Won't work. People can still drive out of Texas. MT @realDonaldTrump: STOP THE FLIGHTS!
— John Cole (@Johngcole) October 24, 2014
First things first. I now have a real personal problem in that every time I hear or read the word Ebola I mentally hear the old Ricola commercials.
I’m sure I first heard it on TDS or Colbert or John Oliver, but I can’t remember. Can’t remember the source of that joke about stopping the flights to Texas, either, so I’m just straight up lifting shit without attribution all over the place. Dork thug life, I’m living it.
Second, this:
Man do the NYC health care officials make the Texas Ebola shitshow really look like it was run by a clown caucus.
— John Cole (@Johngcole) October 24, 2014
Other than when Cuomo opens his yap, every single person I have seen on the tube talking about this has been calm, in control, delivered facts in a reassuring way that will tamp down the hysterics from everyone but the usual suspects (Trump, etc.), and just on top of things. I like that. I wish the first case had flown into NYC instead of Dallas and I would not have had my “Ebola hysteria” hysteria (freaking out over a fear of people freaking out and reacting to one case of Ebola). By the way, it drives me insane when they call this an Ebola outbreak. It’s an Ebola case.
Finally, I know he is a hero because of the work he does with Doctors Without Borders and has more guts than I do going to far off places and dealing with really awful stuff, and bless him for that, but seriously, why?
A doctor in New York City who recently returned from treating Ebola patients in Guinea became the first person in the city to test positive for the virus Thursday, setting off a search for anyone who might have come into contact with him.
The doctor, Craig Spencer, was rushed to Bellevue Hospital Center and placed in isolation at the same time as investigators sought to retrace every step he had taken over the past several days.
At least three people he had contact with in recent days have been placed in isolation. The federal Centers for Disease Control and Prevention, which dispatched a team to New York, is conducting its own test to confirm the positive test on Thursday, which was performed by a city lab.
While officials have said they expected isolated cases of the disease to arrive in New York eventually, and had been preparing for this moment for months, the first case highlighted the challenges involved in containing the virus, especially in a crowded metropolis. Dr. Spencer, 33, had traveled on the A and L subway lines Wednesday night, visited a bowling alley in Williamsburg, and then took a taxi back to Manhattan.
***Speaking at the news conference, city officials said that while they were still investigating, they did not believe Dr. Spencer was symptomatic while he traveled around the city on Wednesday and therefore had not posed a risk to the public.
“He did not have a stage of disease that creates a risk of contagiousness on the subway,” Dr. Mary Bassett, the city health commissioner, said. “We consider it extremely unlikely, the probability being close to nil, that there will be any problem related to his taking the subway system.”
Bowling, dude?
At any rate, granted NYC has more time to prepare for realistic Ebola cases, but if this doesn’t show the difference between health care and preparedness and professionalism in red states vs. blue states, you just aren’t paying attention.
GregB
Word has it that Governor Rick Perry just appointed Louie Gohmert as the new Texas ISIS/Ebola/Diseased Immigrant Czar.
Omnes Omnibus
Did he follow the procedures set out for him? If so, no one should give him shit.
PhoenixRising
Seriously, he didn’t realize that if the incubation outside is +21 days, he should come home & order in takeout and watch movies for 3 weeks? Alternating with walks to the park? I mean, where I live or in Cole’s shoes, this would present a serious practical problem, but dude lives in an apt in the E 30s, make it work…
Regardless of what guidance he was offered, common sense.
More support for the notion that viruses are working their agenda (‘Make more viruses!’) by affecting the host’s behavior…it’s not my field but someone should be able to pull the studies on herpes, common cold, flu, etc.
jl
@Omnes Omnibus: I guess anyone brave enough to actually go to Africa and help with the Ebola outbreak is expected to go total quarantine themselves for 21 days.
Who is going to pay them for sitting in their apartment, how they are going to get food, live even quarter way normal lives, or maybe they have important work to do where they live?
Edit: OH WAIT? They quarantine themselves IN THEIR APARTMENT? They will contaminate the garbage chute and the sewers!? OH MY GOD!!??
Who gives a crap? EBOLAAAAA!!!!!
You are correct, did he follow procedures or not?
If they guy was not symptomatic while he was out, then there is very very little, tiny, virtually zero chance he transmitted it to anyone in the general public.
Or are we going to adopt the Cheney rule for everything.
When the procedures are changed, and some one coughs up resources to pay for a three week total quarantine, and that is violated, then we can give them shit. Until then, no way.
Or maybe we should charge him with bioterrorism ‘just to be extra safe’?
Anyway, this is my amplification of your comment. Thanks for your common sense.
Stella B.
‘Cause they’re waiting for you at Bellevue with their oxygen masks.
Ear worms.
jl
@PhoenixRising: Sure, we can stand off at distance, and some slob who we deem can do it easily, let him do it, hell with him. Why didn’t he do what we deem is so easy when we know what all about his situation…?
KG
@GregB: does that mean that Gohmert can’t serve in Congress anymore? because, that’d be a win, right?
(I swear, if someone says there’s a worse alternative than Gohmert for Congress, I’m quitting life)
eemom
If I was on Twitter I’d totally follow you, Cole. However, according to my kids, even Twitter is fucking Tutankhamun at this point.
Omnes Omnibus
@Stella B.:
jl
Who proposes to pay these people while they sit on their asses in their apartments?
And how will this fly when the headlines let fly about ticking EBOLA!!!! time bombs sitting around in densely population apartment buildings. O. M G!!!!!
Omnes Omnibus
@jl: Nah, per Cole, we should freak out and demand silliness because the media is doing it. Medical knowledge and science don’t really matter.
dance around in your bones
@John Cole –
I love the Ricola twinsie thing – I have thought the same thing. EEEEEEbola! EEEEEbola!
PhoenixRising
@jl: Welp. I know a bit about his situation as a returned health care professional who knew he had treated patients with Ebola, as a friend is in that situation now. She had a sensible plan for how long she could serve, and where she could go upon return, because even 8 weeks of training from the US Public Health Service on proper use of protective gear didn’t offer her assurance that she would remain disease-free.
So instead of betting her friends’ lives that she was going to be careful enough, she made a plan that lowered the exposure for her loved ones and the public.
It’s not too much to ask, due to the simple fact that taking a month off to volunteer is a choice, so planning to avoid infecting others is part of the assessment of what you can afford to offer. Note that his employer wasn’t having him in to work during this time, so it really was at his option to leave his house. How important was that bowling session?
If we had a goddam Surgeon General, one of the items on her plate would be to issue direction about how returning health care workers should behave. But since we can’t have nice things, the responsibility devolves to the individual.
divF
I just saw Judge Clay Jenkins on Rachel Maddow, who has been the person in charge of the Ebola response in Dallas for some time now. Invited to comment on New York’s first case, he was right out there saying that the people of NY have nothing to fear, that the patient and the NYC and Federal Health Officials are handling this very effectively and professionally, calling out for particular praise the CDC. His advice to New York public officials was to get *everyone* in the community – elected officials, medical community, community leaders, clergy – to keep pounding the same points he was making, because we are fighting two problems: Ebola as a public health risk, and needless fear and panic on the part of the public.
In short, Judge Jenkins was a real mensch. He’s an elected official in a right-wing Republican city, but there was no trace of red or blue in his statements, but instead a clear sense of common civic responsibility with his counterparts in NY.
Omnes Omnibus
@PhoenixRising: What is the CDC protocol? If someone follows that, can we criticize the person?
BillinGlendaleCA
@Omnes Omnibus: I’m sure that Joe Scar will freak out enough for all of us. I’ll stay up and make some popcorn.
PhoenixRising
@jl: Have you observed that the infected health care workers aren’t going to work anyway when they become symptomatic?
Why do you think that is? Hint: Hospitals have these mean assholes on the payroll called ‘lawyers’. These people use a type of risk assessment metric like the one rock climbers use: Who cares what the odds are, what are the consequences if we beat the odds?
They can’t have him come in until 21 days have passed. He was bored. He did not have a plan for how to entertain himself during his vacation from work following his volunteer stint, or he wouldn’t have been in a bowling alley in Brooklyn. It’s not easy, but it is simple.
John Cole +0
@Omnes Omnibus:
You’re just reading what you want to read and then flaming me for shits and giggles. I clearly posted my tweet stating that I feel completely confident about the situation, bolded the part where the officials said there was nothing to worry about, made fun of Trump for his hysteria, and then teased the guy for going bowling.
Just go fuck yourself. You’re being a halfwitted troll at this point, and I’m giving you credit for the half just because you’ve been around for a while.
mk3872
Is it the harsh to ask Drs coming back from treating Ebola patients to wait 21 days in isolation before galluping around US cities ??
PhoenixRising
@Omnes Omnibus: That’s a fair question. In part because we don’t have a flag officer commanding the public health corps, because Senate Republicans are assholes who want Americans to die to prove that government can’t do anything, the CDC’s guidelines are clearly inadequate.
The fact that his employer didn’t have him scheduled for a shift is the higher bar, and the one that reflects their perception of the risks that exist despite the fact that we literally don’t have the person in the job with the right to impose quarantine on US citizens. This was litigated around smallpox, flu and typhoid over a century ago and all I can say here is: We need a surgeon general. Immediately if not sooner. This IS the kind of problem we have an infrastructure to address.
On the weekend I can lob a post over the wall on USPHS, quarantine, the USSG’s historic role and why we don’t have one, if there is interest, but I still have a workday ahead of me right now to get back out of this week.
LABiker
It’s a new sport called eboling; it’s catching on everywhere.
srv
Well, there goes League Night.
@LABiker: Thread sure went into the gutter quick.
Jim, Foolish Literalist
Do they tape in New York? I bet Joey will make himself a homemade hazmat suit out Hefty Bags (with Odor Contro!) and demand a home remote studio for his place in…. Westchester?
divF
@mk3872:
That reasoning, taken to its logical conclusion, would have us rounding up all the medical personnel treating Ebola patients in this country into isolation facilities when they come off shift, and for 21 days after they stop treating such patients. If there was any possibility of transmission from casual contact with someone who is was infected, but non-symptomatic, it would be an arguable point. However, there is affirmative scientific evidence that there are no such risks, from studies done of Ebola epidemiology in Africa over the last 40 years, combined with the known properties of the virus and of the way the disease progresses and is transmitted.
dance around in your bones
@Omnes Omnibus:
It’s all your fault that I am listening to The Vapors ‘Turning Japanese’.
No sex no drugs no wine no women
I’m on an 80’s binge.
I’ve had this Ebola argument with an old friend of mine – he thinks it’s a real threat and I tell him it’s overblown in the media. Jeebus – what was the Andy Borowitz thing?
Oh yeah – Holy Crap – we’re all gonna DIE!
dance around in your bones
Ok – Rock Lobster! The B-52’s
Much more fun than the very slim chance that any one of us will get EEEEEEEEEEEEEEEbola !!
Mike G
Remember, right wingers aren’t contagiously stupid unless they’re frothing about something, which is all the time.
PurpleGirl
I get my medical care at a City-owned/operated hospital. I go there several times a week to the various clinics. Last week large poster signs on ealses appeared at the entrances to the clinic building and the main hospital. In large letters they instruct people who have fevers and have traveled to NYC from the West African countries to tell anyone on the staff that they have a fever and the medical staff will proceed to help the person. As I have said for several weeks, HHC and the Health Department have been reviewing protocols and revising them if needed. For instance, nurses will work in teams with suspected Ebola cases. Not all HHC hospitals have the isolation rooms but they are prepared to send people to Bellevue. Today I saw new signs for the hospitals own staff to attend “town halls” about Ebola, care and protocols. Also said they wanted to staff to ask questions.
Yeah, NYC has high taxes and doesn’t do everything as I’d like but there some things the City can and does do correctly.
Full metal Wingnut
@PhoenixRising: Where do you get E 30s from? I’m pretty sure his place is at W 147th and I forgot the cross street. Which makes sense since he supposedly works/worked at the Columbia Medical Center which is in the W 160s. Super short commute-my kind of guy.
BillinGlendaleCA
@dance around in your bones: I was scanning my slides from when I went to Europe in 1979. In a picture of Munich city hall, there are posters on a building in the foreground advertising the B-52’s.
Full metal Wingnut
@jl: There are a number of great grocery delivery services for carless New Yorkers such as myself who don’t like schlepping a week’s worth of groceries but also don’t like having to make several runs that are easily carry able or fit into a stupid rolly cart able. FreshDirect is a decent one. I suppose the delivery dude could simply drop the boxes at the front door and run.
Of course, it costs *money*, but one does not need to leave their apartment to get groceries. The necessities of life are not a problem, they are easily ordered and acquired from your phone/computer in the 21st century.
The problem of course as you said is earning a living. Unless we’re willing to pay their living expenses, it’s just not reasonable to ask people to not work for three weeks. I can’t afford to not work for three weeks, I imagine most people can’t either.
dance around in your bones
I’m listening to the B-52’s doing ‘Dirty Back Road’ atm..
How interesting! Posters for the B-52’s in Europe! I think they never really got a chance on the Big Scene. But then, they woud be like The Rolling Stones (not that there’s anything wrong with that, HA!)
jl
@PhoenixRising: Thanks for correction. if there are paid leaves for quarantine period, that is good. But seems silly to me to totally quarantine yourself if there is no reason.
@mk3872:
Yes I believe that it is harsh. Anyone know a person who can’t show up for work during the three weeks and is bored shitless, if they are not symptomatic and are following protocol to monitor fever, send them out to Calfiornia. I will go bowling with them.
@PhoenixRising:
” Have you observed that the infected health care workers aren’t going to work anyway when they become symptomatic? ”
I would expect that since once they show the initial signs and symptoms of the illness, then they can more easily transmit the disease. Did your sentence contain a typo? I am not sure what your point is. Before they show those initial signs and symptoms there is virtually no chance they will transmit the infection.
I still believe it is unreasonable to expect people to come up with their own rules for quarantine. If there is a reason for a formal total quarantine, then it should be written down and people should follow it.
