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You are here: Home / Organizing & Resistance / Don't Mourn, Organize / Nigeria Shows Us How Ebola Should Be Handled

Nigeria Shows Us How Ebola Should Be Handled

by Anne Laurie|  September 30, 201410:07 pm| 71 Comments

This post is in: Don't Mourn, Organize, World's Best Healthcare (If You Can Afford It)

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From the NYTimes:

With quick and coordinated action by some of its top doctors, Nigeria, Africa’s most populous country, appears to have contained its first Ebola outbreak, the United States Centers for Disease Control and Prevention said Tuesday.

As the epidemic rages out of control in three nations a few hundred miles away, Nigeria is the only country to have an outbreak with hundreds of potential victims in a city with vast, teeming slums and yet to beat it back.

“For those who say it’s hopeless, this is an antidote — you can control Ebola,” said Dr. Thomas R. Frieden, director of the C.D.C…

While the danger in Nigeria is not over, the health minister, Dr. Onyebuchi Chukwu, said in a telephone interview that his country was now better prepared, with six laboratories able to make diagnoses and response teams and isolation wards ready in every major state.

After the first patient — a dying Liberian-American — flew into Lagos on July 20, Ebola spread to 20 other people there and in a smaller city, Port Harcourt.

They have all now died or recovered, and the cure rate — 60 percent — was unusually high for an African outbreak.

Meanwhile, local health workers paid 18,500 face-to-face visits to repeatedly take the temperatures of nearly 900 people who had contact with them. The last confirmed case was detected on Aug. 31, and virtually all contacts have passed the 21-day incubation period without falling ill…

On July 17, Mr. Sawyer defied medical advice and left a hospital in Monrovia, Liberia, where he was being held for observation after caring for his sister, who died of Ebola, although it was unclear whether he knew what she had.

Nigerian news reports said he used Liberian government contacts for permission to leave, flying to Lagos by way of Ghana and Togo. He planned to go to an economic development conference there and then fly back to Coon Rapids, Minn., for his children’s birthdays, according to media interviews with his widow.

Taken to a small private hospital after he collapsed, he denied any contact with Ebola victims and was initially treated for malaria. He died on July 25…

… Dr. Shuaib emphasized that even terrified Nigerians did not deny the virus’s existence or attack health workers, as happened in the other countries. “No conspiracy theories entered the debate,” he said…

Seems like the Ebola victim now under treatment in Dallas wasn’t nearly as sick when he left Africa, and our “World’s Best Healthcare” system should be at least as capable of coping as that of Nigeria’s.

On the “no conspiracy theories” level, however…

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71Comments

  1. 1.

    RaflW

    September 30, 2014 at 10:12 pm

    As someone who lives in the same metro as Coon Rapids (yes, it’s a Twin Cities suburb), I’m glad we didn’t have to test Minnesota’s public health system, though I’m actually quite confident it is good. We’re all above average up here, don’tcha know!

    ETA: Coon Rapids is in Mmme Bachmann territory, so that does give a certain thrill/terror to the idea of Ebola up this-a-ways.

  2. 2.

    jl

    September 30, 2014 at 10:23 pm

    Thanks for the post and link. Nice to read a success story about the outbreak. Hope others can follow Nigeria’s example.

  3. 3.

    Gin & Tonic

    September 30, 2014 at 10:25 pm

    wasn’t nearly as sick when he left Africa

    Wasn’t sick at all, from what I saw of the CDC’s presser on closed-captioning at the gym. He was infected but asymptomatic and not contagious. Had he been contagious when he traveled, given the known timeline, he’d be dead by now. That’s why the CDC wasn’t answering questions about his flight plan, because it doesn’t matter.

  4. 4.

    Warren Terra

    September 30, 2014 at 10:25 pm

    Health care spending per capita, 2012 (current US dollars):
    Nigeria $94
    Sierra Leone $96
    Liberia $65
    Guinea $32
    DR Congo $15

    GDP per capita, 2012 (current US dollars):
    Nigeria $2742
    Sierra Leone $633
    Liberia $414
    Guinea $493
    DR Congo $418

    Basically, it’s not surprising that Nigeria – which has oil money, has a strong and professional (if occasionally antidemocratic) military, has a better civil service than many of these others, hand hasn’t faced a recent civil war – is doing better than most of the others. I’d be curious about Sierra Leone, which has been doing a better job of funding its medical infrastructure than some of these others, but it’s recently war-torn and a lot poorer than Nigeria.

    For comparison, the USA: $8,895 per capita spent on health, of $51,755 per capita GDP. Obviously, the US infamously overspends on health compared to its peers and compared to outcome – but one key thing you’ll note is that our relative wealth permits us to spend a much higher proportion of our income on health, and we get a much more robust infrastructure thereby.

