For those who flamed me all day today:
I’m just crazy and evil and mean for repeatedly suggesting the health care workers should have used a lick of common sense or they will infect someone else or the hysteria is going to cause a national over-reaction with real quarantines and travel bans:
Texas health officials have ordered any person who entered the room of the first Ebola patient at a Dallas hospital not to travel by public transport, including planes ship, buses or trains, or visit groceries, restaurants or theaters for 21 days, until the danger of developing Ebola has passed.
Now, they need to make sure that these people who are having their lives disrupted are being taken care of- reimburse them for planned travel tickets and vacations, give them time off for the days they will basically be confined to their homes, make sure they are getting help with groceries and what not, etc. They ought to be given hazard pay, too. Let this virus burn out in Texas, get things back to normal and stop scaring the shit out of the easily hysterical, and then, for the love of everything holy, train them and provide them with adequate equipment and do a top-down review of the clown show that is the upper administration at Texas Presbyterian, as that is where the real problem lies. And cross your fingers that it ends there and Vinson didn’t infect anyone else.
Again, I think that these guys shouldn’t have to have been told they shouldn’t be on planes and trains and cruise ships, but you know me, what with the witches to burn and everything. I’m just a dick that way. Seriously, though, I wouldn’t have done that and honestly think it is stupid. Maybe that is because I am particularly risk averse, knowing that I can injure myself sitting in a rocking chair. But I never in a million years, after handling an Ebola patient, particularly in a shitty situation without the right equipment and training, would have done something like that.
To everyone suggesting I should have apologized, lemme just give you a big fat I TOLD YOU SO. Let’s hope it stops here, and let’s hope this calms the rabble, but if there are cases related to the Texas shitshow, there’s going to be more mandated quarantines and travel bans and who knows what else. It’s an election year, so the public over-reaction to anything is going to be at eleven because of irresponsible politicians and media. Remember, we’re still taking our shoes off before we board a plane ten years after precisely ONE jackass unsuccessfully tried to blow up an aircraft with his Chucky T’s.
There’s this and there is also this.
And, for you Zombie Apocalypse and Walking Dead fans, they are here.
And we all know who caused all these problems, amirite? Thanks EBOMA.
As I said in previous threads, no one is calling for travel bans or quarantines for hospital staff at the hospitals that have handled other Ebola patients–Emory, the hospital in Nebraska, etc. The freak out is due to the mistakes and poor handling of Mr. Duncan. Had Texas Presbyterian handled his case correctly no one would be calling for a travel ban.
Probly shouldn’t say this, because I don’t come around much anymore and try to stay out of trouble when I do…..but man, what a brilliant exercise in moronic condescension that AL post was.
And that’s before you even get to “Jew in well.”
Yeah, because we have idiot politicians and media we should overreact before they impose it on us. Why, if we’d just started taking off our own shoes right after 2001, we wouldn’t have regulations making us do it. We should all just fall in line with whatever the crazies might want, because John told ya so.
Chomsky was right; you don’t have to impose crap on Americans; they’ll gladly impose it on themselves. Unthinkable thoughts indeed.
John Cole +0
@efgoldman: I know it’s not airborne, boss. But Vinson was!
Drum roll please! I’ll be here all night.
Actually not. Going to bed. Night all.
John Cole +0
@eemom: C’mon back- according to FB quizzes, you and I are soulmates.
That upsets me as much as it does you.
Looks like the hysteria isn’t confined to the U.S. (via):
Wrong. Republicans would be calling for a travel ban from African countries if Mr. Duncan had had chicken pox.
The terror tots bringing Sharia law over the Mexican border were the last straw. You will never again see a day pass without a Republican screaming “OMG! We’re all gonna die!”
Very likely. What will be interesting is how they will twist it around and claim it is Obama’s fault.
Yeah, and in related news, the Carnival cruise ship with the lab tech from the Dallas hospital can’t dock anywhere:
@Splitting Image: In the context of my comment I was referring to a travel ban for hospital staff. Of course Republicans don’t want anyone with dark skin from any country to enter the US, whether legally or illegally. That hasn’t changed. They just come up with new reasons why.
@efgoldman: A bucket of thumbs up to this comment. So far, Cole’s up on honesty but down on those waddayacallits . . . facts.
It looks more like Texan officials covering their asses with security theater than anything else. I am pretty sure that doesn’t count as an “I told you so” moment. YMMV.
The Pale Scot
Perhaps there’s a way to convince WRNJs to stay away from the polls next week by toting the existence of a gay/atheist/pro-union strain of Ebola.
I’d happily spend the day north and east of Tampa wearing a tye-dye shirt and heavily breathing on the locals.
I’m with you on this John. The medical people should have known better. The problem is that this is Texas and each of those that exhibited any sort of common sense would have had to eat all the cost.
@Violet: I saw that. I got a funny feeling everyone on that cruise just got a free extension to 21 days.
@The Pale Scot: Very dark skinned people wearing African style clothes standing outside polling places in white neighborhoods might dissuade a few.
@eemom: AL’s post was not only moronically condescending, it was illogical as well. Sometimes my first impulse is to blame someone, other times it is to look for solutions. In fact, they’re not mutually exclusive inclinations. Her post was total bullshit, through and through – glad John didn’t just take it on the chin, because he said nothing wrong or degrading.
Let’s face it, also – if this occurred under Bush, we’d find a way to blame him for not doing more. The impulse to shoehorn this affair into conventional partisan politics is almost irresistible (however irrational). At some point we have to cop to the basic fact that we are tribalistic beings.
When it’s Texas officials agreeing with you, you might not be as right as you think you are.
@efgoldman: If crazy white racists are shooting black people outside white polling places I suspect that would dissuade a few white people from voting. As much as the white people talk a big game, they really don’t want to get shot while voting. Even if it’s black people getting shot, shots are still being fired. Moms aren’t going to get the middle of that.