The experts do not appear to think there is reason for a total quarantine, therefore I will not sit around and second guess with 20/20 hindsight judging people at distance about whether they should have gone to park or bowling or drink a beer in public.
Can they leave their house or apt? Can they take out the trash? Mow their lawn? Walk near a playground? Can they come to door to receive and pay for the take-out food delivery. Or should they have a neighbor pay for at another address and throw it onto the porch from a moving car (oh, wait, would have to open the window of the car danger danger!!) How close can they walk to a play ground? Should they get on google maps and make sure there are no playground within X feet of their walk in the park?
Really, this hindsight second guessing is ridiculous unless rules are written down on paper. And as far as I know, there are no such written policy in general.
Edit: I did see a report about a television crew that was under a stricter quarantine, and maybe they violated some instructions by going out to a take-out place. If that is the case, then I would be glad to criticize them.
jl
@Full metal Wingnut: Well one commenter does say that there are leave policies, so that is taken care of at least in some places. Not sure if there is a general policy.
Before symptoms, there is virtually no chance of transmission through casual contact. So, send any bored people who cannot show up to work and have some rental car money out to Northern California, I’ll be glad to show them around as long as they monitor their temperatures as per written protocol.
A Humble Lurker
@Full metal Wingnut:
So we shouldn’t even try, though? I mean…it would probably be kind of difficult to pinpoint the exact time they’re contagious. Wouldn’t it be safer to do something?
I understand that we are in far less danger of an outbreak than in a less developed country, and I’m not living in fear of that, but it seems just a little irresponsible to not try to contain the cases we do get.
PurpleGirl
This is the NYC web site subpage from the Department of Health and Mental Hygiene on Ebola:
http://www.nyc.gov/html/doh/html/diseases/ebola.shtml
for those who are interested.
Botsplainer
Total hipster. No doubt done ironically.
Gvg
Your post does not come off as ironic or joking. it comes off as serious. You are over reacting and we need to stop these unrealistic and unnessesary self crested add ons to real science based recommendations. this idea everyone should self isolate when coming back from Africa are xenophobic. have you realized that if everyone who might be in contact with a suspected Ebola case here went home and isolated themselves, that it would only take about 3 people to empty a hospital staff from working and taking care of all the real medical needs of their hospital? there have already been at least a 100 false alarms. what if all their staff got sent home? who is going to take care of the real Ebola cases if everyone who has contact is sent home? Not to mention the heart attack, the gall stone attack and the baby with the flu.
it would actually be best for the nurses and doctors to stay on the patient with Ebola, and not keep exposing new staff to that patient, which would be different form current norms on how schedules and work loads are done.
the reason the proposed isolation is xenophobic superstition is that it’s only for people who were exposed over there, not for treatment of Americans. Hospitals asking returning aid workers not to work is just giving into what they know is irrational hysteria. the doc didn’t stay isolated because he knew it was nonsense. the contacting fellow subway riders is a waste of time and builds hysteria. Officials are covering butt and looking like they are doing something which we require them to do because we are hysterical. we need to stop. if we have a real epidemic, people will expect impossible unnecessary things and cause slowdowns we don’t need.
NotMax
Perhaps Mitt or McCain might offer one of their many mansions as an option for 21 day stopovers…
The Ebola/Ricola similarity is new to you? Really? Can remember it being repeated over and over during the Zaire outbreak in ’95, at least.
Chris
@Stella B.: You beat me to that one.
I'mNotSureWhoIWantToBeYet
@Gvg: Well said. Thank you.
Cheers,
Scott.
brantl
He wasn’t symptomatic, why wouldn’t he be doing whatever the hell he wanted to? No reason at all.
brantl
@jl: “Or are we going to adopt the Cheney rule for everything?” The general public, made into bedshitters by Fox Noise and CNN, are already there.
Xboxershorts
If NY City got the heads up from the CDC with a full list of preparations to make, then I’m pretty sure Dallas and Houston et al, got that same message. And NYC claims they’ve been preparing since July.
How much did the atmosphere of distrust of Washington that republican politicians and their media allies have been playing to, affect Dallas Presbyterian Hospital’s ability to prepare for their Ebola patient?
How much did republican state budget cuts affect this same preparation?
This shit matters, even Life and Death matters.
I'mNotSureWhoIWantToBeYet
@brantl: You’re applying what is known from science and logic. That’s wrong. Too many people’s feeling and clicks and Nielsen numbers depend on generating hysteria.
Just like with Climate Change, it might be the case that there’s something wrong with some aspect of the scientists’ current understanding, therefore, just to be sure, we need to insist that individuals do things that are counter-productive, nor not do things that are necessary, because government action always make things worse. Just like RWR said – “The Government is the Problem!”.
That’s why people in Pakistan are right to refuse polio immunizations, also, too.
Gut feelings and “common sense” are always more important than Science and Logic.
Amirite!?! Who’s with me?!?!!!1ONE
/snark
(sigh) – (Just for you, Cervantes. ;-)
Cheers,
Scott.
R. Porrofatto
@PhoenixRising: I think it would be prudent if health care workers who care for actively contagious Ebola patients place themselves in a 21-day quarantine before or after they take the plane home. It would obviously not keep them from getting the disease if they already have the virus, and if they are not yet symptomatic and seek medical attention immediately on getting a fever as this doctor did the risk of spreading the disease to others is very small, but it certainly would make the job of public health officials much easier to trace their contacts.
BTW, the patient lives about 110 blocks north of the East 30’s, in Harlem. Bellevue Hospital is in the East 20’s.
I’m waiting for the professional victims to start screaming “First 9/11, and now THIS? Thanks, Obama.”
brendancalling
I never hear the riccola commercial. I hear the Gypsy Kings singing “Volare”
d58826
@Xboxershorts: I was going to make the same point about preparedness. It’s not like Ebola just dropped out of the sky a week ago.
Since after a week of publicity about the nurse traveling, the doctor still went walk about, maybe we can cut the nurse some slack.
Since travel bans are considered ineffective and temperature screening is more security theater than anything else maybe there is one thing that we can do. Just for the medical/missionary types who are treating Ebola patients in West Africa impose a 21 day quarantine BEFORE they fly home. Set up a safe area at the airport in the West African country and the medical professionals will stay there for 21 days. As just a guess the vast majority of people in West Africa who are getting sick are too poor to fly so they can be eliminated from the risk pool. The relatively small number of non-aid worker type travelers will be monitored as they are now. This epidemic has been going on for over 9 months and how many cases have cropped up in Europe and the US that involve just plan travelers? That leaves the high-risk aid worker category and they are covered by the 21 day in-country quarantine. Not sure how practical that is but it seems to apply the maximum inconvenience to the people who are most likely to be infected. ooops someone already had the same idea.
kc
So the nurse gets called an “asshole” repeatedly. The doctor is a “hero” with “guts” and gets just a stern “come on, dude.”
kc
@John Cole +0:
You call that “flaming?”
Here’s a flame: You’re being the asshole here. 100%.
g
@divF: Jenkins has been admirable this whole time. He helped Duncan’s family find a place to stay, he cared about those people. He’s been great.
John Cole +0
@kc: I give up. I personally think he was selfish and a jerk for going out, but I think the situation is much different. People have had time to adjust, NYC isn’t caught with its pants down, and New Yorkers are generally a hardier group than Texans. If it makes you feel better, I can call him an asshole.
And then you can comment twenty times that I am a hysterical jerk who is not paying attention to the scientific community.
Fuck off.
Xboxershorts
@John Cole +0:
I think you went overboard on that nurse too. The real assholes in the Texas case operate at the state level.
See my questions above.
As far as this doctors actions, being asymptomatic, one would think getting on with life would be ok…..and ALL the data we have so far suggests one needs to be HIGHLY symptomatic before exposure becomes critical.
chopper
@kc:
to be fair, the doc here went bowling/taking the subway before he started noticing symptoms. It’s not like he had a temperature and was convinced he had the virus and said ‘alright, off to the bowling alley!’
C.V. Danes
But that’s the issue, no? Those who are committed to red state ideology are probably also just not paying attention.
fubs
Naw, it’s all good, because Dr. Spencer, who himself contracted ebola, knows exactly what to do in order to ensure that people do not contract ebola.
….
…
Wait a minute…
Geeno
I don’t get what people are jumping on about Cole’s post. Maybe I just automatically assume he’s being sarcastic, but it seemed pretty clear to me what his point was.
R. Porrofatto
@Xboxershorts: While an asymptomatic person who has the virus still has scientifically little likelihood of giving the disease to others, the one absolute benefit of a 21-day isolation is that, once symptoms appear, public health officials would have a much easier job tracing contacts, and the general public would have less reason for concern about that person taking the subway, among other things.
The doctor belongs to a very tiny subset of people who have worked directly with highly-symptomatic Ebola patients. Given that, imagine how much simpler and less worrisome this story would be had he been in some sort of isolation for 21 days.
I'mNotSureWhoIWantToBeYet
@R. Porrofatto: Or, one could simply take the science-based recommendations of experts who have been fighting Ebola for decades, like MSF:
Isolating people who have no science-based need to be isolated is counter-productive. It takes resources away from where they are needed, it increases fear (“he’s isolated so he must be dangerous!!11”), and it won’t help prevent additional infections.
Cheers,
Scott.
the Conster
@R. Porrofatto:
This. This concept seems to be lost on most of the commenters here, and I don’t get it. Yes, the public is a bunch of stampeding ninnies, which is why these public health workers who are highly likely to have contracted it should self-quarantine – because the public is a bunch of stampeding ninnies. We, and they, all know this now. Is it the fault of the health care workers that this is a fact? No, and no one is making that argument, including Cole. This guy most likely followed protocols while he was in West Africa and yet contracted it, and probably knows many others who did too, some of whom died according to the MSF reports. So, no matter what the protocols are, stay home until you know for sure what your status is! Jeebus.
Larv
Okay, quick question for those who think a self-impose quarantine is “common sense”. If this is so obvious, why (AFAICT) does the CDC not recommend it? You know, the professionals whose job is to stop the spread of communicable diseases like Ebola? The only recommendation I can find from them for people who think they’ve been exposed is to monitor their health for 21 days, which all of the people being criticized have apparently done. They do not recommend limiting contact until after one is symptomatic. As I and others have said on several threads, if a quarantine period is necessary, that should be decided and implemented by the CDC, not individuals who may or may not have the resources to do so.
Larv
@I’mNotSureWhoIWantToBeYet:
Also, this.
the Conster
@Larv:
Because the CDC is solely concerned about spreading the virus, not spreading media ginned up hysteria which is not their purview, but perhaps should be since the public is easily infected by media overreaction.
R. Porrofatto
@I’mNotSureWhoIWantToBeYet: Then maybe the MSF and CDC guidelines need to change. As I said, a 21-day quarantine has probably little to do with spreading the disease, and everything to do with the response to someone exposed to the disease actually having it. Because speaking of taking resources away from where they are needed, there are huge numbers of health, police, and emergency workers right now going apeshit in a city of millions to locate all the people and places this doctor has been in contact with, whether scientifically necessary or not.
If need be, some sort of fund should be established to pay those in isolation for 21 days. It’s 3 effing weeks. The cost would be peanuts at this point, and hopefully will stay that way.
Larv
@the Conster:
So just to be clear – you think health care workers should isolate themselves for several weeks not because of any actual public health concerns, but because the media and their fellow citizens are ignorant and easily scared?
chopper
@I’mNotSureWhoIWantToBeYet:
That’s assuming the doc’s hospital is at all interested in him coming right back to work.
the Conster
@Larv:
If you have been exposed to Ebola in its most virulent form, yes. Stay home until you’re tested free of the virus, and none of this other nonsense will happen.
chopper
@R. Porrofatto:
remember, the cdc told nurse Vinson that she was okay to fly, and later admitted that was a boneheaded move and the rule should be changed. CDC guidelines are not perfect.
JR in WV
@the Conster:
You and Porrofatto are both full of it: “…these public health workers who are highly likely to have contracted it… ” is bullshit. They aren’t highly likely to have contracted it at all!
That’s a fucking lie right from your mouth. Very few health workers contract the disease because they follow the CDC and WHO guidelines to protect themselves, and in the vast majority of cases that works just fine.
Further, these health workers have not yet infected a single person by following the CDC guidelines. They have moved in public freely while free of symptoms, and have reported their change in health status appropriately, and been hospitalized when necessary.
Get over your senseless fear! Use your brain instead of your lack of heart!
chopper
@R. Porrofatto:
Indeed. Tons of otherwise-unnecessary work goes into contact tracing, resources that are better-used elsewhere if it can be avoided.
fubs
@I’mNotSureWhoIWantToBeYet:
“science-based recommendations of experts ”
Science-based recommendations are irrelevant. Science-based practices are what matter.
If Dr. Spencer had strolled into Bellevue on Wednesday–not on Thursday, but on Wednesday–and told his story and related his symptoms, how would the medical professionals in that hospital treating that patient on that day have dressed?
How would their dress have differed from the dress of the people in the bowling alley?
The science-based practices of health care professionals who believe they may be dealing with ebola scream red alert. If you want the hysteria over this disease to subside, you should write a sternly-worded letter to the medical community, advising them to chill the fuck out already.
Larv
@the Conster:
Again, why does the CDC apparently not agree with you?
R. Porrofatto
@JR in WV: For the record, I never said that these health workers are “highly likely to have contracted it”. For me, it’s a case of being careful and wise — if a health care worker who has been working with highly contagious Ebola patients returns to the U.S., a 21-day period of isolation makes the task of all involved that much easier and less fearful should he or she prove to have actually contracted the disease. Had Columbia-Presbyterian put this doctor to work immediately in the ER there would be nightmares right now for the hospital, public health officials, and a thousand others.