  5. 5.

    Comrade Mary

    September 30, 2014 at 10:28 pm

    Dr. Ada Igonoh was infected by Sawyer, got extremely ill, but survived, unlike several others in her hospital.

    The ambulance door opened and a Caucasian gentleman approached me but kept a little distance. He said to me, “I have to inform you that your blood tested positive for Ebola. I am sorry.” I had no reaction. I think I must have been in shock. He then told me to open my mouth and he looked at my tongue. He said it was the typical Ebola tongue. I took out my mirror from my bag and took a look and I was shocked at what I saw. My whole tongue had a white coating, looked furry and had a long, deep ridge right in the middle. I then started to look at my whole body, searching for Ebola rashes and other signs as we had been recently instructed. I called my mother immediately and said, “Mummy, they said I have Ebola, but don’t worry, I will survive it. Please, go and lock my room now; don’t let anyone inside and don’t touch anything.” She was silent. I cut the line.

  6. 6.

    jl

    September 30, 2014 at 10:52 pm

    @Comrade Mary: Thanks. Very moving story.

  7. 7.

    Tommy

    September 30, 2014 at 11:11 pm

    In 2014 sad to say this is important:

    Dr. Shuaib emphasized that even terrified Nigerians did not deny the virus’s existence or attack health workers, as happened in the other countries. “No conspiracy theories entered the debate,” he said…

    I guess because I read the Hot Zone many years ago Ebola just freaks me out. It is real. It kills. Something to be taken seriously.

  8. 8.

    Omnes Omnibus

    September 30, 2014 at 11:21 pm

    @Tommy:

    Something to be taken seriously.

    Is anyone laughing it off?

  9. 9.

    beltane

    September 30, 2014 at 11:37 pm

    @Omnes Omnibus: I think that means we’re supposed to be running around in circles, flapping our arms and peeing our pants. That is the proper way of dealing with a deadly virus. It also might be of some help to have groups of flagellants march through all our major cities. The population of Europe might have been reduced to zero during the Black Death if not for the flagellants.

  10. 10.

    Tommy

    September 30, 2014 at 11:39 pm

    @Omnes Omnibus: Yes in we won’t throw money at the problem.

  11. 11.

    beltane

    September 30, 2014 at 11:43 pm

    The GDP figures for those African countries make me sad.

  12. 12.

    suzanne

    September 30, 2014 at 11:44 pm

    @Tommy: Um, what? You’ll have to mansplain to me a little more about your assertion that we’re not taking Ebola seriously, in light of the Great Collective Pants-Crapping that is going on right now.

  13. 13.

    Omnes Omnibus

    September 30, 2014 at 11:45 pm

    @beltane: Like terrorism, horrible diseases deserve a serious response. Panic is not a serious response. A realistic analysis of the situation and reasonable precautions are what we need. Having written that, I should probably go to bed because I am obviously drunk or high.

  14. 14.

    Omnes Omnibus

    September 30, 2014 at 11:46 pm

    @Tommy: Link?

  15. 15.

    suzanne

    September 30, 2014 at 11:50 pm

    Can someone help me think of a way to go as Ebola for Halloween?

  16. 16.

    Omnes Omnibus

    September 30, 2014 at 11:52 pm

    @suzanne: Do you want candy?

  17. 17.

    beltane

    September 30, 2014 at 11:54 pm

    @Omnes Omnibus: Unfortunately, the response to the AIDS epidemic tells us that many Americans will object to sensible precautions if these precautions conflict with their ideology.

  18. 18.

    Omnes Omnibus

    September 30, 2014 at 11:56 pm

    @beltane: Yeah, I know, but that doesn’t make what I said wrong. It makes the people think that idiots.

  19. 19.

    Gex

    October 1, 2014 at 12:02 am

    @beltane: Taking things seriously and assuming things are like they are in the movies seem to be conflicting ideas.

  20. 20.

    jl

    October 1, 2014 at 12:02 am

    @suzanne:

    ” Um, what? You’ll have to mansplain to me a little more about your assertion that we’re not taking Ebola seriously, in light of the Great Collective Pants-Crapping that is going on right now. ”

    My view is Great Collective Pants-Crapping is not really taking it seriously, but media putting on a show of taking it seriously in order to make some $$. The world spending enough money on controlling the outbreak, and improving public health to lower chances of repeat would be taking it serious.

    I thought that was Tommy’s point.

  21. 21.