@Felonius Monk: FOX News is way ahead of you — they’ve already got an “expert” (Keith Ablow? can’t be arsed to look it up) explaining that President Obama, due to his Kenyan/Marxist roots, wants Americans to die of Ebola as “reparations”. The reports I’ve seen, second hand, are that FOX is carefully explaining that they can’t say whether the President actually personally encouraged that diseased Liberian to lie about his exposure and bring his dark-skinned, ferrin contamination into the heart of Pure Texas, but, y’know, some people say. By this time next week — barring ISIS kidnaps a young blond woman off the beach in Monterrey, and distracts them — I expect to see bad forgeries of Duncan’s plane ticket, signed by the President, posted on Jim Hoft’s site.
And *that* is why I don’t want to encourage the idiots to run around “taking precautions” that are entirely theatrical. We have waaay too many people exercising their imaginations on this topic already!
Agree with you, Cole; it’s common sense. The nurse hopping on a plane is incredibly stupid.
Calling the nurse stupid in no way eliminates the responsibility of the Hospital execs for their fuckups.
Hey, they’re making an Ebola TV show!
October Surprise! Which side will be so freaked out they are afraid to go to the polls? With all those strangers,ugh! Standing on line, and using the common and no doubt germy markers.
All this freakout over one death?
That says it all, more than anything.
You look at the horror in Africa….and the bullshit going on here becomes nothing less than obscene.
Two different and understandable points of view are operating here.
John Cole seems to have recently experienced life as a series of improbable medical disasters, and his resulting nervous condition seems to have been pumped up a little by listening to whatever noise is coming out of cable news.
The nurse, on the other hand, lives around disease and is conditioned to be calm about it. And she is probably America’s foremost authority on what a ebola looks like as it advances into a communicable stage. She allowed herself to get up close to it, because she is the kind of person who can reason her way to doing that.
The nurse considered what she knew and made a reasonable call, and she responsibly checked with the CDC to confirm that it was the right one. Calling her stupid doesn’t add anything at all. It’s just a little more irrationality injected into a situation that doesn’t need any more.
Well, John, I completely agree with you. The second nurse and the lab worker who went on the cruise are incredibly selfish idiots. Its 21 days. It’s not even a month. Reimburse them for their trouble. Furthermore, there’s a simple fix to this. Pass a fucking federal law forcing travel related businesses to refund money to people under quarantine. The business lobby manages to get complicated tax legislation passed. Congressional staff can fashion a bill that limits abuse of the law. I’m betting money the second nurse didn’t want to lose her trip or pay extra and so just got on the plane. Ditto the lab worker. I don’t know who the bigger idiot is. And, no, I’m not blaming anybody for getting ebola in this situation.
Full metal Wingnut
@efgoldman: Sweat is also a bodily fluid, dingus.
@Lee: Can the ship survive at sea for 21 days without docking for refueling etc? And I hope the nurse’s fellow cruise passengers don’t end up locking her in her cabin for the whole cruise like that poor passenger who got locked in the bathroom during flight after getting sick
Don’t have to take shoes off anymore, mostly.
In addition to the woeful state of basic economic education in this country, please let me add how basic medical principles work. And God bless, John, but why do medical professionals need to kowtow to professional and opportunistic fake hysterics in making plans in the course of doing their jobs?
I’m old enough to remember the early days of AIDs hysteria. This is reminiscent of my mother getting the trepidatious whim whams because I shared dryer loads with HIV positive persons in 1987. I never did get AIDs from my socks and underpants, but that’s probably just pure luck, not science.
TL;dr: if you aren’t in a position to be vomited on or shat upon by a symptomatic patient, you can probably go on vacation without worrying about what Keith Fucking Ablow thinks. And you’re rolling over for the nutbag brigade if you try to play the I’m not crazy, but let’s facilitate for the crazy paranoids. Enjoy your Alex Jones gift bag on the way out.
I’m a nurse and I’ve possibly been exposed to Ebola and I think I maybe should be quarantined
I mean Common Sense tells me I might be a danger to others by spreading this deadly virus around.
However neither the health authorities nor my employers at the hospital I work at and where my possible exposure took place have said anything about me not doing my job while I “self-monitor” for Ebola symptoms. Since my job obviously involves dealing intimately with sick people some of whom will have compromised immune systems then clearly the experts are not at all worried about me being contagious.
Now a nurse’s income isn’t poverty level but it’s not wealthy either and I have these non refundable tickets to fly to my family and fiancee several states away as I’ve moved for my job and been living in a new city apart from my family for some months now and I sure would like to not lose the money I put into the tickets and I’d really like to see my family and get some moral support after what I’ve been through lately. I haven’t had time yet to make any friends here so if I don’t use my tickets I’ll spend my time off basically alone.
Hmm… Me still working with full approval of both the authorities and my employer indicates the experts aren’t worried about me being contagious, I know what, I’ll call the experts and see if it’s OK to go ahead and fly and not lose the money I had spent on those tickets.
BTW, my security software says there’s five trackers on the email login and recommended I mask my email but I figured that would throw my comment into moderation.
What’s up with the tracking?
Sister Rail Gun of Warm Humanitarianism
@Sister Rail Gun of Warm Humanitarianism: In this case it’s a don’t track me plugin for Firefox, don’t really know that much about it but my number of bogus emails has dropped dramatically.
I think I have tracking cookies selected for deletion in AVG, I’ll check to make sure. I don’t think I’ve logged in here since I started using the plugin so it was the first time I saw that message here.
Thanks, I’ll go back to Lurkin’ now..
Sister Rail Gun of Warm Humanitarianism
@bin Lurkin’: I think I found it. There’s a cookie set whenever someone comments that identifies that person as owning that comment. It triggers the editing options.
Which suggests that automatic cookie management might explain why some people can’t edit their comments on certain systems. And that it won’t transfer between systems. Must remember to test this after class.
@efgoldman: Exactly. Zero people on that plane will get it. It doesn’t spread until people are at the vomiting and diarrhea phase. The only real risk is to healthcare workers and close family members who are caring for them at that stage. I think it’s stupid to quarantine people until they start having fevers. If we get to carried away then we’ll be closing down hospitals just because they had an Ebola patient.