For the record, and speaking from the Supreme Authority in my house, my wife is a nurse who has gone on medical missions to Africa and she agrees with me. So there. :)
(Actually, I should probably say, I agree with her. Just to be safe.)
the Conster
@JR in WV:
I”m not afraid you moron. These particular healthworkers contracted Ebola after being exposed to it in its most virulent state – it’s not heartless to point that out. I don’t understand why it’s so hard to understand that I have all the sympathy in the world for their plight, but think it’s wise for them to stay home until they’re tested free of the virus instead of creating a situation that sends all these other health professionals on wild goose chases to track contacts, which apparently they feel the need to do. Why are they doing it considering the likelihood of anyone this guy was in contact with has contracted the virus is zero? It’s security theater, and no one should be wasting their time by creating that situation when it could have easily been avoided by just staying home.
d58826
@the Conster: I think I would draw the line a bit tighter. For medical staff in the US ‘exposed’ means actual contact with infected bodily fluids not just treating an Ebola patient. For the medical people treating patients in West Africa I would impose the 21 day in-country quarantine. I would make this distinction because of the different level of medical infrastructure between the US and West Africa and the sheer number of patients that a doctor/nurse would be exposed to see in Africa vs the US. Surely there is work that they can do, training new people, etc during that time. They don’t have to sit around playing solitaire all day.
And yes a fund should be set up to compensate people in quarantine. If we can piss away several trillion dollars in Iraq then surely we can afford and few hundre thousand for this.
On the other hand I don’t think the quarantine issue is the ‘hill to die on’ with this disease and if the CDC/MSF/etc are comfortable with the current protocols then lets see how it plays out over the next couple of weeks
On a positive note the first Dallas nurse is Ebola free and will be released from the hospital today
PhoenixRising
You people.
This doctor didn’t GO TO WORK within the Ebola incubation period. Because the lawyers would have shit blood just hearing of that idea, at the hospital where he WASN’T SCHEDULED for a shift.
He went fucking bowling. Because he got bored. Now everyone who is deputized to track down the other people at the bowling alley is doing that instead of their jobs. Foolish, selfish and needs a spanking…which a virus that may well kill him is currently providing.
Apparently he followed the protocol from MSF, which is the CDC protocol for returning visitors from the region. The difference between ‘visiting Liberia’ and ‘treating patients with Ebola in Liberia’–where you went to work because conditions in Liberian hospitals are worse than a horror movie–isn’t recognized by either set of guidelines, and I’m not convinced that having a USSG in the saddle to direct action wouldn’t have made a difference.
Before humans understood germ theory, we had shunning. This isn’t a hard problem.
feebog
I would the commenters who think Dr. Spencer should not have gone out on Wednesday night exactly how they think someone at the bowling alley could be infected. Keep in mind that best scientific evidence, gathered over 40 years of experience with ebola, says that he was not contagious.
d58826
@feebog: I take your point but it seems that if you have a 21 day quarantine then you stay quarantined for 21 days. Otherwise why bother with the quarantine at all.
I remember the chickenpox/measles quarantines as a kid in the 50’s. It drove the mom’s mad but if the Dept. of Health said the sick kid has to stay in doors for 5 days then they stayed in doors for 5 days. Did not matter how good you felt on day 4. And yes I’m sure more than a few kids did sneak out.
the Conster
@feebog:
O fer fuck sake, we don’t think he was infectious!! We think he was unwise for creating a situation that is now occupying the time and resources of health care professionals that are better put to use than tracking down people that he CLEARLY couldn’t infect, because that’s the fucking stupid world we live in now.
Larv
@feebog:
That’s what I can’t figure out. Is he being criticized for actually endangering anyone, or just for wasting resources required to track his movements and notify his contacts out of an abundance of caution? Because if it’s the latter that seems pretty fucking silly.
Ella in New Mexico
@John Cole +0:
Just when we thought we could blame it all on the selfish doctor who bowled himself his first 250 game in months, it gets better. ;-)
http://www.huffingtonpost.com/2014/10/24/police-ebola-garbage-can_n_6039880.html
chopper
@Larv:
What’s wrong with criticizing a person for creating a mess of a situation that wastes a bunch of resources unnecessarily?
I'mNotSureWhoIWantToBeYet
@chopper: Um, maybe the doctor isn’t doing that?
It takes resources to have 24-hour guards outside people’s homes to make sure they stay quarantined. That’s just one example. Every public health decision has consequences in terms of resources. Giving into fears about Ebola doesn’t make the situation better – it makes it worse. The most sensible way forward, in terms of public health and in terms of public perceptions, is to not feed the Crazy and to do what works.
Cheers,
Scott.
Xboxershorts
@fubs:
He didn’t have any symptoms on Wednesday….and that’s kind of important here.
d58826
We have spent a lot of time arguing about whiother the doctor should have stayed home. But the MSF/CDC guidelines up threat do not say anything about a quarntine – voluntary or otherwise:
Now maybe the guidelines should change but if that is the complete list then the doctor (and the flying nurse) did nothing wrong.
Larv
@chopper:
Well, among other things it strongly disincentivizes anybody from working with Ebola patients. This guy risked his life to go to Africa and confront a serious public health crisis. Upon returning he followed CDC guidelines and followed the best medical protocols for assessing his potential for infection and risk to public health. And yet here we have several assholes calling him selfish for going bowling, which put absolutely nobody at risk. Those people need to go fuck themselves. Preferably with a bowling pin.
LogicIsScarceInHere
Wow, education on disease is hopeless based on multiple commentators on this thread in a forum I would typically describe as higher than average intelligence. I’m glad all you people trained in infectious disease (oh wait- you’re not!) know better than the CDC and WHO. A quarantine of any and everyone who worked with patients or had contact with someone with Ebola does not need to happen. Period. In the 40 years this virus has been around, there has not been 1 case of infection from someone who is asymptomatic, which the doctor was prior to Thursday morning. As soon as he became symptomatic Thursday morning, he followed protocol exactly. Why did 2 nurses who treated Mr. Duncan become infected, but not a single family member who took care of him prior to him being admitted to the hospital? Hint: please use logic and the facts surrounding transmission of this virus. The only reason those 2 nurses became sick was the for-profit hospital they worked at did not train them and did not have the materials and/or protocols in place to adequately protect those who had to care (i.e. handle fluids and dispose of waste) for the person infected with this virus. Especially, when the most dangerous time for transmission is later in the disease cycle.
I would put money down on finding a correlation between people who are panicking about Ebola as being the same people who panicked about being near someone with AIDS back in the 80’s/early 90’s. Ebola is actually harder to get than AIDS. Hmmmmm. AIDS was considered a “scary ‘GAY’ disease” back than and Ebola is coming from a “scary black people area” now [that’s not what I believe, thus the quotes]. It’s almost like people are transferring prejudiced (whether conscious or unconscious) on a virus/disease. Last year the flu killed more people in the U.S. alone than all people killed worldwide form Ebola in this outbreak. If you want to talk quarantine, start talking about how to handle cases of the flu, which is actually airborne virus unlike Ebola.
Oh, and no I’m not an expert in infectious disease. However, I firmly adhere to things like “scientific research” and “facts”. Therefore, I actually read, listen, and comprehend what experts in infectious diseases are saying. I’m not going with feelings, or what my gut says, or what might make me arbitrarily feel safer.
Omnes Omnibus
@John Cole +0: Overstatement and hyperbole are fine when you do them but not when others do? You’ve beaten the drum for increased precautions to allay hysteria. I think it is a silly idea. Since I think it is silly, I tend to mock it. Sorry if that offends you, but you could consider not advocating silly things.
retr2327
@PhoenixRising: Megyn Kelly on Fox: “You tell me if I am wrong, which very well might be the case,” Kelly said to Dr. Marc Siegel, a Fox News contributor. “But you are over there treating Ebola patients. You’re well aware of the contagiousness of this disease. He comes back into New York City. He knows he’s been handling Ebola patients, and he’s here for a week? He doesn’t tell anybody and if he starts to feel symptomatic before his 103 fever, he’s still out there bowling and taking taxis and not quarantining, not just self-quarantining?”
Pro tip: if you find yourself agreeing with something on Fox, it’s time to reconsider your thought process . . .
retr2327
@mk3872: Yes. SATSQ.
For a longer version: it’s also counter-productive. It will be really, really bad if Ebola becomes endemic in Africa. Then — and only then — will there be any real risk that Ebola will affect our nice, comfortable, first-world lives.
These health care workers volunteering their time, and risking their lives, to go over there and try to stamp this disease out, while also offering care and compassion to desperately ill patients who will otherwise die in the street like dogs, are our first line of defense against the above. To ask them to not only risk their lives and volunteer their time to treat in Africa, but to also include an extra month or so of self-quarantine as well on their return, just so we can all continue to feel safe and not have to deal with our irrational fears, is an appalling display of self-centeredness.
And there’s just no good reason for it: we do not have a single case of a civilian catching Ebola from a health care worker “gallivanting about” in public after treating patients. There is NO DAMN REASON AT ALL to believe that self-monitoring, with quarantine only after a rise in temperature, is inadequate to protect us all.
chopper
@I’mNotSureWhoIWantToBeYet:
Takes much more and more important resources than a single guard to contact trace everybody the dude was near over the course of a few days.
the Conster
@I’mNotSureWhoIWantToBeYet:
Not feed the crazy? You mean Ebowling?
retr2327
@chopper: Yes, but t’s also a waste of time. So maybe the better answer is, don’t do it (i.e., don’t squander resources contact tracing when the source was non-symptomatic). Especially since it ends up being interpreted by the public (see above) as ‘proof’ that there’s a risk.
Talk about a vicious circle.
kc
@John Cole +0:
I don’t want you to call him an asshole, silly. I was just commenting on the double standard.
Aww. Thanks!
Larv
@chopper:
But you’re talking about guarding everyone who’s potentially been exposed, while the contact tracing is only done with those who actually develop disease. And that’s if we’re ignoring the multiple other costs of a quarantine (and the fact that it’s unnecessary from a public health standpoint).
kc
@chopper:
I know; that was meant to be a comment on the harsh treatment of the nurse.
chopper
@Larv:
I don’t think the idea of staying in your nice apartment for three weeks disincentivizes people from working with Ebola patients at all compared to the idea of actually working with Ebola patients in some crappy village in the middle of west Africa.
“You know, I was gonna volunteer to work in the violent slums of Monrovia for 6 months getting bazooka-barfed and diarrhead on 10 times a day by dying Ebola patients but then I heard that when I get back to the states I’ll have to hang out and watch movies and play video games for 3 weeks. Fuck that!”
chopper
@retr2327:
If contact tracing is a waste of time, I’ll have to ask you why you’re disagreeing with the CDC.
chopper
@chopper:
I mean, come on. The sort of people who are willing to dive into the middle of an Ebola epidemic in west Africa are not the sort of wilting flowers who will up and quit if they have to hang out at home after the fact.
retr2327
@chopper: That’s a pretty funny post, with a lot of truth in it as well.
But it’s not entirely accurate. The 21-day quarantine sends a message to the volunteer (and one with at least a grain of truth): despite your best efforts, and all feasible precautions, you may still get infected, and with a disease that has about a 75% mortality rate, at that.
Now, we can debate whether that’s a good thing or not, but I’d submit that for many of the volunteers, a certain amount of self-deception (i.e., if I do everything right, I’ll be okay) is an essential part of the decision process about whether to go over there. If so, a 21-day quarantine would tend to undermine that self-deception, and discourage volunteering.
Davebo
Just because DFW is a shitstain let’s not taint all health care in Texas.
The Houston Medical Center is arguably the finest collection of hospitals not only in the US but in the world.
From MD Anderson (consistently either #1 or 2 cancer center), Texas Childrens, Methodist, St Lukes, Memorial Hermann, The Menninger Clinic (#4 nationwide psychiatric).
And the Medical Center alone is larger than downtown Dallas.
chopper
@retr2327:
I think the sort of doctors volunteering to go over there generally know what they’re getting into. I don’t think this self-deception effect adds up to much of anything at all.
Elie
@d58826:
I must disagree. Your reference to temperature taking as “theater”is factually wrong. There is a high degree of correlation between the temperature and infectivity. People become more infectious with increasing temp and are not infectious before the temperature elevation. Add to that, if there are NO OTHER SYMPTOMS, such as vomiting, diarrhea, you are even less infectious.
I know its hard, but we must get used to science and facts and not just impose political and social fears as the standard for managing ANY condition. It is not right to just believe in facts and science when it meets your fancy. If progressives can’t do that then all is lost.
John Cole +0
Chopper, just give up. I have. Apparently these guys live in a different country than I do, where logic, reason, and science based evidence rules. It sounds like a nice place. I hear that in that place they don’t elect people like Rand Paul or Ted Cruz or Sarah Palin, and that 42% of the population doesn’t believe in creationism that half the country doesn’t believe in climate change or the big bang theory. Like I said, it must be a nice place.
And by pointing this out, I will be hit with the second round of attack, which is paying attention to the hysterics and the idiots. Apparently you are supposed to just ignore them and everything goes away.
Also, in this world they live in, it is cheaper to spend millions on chasing down contacts (which, as you noted, the CDC thinks is vital but they disagree with it, which is allowed for them- you’re just an idiot when you disagree with other CDC protocols) than it is for one person to stay inside for a couple weeks.
Another fascinating thing in this world is how the quarantines work. In my world, a self-quarantine would require someone to stay quarantined for the entire allotted time, but in this alternate universe, if you self-quarantine for 18 of the 21 days and go bowling on the others, well, that’s close enough.
And stop being such an asshole and fearmonger or you will kill all the incentives for people to travel to the world’s shitholes to wallow in other people’s bodily fluids. What’s wrong with you?
Elie
@retr2327:
This:
fubs
@Xboxershorts:
“Dr. Spencer began to feel sluggish on Tuesday but did not develop a fever until Thursday morning, he told the authorities. At 11 a.m., he found that he had a 100.3-degree temperature and alerted the staff of Doctors Without Borders, according to the official.”
“Sluggish” is enough for me–and it’s enough for various authorities, including medical authorities to track down all of Dr. Spencer’s contacts over the past few days.
Why are they tracking down his contacts? Because it is possible he was symptomatic beginning Tuesday, which is something Dr. Spencer should have known. And it is something you should know, while we’re at it.