    Violet

    October 1, 2014 at 12:03 am

    Dr. Shuaib emphasized that even terrified Nigerians did not deny the virus’s existence or attack health workers, as happened in the other countries. “No conspiracy theories entered the debate,” he said…

    No conspiracy theories entered the debate? How the hell is that allowed to happen? Where is their media? Are they not stirring up fear with flashy graphics and scary sound effects? No panels of talking heads discussing the “seriousness of the threat”? No elected officials spouting falsehoods based on unscientific beliefs and religion? What is wrong with these people?

  22. 22.

    Tommy

    October 1, 2014 at 12:05 am

    @suzanne: Maybe I don’t see it. I got rid of cable TV a few months ago and I get my news from sites like this or PBS and Democracy Now. I bet my worldview of news is changing. Or has changed.

  23. 23.

    beltane

    October 1, 2014 at 12:07 am

    @Gex: Yes, instead of being informed by Hollywood movies designed to shock, it would be better to read up on successful efforts to contain past epidemics such as this: http://www.amazon.com/The-Ghost-Map-Terrifying-Epidemic/dp/1594482691

    Of course, investigating the minutiae of a neighborhood’s water supply is nowhere near as exciting as a movie with a dramatic soundtrack and lots of panicking and freaking out.

  24. 24.

    Violet

    October 1, 2014 at 12:10 am

    @suzanne: Ebola itself would be hard to do. I mean, a blown up costume of a virus? But you could do the haz mat suit everyone dealing with it seems to be wearing. Or maybe you could paint “sores” on your arms and legs and wear a sign with “Ebola Patient Zero” on it. Don’t expect a lot of candy though.

  25. 25.

    Omnes Omnibus

    October 1, 2014 at 12:13 am

    @Tommy: So PBS is suggesting that we aren’t taking Ebola seriously? Please explain.

  26. 26.

    Suzanne

    October 1, 2014 at 12:21 am

    @Violet: I don’t care about candy. I want Jell-O shots. One of my neighbors gave them out to the adults last year, and it was the greatest thing ever.

  27. 27.

    Omnes Omnibus

    October 1, 2014 at 12:25 am

    @Suzanne: OMG, drunk parents with trick or treaters. Oh well, I am still angry at my dad for putting fluorescent green paint on my 4th grade vampire cape. Safety, my ass! It ruined the integrity of the costume.

  28. 28.

    Anne Laurie

    October 1, 2014 at 12:30 am

    @Suzanne: The local news media seems to be using the same yellow-on-fuchsia ‘twisted rope’ electron-microscope virus pic over & over. Maybe print that out and wear it as a tabard, over a ‘hazmat’ suit if it gets cool enough you won’t pass out from heat stroke before the jellos shots getcha?

  29. 29.

    Ella in New Mexico

    October 1, 2014 at 12:32 am

    Ok, former Bio major and RN here folks.

    So forgive me for thinking pessimistically–maybe the more correct term should be, realistically.

    If Ebola is transmitted ONLY in the ways that we are all being reassured that it is, through close (possibly repeated or prolonged) contact with body fluids and blood, we have FAR too many victims identified for whom they have not offered ANY explanation as to how they acquired the disease, MANY of which were supposedly utilizing all standard, recommended personal protective equipment/precautions.

    This indicates we do NOT know enough about how this particular outbreak is being propagated. The virus may have evolved and found a way to be transmitted more casually than official reports are telling us, eg. by respiratory exposures.

    I don’t think anyone should get too smug about mocking people who are feeling a bit concerned about it spreading in the US, especially given that we are apparently not doing a DAMN thing about limiting travel between our country and Africa right now. Does anyone here REALLY believe that the CDC is willing to risk widespread panic by even hinting it’s basically making it up as they go along right now? Of course it’s gonna say “Everything’s fine here, folks”.

    Hello? “WMD and Yellow Cake”? “We Are NOT Recording Your Every Phone Call”? “Secret Service President’s Detail is the Best in the World?”

  30. 30.

    Omnes Omnibus

    October 1, 2014 at 12:41 am

    @Ella in New Mexico:

    Hello? “WMD and Yellow Cake”? “We Are NOT Recording Your Every Phone Call”? “Secret Service President’s Detail is the Best in the World?”

    Take a couple of deep breaths. Or are you saying we should start panicking? If it is a real threat, in your view, how about a few suggestions of how to protect oneself?

  31. 31.

    beltane

    October 1, 2014 at 12:45 am

    @Omnes Omnibus: A big part of the problem in Africa now is that panicked people are behaving in ways that not only do not help, but which are actually working to spread the disease and make things that much worse.

  32. 32.

    Omnes Omnibus

    October 1, 2014 at 12:49 am

    @beltane: Again, I don’t yet see it as a reason to freak out. Dropping CT references into the conversation isn’t helpful. And that was the point of my comment.

  33. 33.

    Villago Delenda Est

    October 1, 2014 at 12:52 am

    Conspiracy theories give the reassurance that someone is in charge of this stuff, even if they’re evil.