Sister Rail Gun of Warm Humanitarianism
@Van: The only part that bothers me, and the reason I wouldn’t travel were I in those people’s shoes, is that travel involves being trapped for several hours (or days, in the case of the cruise) among a lot of people. If there’s a chance, however small, that I could be not feverish when I start the process and develop diarrhea and/or vomiting before I’m finished, it’s just flat out rude to chance subjecting the people around me to the mess, infectious or not.
We need a border fence. Surrounding Texas.
@Blister: Yes, this is well stated. We need to understand where people are coming from, but some points of view are more defensible than others, and there’s no reason to give in to hysteria.
Yes, John Cole, I feel ya… I made a comment early on that the hospital in Texas had NOT followed CDC protocols as they said they had, and that nurses and hospital staff had not worn adequate protective gear, used infectious disease preventive measures, etc. My friends and acquaintances were OUTRAGED at me for blaming the victims and/or not understanding that the virus somehow penetrated the defenses, yada yada!
I am exhausted by how stupid everyone is getting.
…is that you probably would catch AIDS from their socks?
Not to worry: those weren’t their shoes at all—they got someone else’s on the far side of the TSA check-in.
My issue is with the lab tech. Unless his lab is unsafe why can’t he go out where he wants merely because idiots are wetting their pants over Ebola?
It’s issues like these that make me understand how John used to be a a Republican. Lots of ink spilled condemning health care workers for supposedly stoking this panic, none whatsoever for their bosses who failed to institute a travel ban or for the media that is blowing on the flames as hard as they can.
For John or others who think the nurse or lab tech were stupid, can you please explain why? Neither were symptomatic, neither had any reason to think they had contracted the virus. Vinson flew to Ohio before Pham was diagnosed and probably knew nothing about it until she got there. She monitored her temp as directed, noticed a slight elevation which was within the normal range (not a fever) and which was well below the diagnostic level for contagious Ebola. Still, she called the Texas Dept of Health, who told her she was ok to fly. What else should she have done? Could she have afforded to rent a car and spent two days driving back to Texas? If anybody fucked up there, it’s the Texas DOH or the CDC. Vinson used appropriate medical judgement – she didn’t endanger anybody, even in retrospect. According to the best medical knowledge available, she was not contagious. Her superiors and the CDC agreed. As for the lab worker, jesus fuck that’s ridiculous. Assuming he/she followed even minimal PIM protocols, the odds of infection are tiny. Almost all known transmissions are from direct contact with acute Ebola patients – at a stage of the infection where they’re shedding so many virus-laden fluids that it’s difficult to avoid them. It would take a serious fuck up to manage to transfer fluid to your mucous membranes while processing blood from a test tube. Dealing with an acute Ebola patient is one thing; it requires special protocols with which the hospital was obviously inexperienced and unprepared. But handling potentially infectious blood is standard stuff, and freaking out about it is just silly.
Absent any clear directives from the hospital or CDC, there is simply no medical reason for either of them to have acted differently. Anybody who disagrees needs to show their work.
John Cole +0
The nurse was stupid because she was exposed to a patient at his most contagious with what all the nurses there state were inadequate training and equipment, and then hopped on a flight anyway. It’s that simple.
And this whole “YOU AREN’T TALKING ABOUT THE HOSPITAL” smacks of the lamest of internet arguing techniques- “You’re talking about X so you clearly don’t care about Y.”
Obviously, the vast majority of the blame is due to the hospital administration for not being even remotely prepared. Some of the nurses have said they never even discussed Ebola prior to handling the patient. The hospital is a disgrace- as others have noted repeatedly, no other “panics” from other hospitals have arisen. All this is from one shithole.
But you don’t get to have it both ways- if you and the nurses are all know and state you were not trained and not given the right equipment, you don’t get to turn around and say “whoopsie- hoocoodanode” after you hopped on a plane and turn up positive for ebola. Hoocoodanode? YOU! You were the one at ground zero.
@Thomas F: Anthrax happened under Bush and there was no mass cable/media freak out to blame him. There was a freakout of course (remember folks wrapping their homes in saran wrap and duct tape). It died down after a couple of weeks once everyone saw that we were not all going to die. The irony is that antrax is transmitted thru the air hence all the hazmat responses to white powder in envelopes. If I remember, one of the last victims picked up the disease from an envelope in her mailbox that had gone thru an infected postal sorter. NOW that is contagous!.
@Thomas F: There actually might have been a way to blame Bush. The man was the governor of Texas, the only state to fuck this up so badly and famous for deregulating and profitizing every last possible industry. Do I also need to mention his other fuck ups concerning Katrina, Iraq and exempting the frackers from polluting our water?
One thing I haven’t seen mentioned anywhere: the very first Ebola patient brought to the US was treated with an experimental drug and cured. Does anyone know why this was not made available to Duncan?
Well-said, John Cole. EXACTLY correct on every point.
@Glidwrith: I saw in a couple of places that the drug is very hard to make and there were only a couple of doses available. Those doses had already been administered to the earlier Ebola patients. They are trying to ramp up production.
In light of the first doctor donating blood to the nurse the question has come up why not to Mr. Duncan. Again the news reports are that there was a compatibility issue between the blood types of the two men..
@John Cole +0:
So you have a quote from Vinson herself saying as much? Otherwise, I suspect that’s 20/20 hindsight. Yes, once two of the nurses were known to be infected, it’s obvious that the protocols were insufficient. But given the lack of knowledge and experience with Ebola in this country, it’s not at all obvious that was apparent at the time. Remember, when she hopped on the plane there were no known cases of transmission in this country.
Suffice to say that’s not at all obvious from your posting history on the subject, which has been “OMG, stupid nurses are going to kill us all/force the gov’t to do crazy shit!!!”
@Larv: You are talking sense. It won’t penetrate through all the hysteria. Mebbe cole could volunteer to be that all knowing nurse at the warfront?
Ah ha ha ha ha! ‘Cause Capitalism where the bean counters and short term profits rule the roost and where in the meantime people still need to live their lives.
@eemom: Ebola in West Africa started with one death. Exposed/infected people traveled freely, exposing others spread the disease until the outbreak started to go exponential.