On the other hand:
“He told the authorities that he did not believe the protective gear he wore while working with Ebola patients had been breached but had been monitoring his own health.”
Seems Dr. Spencer might have believed, as you believe, that he was asymptomatic until Thursday morning. Of course, at this point, I wouldn’t put much credence in what Dr. Spencer believes.
WaterGirl
@JR in WV: I stopped reading as soon as I saw this:
If you want people to read your 4 paragraph comment, may I suggest that you don’t start paragraph 2 with something incredibly rude?
Larv
@chopper:
I didn’t say that a quarantine was disincentivizing, I said that criticizing people for not self-quarantining was. Reading comprehension, please. It’s one thing to take a risk doing something you think is important over there, but to then come home and have ignorant assholes on the internet throwing your name around, critiquing your every movement and calling you selfish for not kowtowing to their irrational fears could be a bit of a shock. If I were thinking about going over to help, the treatment we’re seeing of people who have been around Ebola patients would certainly factor into my decision.
Omnes Omnibus
@John Cole +0: I don’t think security theater is useful. Real precautions? Of course. But just doing something to so that it looks like you are making people safer is pointless. As I have noted in previous threads on this, I think the ratchet only works one way and if medically unnecessary quarantines start being used, people will accept that as the new normal. Then the next time someone in the US gets Ebola (and it will happen), we will have to do some other silly, medically unnecessary thing to calm people down. I don’t really care to have government by panic.
Until he was symptomatic, he did not need to quarantine himself; he needed to self-monitor.
chopper
@Elie:
The other thing is, Ebola is known for it’s very fast onset in many people. An elevated temperature or a full-on fever is usually the first symptom, but some will end up feeling like a beat-up sack of nausea within a matter of hours. Monitoring temperature is pretty key when you’re dealing with a disease with such abrupt onset of symptoms.
chopper
@Larv:
being criticized for breaking quarantine is going to disincentivize doctors from throwing themselves into an Ebola epidemic? That’s even sillier than what I thought you were arguing.
the Conster
@John Cole +0:
42% of the population DOES believe in creationism. We’re stupid, but not that stupid – yet.
Larv
@fubs:
Then I hope you aren’t a doctor. The contact tracing is done out of an abundance of caution – if an outbreak does occur, it makes it easier to rule out potential vectors of transmission and locate the source. It does not mean that they think he’s potentially infectious. Feeling sluggish or off has no diagnostic value, and is only a potential symptom in retrospect. The primary diagnostic criteria for Ebola is fever, which is why they do the temperature monitoring. If your viral load is sufficient to be infectious, you will have a fever. No fever, no transmission.
d58826
@Elie: True but a person w/o symptoms will have a normal temperature. That is the part that is misleading. It is ‘theater’ (which maybe is a bad word for it) when people think that by screening for temperature you have eliminated the possibility that someone is infected. After a couple of people come into the country with a normal temperature (like Mr. Duncan and the doctor) and then get sick then people will view it as a waste of time.
Larv
@chopper:
He wasn’t under any sort of quarantine. Therefore he couldn’t break it. He’s being criticized for doing exactly what MSF and the CDC recommend as best practices. You seem confused by this.
chopper
@Larv:
Fine, add the word ‘self’ into my post. Still just as silly.
kc
@John Cole +0:
#NeverForget
Has any man ever been so persecuted?
John Cole +0
@Omnes Omnibus:
Neither do I, but the difference between you and me is you’re way is going to lead to it. In my way, we would set up a fund and anyone who was in a circumstance like the doctor or the two nurses would have a paid three week quarantine with hazard pay and legal security from being fired (should they not be in the health care field). People would know the possible carriers are quarantined and feel safe. And how people feel is important. Fear based reactions which lead to voting for fearmongers and wingnuts and crazy hysteria is based on whether people “feel” safe. You may not like that, but it is what it is. Right now, America is as safe from violence as it has ever been with crime rates at the lowest they have been in forever, but people still “feel” unsafe, which is why drug decriminalization and prison reform and sentencing reform is almost always impossible to do and being a law and order guy is the surest way to help win an election. It’s why Democrats still scramble to get endorsements from the various LEO communities.
In your way, which is to yell “SHUT UP MORONS YOU’RE SAFE,” we get a guy who spent months in the trenches in the worst place possible for exposure to Ebola coming home and self-monitoring because, according to you, that’s all he needed to do. Lo and behold, he has it, and now people are once again freaking the fuck out, the CDC and authorities are basically doing the virus equivalent of the show 24, tracking down dozens of people and quarantining anyone who might have been in contact, while New Yorkers are running around in masks left over from the SARS scare and panicking because ONE FUCKING PERSON was strolling around NYC following the procedures that you think are failsafe. Lo and behold, he has Ebola. And now instead of one person being under quarantine, who knows how many will, while a significant portion of the population (needlessly, IMO) is freaked the hell out. Bang-up job there, Omnes.
So you tell me, who is being irrational and unreasonable here? Whose approach is more likely to lead to more government by panic. If you tell me you and Larv and the others, then you really are living in a different world than me.
I'mNotSureWhoIWantToBeYet
@John Cole +0: Sorry to be blunt, but do you know what the words “close contact” means? Nobody is going to be spending “millions chasing down contacts”.
CDC:
Emphasis added.
I heard last night or this morning that he had a total of 3 close contacts after he developed a temperature.
Cheers,
Scott.
John Cole +0
@the Conster: Re-red what I wrote. I said they are living in a world where 42% DOESN’T believe in Creationism. In my world, sadly, 42% do.
John Cole +0
@kc: Your troll fu is strong. I’m clearly not feeling persecuted, because, you nkow, I keep commenting and posting. I’m just pointing out (accurately) what the next argument will be for pointing that out. And watch the follow up comments. I’ll be and am right.
Which is really what bothers you, I think.
Steve from Antioch
The nurse in TX who had Ebola is being released from the hospital.
What is your “common sense” approach to this?
This isn’t someone who “might” have Ebola and went traveling around. She actually had/has it.
How long should she be in quarantine and not in contact with anyone not in full protective gear, using common sense?
the Conster
@John Cole +0:
Gotcha, and btw, completely agree with you.
chopper
@I’mNotSureWhoIWantToBeYet:
Those three people are being full-on quarantined. Also, authorities in NYC are doing notably more than just that, according to her times.
John Cole +0
@I’mNotSureWhoIWantToBeYet:
Current headline at the New York Times: Officials Try to Trace New York Ebola Patient’s Every Contact
Yes, they are going to spend millions doing this. Tens of thousands of man hours, most likely. Again, whose approach makes more sense? Yours, which is to say “nothing to worry about” while spending millions on this crap, or mine, which is to just put someone in their situation in a quarantine for a couple weeks? I’m sticking with my approach as making more sense from a financial and public fear and health standpoint. Remember, both the people were told not to worry about (Vinson and Spencer) both actually DID have Ebola. It doesn’t matter to the public that no one else caught it from them.
And this doesn’t include the amount of waste that we won’t be able to easily measure. How many hysterics are now or will race to the ER or their general practitioner because they have a fever and were in the general vicinity of where Dr. Spencer was? How many man hours and resources will be wasted. How many legitimately sick people will have their care diminished because already spare resources are being wasted because of the panic caused by ONE FUCKING PERSON who just had to go bowling.
Jeebus. This is not rocket surgery.
d58826
@Steve from Antioch: No need for anyone to worry about her. She is virus free and presumable has the anti-bodies in her bloodstream. She could become a donor like the first doctor has. Obama doesn’t seem concerned since he is meeting with her in the White House. Of course I can think of easier ways to get a tour of the White House :-)
chopper
@Steve from Antioch:
Give this woman a high-ass paying job treating Ebola patients. She’s immune now.
John Cole +0
@Steve from Antioch: She no longer has the virus. What is your point?
John Cole +0
Oh, and now the freakout is because some cops wore masks and gloves to protect from potential exposure and then dumped them in a public trash container while people took pictures. Awesome.
kc
@John Cole +0:
You haven’t been right yet, but I’ll keep watching.
Larv
@John Cole +0:
This from the guy who accuses others of living in a different world? Does this fund currently exist? No? Then shut the fuck up about what people should be doing until it does.
Elie
@d58826:
WRONG
You said:
True but a person w/o symptoms will have a normal temperature.
A person can have a temperature without symptoms. The temperature is the earliest possible indicator of infection. That is why taking the temp twice a day is such a helpful diagnostic activity — it is actually pretty sensitive indicator of infection. That said, the temperature alone does not assure that you transmit the disease. You also need exposure to bodily fluids (whether remembered or not). The doc went bowling because he did not have a temp, much less any diarrhea or vomiting. Based on the facts of Ebola transmission, he was not infectious. That is just not enough, right?
I get it. John and some of the others want to have political disease guidelines that are driven by trying to avoid the political and social fall out from dealing with too much science or fact based policy. I know, I know. Its HARD to believe in facts and science. You have to stand up for it and Lord knows, you are right, it is much easier to give in to political expediency. I guess we will just use facts some other time that is more convenient.
fubs
@Larv:
“It does not mean that they think he’s potentially infectious”
Yes; it does. That is precisely what it means.
(well, “was” precisely)
“if an outbreak does occur”
Then, he would have been infectious.
“Feeling sluggish or off has no diagnostic value, and is only a potential symptom in retrospect.”
No. In retrospect, it was a symptom of the ebola he actually fucking has.
“No fever, no transmission.”
Prove it.
retr2327
@chopper: Well, you could be right, and to some extent, I hope you are. I don’t have any first-hand experience with the thought processes of health care workers who volunteer for such risks.
But I do have decades of experience with the thought processes of people who choose to confront other risks, for far more selfish reasons, i.e., advanced rock climbers and whitewater kayakers. And I know that when something goes sideways, and someone ends up dead, there is an overwhelming urge among the survivors to identify what the decedent did ‘wrong,’ so that the illusion that the risks can be perfectly controlled if one does everything right can be maintained. So it would not surprise me to find some similar mechanism operating with health care workers as well, even though the motives (and social value) are so very different.
As for contact tracing, it’s obviously essential when you have an openly symptomatic individual like Duncan. And it’s probably justifiable, if only as an abundance of caution, when you have a mildly feverish nurse flying around the country. But for a non-feverish doctor who goes bowling?
It pretty much has to be pure security theater, with no value. If there’s any possibility that it’s not, then the CDC guidelines on self-monitoring, but not self-quarantine, are an appalling mistake. And we’re all gonna die. . . .
d58826
@John Cole +0:I think that falls in the ‘there is always someone who doesn’t get the memo’ category.
The optics are unfortunate to say the least. If the Dept. of Health is doing contact tracing out of an abundance of caution then the cops should be a bit more careful.
chopper
@retr2327:
We’ll you and I are just schmucks on the internet. Neither of us are the sort of people who volunteer to go to the middle of a huge Ebola epidemic in one of the poorest places on earth to treat people. So your own resistance to criticism is misplaced here.
The sort of people who are actually going there are some of the bravest, most insanely selfless people around. I doubt that the idea that their fee-fees could be hurt if they break a quarantine (self- or official) back in the states really enters into the decision at all.
I know a lot of doctors. Some of them are these sorts of people, who go to god-knows-where to deal with god-knows-what. It’s crazy but the only real thing on their mind is helping people.
I'mNotSureWhoIWantToBeYet
@John Cole +0: Also from the Times:
OMG! They had contact!! Why aren’t they in quarantine?!!1ONE
Just because the city health officials have decided that they want to contact everyone who may have had any contact with the doctor, out of an “abundance of caution” doesn’t mean that it makes sense. I think it will add to the hysteria, myself. YMMV.
Remember the things posted here about schools freaking out?
(Emphasis added.)
How would quarantining people prevent overreactions like that? It wouldn’t.
Hysteria costs lots of money, on that we can agree on. Where we disagree is what sensible responses should be, apparently. I don’t think it pays to try to find a sensible response to a Crazy reaction. Sure, things should be done to lessen the fear and panic. But tracking down hundreds of people at no risk is not one of them.
It’s a good thing we’re continuing to argue about how to prevent people from freaking out over a 1E-20 chance of infection rather than talking about how to win an election, huh.
:-/
FWIW.
Cheers,
Scott.
retr2327
@John Cole +0: “In my way, we would set up a fund and anyone who was in a circumstance like the doctor or the two nurses would have a paid three week quarantine with hazard pay and legal security from being fired (should they not be in the health care field).”
And we’re the ones being unrealistic? Get back to me when your nice scheme is implemented . . .
Elie
@d58826:
Lets try again.
If you do not have a temperature, (whether the disease is incubating in you or not), YOU ARE NOT INFECTIOUS.
People who are vomiting, having diarrhea with Ebola, ALSO HAVE TEMPERATURES — USUALLY HIGH TEMPERATURES.
Temperature is highly helpful in determining the earliest onset of symptoms. It is great tool because the temp goes up either right before or in synchrony with other even more infectious symptoms — vomiting and diarrhea etc. You are NOT infectious till then which is why the doc went bowling… he was feeling well and DID NOT HAVE A TEMPERATURE. They are doing political contact quarantine. That is all it is because his fiance and friend are at almost zero likelihood of getting the infection.
Some of you want to impose political or social rules around the interpretation o actually fairly straightforward science here. I get it. The Sheeple are scared and its right before elections, etc. Lets make it look like we will make them safe. Facts and science are never enough. Got it.
fubs
@retr2327:
“It pretty much has to be pure security theater, with no value. If there’s any possibility that it’s not, then the CDC guidelines on self-monitoring, but not self-quarantine, are an appalling mistake. And we’re all gonna die. . . .”
Not all of us, no.
The big fear is that ebola will spread through the homeless population of NYC. That’s why the cop gloves in the garbage are such a big deal and why the contact tracing is happening.
Larv
@fubs:
No, it really doesn’t. It’s standard procedure when dealing with infectious diseases. If somebody else in NYC tests positive, they want to be able to positively rule out any contact with Dr. Spencer, so that they can eliminate that and find the real source.
