have to do is keep level heads, teach our children to be kind, remind our friends not to spread misinformation and gossip, and perhaps, not travel to West Africa unless you are a health professional. Most importantly, we have to treat our health care workers as the heroes they are, and not like some zombies from Resident Evil.

Unfortunately, fear is in charge now, and fear gets what it wants.

Harry Cheadle of Vice magazine put it best today:

“I’m not sure when Americans got scared. Maybe the indigenous tribes of the plains spent evenings huddled in their teepees telling stories of twisted night creatures, maybe the nomads who trekked across that bridge from Russia to Alaska were running away from something. Whatever the case, by the time the white people showed up from across the sea and started putting women on trial for witchcraft and convincing themselves the natives were conspiring with Satan, fear was firmly established as the ruler of the continent and it hasn’t left since. The national anthem, like most of what you learn in elementary school, is mostly lies, forget the brave and the free, we’re the land of the terrorized, the home of the perpetually panicked.”

There is some good news. In New Jersey, nurse Kaci Hickox, who we wrote about yesterday, was discharged after testing negative for Ebola. So cooler heads prevailed there. After all, she was not symptomatic, and she tested negative twice.

What’s today’s takeaway? We have 316 million people in this country, more or less. And 5 cases of Ebola. Sure as shootin’, there are political operatives out there who know that fear can keep voters home on Nov. 4th. That’s a week from today.

Let’s keep it all in perspective, and not let them fear us into failure. So keep calm. And read this column. We’ll try to bring you everything we can, daily.

The Policy Geek


UPDATE: The director of the CDC said that active 21-day monitoring began Monday in seven states for air travelers who enter the United States from Liberia, Guinea and Sierra Leone, the hardest hit countries in West Africa. Those states with fear driven Governors are New York, Pennsylvania, Maryland, Virginia, New Jersey, Illinois, and Georgia.

Also, on Monday, a 5-year-old boy who recently visited West Africa, and had a fever, tested negative for the virus in New York, according to health officials. So if you hear about the young child in New York, you can tell your friends, he’s fine. Just a little kid with a fever. Like we see every winter, everywhere.

Lastly, according to MSNBC’s Rachel Maddow, it seems we are also putting our Army troops, those who have just completed a mission to set up Medical Facilities in Liberia, into 21 day quarantines In Italy, no visitors, even though they were never in contact with any Ebola patients while on the African continent. Again, fear is winning. Along with those troops, we have also quarantined our two star Major General Williams who is head of U.S. Army, Africa. That’s right, the man in charge of the Army in the entire continent of Africa is also in quarantine. This is policy that makes no sense. And we predict will cause more damage, than not.