    It’s better than the reality, which is that shit happens. A lot of people (especially the theoaddled) just can’t cope with it.

  34. 34.

    Ella in New Mexico

    October 1, 2014 at 12:58 am

    @Omnes Omnibus:

    Take a couple of deep breaths. Or are you saying we should start panicking? If it is a real threat, in your view, how about a few suggestions of how to protect oneself?

    Panic is a waste of time. I’m just saying that we are obviously, from where I sit as a health care provider and a person who did a little bit of studying on the genetics and transmission of emerging infectious disease, NOT getting ALL the information. And knowledge is power, in this circumstance.

    Except for not traveling to or from Africa, I really cannot tell you with confidence how to avoid acquiring Ebola, or that there is no real threat to the mainland US of outbreaks of this disease (which, I will admit, would most likely be small and contained. But they shouldn’t be here at all, if Ebola is the disease they’re telling us it is.)

    Ebola is not the “H1N1 of 2009” dud/outbreak. It’s frigging DEADLY, and we all ought to be calling our elected reps and demanding that our public health agencies fess up and give us the truth about what we do and do NOT know about how this disease is apparently infecting people who are not acquiring it through “close contact or body fluid exchange”. When the CDC can start to answer those questions with a reasonable amount of believability, then I’ll be more comfortable.

  35. 35.

    beltane

    October 1, 2014 at 1:01 am

    @Omnes Omnibus: I agree with you. I cannot think of a crisis, any crisis, were a panicked, irrational response is beneficial.

  36. 36.

    Omnes Omnibus

    October 1, 2014 at 1:02 am

    @Villago Delenda Est: God damn it, the earthquake, flood, and avalanche were totally the fault of the gay couple who moved into your ski-in/ski-out condo building. Amirite?

  37. 37.

    Warren Terra

    October 1, 2014 at 1:04 am

    @suzanne:

    Can someone help me think of a way to go as Ebola for Halloween?

    Well, the virus is visually uninteresting, so that’s out. Going as a sufferer would be incredibly tacky, just in awful taste – and it would be laborious and unflattering, plus people would think you’re being a zombie, which has been done to death. Similar issues (save the last one) with being sub-saharan Africa.

    If you’re stuck on viruses, some bacteriophages are beautiful – though that would be a lot of work.

    My best suggestion: a bowler hat with an “e” on it. Better yet, a whole stack of them, and you can infect other party-goers or people who give you Jello shots. It looks like you can find (presumably terrible) bowler hats for $5 apiece on eBay.

  38. 38.

    Ella in New Mexico

    October 1, 2014 at 1:06 am

    @Omnes Omnibus: and you don’t seriously think that my references qualify as “conspiracy theories”, do you? Those were, and remain, well documented LIES that our Government has told us to get us think everything they were doing was hunky-dory. AND THINGS WEREN’T.

  39. 39.

    Omnes Omnibus

    October 1, 2014 at 1:07 am

    @Ella in New Mexico: Is it contagious? Is it likely to be a nationwide problem?

  40. 40.

    Ella in New Mexico

    October 1, 2014 at 1:14 am

    @Omnes Omnibus: It appears to be more contagious in Africa than previous outbreaks, and no one is totally sure why. I’ve read lots of theories, and including how social/political responses over there have definitely made things worse in Africa, but again, why we have people who contracted it even though they consistently used isolation precautions and/or did not share body fluids/blood or have prolonged exposures is what sticks in my mind right now.

    I really don’t see it being a nationwide problem here, but seriously, how many Americans with Ebola go from anomaly to outbreak? Not that many, in my book. Because they told us it’s NOT SUPPOSED TO COME HERE.

  41. 41.

    RaflW

    October 1, 2014 at 1:15 am

    @Ella in New Mexico: So the Times is saying

    About 18 percent of patients in Liberia and 40 percent in Sierra Leone are being treated in appropriate settings

    but you feel that the virus is transmitting through some other means than the shit/blood/snot/puke/sweat of the already ill and their close contact with others in uncontained settings?

    I don’t want to be unreasonably calm, but I’m not seeing how one can conclude that the Ebola epidemic in Africa is spreading by any special, secret, ALL CAPS scary new ways. Can you cite transmissions that are freaking you out. Specifics, please?

  42. 42.

    Mnemosyne

    October 1, 2014 at 1:21 am

    @Ella in New Mexico:

    If you read the story by Dr. Igonoh above (at #5), it sounds as though they were NOT using the full precautions with Patrick Sawyer at first because they thought he had malaria, not ebola. They didn’t start using the full precautions (face mask, coveralls, etc.) until several days after they started treating him.