To the best of my knowledge, there is not a single case of documented Ebola transmission from an asymptomatic individual. Symptoms means actual clinical symptoms like fever, severe headaches, muscle pain, etc… Not sluggishness. The best medical judgement at this point is that individuals without a fever are not infectious. Please actually read up on this before freaking out.
d58826
Obama hugged the nurse in the Oval Office. I guess the faux news folks will just have to settle for quarantine if they can’t get impeachment!!!!!!
And back on planet earth a reported school shooting in Marysville Washington
retr2327
@chopper: “We’ll you and I are just schmucks on the internet.” Agreed.
“So your own resistance to criticism is misplaced here.” Seriously? After I agreed that neither one of us really knows, and hoped you were right? You and I are just having an interesting discussion.
I may have a bone to pick, but it’s not with you. It’s with the people who want to jump all over the doctors and nurses we both agree are heroes trying to help, just because they didn’t go above and beyond CDC guidelines and self-quarantine so that ignorant fools wouldn’t wet their beds.
I'mNotSureWhoIWantToBeYet
@John Cole +0: We don’t know that. We only know it hasn’t been detected. She might have less than the detection threshold. What should be done if people fear that the testing isn’t good enough?
What about the people who have been shunned even though they were never infected?
Quarantines have real consequences. It’s not just a “3 week paid vacation” as some have called it…
FWIW.
Cheers,
Scott.
Omnes Omnibus
@John Cole +0:
My preferred way would not involve yelling anything. It would involve people calmly telling the truth about the disease and explaining the appropriate precautions and then not reacting to idiots or the MSM (but I repeat myself). One doesn’t calm a panic by fanning it.
It’s not according to me. It’s according to the experts on the disease.
Elie
I have had two comments disappear and also been advised that I was double commenting — incorrectly! I am just trying now to see if this comment will work
chopper
@retr2327:
What I’m saying is that your own personal feelings about how you would feel being criticized in that situation are pretty meaningless. You’re not one of those guys. They’re not really thinking like that.
the Conster
@Omnes Omnibus:
It’s so blindingly obvious that we don’t live in that world anymore, if we ever did. One shouldn’t start a panic by behaving like one does live in that world. If that’s not blindingly obvious by now, which it apparently isn’t, I give up too.
Xboxershorts
@fubs:
I trust the Dr’s credentials over anonymous commentators on an internet blog, nothing personal, just sayin…
Omnes Omnibus
@the Conster: I don’t know about that. This kind of approach has generally worked for Obama. IMO.
@Xboxershorts: I’m pseudonymous.
retr2327
@chopper: Then what we have here is failure to communicate. (a first on the internet, I’m sure).
I wasn’t talking about how they would feel being criticized; I was talking about how being told that they were required to self-quarantine might enter into their initial decision-making, if only subconsciously.
But I think we’ve beaten this dead horse long enough. Until the next thread!
kc
Pandering to irrational fear has never worked out well for this country.
Omnes Omnibus
@kc: My point exactly.
John Cole +0
@kc: Then why is the CDC spending shitloads of money tracking down lots of people who may have been in contact with Dr. Spencer but are not at any risk? Either we’re pandering to irrational fear, just in the most illogical way possible, or there is a risk. Which is it? I vote the former.
kc
@John Cole +0:
I didn’t know the CDC was doing that. If the people are not at any risk, than that is irrational.
But from what I’ve read, it’s not the CDC, it’s NY officials, they’re tracking only people he had contact with from the time he developed symptoms.
chopper
@retr2327:
I got you confused with larv for a second.
In either case. Docs who work with infectious diseases like Ebola know all about quarantine. Doubt they’d take it personally if they had to sit out a spell at home afterwords and I seriously doubt it would have an effect on their decision to go.
R. Porrofatto
Speaking for myself, I don’t blame Dr. Spencer for following established MSF/CDC guidelines. But when nurse Vinson was diagnosed, Ohio public health quarantined 12 of her contacts. And yet she was asymptomatic until then. The New York City Health Commissioner just put Dr. Spencer’s fiancee and friends under quarantine. And yet he was asymptomatic. Clearly the guidelines aren’t adequate, if for no other reason that to avoid the enormous waste of people, dollars and public fear when a returning Ebola caregiver who has not been isolated and quarantined for 21 days begins to exhibit symptoms. If voluntary guidelines dictating such a restriction aren’t put into place, the one thing I’m absolutely sure of is that public, political, and media pressure will force authorities to make it mandatory, no matter the consequences or problems of enforcement.
Steve from Antioch
I seem to recall that your “common sense” told you that the nurses in Texas who came into contact with the Ebola patient should have know better than to get on a plane and fly across the country.
Does your “common sense” also tell you that nurses/doctors in NYC who come into contact with the Ebola patient should not get on the subway?
Elie
As progressives, we are either fact and science based to the extent we can be, or otherwise we just give in to emotion based policy.
Nina Pham was released from NIH today and there is a pic of the President hugging her. Its a small but important thing to stand up for science and facts in the face of political expedience – and yes, all the contact tracing is mostly political theater.
What does it mean to support integrity? Integrity to me is being true to one’s values and standing for something that doesn’t just blow around in the wind. While I am a political pragmatist, and realize that I will fudge some things in the name of politics, this is an instance where standing up calmly and proudly is indicated – even in the face of continued criticism or doubt.
Just me anyway…
Elie
@Steve from Antioch:
But the facts have indeed borne themselves out. No one – NO ONE – got sick from that nurse on the plane! If someone had, we would be right in forbiding any travel when temps are 100 or more.Indeed, NO ONE got sick from Mr Duncan when he was sent home from the hospital with a fever of 103! What was significant was that he wasn’t throwing up or having diarrhea that exposed his family or the ER personnel to make anyone sick.
Facts.
fubs
@Larv:
“If somebody else in NYC tests positive, they want to be able to positively rule out any contact with Dr. Spencer”
No. They are tracing his contacts and quarantining people with whom he had known physical contact in order to see if those people become sick, because they are afraid those people might become sick, because they are afraid Dr. Spencer became symptomatic earlier than Thursday morning.
“To the best of my knowledge”
This is more or less the opposite of proof.
“The best medical judgement at this point is that individuals without a fever are not infectious.”
No. The best medical judgment on this is that sluggishness may indicate he was symptomatic on Tuesday, which is why they are tracing his contacts back to Tuesday.
“Please actually read up on this before freaking out.”
What freak out?
fubs
@Xboxershorts:
“I trust the Dr’s credentials over anonymous commentators on an internet blog, nothing personal, just sayin…”
Yeah! He obviously knows a lot about ebola! Very experienced with it, in fact!
Steve from Antioch
@Elie:
I do understand that.
I am just trying to understand what Mr. Cole’s “common sense” approach to these matters is.
You may have missed it, but he previously pilloried the nurses in Texas because they followed the CDC guidance instead of “common sense.”
Elie
@Steve from Antioch:
Yep..
He’s politically/socially “Noivous”. He wants everyone to feel safe by falling back on folklore. Folks don’t vaccinate their kids based on fear and folklore that the vaccine MIGHT cause autism (even though they have been given facts out the yin yang). So instead, some kids get preventable diseases with sometimes fatal complications. Of course, that won’t happen to their kid. It is the ultimate narcissism. Make up your own facts and science.
SWMBO
I have questions. The Times article says “The Centers for Disease Control and Prevention said Friday that its laboratory had confirmed a city laboratory’s finding, on Thursday, that Dr. Spencer had the virus.”
If they can detect the virus, why aren’t they doing daily screenings, just to be on the safe side? If they only test after symptoms appear and the test is positive only after symptoms appear, does this mean they aren’t contagious before then? What is the test? Is it blood, spit, what do they detect it in?
If their diagnosis is based on a process of elimination (malaria for example), is it because we can test for the other things and don’t have a definitive test for ebola? (I blame Congress for this since they cut funding.) If they know the nurses are ebola free but they don’t have a test, what then? I had chicken pox when I was 8 and I’ve had shingles (chicken pox the sequel) multiple times since then. I will always have chicken pox virus but I am not contagious all the time. How does this work with ebola? Do they have delayed outbreaks years later? Do we quarantine them until we’re sure?
If transfusing the blood from a survivor is helpful, are we going to go to the affected countries and get blood serum to help? Do we give it to them first? Can we give it to the health care workers before they go and keep them safer?
As I said, I have questions and I don’t know if there are any answers.
I'mNotSureWhoIWantToBeYet
@fubs: You seem to be misinformed.
CDC – Could it be Ebola? (1 page PDF).
Note that a person needs 2 things to be considered for isolation: 1) A fever of 38 C or higher, or at least one of the other listed symptoms, 2) been exposed to a patient with Ebola or been in an area with Ebola.
Note that “sluggish” with no fever is not an Ebola symptom.
HTH.
Cheers,
Scott.
Elie
@SWMBO:
have questions. The Times article says “The Centers for Disease Control and Prevention said Friday that its laboratory had confirmed a city laboratory’s finding, on Thursday, that Dr. Spencer had the virus.”
If they can detect the virus, why aren’t they doing daily screenings, just to be on the safe side? If they only test after symptoms appear and the test is positive only after symptoms appear, does this mean they aren’t contagious before then? What is the test? Is it blood, spit, what do they detect it in?
It is a blood test initially run by the state lab then results confirmed by cdc a day or so afterward. The test is usually done on a symptomatic (fever of over 100 and one or more other symptoms) person who is already isolated. They are looking for antibodies to the virus and also assessing viral load
If their diagnosis is based on a process of elimination (malaria for example), is it because we can test for the other things and don’t have a definitive test for ebola? (I blame Congress for this since they cut funding.) If they know the nurses are ebola free but they don’t have a test, what then? I had chicken pox when I was 8 and I’ve had shingles (chicken pox the sequel) multiple times since then. I will always have chicken pox virus but I am not contagious all the time. How does this work with ebola? Do they have delayed outbreaks years later? Do we quarantine them until we’re sure?
The test is specific to Ebola.
The vaccine is still being developed that would prevent infection from Ebola virus
If transfusing the blood from a survivor is helpful, are we going to go to the affected countries and get blood serum to help? Do we give it to them first? Can we give it to the health care workers before they go and keep them safer?
Convalescent serum has not been proven to work but they give it when appropriate (that you have a safe, convalescent donor and a recipient of matching blood type). It is not without risk, especially when trying to use convalescent serum from africans who may have exposure to HIV, Malaria and/or other hemorrhagic viruses (yes, there are others almost as bad but you have to test for them )
As I said, I have questions and I don’t know if there are any answers.
chopper
@Elie:
Actually I think he’s trying to reduce the county’s freak out and waste of resources by advocating instituting a few relatively harmless policies to get people to chill the fuck out. If that’s in the same vein as vaccine denial, well that’s pretty nuts.
It would be great if everyone in this country were rational. But they’re not. America is a country with an anxiety disorder. And if you’ve ever dealt with a person with an anxiety disorder, you know telling them ‘you’re not being scientific-minded. Stop being dumb’ does fuck-all.
Elie
@Elie:
Names of tests:from CDC
Timeline of Infection
Within a few days after symptoms begin
– Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
– IgM ELISA
– Polymerase chain reaction (PCR)
– Virus isolation
Elie
@chopper:
Ok – I get it. So because some folks are anxious and absolutely do not accept facts, then we just appease them and throw facts out the window? When should facts count? Sorry, it is pretty much like vaccine deniers — the hysteria remains around an almost zero risk of something that no amount of facts seems to change.
Tell me — when should facts matter most? Ever? When convenient?
John Cole +0
@Steve from Antioch:
No, it doesn’t tell me that at all. Here is what my common sense tells me. The two nurses who were exposed to Duncan and later came down with Ebola were done so in situations in which they were not adequately protected from exposure to a patient who was at his MOST contagious. They didn’t have the right gear, they didn’t have the right guidelines, they didn’t have the right training. My common sense is that it is not surprising that they came down with Ebola, and my common sense tells me they shouldn’t have been flying on planes and the like.
Dr. Spencer was in a country riddled with Ebola, and while he thought he was protected, my common sense tells me that there were already two other American doctors, health care workers, and a cameraman in similar situations abroad. They should have also not been flying on planes (and most of them were not, as they were diagnosed and brought here for treatment). So I think Dr. Spencer, given his situation, should have not been out in public, despite what the guidelines state.
On the other hand, every single one of the people who have treated diagnosed patients with the right protective gear and the right training has come out uninfected. I have absolutely no fear of them doing whatever (although that implies I was afraid of Vinson, Nam, and Spencer- I wasn’t because notwithstanding the fact they are nowhere near me, I understand what asymptomatic means). So common sense would tell me that the health care workers who are in the right protective gear with the right training and the right guidelines are no public health threat or source of public hysteria.
And my “common sense” that you are deriding seems to be borne out with the facts of the cases so far. So mock away.
One other thing, I have no idea why everyone seems to rely so firmly on the currently established guidelines and protocols. You do understand that these things change, don’t you? As lessons are learned and more is known, the guidelines will change. You are aware that we used to bleed people, right? And that treatments and protocols for all varieties and illnesses change over time? Right? Stating that someone is an idiot for not worshiping at the altar of the status quo really makes you look like an ass, especially when things like this are happening:
Why, that would be the CDC examining those options. Are you going to turn on them? Will you go from strictly to adhering to the CDC guidelines to an a la carte approach because now they disagree with you? Are they just doing it because of hysteria, or are they doing it because maybe the established criteria and guidelines need some tweaking?
Thank you all for proving that common sense really isn’t that common. What I see here are a bunch of people with specific health care training basically sneering at anyone who doesn’t agree with them- well, you’re just an untrained fool.