If we, in America, have the capacity to limit the tragedy to poor Mr. Duncan, then we should. That is done by keeping exposed caregivers and others out of the general populace– especially places like theaters and public transport where people are packed in close proximity for extended periods in hot, sweaty conditions. They deserve full compensation, for sure.
Also John, you’re usually pretty good about listening to people with actual subject matter expertise (which you may lack). But numerous people with experience in healthcare or infectious diseases have told you you’re overreacting or blaming the wrong people, and your response has been to double down and scream I TOLD YOU SO. You might want to give that some thought.
In short; profits will rule the day until the potential for disastrous consequences outweighs all short term gain.
No, it’s done by isolating infected individuals and reducing the transmission rate to <1. There are, AFAIK, no known transmission events from nonsymptomatic individuals. Calling for mass isolation of caregivers will just lead to fewer caregivers willing to work with Ebola patients.
You and John both treat this as an aside, but it’s a necessary precondition. If you want people to isolate themselves to allay what are mostly irrational fears, you need to make clear from the outset that they’ll be compensated for it. Just giving them time off, as John (I think) suggested in an earlier post, won’t cut it. It needs to be at full pay.
I don’t get what you were so right about? That the DPH would overreact? I think that was predictable. I agree that health workers should have used a little more common sense but theres a reason why 12000 people die of MRSA every year.
@Blister: Did she check with the CDC or with the Texas Health Department, which in in turn contacted the CDC? This is an honest question. Someone said on a thread yesterday that she talked to the TX Health Dept, and I began to wonder what they actually communicated to the CDC. Did they mention the nurse was in direct contact with the patient? That she did not have the recommended protective gear? That her other immediate colleague was the nurse who got infected?
All signs point to the absolute failure of this one hospital in Texas and the Texas heath care system more generally. Maryland, Georgia and Nebraska have dealt fine with the disease. Non-unionized, non-regulated, highly privatized Texas health care seems to be the source of this fiasco. Far be it from the media to cast a spotlight on the dangers of privatization and deregulation.
John Cole +0
You’re just wanking at this point.
This is widely known. Not to mention, it didn’t need to be widely known for her to make the decision. She knew. And not only did she know she had been exposed, she felt like shit and chose to get on the flight back, anyway:
And this claptrap:
Appeals to authority are fallacious in and of themselves, but particularly so in this case, as you claim to know better but don’t even know the fucking basics of what has transpired in this case.
Reading really is not your strongpoint today:
It’s RIGHT THERE in the post.
@tobie: It really doesn’t matter how the nurse got the information. The CDC was part of the loop.
It’s probably impossible to get accurate information about details like that right now. The best source of accurate news about what the CDC knows is probably news direct from the CDC itself.
With any luck, there will be an official report with all the details that will debunk the rumors and misinformation when this is done.
You are totally right on. Mr Duncan may have survived even if they had correctly diagnosed him at first — he would have been admitted in a lot less severe state (though we might still have had some problems with the break down in technique, but maybe not if he had been supported earlier and maybe given the anti-viral drug sooner).
The CDC muffed this also. Completely, right from the git go. They were very lax and did not take into account how political this was going to become and how much it was necessary for them to get their ducks in a row on message and being there on site at the location as soon as they could get their experts on planes. Way too much laxity and now, there is hell to pay with unnecessary panic. They blew it.
Mr Obama has to count on his agency heads to do their jobs. He can’t go down and do their jobs at every emergency. He trusted Dr Breden to do what needed to be done and it didnt happen, so now its a big clean up — which is never good right before elections. Yes, this will all calm down in a week when there are no other new cases reported from these exposures, but the damage to perceptions has been done. On that JC I believe is absolutely right.
Nothing to do at this point but plough ahead. Apparently I read O is “seething” about this. I don’t blame him.
I’ve stayed out of this brouhaha until now, but seriously, when you’re supporting your argument by reference to people appointed to office by Rick Perry – or hired by said appointees – then you know you’ve got the wrong end of that stick.
I think that John was trying to point out that the hysteria is continuing — not that this is the right decision to make. I think he said several times that he, John Cole, did not believe necessarily that the risk was that bad, but that the perceptions would be that “we are all going to die!”
Dr Frieden who was originally the face of Ebola management for the administration, ended up not knowing some very important things – like the protocol that his agency had on Ebola on their website was incorrect, that the actual preparedness of the 1500 hospitals in the US was actually not known at all and that his leadership didn’t groom the key people who would be communicating with the public or possibly infected workers. And before all that, he should have had a crack team on the ground in Dallas immediately after Mr Duncan was admitted and basically worked with the state to let them direct what was going on and how it was going on — including bringing effing PPE if necessary.
We have effing midterms coming up and with all the other shit happening, this was an unnecesary fuck up by a Director and agency that is usually pretty decent.
Another thing that ocurrs to me is that Obama seems to always give his agency heads and other leaders the opportunity to do their jobs right. I think his move to appoint Klain is a vote of “no confidence”in the ability of the CDC and NIH to manage this. Indeed there is no agency that is charged with coordinating the messages among the various agengies with discrete missions that might not coordinate well. NIH for example does research. CDC makes recommendations on practice and guidelines but is not charged with making states and providers do the right thing. Hopefully Klain can help knit together an approach and stable messaging . CDC still blew it the worst but it will be the administration that pays the price. That is just the way it is.
Hopefully actions (or in this case non-events) will speak louder than words. Assuming people are listening. As far as I know and/or read:
1. The first American to die (man from Minnesota) travelled while sick and no one on his plane has gotten sick.
2. No one on the planes/airports/bathrooms/etc used by Mr. Duncan to get to Dallas have gotten sick.
3. We are almost to the end of the 21 day incubation period and no one in his family or the people they came in contact with have gotten sick (not even the dog).
4. Other than the lab tech on the cruise, no one from the initial hospital visit has gotten sick and they are approaching the 21 day limit as well.