    There’s also this from the New York Times story:

    Nigeria also had some luck. Although the first patient, a businessman named Patrick Sawyer, was vomiting on his flight in, none of the roughly 200 others on the plane fell ill. (emphasis mine) Others did after helping him into a taxi to a hospital.

    So even with Nigeria’s “Patient Zero,” only people who actually touched him got sick.

  43. 43.

    Ella in New Mexico

    October 1, 2014 at 1:22 am

    Yes, there are documented cases of Ebola at this time which do not seem to meet the currently described criteria:

    “direct contact (through broken skin or mucous membranes) with

    blood or body fluids (including but not limited to urine, saliva, feces, vomit, and semen) of a person who is sick with Ebola
    objects (like needles and syringes) that have been contaminated with the virus
    infected animals
    Ebola is not spread through the air or by water, or in general, food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats.”

    http://www.cdc.gov/vhf/ebola/transmission/index.html

  44. 44.

    Warren Terra

    October 1, 2014 at 1:23 am

    @Warren Terra:
    Looking further afield: plastic bowler (or “derby”) hats for $1 apiece in bulk (48 hats) or flocked for $2 apiece (24 hats). At Walmart,com, sadly, but maybe also other places not known to be evil.

  45. 45.

    RaflW

    October 1, 2014 at 1:24 am

    @Ella in New Mexico:

    Yes, there are documented cases of Ebola at this time which do not seem to meet the previously described criteria.

    Link?

  46. 46.

    Omnes Omnibus

    October 1, 2014 at 1:27 am

    @Ella in New Mexico: And? This means what?

  47. 47.

    Mnemosyne

    October 1, 2014 at 1:35 am

    @Ella in New Mexico:

    This is also what that article says:

    Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.

    Basically, if you’re in a room with an Ebola patient, s/he coughs, and you’re not wearing eye protection, you get Ebola, because the microdroplets get into your eyes. As I understand it, the problem with Ebola is that people are shedding such copious amounts of bodily fluids — coughing, vomiting, diarrhea, sweating — that it’s almost impossible to avoid contact with them.

    Here’s an ABC story by a doctor who got suited up to visit an Ebola ward. What he’s wearing is considered standard, normal protection gear for Ebola.

  48. 48.

    suzanne

    October 1, 2014 at 1:43 am

    @Mnemosyne: The thing that strikes me, because I do healthcare architecture, is how the facilities themselves are probably impossible to keep clean. All the interior surfaces look porous and organic, the building envelopes appear to leak, and I’m sure their mechanical systems are dirty as hell. It is difficult to keep infection from spreading in modern American hospitals, never mind an old building in Africa with what are probably lax building and health regulations.

  49. 49.

    Mnemosyne

    October 1, 2014 at 1:44 am

    Also, too, we know how fucking dangerous Ebola is because Richard Preston told us in the 1990s in The Hot Zone. It sounds like some countries have improved — for the outbreak that Preston wrote about, the fatality rate was 90 percent, while Nigeria has gotten their death rate to 40 percent. That’s a huge improvement in patient care that should not be ignored.

  50. 50.

    Mnemosyne

    October 1, 2014 at 1:50 am

    @suzanne:

    From the stories I’ve read, part of the problem with local healthcare is that they still have to resort to cleaning and re-using needles, and it’s not always done properly, so they end up spreading the disease even further.

    If Ebola did get a foothold in a Western country, it would be a horrible tragedy and many of the people who contracted it would die, but that’s because Ebola is already a horrific disease with an extremely high death rate, not because there’s anything new and different about this strain AFAIK.

  51. 51.

    Suzanne

    October 1, 2014 at 1:57 am

    @Mnemosyne: I’ve also read that they burn the mattresses that the infected patients lie on, but that means that it’s conceivable that every other surface they touch could have been contaminated, and if they don’t have full cleaning crews, or HEPA filtration, or fully equipped central sterile departments, or ways to completely incinerate all their waste, then I bet that is a large vector.

  52. 52.

    Mnemosyne

    October 1, 2014 at 2:06 am

    @Suzanne:

    The story by Dr. Igonoh that Comrade Mary pointed to is fascinating — even after she was pronounced virus-free, she had to completely discard all of her belongings that she had brought with her (including her iPad), discard all of her clothes, and be sprayed down with disinfectant several times on her way out of the building.

    And these are all normal precautions for an Ebola outbreak. It’s really mind-blowing.

  53. 53.