Elie
@Elie:
CORRECTION: they are looking for viral antigens (not antibodies which are a person’s reaction to the viral antigen)
Larv
@SWMBO:
I haven’t been able to find anything online about exactly how they’re doing the testing, but my guess would be that the initial testing is by western blot, or possible ELISA if one is available. Both are immunoassays which use antibodies against Ebola proteins to detect those proteins in a patien’s blood. But they’re fairly time consuming and expensive, and supplies of the antibodies may be limited. Immunoassays are slightly prone to both false positives and negatives, so my guess is the CDC is confirming by PCR, which looks specifically for viral genetic material and is very reliable. Both would be done on blood or plasma/serum.
Chicken pox and other herpesviruses can exhibit what’s called latency – their genetic material can exist inside cells for years without symptoms, only breaking out into an acute infection in response to environmental stress or other causes. Retroviruses like HIV are even worse, they actually insert their DNA into the genome of the host cell, making it impossible to remove. This is why HIV can be controlled but almost never cured. Ebola does not (again, AFAIK) exhibit any sort of latency. Once you’re clear of virus, it’s gone and you have immunity form reinfection (but it’s unclear how long that immunity lasts).
John Cole +0
@chopper:
Bingo. Some may even call them common sense policies. Eagerly awaiting all the people here to deride “common sense” gun control.
Elie
@John Cole +0:
John
I respect your valid concern. The “reconsideration” of guidelines in this instance has to do with the politics and appearance of this. There are no new “facts”. Transmissability is STILL linked to:
1) fever over 38 C
2) one or more symptoms including release of bodily fluids to contact others
3) Incubation remains within 21 days (though a few have speculated that there MIGHT be a longer interval, they just can’t say what that might be)
There is no new clinical or scientific data driving the “tweaked” guidelines. Its about making people feel safe and that enough due diligence is being observed.
John Cole +0
@Elie:
See the comments above. Are you going to start flaming the CDC for not sticking with your iron clad facts?
The arrogance here is breathtaking. What do you all think precautionary measures are? You don’t do precautionary measures because there is absolutely zero risk of something. I live on a mountain, basically, and there is no risk of flooding, so I don’t buy flood insurance as a precaution. If I lived in a lower lying area that floods frequently, I would buy insurance because you just have to. If I lived in a moderately low level area, one where it floods every 50-75 years, but is exceedingly rare, I might buy it as a… precaution.
Xboxershorts
@fubs:
he’s been treating it for years, so, yes.
What are your bonafides?
John Cole +0
@Elie: So it was the turn on the CDC option, then. Will you adhere to their new guidelines, should they establish them? Or pick and choose? Remember, just a few comments ago they were the absolute authority on whether or not Dr. Spencer should have been walking around in public.
Omnes Omnibus
@John Cole +0:
I have no issue whatsoever with changing the guidelines if there is a medical or public health reason to so. Based on the reporting I have seen so far, there has been no information indicating that the current guidelines are inadequate.
Fundamentally, we just disagree about the appropriateness of what I, at least, perceive as PR stunts. Your mileage obviously varies.
Elie
@John Cole +0:
I guess I am not clear then – what are you recommending? If there are acknowledged facts about transmission, but you don’t seem to think that they are enough, what then? We go over to some other person’s non scientific or politicized solution. If that is not driven by science, or facts, who makes the decision about what is effective, safe or necessary? Its not like we don’t know, John. We know, but the facts don’t seem to be enough. So is it Joe or some other person who just gets to pick? We have some other form of consensus?
I will go with what they say until proven otherwise. You have another choice besides the seat of your pants? What certainty do you want? 100%?
chopper
@Elie:
Facts always matter. But when you’re dealing with someone with an anxiety disorder, spouting facts doesn’t do shit. It sucks to have to say ‘well, what if we did A, B or C’ knowing that those things are not necessary, but it’s that sort of stuff that gets them off the ledge, so to speak. You can’t get through that shell they put around themselves until you get them to calm the fuck down first and foremost.
When you think about American culture in the vein of a mental illness, things make a great deal more sense.
Omnes Omnibus
@chopper: The problem I have with that approach is that a fairly large number won’t be swayed by it. They basically have to be written off. There are others, though, who are scared because they have been misinformed; I think that they can be talked down off the ledge with a calm factual approach. Maybe I just don’t think that we are as lost as a society as some others do.
John Cole +0
@Elie: I’m stating that we are wasting a shitload of energy, time, and money when we could have just dealt with this easily and quickly by inconveniencing one person.
I’m stating that public hysteria doesn’t give one shit about your facts.
I’m stating that the CDC and health officials are sending mixed messages, both with their guidelines and their actions. “You’re completely safe, the doctor followed our guidelines and is now secure in a hospital. But while we’re at it, we’re going to send hazmat teams in bubble suits to his house to clean and burn everything, track down every single person he has been potentially in contact with, and quarantine a bunch of other people we know he has been in contact with.”
I’m stating that mixed messages are worse than wrong messages because they give a gray area for frauds and charlatans to whip fear up and cause a panic.
I’m stating that while you and I both agree on the facts about transmission, there must be some gray area there, as well, because otherwise there is no need for those precautions (see my comment regarding flood insurance).
I’m stating that sending police in masks and gloves and yellow tape to cordon off the area doesn’t help matters when they then throw the shit in the fucking trash can on the corner.
I’m stating that none of the people treating ebola patients using the right gear with the right training and supervision are no public health threat whatsoever and that some of you just belched that strawman argument up.
I’m stating that if public fear and hysteria are not tamped down, we’re going to get a lot of politically motivated bullshit at a great cost to liberty and the wallet.
I’m stating that tamping down that fear and hysteria isn’t going to happen in this country by a couple people snottily saying “I KNOW MORE THAN YOU SHUT UP.”
I’m stating as proof of that, see the anti-vax movement. The facts were clear there and people would scared into doing stupid shit.
I’m stating that now is the time to bring up anti-vacc idiots, not to use a cudgel to accuse me of relying on folklore.
I’m stating that I am not one bit concerned about getting ebola. I’m pretty sure I will know when someone sweats on me, bleeds on me, pukes on me, etc., and if that person a couple weeks down the road is diagnosed with ebola, then I will be concerned.
I’m stating that guidelines change, so simply demanding that people pay attention to established guidelines and STFO or get out is stupid.
I’m stating that I am quite concerned about the growing hysteria, and that your approach is not working on dealing with that. You all are just blindly dismissing the fact that we live in Idiocracy, where large swaths of the public believe in creationism, don’t believe in man made climate change, still think that tax cuts for the rich helps them, and on and on. I’m trying to confront that head on, you’re just saying OH FUCK THEM. They’re idiots, and they vote and they run our media.
I’m stating that a little common sense, which you all have derided endlessly, to the point of turning me into Jenny fucking MCCarthy on this very thread, could have stopped all of that. Had those folks that treated Duncan been quarantined, and had Spencer been quarantined, none of this would have happened. I think I am right. You think that makes me ignorant about the science and the facts and relying on folklore and an anti-vaxer and pandering to fearmongers.
That’s what I am stating.
Elie
@chopper:
I agree with Omnes… I don’t think that we can let the anxious make our policy and decisions. That is what you seem to be saying. I can sympathize with their anxiety and try to work with them in other ways. But they don’t get to be the drivers of what is fact and what is most importantly, the right thing to do.
Am I always comfortable about the “right thing”? I considered going over to help in Africa but was afraid of the challenge of it — of becoming sick.I wrestle with it now as I seek a way to help besides sending money (which I have). These people (MSF and others), are heroes to me. We have to support what they are doing if we are to ever snuff the risk for us in the US. We need reasonable guidelines — and the ones that start Sunday seem good and are based on the facts: temperature and transmissability are strongly associated. So travelers who have been to the three affected countries should take their temps twice a day, provide reliable contact information and immediately notify CDC or state public health agency if their temp goes up. Since we all know that they are not infectious before a fever, there is no reason to make them hole up in their homes without that key indicator changing.
R. Porrofatto
Well, this is now all moot:
Elie
@John Cole +0:
I think you are definitely right about the mixed messages. No doubt about that. I think that the political pressure on them is immense or all the reasons you cite. They KNOW we live in a county of idiots and cynics who manipulate the idiots
I’m stating that if public fear and hysteria are not tamped down, we’re going to get a lot of politically motivated bullshit at a great cost to liberty and the wallet.
You are probably right about this also.
My only point is that if you give in to hysteria, when is there ever going to be the ability to live from facts? How do we ever get there if we never live that value? — if our leaders don’t try that approach? I think Obama and our public health leadership are trying to tack to a midpoint between facts and politics but that is pretty hard to do. Still, its an important investment even as it costs us politically and maybe money wise. I wish the President would just call it out — that we believe in facts and science which though at times imperfect, give us the best chance to do the right thing the right way — to lead our people expecting the best from them – not from the cynical place that they are dupes and idiots who cannot understand. Pretty risky I agree. We need that courage though, John. A lot of stuff, not just this, needs us to be awake and fact based.. Otherwise we all are really going to die.
Omnes Omnibus
@Elie:
This.
Elie
@R. Porrofatto:
What are the terms of the quarantine?
John Cole +0
@Omnes Omnibus: I actually agree with you both.
WaterGirl
@John Cole +0: I haven’t read all the Ebola threads but I pretty much agree with you, from what I’ve read.
Proceed with an abundance of caution.
It is SO much easier to prevent a situation than it is to deal with the consequences.
I felt kind of sluggish a few days ago, I had no fever but I could tell I was trying to get sick. And I know you’re typically most contagiousI when you’re in the “hmm, I wonder if I’m getting sick” stage. So I stayed home – if you’ve been exposed to Ebola AND you feel kind of sluggish, STAY HOME.
I don’t think that’s asking too much.
Omnes Omnibus
@John Cole +0: Then why have you been shouting at me all day?
Elie
5:05 P.M. Cuomo Chides Ebola Patient
Governor Cuomo chided Dr. Spencer, who left Guinea on Oct. 14 and landed in New York Oct. 17, for not choosing to quarantine himself.
“He didn’t follow the guidelines for the quarantine — let’s be honest,” Mr. Cuomo said. “It’s too serious a situation to leave it to the honor system.”
Doctors Without Borders, for whom Dr. Spencer was working in Guinea, said that he had followed all of its protocols, including closely monitoring his health and immediately reporting any symptoms.
Federal guidelines do not require automatic quarantine for returning workers who show no symptoms. But Mr. Cuomo said that they were not stringent enough given the potential problems if someone with Ebola were, for instance, to ride the subway in New York. (Dr. Spencer rode the subway on Wednesday, but is not believed to have been contagious then.)
“This region is a little different than most places,” Mr. Cuomo said. “It’s more dense. It’s a little higher pressure. And Governor Christie and I believe in this area, we need guidelines and procedures that go further.”
Mr. Cuomo said of the concept of voluntary quarantine, “It’s almost an oxymoron to me.”
— THOMAS KAPLAN
The only moron in this piece is Cuomo. But no worries, John — he is following your recommendations and making it up by the seat of his pants as the politics dictate. Its all good. Feel better?
WaterGirl
What I don’t get is all the hate and personal hostility as this is discussed. I’m pretty sure it’s easier to get your point across when you are not personally attacking someone.
John Cole +0
@Omnes Omnibus: No, I agree that Obama should come out and make it clear.
Elie
More from the NYT chat.
Oh Goodie! Christie and Cuomo teamed up to single handedly “improve” the guidelines so that all travelers (it appears largely health care workers who have treated people in the three countries) will be quarantined:
YAY!!!!! We are all safe and we don’t have to worry about any of our healthcare workers coming back home. I guess we won’t be evacuating them either if we know they are sick. Why bring someone sick here?! Whew, we are definitely safe now…
I'mNotSureWhoIWantToBeYet
@R. Porrofatto: Oh well, there goes hopes of gaining quicker control of it in western Africa.
Yeah, make it even more difficult for US medical personnel to go to help. That’s brilliant.
Actually, no. It’s stupid, stupid political grandstanding.
:-(
Cheers,
Scott.
I'mNotSureWhoIWantToBeYet
@John Cole +0: He already did in his Saturday video last week. Lot of good it’s done so far, what with people screaming for mandatory quarantines today…
:-(
Cheers,
Scott.
John Cole +0
@Elie: Why are you mad at me? I told you this would happen. I’ve been saying since day one if they don’t get ahead of this more shit is going to come down the pipeline and you all just sneered at me. And there is no doubt that quarantining doctors coming back from ebola-ridden nations, from a NYC officials standpoint makes sense. It’s far cheaper than spending millions of dollars and who knows how many man hours doing the post-hoc crap they’ve been doing since Thursday.
Omnes Omnibus
@John Cole +0: Got it.
Elie
@WaterGirl:
Hmmm. I am pretty sure that I did not show any hate — in fact I have been pretty careful to be respectful and actually did not feel anger up until I read what Cuomo and Christie did a short while ago. Really. John made good points. I was asking him serious questions that he answered seriously
Go back and check (at least for my comments)
I am very pissed at Cuomo
Elie
@John Cole +0:
I am not mad at you and apologize if that is how it came across. I went to look at the NYT and I already can’t stand Cuomo so I lost it.
Apologies. NOT intended for you even though I asked you if you were satisfied now
Elie
So lets finish up with some calculations about cost.
Ok — there have already been fewer healthcare worker volunteers going for Ebola affected countries in Africa. In part this is thought to be due to the longer and more uncertain timeframe that employers (who give the volenteers time and healthcare coverage) and the possibility of bad disease. So now, these will be further diminished.
Lets go back to a little science. Every medical/epidemiological scientist says our best chance to keep this from being a pandemic is to stop it IN AFRICA. Now we just made it harder to do that. HOW MUCH IS THAT GOING TO END UP COSTING US – THOSE OF YOU WITH THE SHARP PENCILS OR CALCULATORS?
We.just.made.this.worse.
Steve from Antioch
It seems to me if your “common sense” is based on following the right guidelines, the right training and having the right gear that it’s not really “common sense” anymore, is it?
Seems like it is more like “carefully following recognized medical protocols” than “common sense.”
You are assuming, also, that the nurses/doctors in NYC are carefully fooling the medical protocols. The nurses/doctors in TX thought they were, too.
The point being that common sense ain’t got jack shit to do with it.