The lesson from all of this – Ebola is a horrible disease that is very infectious to the individual with it but it is not highly contagious to those around that person. Once the public (and maybe the media) starts to see how many people are NOT getting sick they will take a deep breath and go back to watching the World Series or the NFL.
And at the risk of getting embroiled in the controversy of this thread – the horse is dead. It has been beaten to death several times over. It is no longer even recognizable as a horse. At this point no one is going to change any one else’s mind. Maybe its time to move on.
@John Cole +0:
You’re right, I had missed that particular report about Vinson’s conversation with her pastor. Wow, my bad. It’s still after she knew Pham was infected; prior to that I doubt she was terribly concerned. The article bears that out, it was only after finding out about Pham that she became afraid. “Feeling funny’ is not a symptom of Ebola, and after the stress of her last few days it would be surprising if she didn’t feel off. Stress can also cause a slightly elevated temperature. Nevertheless, she called and got approval to fly both times. If she bears any responsibility, it is far less than the public health experts who gave that OK. But you choose to focus on the scared nurse, who was obviously supposed to be making coldly rational decisions about public safety. The Texas DOH and CDC? Meh. So much easier to punch down. You also haven’t answered the question of what Vinson should have done once she was in Ohio. Drive? Stay? Call public health experts for advice? Give us your insight, oh wise one.
I read it, I just didn’t remember which post you said that in. But yes, you’re treating that as an aside. It’s inserted in there as a minor point, but it isn’t. It’s something which has to be established before the fact, because it’s central to incentivizing the behavior you claim to want. Also, you say they should be given time off for their period of confinement, which is bullshit. If they’re expected to confine themselves for something that was part of their job, any confinement should be at full pay. Not everyone can afford a three week staycation where they get to sit around the house all day with nothing to do but worry whether they have a terrifying disease.
This is complete bullshit. Suggesting that people with subject matter expertise might have insight that you lack is not a fallacious appeal to authority (appeals to authority are also not inherently fallacious, but lets leave that aside for now). And even if it were, you then turn around and do the exact opposite of what you’ve just said, claiming your own authority on the basis of your supposedly superior knowledge of the facts here (that one article I missed).
If you want health care workers who have contact with Ebola to isolate themselves to avoid causing a panic, it’s both stupid and counterproductive to expect them to do so on their own, or to castigate them for not doing so. That’s a condition that needs to be mandated by hospital or public health authorities and properly incentivized. Demanding they do it on their own or criticizing their failure to do so just reduced the incentives to provide care for Ebola patients. “Here’s your new patient. You can’t go out in public while he’s in your care or for a month afterwards (you may or may not be paid for that month), and whatever movements you are allowed will be scrutinized and criticized by the press and ignorant bloggers. Oh, and you might die a horrible death, whereupon you’ll be blamed for not following proper protocols even if you haven’t been trained in them.” Why would anyone say okay to that? I’d either refuse or quit. That’s not what you want nurses thinking if we do have a larger outbreak. A shortage of professional caregivers hasn’t been working out well in West Africa.
I had a very similar thought. Let’s just say that I’m very, very skeptical that anyone would get any compensation related to any measures taken to contain Ebola.
*Flips bird in Cole’s general direction*
John Cole +0
@Larv: No, I want health care workers who have been exposed to Ebola when not adequately protected to use some common sense and not get on airplanes. That you find this to be an over the top request is baffling to me. Thousands of people are exposed to things all over the country every day, and I think nothing of it. This case is different.
@John Cole +0: You’re getting upset after the fact. “Feeling funny” isn’t a symptom that indicates Ebola infection, or more importantly, that Ebola can be transmitted. The reports you trust say that she checked with others (either the hospital or the CDC directly) and was told that she was Ok to fly.
“She should have done this and that” is hindsight. It doesn’t have any bearing on what happens in the future. She wasn’t infecting people on the plane. The lab supervisor?
19 days with no symptoms. But she “handled” or “may have handled” a lab specimen, depending on the report you trust.
Duncan died on October 8, so if the 19 days is correct, then the “handling” and potential contact would have been around September 29 (when Duncan was officially diagnosed with Ebola) or very shortly thereafter. Nobody else in Texas was diagnosed until October 12 when nurse Pham was diagnosed – the same day that the cruise ship left Galveston.
In 2 more days, e.g. Monday, the lab supervisor will be in the clear, and so should everyone else who might have been exposed at the Dallas hospital (assuming no other potential exposures occurred after Duncan’s diagnosis, of course).
tl;dr – the nurses and lab supervisor were doing their jobs with the best information they had. They weren’t required not to travel, and there was no need for them not to travel. Saying they shouldn’t travel because they “should have known” is hindsight – point is they didn’t know. Making everyone else in the future who has to deal with Ebola lock themselves up for 21 days because they “should know” is a stupid, counter-productive policy.
It’ll be good when we can argue about how stupid and evil Republican policies are again. :-)
@John Cole +0:
Why? That’s a serious question. It’s not clear whether your primary concern is public health or public opinion.
If it’s public health, you seem unwilling to acknowledge that asymptomatic individuals aren’t contagious. As a medical matter (caveat: IANAD), I don’t see anything wrong with what they did – Vinson wasn’t symptomatic when she left for Ohio, she monitored her condition regularly and contacted the appropriate experts when that changed. Medically, I think they were right in letting her fly. She wasn’t infectious, and it was the quickest way to get her back to Texas where there was already an Ebola presence and she could be monitored. Maybe they should have flown her directly to NIH or Emory, but in the absence of any actual symptoms that may have been premature. The lab worker is an even easier case – there’s no valid public health reason to restrict her movements.
If your concern is public opinion and the potential for panic, then you’re criticizing the wrong people. Their expertise is in health, and their decisions are defensible on those grounds. They aren’t PR experts, and expecting them to anticipate the current panic is unreasonable. That’s the job of more political types at the state DOH, NIH and CDC, and if you want to restrict their movements on those grounds, they are the ones who need to implement and facilitate such restrictions.
from what i understand the nursing staff at this particular hospital has been complaining about training and equipment etc long before ebola came to texas. maybe it’s wrong, but my assumption is that this particular nurse was well aware of the fact that she was being made to work without proper equipment and guidelines, and seeing a colleague of hers become infected likely hit the point home.