    Ella in New Mexico

    October 1, 2014 at 2:10 am

    @Mnemosyne:

    Basically, if you’re in a room with an Ebola patient, s/he coughs, and you’re not wearing eye protection, you get Ebola

    YES, that is my concern! But that type of transmission is technically considered “Airborne” or “Respiratory” in the health field, which is NOT how it is being described when they speak of “transmission by contact with body fluids”, which might seem like semantics to the normal person but to a health care worker, these require completely different levels of isolation and protective gear. The CDC and others are telling us that you must have more than casual or airborne contact with the virus to catch it. “Ebola is not spread through the air”, per the CDC, is contra what you are describing above.

    For example, Hepatitis C is transmitted by contact with blood or bodily fluids. As a precaution to protect myself from acquiring the virus, I use “Standard Precautions” with all my patients: gloves and vigorous hand washing. Only if I may be exposed more extensively will I use a disposable isolation gown for good measure. I do NOT have to avoid entering the patient’s room, touching objects in the room, or breathing his air if he’s coughing. C-difficile, on the other hand, is ridiculously contagious, and as such, we invoke “Contact Precautions” which require before and after hand washing, gloves, and gown whenever we’re (or visitors are) in the room with the patient.

    Tuberculosis and meningitis, and certain antibiotic resistant bacterial pneumonias, on the other hand, require specialized facial masks and protective gowns and eye wear in addition to standard precautions when working with the patient to prevent inhalation or eye contact with the organisms. We also use rooms in which we control air flow in a reverse fashion, to prevent it from entering the general airflow of the hospital. Tuberculosis is considered to require longer, more prolonged contact to acquire, but Meningitis is extremely contagious, requiring very brief exposure.

    Right now, were are being told that Ebola is more “Hep C” than “Meningitis”, and I really think this will prove to be wrong.

    If you are flying on a plane with someone who should be on “Airborne/Droplet” precautions, and you don’t have a mask and protective eye wear, you are fucked. If you use the restroom after an Ebola patient, and it is as transmissible as C-difficile, only a bleach solution left for 10 minutes on all surfaces will prevent you from picking it up on your skin.

    We need–deserve– to know just how easily transmissible Ebola REALLY is. Again, especially since the world is a tiny little place given our collective ability to travel and the fact that we seem to be unable to reliably screen the “sick people” or limit people who may have been exposed but are not symptomatic’s movement out of Africa.

    :

  54. 54.

    Ella in New Mexico

    October 1, 2014 at 2:16 am

    @suzanne:

    never mind an old building in Africa with what are probably lax building and health regulations.

    Shit, never mind half the community hospitals in the US. And the fact that they are laying off half the janitorial staff to save money under the dreaded “Obama care”, which means rooms and beds and equipment are definitely not being cleaned at the highest standards.

    And the fact that most of us don’t live near frigging Emory University. ;-)

  55. 55.

    Ella in New Mexico

    October 1, 2014 at 2:22 am

    @RaflW: Sorry, missed this. I believe Dr. Kent Brantly, the first case they flew into NIH was one who took all the precautions but still contracted this virus. If I’m wrong, I’ll stand corrected.

  56. 56.

    Bjacques

    October 1, 2014 at 3:03 am

    Hmm, Dallas now.

    Texas’s healthy bidness climate makes it unhealthy for people. Right To Work and refusal to sign into Obamacare mean that potential contacts have to consider whether to risk losing their jobs, being quarantined and/or getting socked with a $100K hospital bill, or hoping it’s just a cold and they probably won’t spread it to coworkers and customers before it clears up.

  57. 57.

    chopper

    October 1, 2014 at 7:01 am

    @jl:

    My view is Great Collective Pants-Crapping is not really taking it seriously, but media putting on a show of taking it seriously in order to make some $$. The world spending enough money on controlling the outbreak, and improving public health to lower chances of repeat would be taking it serious.

    there’s that mansplaining again.

  58. 58.

    Shortstop

    October 1, 2014 at 9:49 am

    @suzanne: Seriously? This thing has killed many thousands in West Africa.

  59. 59.

    Suzanne

    October 1, 2014 at 10:24 am

    @Shortstop: No, not seriously.

  60. 60.

    shortstop

    October 1, 2014 at 11:08 am

    @Suzanne: Whew. You got some serious answers, though…ouch.

  61. 61.

    Mnemosyne

    October 1, 2014 at 11:27 am

    @Ella in New Mexico:

    I think you’re conflating two different concerns, though. For the general public, it sounds as though Ebola is not easily spread by casual contact in public places — again, even though people spent several hours on a plane with Patrick Sawyer, none of them contracted the disease. The only casual contacts who caught it were people who actually touched him.

    However, I do agree with you that healthcare personnel need much more guidance from the CDC about how to identify potential Ebola cases and how to protect themselves. Healthcare personnel are clearly at much higher risk of infection than the general public because of the nature of the job and because they’re in more frequent contact with the patient. Just putting in an IV line could potentially be deadly for a nurse or PA.

  62. 62.