R. Porrofatto
@Elie:
With all due respect, this doesn’t remotely describe the world I live in. Imagine if Obama went on the TV and said “Don’t worry, no one needs to be quarantined. Science assures us that a person is not contagious if they don’t have symptoms and facts are facts…” etc. And he makes all the best rational arguments in the best possible way.
And then a health care worker comes home from treating Ebola patients in Sierra Leone and goes right back to work at a hospital. Let’s make it really exciting— the maternity ward of a hospital. And 10 days later he or she shows symptoms and is tested positive for Ebola. Can you imagine the nuclear shitstorm that would ignite, in every way imaginable? You simply cannot divorce public opinion and politics from these issues.
Besides, there are doctors and experts who are divided on the issue, too.
There are probably even more medical people opposed to the idea, too. But it’s happening anyway. I hope they at least ameliorate the hit and come up with financing to pay all returning medical personnel for their time lost.
R. Porrofatto
@Elie: I haven’t seen any more details yet, other than the use of the word “mandatory.”
Elie
@R. Porrofatto:
You have good points. That said, under current medical practice, I don’t think docs are coming back from active care of Ebola patients to direct care in hospitals (or elsewhere) right away. That would feel creepy, but really, if the science about transmission is solid, why wouldnt we monitor their temperatures twice a day (or more?) as a good indicator of when to take them away from contact with patients and people? Are you saying that against all information to the opposite, that they would actually be able to transmit Ebola without evidencing any sign of having it? Really? Your fear is that the science isn’t reliable or trustworthy, right? Lets just give in to your fear then! That was easy… we’ll just ask you or Joe for policy and forget the science, right? Well if not, when do we get to use the science?
When?
Elie
I can’t seem to comment successfully
Omnes Omnibus
@Elie: I’ve never really been able to do so. Just look through my collected works and despair.
I'mNotSureWhoIWantToBeYet
MSF Responds:
Cheers,
Scott.
Elie
@Omnes Omnibus:
LOL
wordpress won’t let me respond to a comment
Omnes Omnibus
@Elie: Try making a small alteration to the ‘nym once you have hit the reply button. It sometimes fixes things.
Elie
@I’mNotSureWhoIWantToBeYet:
This says it all — ALL
I tried to respond to M Parrafato — when do facts matter? When? If we just give up to the hysterics, when will facts ever matter? Why are the costs onlly weighed for this side of the equation? There are no costs for not being fact based? What happens to having decreased volunteers in Africa? Oh – sorry — who cares, I guess.
Elie
You or rather, our leaders can help bring people along. Is it popular or easy? NO – I realize that. But don’t you see what has happened is happening? Once you get away from facts and science – you are in the dark ages and into the question of who then gets to set policy. Witches? We saw that In Sierra Leone where health workers were killed in the remote villages because they thought that they were witches bringing disease. Is that where we want to be? Is it the rich and powerful who get to pick policy “on the fly” from the seat of the pants?
I appreciate John’s instinct about “getting in front” of the politics. Sometimes there is no honorable way to do that without selling out the facts and the “rightness” of policy.
We are no better right now, than the remote villages in sierra Leone – in thrall to shamans .. making it up from little bones and how the pebbles fall in the sand.
Elie
@R. Porrofatto:
Oh by the way, there should be plenty of money to “ameliorate” the salaries for 21 days… there won’t be that many workers, thanks to this really progressive, science based policy.
And here is another FACT you can ignore… we won’t be able to keep Ebola out of the US or anywhere soon. Of course, please ignore that since you will think that the “quarantine” will work well. Go look at the transmission models and then lecture ME about how realistic fact based folks need to be.
I'mNotSureWhoIWantToBeYet
@Elie: What I find infuriating about Cuomo’s and Christy’s announcement today is that it’s diametrically opposed to what Cuomo said just yesterday:
(Emphasis added.)
That was yesterday. Today, it’s effectively lock everyone who treated an infected person up for 3 weeks – whether they have any symptoms or not, whether it makes any sense or not, whether it is counter-productive or not.
Part of the reason why so many Americans are so afraid is that their leaders are cowards and have no understanding of science or medicine. They only listen to pundits and screamers on TV. Such leaders cannot be relied upon to make sensible decisions. We’re all going to suffer for it – even more than we have already…
:-(
Cheers,
Scott.
R. Porrofatto
@Elie: I really don’t know who you’re talking to. I don’t ignore the scientific facts of the disease. And I’ve repeatedly said a quarantine of health workers has virtually nothing to do with containing the spread of it, and everything to do with managing the consequences of cases like Dr. Spencer’s. I have also neither said nor do I think that “the quarantine will work well,” whatever that means, or that any of this will “keep Ebola out of the US.”
Seriously, WTF?
Elie
@I’mNotSureWhoIWantToBeYet:
AND ESPECIALLY when those of us who should know better (progressives) can’t be comfortable with and support facts and science. WTF?
Its actually worse political posturing than TEXAS!!!! (who knew)
More sadly, lets calmly figure out where we are and how to support our health care people to provide the vital services still so desperately needed?
Clearly, for those still there, they will have to undergo this policy and its implications as they return from service. Thankfully most will probably be disease free but I am still unclear as to where and how this quarantine will be administered and enforced. Presumably, no matter when our people return, including our military and other docs, they will be quarantined?. Is this just for the folks living in NY and NJ. Don’t worry, every other state with a key airport will follow suit with the same policy, so defacto, we will have a national quarantine policy initiated by two, shitty, corrupt governors.
I am very upset. Most worrisome of all, it will actually make us less safe as we have fewer workers as a result of this. And watch — we will still get Ebola here at home
Elie
@R. Porrofatto:
Ok — let me walk back. What were you trying to say here? Doesnt sound to me in your last sentence that science is king at all. Sounds the opposite. But please proceed…
Elie
@R. Porrofatto:
Man, I looked back at your comments and I don’t get you at all.
It seems like you don’t comprehend what “science” means at all. Your examples are all about political fear. Your hypothetical about the doc practicing immediately on return is devoid of factual knowledge about actual practice and just another opportunity to highlight your stance about how politics have an all important role rather than figuring out how to make science work
this is the bone you threw to the possibility of the cost to the health worker volunteers:
well whoopdie do, Mr Science for when its convenient…
PS (do you read what you write?)
chopper
@Elie:
I think he’s saying ‘let’s be realistic’. America is not, and never will be, a society where things are completely evidence-based. Accepting that and trying to work within those confines doesn’t make someone anti-science, it makes them a realist.
Go back to my example of mental illness. You can’t just demand that your depressed sister ‘stop being sad’ like that’s going to work.
R. Porrofatto
@Elie: I’m basically saying that I would love to live in an ideal world where science. facts and rational argument trump all other considerations, but unfortunately, we don’t live in that world. (Otherwise we wouldn’t have invaded Iraq in response to a terrorist attack by al Queda, or any of the other countless insanities we’ve endured since forever.) Sad to say, no matter what the facts are, they don’t exist in a world by themselves, especially about something so highly charged as a dangerous infectious virus coming to visit. Politics, public opinion, disagreements even among those in the scientific community about policy, and so on, all of it matters whether we like it or not. Which is why politicians, public health officials, and even aid organizations themselves, will institute and mandate new guidelines to handle crises like these, whether it’s out of an abundance of caution, or just to cover their asses.
I started out above saying that a voluntary quarantine made sense to me for only two reasons: 1. to vastly simplify in every respect the scope and cost of investigating contacts, history, etc. of the patient, and 2. to minimize the inevitable impact on public concern.
IMO, had Dr. Spencer been under a voluntary quarantine of his own we wouldn’t be having this conversation, and we wouldn’t see states instituting mandatory quarantines for returning health workers. But it’s too late now. Science is king only in that part of the world governed by science.
Elie
@chopper:
Are you equating our so called leaders with your depressed sister? Is that ok?
I get that we can’t expect some of them to be fact based, but should I assume that we should just give that up? If not, when should we use facts? Once we are not using facts anymore, who should decide what is used and who is using it?
Today, Governors of NY and NJ made totally un fact based decisions on how to manage one doctor returning from service in Africa with no evidence that the risk to the population is significant. None. He followed all the “rules” – he immediately reported himself when febrile and reported his contacts. Nothing he did was against what we know in science.
Cuomo and Christie decided to make up science to match their political fear and vulnerability. That is all.
NO. My or your mentally ill sister should not be making our science related policy decisons. I think it is sick to think that is ok. Stop making that kind of lame excuse. BTW how different is that from the shamans in Sierra Leone calling the shots and having the healthcare workers murdered? Explain how that is different.
I'mNotSureWhoIWantToBeYet
@R. Porrofatto: You’ll “love” this poll then.
(How on Earth can an on-line poll have an validity??)
Keep Americans out of the country! You betcha!!11
Mission Accomplished, Fox News. You must be proud.
:-(
Sometimes supposed public opinion has no business driving policy. This is turning into one of those cases…. It’s a sad day.
Cheers,
Scott.
(Who doesn’t think that surrendering to bad ideas is good a way to reduce panic.)
Elie
@R. Porrofatto:
Sadly true and reinforced/approved by people like you who will not stand for something deeper.
I am done.
Sleep well. Think of the many doctors and nurses laboring in West Africa, doing God’s (however you define him,she/it’s) work. They choose to follow the science to address their risk and are more optimistic about us than we deserve.
John Cole +0
@Elie:
Why do you keep taking this tone as if we are to blame. We’re the ones dealing with the realities of idiot America. There is no point in making a stand because it’s a lost cause. There are better windmills out there.
FWIW- another Doctors Without Borders is now apparently being quarantined. Great Doctor named Irwin Redlener on Maddow who is managing to acnkowledge both that we need to not go too far but to also take note that the public is nervous. he manages to mention both without attaching himself to a burning stake wailing about science and calling everyone ant-vaxers. You should watch it.
I'mNotSureWhoIWantToBeYet
@John Cole +0: You’ve got a big megaphone, JC. It’s disappointing to me that you think this isn’t a cause worth pushing-back against.
FWIW.
Cheers,
Scott.
the Conster
If this guy had just stayed home for another week, none of this ridiculous lock down nonsense would have happened. We were [[this close]] to having the Great Ebola Scare behind us, and then this fucking guy went bowling.
I'mNotSureWhoIWantToBeYet
@the Conster: Yeah, it’s all Craig Spencer’s fault. It’s always best to punch down, it’s always the little people trying to do their jobs and live a normal life that are always responsible.
It has nothing to do with Republican politicians, or scare mongers, or conspiracy theorists.
Yup. You’ve got it all figured out. Congratulations!1
:-/
Cheers,
Scott.
Elie
@the Conster:
YOU are a moron.
Staying at home had nothing to do with it. You and the other morons wouldn’t accept that he would not transmit Ebola given the science so you tacitly support the even more moronic decision to slap on a quarantine that IS NOT SUPPORTED BY THE SCIENTIFIC FACTS. Of course being a moron, facts don’t matter. Moronic ideas matter. And you ARE AFRAID BECAUSE BECAUSE THOSE OTHER PEOPLE ARE AFRAID SO THATS ENOUGH FOR ME! See now what you did, you made us scared because because we are just scared and we support scared policy because .. you believe in it
John Cole +0
@Elie:
I don’t get this. It has everything to do with it. If he had stayed at home and was diagnosed with it, the story would be “A doctor who treated patients in Liberia has tested positive with the virus and has been checked into a hospital specifically set up to handle ebola patients. The CDC has quarantined his girlfriend as a precaution, his apartment is being cleaned, and since he had no contact with anyone, authorities state there is no reason anyone should be worried.”
Follow it up with this woman, my new personal hero, who was their neighbor:
That would be it. That would be the extent of the story. There would be no mandated quarantine, no hysteria, no room for the assholes in the media and the GOP to whip up fear, no cops running around ebola protective gear in public trash cans, no people donning SARS masks in subways, no people freaking out because they were in the same bowling alley, no need for politicians to “DO SOEMTHING.” That would have been the end of it.
But now, we have this ridiculously shitshow fail parade and more awfulness is going to come down the pike. You may adore scientific facts, but you clearly have no grasp of the facts regarding the country you live in or the political realities of things. And you keep acting like we’re the enemy.
Keep slamming your shoe on the podium screaming about scientific facts and evidence and ignoring the world around you, and you will continue to be your own worst enemy. We’re on your side about the scientific facts and evidence. What’s killing us is that trying to get you to acknowledge the realities of this country is like trying to teach a dog how to program in machine language.
Elie
@John Cole +0:
It is NOT a lost cause, John. Its not lost cause it hasnt been fought. You just gave in. Whoops, the stupids win!
Maybe over time some half way compromise can be reached, but again, it goes back to facts and you either support them or dont. This guy is not a danger to anyone. No one else will be infected. His infection came from caring from a lot of sick people in Guinea.
The public policy that you seem to think was inevitable now says that our healthcare workers returning from doing what is needed in Africa are going to be punished and other volunteers will be discouraged from volunteering to do this (by many of their employers). We should just be obedient to those who are ignorant and fearful in this crisis — where the outcome will be dependent truly on inescapable scientific facts. Each day that we don’t send thousands of healthcare workers to do what needs to be done is a travesty. Today, the first person, a two year old, died in Mali – a very poor country without any infrastructure. The index case for this huge outbreak was similarly a toddler in Guinea. It is spreading and you and the people like you are letting fear set our policy. You talked previously about “getting in front” of this. How? There is no front! There are only facts, John. Politics will die as facts inexorably assert themselves. You will not be able to argue with the ruthless reality of the spread of this virus that we truly have the best chance to address now. Once that window closes, well, it will be a lot harder and the panic will be much much worse. Don’t you get it? Now is the time to stand for science. It is going to be much harder when later, Ebola is increasing in prevalence and nothing seems to work.
I am not naive. I am very much a pragmatist. Sometimes however, you cannot fight the laws of physics. You and others seem to think that is possible.
I'mNotSureWhoIWantToBeYet
@John Cole +0: You’re simultaneously arguing that people have irrational fears, yet if we only do one little thing (mandatory quarantine) then everyone will suddenly behave rationally. Don’t you see the contradiction?