John Cole +0
@Larv: She has ebola. It didn’t just miraculously appear. I’m going to go out on a limb and guess she contracted it, through no fault of her own, while unsafely handling an Ebola patient at his most contagious without adequate training or equipment.
So not only was it stupid to fly from a medical standpoint (your call for me to rely on her expertise is laughable because the major point is that THEY HAD NONE- that’s the key gripe against the hospital), but it was stupid from a personal and public concern standpoint.
At this point, I just think you want to absolve her of any and all responsibility. She was dealt a shitty hand by her hospital, and she doubled down. She should not have been on the flight there, and she most certainly should not have been on the flight home, and that you find it defensible despite the fact that she is one of a handful of people who have contracted the disease is ludicrous. She was exposed, she developed it. It’s as clear a cause and effect case you will find in medicine.
And this reliance on it not being contagious when asymptomatic if also foolishness. I didn’t say she had to lock herself in a room. I said she shouldn’t have been on a public plane because she knew she was exposed under circumstances that made it very likely she might have it, and went anyway. And now she has ebola, may have exposed other people because she was symptomatic on the flight home, and you still can’t seem to figure out the cause and effect and are just flailing away at me for saying “Wow, that was fucking stupid.”
And because of the way idiot nation works, instead of relying on a little common sense, we’re going to face backlash and real quarantines and travel bans and the like. And they may end up affecting you. You’re your own worst enemy.
@John Cole +0: A-Hem. The CDC would like a word with you, JC:
Give up yet?
@Elie: If the CDC can only make recommendations, how can they enforce compliance? Especially in a state opposed to all federal, regulatory intervention? Georgia, Maryland, and Nebraska have all dealt fine with the disease. Why did CDC recommendations work there and not in Texas?
@John Cole +0:
So you’re just going to repeat yourself rather than actually respond to what I wrote? Hey, it’s your blog.
See Scott’s post above. The CDC disagrees with you. Or is that another appeal to authority?
I’ll be charitable and assume you’re just misreading the media reports. She was not symptomatic. She was “feeling funny” which has no diagnostic value. She wasn’t feeling poorly enough to mention it to the Dept of Health when she informed them of the elevated temp and asked for advice on flying. She did not have a fever and she was not shedding fluids – no sneezing, vomiting, diarrhea, etc… She was, according to the best medical knowledge available, not contagious. Again, the CDC disagrees with you. If you’re still convinced that you know better, try targeting them rather than low level workers you’ve already conceded didn’t have the training to decide on their own.
That’s fucking ironic coming from a guy who is utterly refusing to reconsider his initial post on the basis of new evidence (the CDC approving her travel) and has instead decided to double down on the blame game.
I have to say, you’re doing a fine job of demonstrating that. You do realize that Colbert was being sarcastic about believing in your gut instead of facts, right? I really am generally a fan, but you’re just way off base on this subject.
This is NOT an I told you so moment. Complete fail, John.
For most of us poor working schmucks, changing travel plans is a *very big deal*. It is expensive, it takes work time-of planning, and everything else that goes along with that. Those things fucking matter to regular people. It’s not fucking selfish to decide to stick with longmade travel plans – it’s usually just plain necessity.
The CDC HAS to have a protocol, and a number on this. They decided on 100.3. If they have to change that – fine. But getting on that nurse, who is by all accounts a hardworking and caring nurse, is just monumental fail for you.
And for fuck’s sake – people still get colds. Even nurses. And you probaly walk around with a 99.5° all the fucking time.
“And now she has ebola, may have exposed other people because she was symptomatic on the flight home.”
You cannot have just saidthat. I just spent way to much time arguing with a REALLY FUCKING STUPID PERSON about this. Now YOU? Fuck me.
Unless she invited every guy on the flight to skullfuck her, and went down on every woman, and for the kids just had them eat her saliva – SHE, WITH ALMOST 100% CERTAINTY, DID NOT INFECT ANYONE ON THAT PLANE.
“Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.”
You’ve probably seen this:
I don’t think cole is arguing that she was violating CDC rules. I think he’s arguing that she was violating common sense.
Just because you have a slight temperature before boarding a plane does not mean you won’t become fully symptomatic on the flight. Ebola can work fast sometimes.
I still think it’s common sense to avoid air travel if you work with an Ebola patient and think you have caught the virus.
dude, Ebola is awesome
@chopper: Common sense is often wrong. Very often wrong. This episode is one of those cases.
She asked the experts. They said she was Ok to fly. She was Ok to fly.
Ebola isn’t something new – it’s been around since 1976 (at least). Just because too many people think that an often deadly disease is a highly contagious disease doesn’t mean that it should suddenly be treated that way when, in fact, it isn’t.
Judge Jenkins and the Mayor have been handling a major fubar of a well respected hospital and doing what they can to correct the mistakes made by same.
@chopper: And just because you have a really low greade fever doesn’t inherently mean you cancel months of planning, almost certainly involving getting time of work, expensive plane tickets made more expensive if they’re rescheduled (not to mention it was for her wedding plans, which adds another layer of very natgural human emotional response), acomodation, and who knows what else.
I think people are making a mistake of not putting themselve in her shoes regarding all that. Just because she’s a nurse, and just because she treated an infectious person – something she’s probably done a thousand times – doesn’t make her markedly different from the rest of us in how she deals with, or should deal with, a situation like this. She did the responsible thing – and asked CDC. They have a protocol. If it needs changing – well, that’s how the world works, isn’t it?
it sucks to be sure but if you think you contracted ebola from the ebola patient you treated at the shitty hospital, common sense dictates that yes, you do cancel your trip to cleveland.
who have turned around and said ‘it was stupid that we told her she could fly. that was dumb of us and a mistake’.
needless to say, the CDC recommendations are not necessarily perfect, and they themselves admit that what i’m calling a common sense decision should have been the one made.