    Suzanne

    October 1, 2014 at 11:55 am

    @shortstop: I am serious about the Jell-O shots, though.

  63. 63.

    JR in WV

    October 1, 2014 at 12:40 pm

    @Villago Delenda Est:

    Theoaddled ::: that’s a GREAT word! Thanks for sharing it with the innertubes universe.

  64. 64.

    shortstop

    October 1, 2014 at 12:43 pm

    @Suzanne: Naturally. You’re not a fool.

  65. 65.

    JR in WV

    October 1, 2014 at 1:13 pm

    In 2010, according to the CDC, 53,826 people died of influenza and pneumonia.

    So far the whole ebola plague has apparently caused something like 6,000 fatalities.

    I think hysteria is not yet called for anywhere. Yes, it is a horrible disease. Yes, it has a very high fatality rate, and is easily spread in the later stages of the illness.

    It is obviously not so easily spread in the early stages of the illness, even after a patient is obviously becoming quite ill. The first person article by the young Doctor in Nigeria was quite informative. She went home for a visit to her parents, became ill, and inspite of her close contact with her family, no one else was infected by her illness. This is partly because the Nigerian health authorities went to the home and did their best to sterilize it with chlorine bleach, not a high-tech, expensive state-of-the-art technology.

    Obviously in a culture where families are expected to handle a deceased relative quite intimately this disease could be transmitted easily, especially if many people were not educated about the germ theory of disease at all. America and western culture is not at all like this. Except for the Vaccine alarmists.

    So please stop fomenting panic and distrust of the CDC. Don’t be like that dippy woman who has almost single-handedly made whooping cough a disease that kills kids, even with a vaccine and advanced medical treatment. Just Don’t!

    Thanks.

  66. 66.

    Larv

    October 1, 2014 at 2:12 pm

    @Ella in New Mexico:

    Right now, were are being told that Ebola is more “Hep C” than “Meningitis”…

    Who exactly is saying this? Because every picture I’ve seen of people treating Ebola patients has them in full precautionary gear, including facemasks. I haven’t seen many people do that for Hep C.

    I also think you misunderstand what the CDC is talking about when they say it’s not transmitted by air. What they’re saying is that it isn’t transmitted via aerosolized droplets, which can “hang” in the air. If a patient coughs a non-aerosolized droplet directly into your eye or other mucous membrane, however, that’s a potentially infectious event (which is why they all wear face shields). But that doesn’t meet the standard for “airborne” transmission.

  67. 67.

    Ella in New Mexico

    October 1, 2014 at 3:03 pm

    @Mnemosyne:

    I think you’re conflating two different concerns, though.

    I have been known to conflate a time or two. :-)

    @Larv:

    Who exactly is saying this? Because every picture I’ve seen of people treating Ebola patients has them in full precautionary gear, including facemasks. I haven’t seen many people do that for Hep C.

    I also think you misunderstand what the CDC is talking about when they say it’s not transmitted by air. What they’re saying is that it isn’t transmitted via aerosolized droplets, which can “hang” in the air.

    Of course, they are wearing that full protective gear–they are working with identified patients who have either been exposed or have full blown Ebola. Which will NOT be the case in most EU or US health care settings in which these patient’s may present. It’s also unclear how long the virus could circulate in the closed air system of an airplane or on surfaces that people may unknowingly touch and transmit viral particles to eyes, nose, mouth etc.

    And yes, in the story referenced, the doctor’s family thankfully did not acquire Ebola, but it may have if authorities had not been aware that she was positive. A few more hours at home feeling bad could have spelled disaster for her family, which is really what my concern is all about right now. (And seriously, I am AMAZED she entered a patient’s room who had a mysterious illness with no gloves on, much less touched things there. I am assuming she would have at least washed her hands before leaving the room–so why did that not prevent her from acquiring Ebola? I’d love to chase down the facts in that story from moment to moment.)

    I’m not hysterical, but I really believe, having seen public health education missions from the inside, that in their effort to calm public panic they are quite possibly downplaying how much we do NOT know about the more casual ways it could be being transmitted in public settings. As more “apparently healthy during travel then diagnosed after arrival” cases pop up outside of Africa, they will have to do lots of detective work to go back and identify their exposure where it will be confirmed that many caught it through very casual means–not close contact.

    Which really makes me wonder if the world health agencies don’t need to push for limiting travel to and from Africa right now.

  68. 68.

    Ella in New Mexico

    October 1, 2014 at 3:20 pm

    Just ran across this and it kind of resonates with my thinking:

    http://www.thedailybeast.com/articles/2014/10/01/how-to-keep-ebola-from-spreading-to-other-u-s-cities.html

  69. 69.