Nebraska:
Nobody in Nebraska has been infected there, of course.
The situation won’t get better by giving in to crazy fears. Crazy feeds on counter-productive reactions.
Cheers,
Scott.
Elie
I have to step away from this for now..
Conster and John – my apologies. Conster particularly, you are NOT a moron.
I am very upset by this and while John and others, it is not your fault that stupid is winning, we have to work this through. We are seriously at risk if we let our fear lead this…
I am reminded about the sci fi movie, Jurassic Park. Our biological systems, jes don care… the rules of this virus, just as the rules of recombinant DNA at the Park, are not ours. We had better respect that and bring all of our resources to bear correctly. Right now, Ebola has spread to Mali and we already are stretched to the max and undermanned in Liberia, Sierra Leone and Guinea. We can still get on top but its critical that we have the “boots on the ground”, the healthcare workers, to do it. To discourage that is to assure a bad outcome.
the Conster
@John Cole +0:
What you said.
the Conster
@Elie:
Apology accepted. We are all extremely concerned about every aspect of this problem. We’re all just talking here, and thank you John for providing a sane informative forum.
R. Porrofatto
@Elie:
Oh Christ I give up. I neither reinforce nor approve of people being morons. And frankly, what I stand for, despite your not having a clue what that is, seems to be a whole lot less arrogant than your intransigent self-righteousness.
As to the many doctors and nurses laboring in West Africa, my wife used to be one of them. But she she lives in the real world, so I guess she doesn’t stand for something deeper either .
Sayonara.
fubs
@Xboxershorts:
“he’s been treating it for years, so, yes.”
How’s that working out for him?
“What are your bonafides?”
I have never contracted ebola.
fubs
@I’mNotSureWhoIWantToBeYet:
“Note that “sluggish” with no fever is not an Ebola symptom”
Quick! Tell the CDC! Before they waste all that time and money tracing all of Dr. Spencer’s contacts back through Tuesday, because that’s when he started feeling sluggish!–which feeling we now know was a symptom of ebola!
It is really important that your internet research guide the practices of the medical authorities who are carrying out the investigation of this ebola case in New York fucking City!
These investigators must be stopped before they further undermine your credibility as a blog commenting authority on ebola!
Elie
@R. Porrofatto:
It is not your fault either.
apologies
chopper
@Elie:
I’m equating our society with a person with mental illness. I explained that clearly earlier.
chopper
@Elie:
And it isn’t a matter of either being ‘completely fact-based’ or ‘just giving up’. Nobody ever said that.
Sounds to me like you’ve never dealt with anybody in your life who wasn’t a completely evidence-based person. Must be nice.
chopper
@Elie:
That’s not how it’s looking on this end.
The behavior or humans en masse isn’t explained by the laws of physics. I think that’s one of johns points here.
I'mNotSureWhoIWantToBeYet
@chopper: You might want to review John’s posts on this topic again. He started off calling a nurse an “asshole”. That’s not just sitting back, tut-tutting, and saying that “Oh well, Americans are stupid fraidycats – what are you going to do?” or something.
Speaking of malicious ignorance:
1. Colds are airborne viruses. Ebola isn’t.
2. Really? The same as unprotected sex?
3. Someone who helps patients who have an often deadly disease, at some risk to themselves, has “casual disregard for your fellow man”?
He fed the stupid with those statements. AFAIK, he hasn’t taken those statements back.
We can all agree that over-reactions by the public are bad, counter-productive, and hard to combat. But making the argument by attacking a victim, by not condemning Phil Gingrey, John McCain and other Republican politicians (and Stalin) who have done the most to create this environment of unbridled panic (Gingrey was yelling about Central American children with Ebola invading the US in July) is just punching down and fanning the flames.
Lots of us, on both sides, feel strongly about this episode. You folks on the other side should re-examine your positions as well.
Cheers,
Scott.
chopper
@I’mNotSureWhoIWantToBeYet:
i think ‘asshole’ is pretty strong, but getting on a plane when you’re convinced you have ebola (to the point that you refused to let your family members come near you as you were afraid of getting them sick) and have a temperature is pretty stupid, especially given the aftermath of the situation.
Larv
@fubs:
Ha ha, zing! It’s funny because he might die! Christ, you’re an asshole.
chopper
@I’mNotSureWhoIWantToBeYet:
‘as well’? i don’t get the feeling from ‘you folks on the other other side’ that you’ve been re-examining your own positions on this matter.
I'mNotSureWhoIWantToBeYet
@chopper: And she didn’t infect anyone, and she fully recovered. Maybe those facts will eventually sink in with the public. Maybe it’ll happen a little faster if people don’t continue to call her names and second-guess her actions.
One would hope that recommendations base on nearly 40 years of experience with treating this disease will eventually make it’s mark on those who are panicking.
We can hope, anyway…
Have a good weekend.
Cheers,
Scott.
chopper
@I’mNotSureWhoIWantToBeYet:
who says she did?
Larv
@chopper:
Yes, calling the experts and asking them what you should do it totally stupid. That sort of responsible behavior is obviously to be mocked. We should just decide what she should have done based on our gut, which is wise and all knowing. Facts and science are for naive people.
chopper
@chopper:
i think the point of the flight is, she was lucky. you add up a flight to dallas, boarding and exiting, plus a bad luck ‘wait on the tarmac for an hour and a half’ situation (which has happened to me at least half the time i fly these days; one of the last flights i was on took 6 hours from the beginning of boarding to getting off the plane and the actual flight time was supposed to be an hour fifteen minutes), plus the fact that sometimes the disease goes from the beginning of symptoms to full-on in a matter of hours, and you have a worst-case scenario of someone getting sick all over the person next to them.
now, the worst-case situation didn’t happen here. however, when it comes to ebola, generally speaking the worst-case situation is one that is always considered, no? why do you think health care workers dealing with ebola patients are supposed to wear full suits covering every square inch of their bodies?
chopper
@Larv:
given that the CDC came out later and said that their recommendation was dumb and she shouldn’t have flown, it turns out that merely calling the CDC doesn’t necessarily relieve a person of the burden of applying some common sense to the situation.
I'mNotSureWhoIWantToBeYet
@chopper: The panic is base on fear that she would infect people. Once people see with their own eyes that, yes, the disease is hard to transmit until its late stages, just like the experts say, the fear should (and my guess is, will,) abate. (In some people, it won’t of course. Some people were afraid to touch black people, even before Ebola, after all…)
FWIW.
Cheers,
Scott.
I'mNotSureWhoIWantToBeYet
@chopper: Don’t confuse a statement at a CDC press conference with what the CDC recommends. Their policy recommendations and news posts are here.
Cheers,
Scott.
chopper
@I’mNotSureWhoIWantToBeYet:
yes, but ebola is also known for its very swift onset of symptoms, as i pointed out.
when you’re convinced that you’re starting to show symptoms of EVD, a disease that in many hits like a ton of bricks and can make some nauseous and puking within even a matter of hours, putting yourself in a situation where you’re stuck in a small tube in close contact with other people for what could reasonably end up being an extended period of time isn’t necessarily a very smart move.
chopper
@I’mNotSureWhoIWantToBeYet:
why not? we trust the CDC, right? why would we disagree with them?
I'mNotSureWhoIWantToBeYet
@chopper: Because off-hand answers to a question aren’t as clear as a policy paper that has been reviewed at multiple levels before being published.
You’re not really having trouble seeing the difference between an official publication and a few-second sound-bite on TV, are you?
Cheers,
Scott.
I'mNotSureWhoIWantToBeYet
@chopper: You keep making this statement (about how quickly Ebola takes over) without any apparent recognition that the treatment policy is based on nearly 40 years of experience in treating the disease. Is the MSF naive about what they’ve been dealing with for decades?
Show me a link that says someone goes from low fever to projectile vomiting in 12 hours, please?
Hint – Here’s Duncan’s timeline:
September 19 – No fever, leaves Liberia
September 24 – Begins to develop symptoms
September 25 – Goes to Dallas hospital
September 28 – Returns to Dallas hospital with severe symptoms. Nurses infected.
October 8 – Duncan dies.
Etc.
That looks like at least 3 days after developing symptoms before he became severely infective to others.
HTH.
Cheers,
Scott.
chopper
@I’mNotSureWhoIWantToBeYet:
I am having trouble figuring out when we are supposed to believe the CDC and when we aren’t.
chopper
Anyhoo, I have Halloween stuff to do with the kiddos so this is it for me.
It was fun bring condescended to tho.
Larv
@chopper:
Yes, you and John are the victims here. Damned pointy head intellectuals with our “facts” and “knowledge” being mean to you, when all you want is to call us naive and stupid for recommending that people follow established medical guidelines.
Larv
@chopper:
The CDC is being whipsawed between medicine and politics. Their official guidelines are much more likely to be the result of carefully considered medicine and scientific research. Their statements at semi-hostile press conferences, not so much.
chopper
@I’mNotSureWhoIWantToBeYet:
Ebola is known for rapid onset of symptoms. Including vomiting. ‘Rapid onset’ generally doesn’t mean 3 days. It can be slow in some people but that doesn’t mean all.
chopper
Also, I don’t remember saying ‘projectile’ vomiting. Nausea and regular old fashioned vomiting (hey look, the pilot says we’re going through a bunch if turbulence!), sure.
I'mNotSureWhoIWantToBeYet
@chopper: I asked for a linky. I’m asking again. :-)
Enjoy your Halloween stuff. It’s a good tradition.
Cheers,
Scott.
chopper
@I’mNotSureWhoIWantToBeYet:
but i didn’t say ‘projectile vomiting’. you’re asking me to provide a link to something i didn’t argue.
now, i don’t have access to pubmed on my iphone, unfortunately. however, of course ebola symptoms are known for rapid onset:
in terms of an acute viral infection, the phrase ‘rapid onset’ generally isn’t strictly defined, but isn’t going to refer to 3 days. some people get lucky and it takes a while. some people don’t; if you’ve ever been unlucky enough to get a particularly acute case of the flu, you know what ‘rapid onset’ means, and it aint slow.
chopper
@Larv:
no i don’t. i understand what you’re arguing, and i respect it. i don’t think you’re stupid at all.
i just don’t think that american society is very evidence-based, and dealing with it in that manner is not very effective or realistic.
chopper
from MSF’s ‘return from west africa’ policy:
so MSF recommends that returning doctors stay away from work for 3 weeks, in part to avoid ‘needless stress and anxiety’ in their colleagues? that doesn’t sound very science-based to me. that sounds to me like MSF is deliberately giving in to and coddling peoples’ fears and emotions.
Larv
@chopper:
But you have no problem with John calling Amber Vinson stupid, or with criticizing her, the Texas lab tech or Dr. Spencer. All of them followed the protocols recommended to them. None of them endangered anyone. But somehow their failure to anticipate and pander to the irrational panic is cause for criticism?
I’d also note that both you and John are being inconsistent about whether your criticism is based on public health or public opinion. When convenient, you say that maybe what they did was dangerous, because they may have suddenly gone from asymptomatic to infectious in a period of hours (very very unlikely). But at other times you claim that it’s the public reaction to their actions that concerns you. Then the problem isn’t the danger, it’s that americans are irrational, fearful, and not evidence-based. Those being criticized should have known better than to cause a panic and wasted resources on things like contact tracing and decontamination through their selfish refusal to cloister themselves against medical advice. But you can’t have it both ways. If they were actually endangering anybody, than the public reaction isn’t irrational and the freakout is justified (although still mistargeted). Which is it?
Larv
@chopper:
Huh? It clearly says that the problem is that they could acquire an incidental infection, which could cause symptoms similar to early-stage Ebola. Nobody has said that you shouldn’t be cautious around people who are actually symptomatic (and no, sluggishness is still not a diagnostic symptom). The debate is over asymptomatic people.
I'mNotSureWhoIWantToBeYet
@chopper: Thank you.
We should also note that it says:
Emphasis added.
I understand you’re arguing that you understand the science and you agree with it, but you’re concerned about the fear-based reactions. I disagree that the way to combat the fear is to simply impose “a few relatively harmless policies to get people to chill the fuck out.” I don’t think quarantining people who pose no risk is relatively harmless. I don’t think restrictions on the movements of people without symptoms (other than the MSF recommendations) makes sense. I think quarantines makes the freakout situation worse.
It looks like the CDC travel guidelines buried on their web page (but last updated in August) are a bit more draconian than I had believed…
IOW, if I’m reading the table correctly, with or without symptoms, such people should be under “controlled movement” (meaning no commercial air transport among other things) for 21 days. So, the CDC press conference indicating the nurse shouldn’t have flown to Cleveland was seemingly correct. They need to update their published materials to make things like this clearer, it seems to me…
We disagree on the advisability of “abundance of caution” quarantines. You can have the last word here.
Cheers,
Scott.
chopper
@Larv:
i’m not john. you have an issue with his language, take it up with him.
i have no problem saying that vinson getting on the plane was a pretty dumb move. i have no problem criticizing that.
my opinion is primarily over public opinion, that is how people are going to act. i think i’ve made that quite clear.
however, when it came to vinson, it was also about actual public health, for reasons i have also made very clear.
chopper
@Larv:
yes, and cause undue ‘stress and anxiety’. i mean, if the chances of passing along an infection when symptoms are only just starting is basically zero, who cares? why is MSF concerned about the ‘stress and anxiety’ in coworkers if we’re supposed to only follow strictly scientific principles?
clearly, MSF’s own policies are not completely epidemiological in basis here. they’re taking into account other peoples’ fee-fees and saying ‘fuck it, let’s just deal with it’.
chopper
to put it another way, MSF is saying here that policies with regard to returning doctors can’t be, or at least shouldn’t be, rooted completely in cold hard epidemiology, but have to take into account other peoples’ anxieties over the disease. you have to meet people in the middle, and be a bit realistic, so you don’t cause others to completely fucking freak out.
not really all that different from what people like john and i are saying about said returning doctors.