I disagree with you on some stuff Cole, but not this. You’re exposed to Ebola and you take your azz on a plane or a cruise ship?
no, I don’t think so. I don’t blame any of those countries that refuse to let that cruise ship dock. Don’t blame them for one friggin’ minute.
tis true, Violet.
The hospital in Texas treated the man as they had done with numerous poor Texans with no insurance – like shyt.
they just didn’t understand it would blow back like this.
as far as I know the lab tech (the cruise ship dude/woman) was not ever exposed to the virus. plenty of people work with infectious samples in the lab and as long as they use appropriate equipment and follow protocol they’re fine.
Because Americans are irrationally panicky, and triggering panic among them is bad, that’s why. Not sure we’re the worst about Ebola panic but our media (and Republicans including Fox, for perceived electoral advantage) are gamely trying to make us #1 in panickiness.
My employer provided free flu shots last week. The flu-shot place was packed, and some people (including me) commented that we were extra-incentivized to get flu shots because it would reduce the risk of a high fever during the next 6 months and we know that fevers may be bad to have for reasons other than that flu, and associated high fever, are bad. Like the risk of 21 day quarantine, or triggering panic.
@chopper: People don’t usually get to go back in time and do things over.
See the CDC FAQ above again. There was no reason for her to be denied the ability to fly home.
Another thing to keep in mind, also from the CDC:
As long as a person isn’t shedding virus, via vomiting, etc., or being so near death that their skin is covered with virus, there’s effectively no danger in contagion. She wasn’t a danger to other passengers, and it wasn’t stupid of her to travel.
The lack of empathy and the second-guessing of the nurse here is rather disconcerting to me. If she didn’t have any common sense, she wouldn’t have bothered to call to ask what she should do.
The concern over the “optics” in this situation is sadly misplaced, it seems to me.
But, as others have noted, we’ve beaten this subject to death now.
With luck, the freakout will be over soon.
and again, the CDC themselves have said she should not have gotten on the plane. I’m not saying she exposed anyone since she was only becoming infectious. however, Ebola is known for its very sudden onset of symptoms, and in some people that includes vomiting early on. she was certainly taking a risk but luckily it worked out. I just don’t think it’s a risk she should have taken, and even the CDC agrees.
I agree with you. Triggering panic among the Wildebeasts results in stampedes..
Couple off points:
1. While there is a dimension of personal responsibility as a professional that the nurse wasnt 100% on target for in my opinion, the CDC REALLY blew it by not having a strong approach and decision that it had in place to communicate the policy UNEQUIVOCALLY. With a shades of gray direction, she made her own decision (which I personally think was flawed) The problem is because the scientific facts (that she is unlikely to transmit any disease), conflicts with the politics and perceptions of the community. CDC did not see that risk in time to get in front of it. That is, EBOLA WE ARE ALL GOING TO DIE” is operational right now and it is the law of the political universe. That unfortunately, has strong political impacts right before a bi election where Democrats would love to hold on to the Senate. Frieden forgot that he also has POLITICAL responsibilities — not just the science. He has to be aware of and protect the administration from the political fall out. That he fucked up.
2. I think Ms.Vinson may be sicker than Ms. Pham — that she got more viral load, (hence the suspicion that she may have been sicker longer). That is not good. I pray for her — big time. That may be why she is at NIH and I know they are going full out “balls to the wall”. Her family is not allowing any information about her status and treatment to be released at this time. Another not so good sign.
On the good side, by the end of the day tomorrow, we will have cleared 21 days since the first group of exposed people made contact with Mr. Duncan. This group includes his fiance and the three young men who were in the apartment that he stayed in, as well as other care givers at the hospital. That is one small but important thing to be cheerful about.
“but if you think you contracted ebola from the ebola patient you treated at the shitty hospital”
She CLEARLY did no think that. Jesus.
Tell that to her pastor.
I am wrong. Amber Vinson is at Emory and Ms Pham is at NIH
Really tired of the blame the nurse game here. SHE FOLLOWED PROTOCOL. She asked for advice and CDC told her it was OK to fly. Why do some of you still insist that she should have used “common sense”? She did exactly what she should have done. If you want to blame someone, blame the people at CDC who made the decision that she was OK to fly. Ms. Vinson was put in a position by administration at Texas Heath Pres that could kill her. Maybe we should be focusing our attention on that clusterfuck rather than exercising 20/20 hindsight.
@chopper: Unless I’m mistaken, you’re mixing up the timeline (dates below from the NY Times Q&A). 1) Nurse Vinson got OK to travel to Cleveland before she left. She flew on October 10. There was no sign of any contagion from Duncan at that time. 2) She started feeling “funny” according to one report before she returned, and had a 99.4F temperature. 3) According to the NY Daily News, she talked to her Ohio Pastor after she found out that the other nurse, Pham, had been diagnosed (October 11).
Vinson was diagnosed on October 15, 2 days after she flew back to Dallas. So presumably she talked to the pastor on October 14.
So, she was expressing worry a day after her total trip was complete. That doesn’t sound to me like an indication that she was worried that she had contracted Ebola at the time she was deciding to fly to Cleveland, and on the return trip she called to get an Ok.
(Yes, the CDC head said, after the fact, that he thought she shouldn’t have flown. But subsequently, the CDC FAQ that was posted yesterday said, “Therefore, there was no known reason at that time for her to be restricted from boarding the airplane.” The timeline, it seems to me, indicates that the later statement takes precedence.)
Some think that clairvoyance is common sense. I don’t. YMMV.
@efgoldman: “Unless she was barfing, pissing, bleeding, or shitting directly on people on either plane, nobody else got it.”
Barfing, sneezing, pissing, or shitting in a way that left fluid drops on seats, luggage, or other surfaces might also be a problem. A bit of ebola-rich mucus hiding invisibly on your laptop’s keyboard might well lead to catching it.
@feebog: “Why do some of you still insist that she should have used “common sense”?”
Because it’s not unheard of for a plane to sit on the tarmac for hours, with everyone trapped in their seats.
Because she was aware of her risk enough to be taking her temperature.
Because the temperature that gets the (erroneous) OK from the CDC isn’t necessarily going to be her temperature all day. Her condition could worsen dramatically *that same day*.