    Mnemosyne

    October 1, 2014 at 3:48 pm

    @Ella in New Mexico:

    And yes, in the story referenced, the doctor’s family thankfully did not acquire Ebola, but it may have if authorities had not been aware that she was positive.

    From what the doctor said, though, she seems to have helped her family not catch it by taking her own precautions by doing things like keeping her eating utensils separate from everyone else’s and washing them herself. She also told her mother to lock up her room and not let anyone touch any of her belongings. Which, again, are pretty basic hygeine precautions that most families don’t bother to take when a family member is sick, which is why colds and flu end up getting passed around from family member to family member.

    Also, Patrick Sawyer’s illness wasn’t considered mysterious — malaria is endemic and they’re accustomed to malaria patients. The symptoms (especially high fever) are similar. From the stories I’ve read, misdiagnosis in the early stages was a huge contributing factor because the doctors in urban areas weren’t familiar with the signs of Ebola since up until now it’s been a rural disease even in Africa. Someone who turned up with malaria-like symptoms in a US or EU hospital would be treated very differently, because malaria is not a common disease in those areas.

  70. 70.

    Felanius Kootea

    October 1, 2014 at 5:17 pm

    @Ella in New Mexico: There were 200 people on the flight with Sawyer who did not catch Ebola simply from being on the plane with him. This in spite of the fact that he was puking his guts out during said flight. All the people infected by him are people who had direct contact with him by: (a) helping put him in a cab, or (b) treating him in the hospital for malaria since he denied contact with any Ebola patients when asked (he may not have known what killed his sister).

    Ebola had never been seen in West Africa prior to 2014, so most health workers assumed initially that stricken patients had malaria or Lassa fever, which are more common in the region.
    Most Africans prior to this outbreak dismissed Ebola as a rural disease found mostly in the Congo, which is pretty far away from Guinea, Liberia or Sierra Leone.

    Most of the people affected in Liberia, Sierra Leone and Guinea are affected because of distrust of authorities in those countries, a lack of capacity in medical facilities, which means families are caring for feverish, sweaty relatives without protective gear and in many cases transporting very ill patients to the hospital in taxis/public buses due to lack of ambulances (others using the same taxi or bus later might come into contact with the patients’ sweat and other fluids).

    None of these things are issues in the US. Even though distrust of authorities is present in Nigeria and Senegal, none of the other issues came into play.

    Ebola has made it to the US (Monrovia is 5756 miles from Dallas) before making it to say, South Africa (Monrovia is 3385 miles from Johannesburg), so I’m not sure “cancelling all flights to Africa” is a reasonable reaction.

  71. 71.

    Ella in New Mexico

    October 1, 2014 at 10:10 pm

    @Mnemosyne:

    From the stories I’ve read, misdiagnosis in the early stages was a huge contributing factor because the doctors in urban areas weren’t familiar with the signs of Ebola since up until now

    Welcome to “America, aka. Dallas”.

    @Felanius Kootea:

    I’m not sure “cancelling all flights to Africa” is a reasonable reaction.

    Seriously, after reading about the situation in Dallas today, I’d rethink that position if I were you, especially given the state of the American health system today. A MAN FROM EBOLA-INFECTED LIBERIA WAS NOT ONLY TURNED AWAY FROM A TYPICAL AMERICAN HOSPITAL ED, HE TOLD THEM HE WAS FROM EBOLA-INFECTED LIBERIA AND HAD SYMPTOMS. Had they pursued it, they would have found that he was fully aware of his exposure to a terminal Ebola patient. Instead, they decided to go defer, minimize and literally sent the bastard home to expose a bunch of little kids to the virus.

    I’m not saying panic. I’m saying demand that the government stop the whole “nothing to panic about here, keep moving” emphasis and start implementing the same kind of intense training and awareness with your local public health orgs and hospitals that it did for the stupid frigging H1N1 flu in 2008—which had far fewer fatalities then this year’s Ebola, a disease that has absolutely NO margin of error in diagnosis.

    The “Doctor” in Dallas was stupid enough to misdiagnose a person CLEARLY from a country dealing with Ebola presenting with it’s early symptoms. Guess why—-NO ONE IS DIRECTING HIM TO THINK OUTSIDE THE BOX RIGHT NOW. He did what you do in traditional medicine—go with the most likely, “Occam’s Razor” diagnosis and he was DEAD WRONG. (I will add that the triage RN apparently DID query him about recent foreign travel, which he admitted, and while some might be blaming her for not passing that on to the doctor, my guess is she actually did pass it on to him, but he either ignored her documentation or completely tuned her out because that is EXACTLY what too many doctors do, every day, in my experience. Nurses who make pests of themselves with your doctor save your ass every day in this country, thanks to their God complex disorders)

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