Yes, it’s the hospital’s fault that she was in that position, but she still should have used common sense and not flown to Ohio. The airline, i’m sure, would have refunded the ticket price if she explained the situation – that’d be a hell of a lot cheaper than taking the plane out of service and super-disinfecting everything inside it, let alone the potential lawsuits from other passengers.
(Likewise, the woman on the cruise ship probably would have had her money refunded, because that ship is going to be “the ebola ship” until the cruise company announces that it’s been bleached from stem to stern.)
@chopper: ” plenty of people work with infectious samples in the lab and as long as they use appropriate equipment and follow protocol they’re fine.”
We’re not talking about “plenty of people”. We’re talking about Texas Health Presbyterian Hospital. At this point, do you really trust that hospital to have “used appropriate equipment and followed protocol”?
@LT: “Unless she invited every guy on the flight to skullfuck her, and went down on every woman, and for the kids just had them eat her saliva ”
So you’re saying you believe Duncan skullfucked and/or went down on his nurses?
Cole don’t let them grind you down. Hurt fee fee’s won’t do much good shitting out your kidneys with Ebola. And given the last 13 years of spectacular and catastrophic pants wetting if America gets 10 cases it will probably end up like The Stand in a fortnight. And how your military cannot mobilise sufficient logistical support to assist with this is a disgrace.
No, she called her pastor before her flight back. You have the timeline wrong.
From that story, just after the bit you quoted, Scott:
@John Cole +0:
I say amen brother. It’s too tiresome to go into the details of the AIDS Epidemic scare back in the day, but the parallels are there.
Neither disease can be spread just by sitting next to someone who has the virus. But is would be foolish to try to treat these viruses carelessly.
By foolish I mean that someone within an organization like an enormous hospital, must be in charge of obtaining the proper equipment for the staff and in-training them in best practises. In the case of Ebola, best practices must extend to the life of the staff outside of the hospital: at least for the 21 days in which they might be vulnerable to the infection.
We all know this. The administration of the Hospital – at least the bean counters in the administration, must not be allowed to over-rule the doctors and nurses who need very specific equipment and training: on-going training, not just one class and you’re done,
They will cut corners wherever they can, and preparing for an outbreak of a dangerous virus seems to them so unlikely that it doesn’t warrant the funding. I’d be curious to know how many AIDS patients this hospital cares for. My guess is very few or none.
I’d also be curious if the ER staff gets sloppy about other best practices too: bad enough that they sent him home with a fever and an RX . I’m guessing they didn’t spend much time with an uninsured patient and either didn’t bother to get a history from him, or didn’t understand the implications of his return from Liberia.
Liberia! Dammit. Heads up people – too tired to think about that is the most foolish decision of all the foolish decisions made by the folks at that hospital.
Ha, you obviously have not dealt with airlines. During a trip to Hawaii I had emergency surgery and was hospitalized for a week. United Airlines refused to change our flight so we could return home early. In fact, we had to fly to another island as planned to get home. Your assumption that the airline would refund her ticket because she had treated someone with a contagious disease is laughable.
I’ll say this again, this young woman’s life is now at risk for reasons that were completely beyond her control. She did exactly what she was told to do, check with TPH, who cleared her to fly both to and from Cleveland. The main concern here seems to be the fact that Ms. Vinson was on a plane. Let’s assume she went to a crowded restaurant during the same time period. Wouldn’t there be the same risk to other patrons and the employees of the restaurant? And before you answer, remember that this is not an airborne disease, you must come into contact with bodily fluids, not just breathe the same air.
I’m just not willing to give too much shit to some twenty-something who, after taking care of a man dying from fucking Ebola, decided that she really wanted her mom. Yeah, it wasn’t the smartest thing she could have done, but as a group, people who have experienced trauma aren’t known for their rational decision-making skills, and there are people higher up the food chain who really should have been dealing with this. It sounds like they are now, and that’s a good thing.
@Thomas F: Bush would have shrunk the Surgeon General’s office, voluntarily.
That’s after she’s already in Ohio. When she left Texas, she had no symptoms whatsoever and nobody besides Duncan had been diagnosed. So she’s in Ohio and due back to work. And while asymptomatic, after the Pham diagnosis she fears she may also have been exposed. As I’ve asked several people, at that point what should she have done? What would have been “common sense”? Staying in Ohio, and risking endangering her family and a whole new hospital? Driving back to Texas, which would have taken at least an extra day, during which she may become symptomatic? Or maybe calling the experts for advice? And frankly, they made the right call, at least on medical grounds. If she was exposed, the best thing to do was to get her quickly back to Texas while she was still asyptomatic and not contagious, and where she could be monitored by the personnel already at the hospital. The only mistake was by the CDC in making that decision on purely medical grounds and not realizing that it would cause a panic to have her on the plane even though the risk was very very small. At that point there was no solution which was risk-free.
So she still got on a plane thinking she had Ebola and running a temperature. Sorry dude but that doesn’t pass the common sense test especially given Ebola’s notoriously quick onset of symptoms.
What should she have done? Stayed secluded at her parents’ house until determining if she became full-on symptomatic and contacting the authorities then.
@chopper: “So she still got on a plane thinking she had Ebola and running a temperature.”
Are you an idiot or an asshole? She *did not* think she had ebola. Asshole.
There’s a huge difference between “I’m afraid I might have been exposed to Ebola even though I have no symptoms” and “I think I have Ebola.”
Also, I think your proposed solution is a terrible idea. That would have created the potential for a second Ebola epicenter in the US (not to mention endangering her family). We already have one in Texas. If the fear is that she may have been exposed, the best thing by far is to get her back there before she became symptomatic/infectious. Given the known progression of symptoms, if she wasn’t even running an actual fever on the morning of her flight, the chance of her becoming fully symptomatic and endangering other passengers while in transit was miniscule. It was almost certainly safer than the alternatives. The only totally safe option would have been to put her on an isolated medical transport to Texas or one of the Ebola labs (Emory, NIH, etc…). But that’s not something she had any power to decide.