Ebola

[Crafty_Dog]

Giving Ebola its' own thread.  Prior posts can be found on the Epidemics thread:

http://www.breitbart.com/Big-Government/2014/10/14/CIDRAP-Confirms-Ebola-Transmittable-by-Air?utm_source=e_breitbart_com&utm_medium=email&utm_content=Breitbart+News+Roundup%2C+October+15%2C+2014&utm_campaign=20141015_m122611608_Breitbart+News+Roundup%2C+October+15%2C+2014&utm_term=More

[Crafty_Dog]

http://online.wsj.com/articles/e-fuller-torrey-how-the-u-s-made-the-ebola-crisis-worse-1413328767

[ccp]

I cannot get the whole article.

Have to login.

Freidan is a perfect example of a liberal fool.  Of course we should try to close our borders.  At least we should try.
Trickle up poverty and trickle around the world disease.

In any case the politics of the AIDs epidemic seems to be when we started treating infectious disease differently. 

Make us all suffer why don't chya.

[Crafty_Dog]

Here ya go: 

(For the record, I'm not sure I agree 100%, but I offer it here for conversation)

How the U.S. Made the Ebola Crisis Worse
The total number of Liberian doctors in America is about two-thirds the total now working in their homeland.
By
E. Fuller Torrey
Oct. 14, 2014 7:19 p.m. ET
39 COMMENTS

Amid discussions of quarantines, lockdowns and doomsday death scenarios about Ebola, little has been said about the exodus of Africa’s health-care professionals and how it has contributed to the outbreak. For 50 years, the U.S. and other Western nations have admitted health professionals—especially doctors and nurses—from poor countries, including Liberia, Sierra Leone and Guinea, three nations at the heart of the Ebola epidemic.

The loss of these men and women is now reflected in reports about severe medical-manpower shortages in these countries, an absence of local medical leadership so critical for responding to the crisis, and a collapse or near-collapse of their health-care systems.

Although Africa bears 24% of the global disease burden, it is home to just 3% of the world’s health workforce. A 2010 World Health Organization assessment of doctors, nurses and midwives per population listed Liberia, Sierra Leone and Guinea in the bottom nine nations in the world in medical manpower.
ENLARGE
Corbis

In Liberia, a nation of four million people, the number of Ebola cases is said to be doubling every 15-20 days. Based on news reports, I’ve estimated that there were about 120 Liberian physicians in the country prior to the outbreak.

According to an American Medical Association database, in 2010 there were 56 Liberian-trained physicians practicing in the U.S. This number does not include other Liberian physicians who emigrated to this country, were unable to pass state licensing exams, and are employed as technicians, administrators, or in other jobs. Older studies suggest that the number failing such exams is about half of those licensed.

Thus the total number of Liberian physicians in the U.S. is probably about two-thirds the number in Liberia. In addition, Liberian-trained physicians live in Canada, Great Britain and Australia.

The Liberian situation is not exceptional. Altogether in 2010 the U.S. had 265,851 licensed physicians trained in other countries, constituting 32% of our physician workforce, according to the AMA. Among these, 128,729 came from countries categorized by the World Bank as being from low- or lower-middle income countries. These physicians tend to work disproportionately in rural and inner-city jobs less favored by American medical graduates. West Virginia, for example, has the highest proportion of foreign-trained physicians from poorer countries to U.S.-trained physicians.

The U.S. has always welcomed health professionals from other countries. However in 1965, responding to a perceived shortage of physicians for the growing U.S. population, Congress passed landmark immigration legislation giving preference to health professionals. Subsequent legislation in 1968, 1970 and 1994 further opened the door, especially for physicians from poorer countries. The percentage of foreign-trained physicians has steadily increased from 10% of the workforce in 1965 to its current 32%.

Many objections to this policy have been raised over the years. In 1967 Walter Mondale, then a senator from Minnesota, called it a disgrace. It was “inexcusable,” he wrote in the Saturday Review, that the U.S. should “need doctors from countries where thousands die daily of disease to relieve our shortage of medical manpower.”

A 1974 report on the “Brain Drain” for the House Foreign Affairs Committee noted that the current policy was widening the gap between rich and poor nations, and warned that the policy “has a great potential for mischief in the Nation’s future relations with the LDC [less developed countries].”

Despite such complaints, U.S. policy has continued to encourage the immigration of physicians and other health workers from poorer countries. “There’s nothing wrong with a foreign-trained doctor,” Casper Weinberger, then secretary of the Department of Health, Education and Welfare, said on TV in 1973. “Of course we’re using a lot of them, and will use a lot more.”

The consequences of this policy may be more than “mischief.” Ebola may be merely the first of many prices to be paid for our long-standing but shortsighted health manpower policy. Surely the wealthiest country in the world should be able to produce sufficient health workers for its own needs and not take them from the poorest countries.

Dr. Torrey is associate director of the Stanley Medical Research Institute and author of “American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System” (Oxford, 2013).

[ccp]

I wonder if this is what he was rushing back was for.  To make the hospital CEO apologize.  Make him the scapeghoat. 

 The only one who should apologize is the Self Chosen One who will not secure the borders:


Top Texas hospital official to tell lawmakers 'we made mistakes' on Ebola


Published October 15, 2014·
FoxNews.com
top official for the parent company of the Texas hospital where two nurses contracted Ebola from a dying patient plans to tell lawmakers he is “deeply sorry” that “mistakes” were made at the facility, and will vow to determine how the errors occurred.

Dr. Daniel Varga, the chief clinical officer and senior vice president for Texas Health Resources, which runs Texas Health Presbyterian Hospital, will testify before a House subcommittee Thursday along with CDC Director Dr. Thomas Frieden, the director of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci and others.

According to prepared testimony, Varga will apologize to the subcommittee for how the hospital handled the treatment of Thomas Eric Duncan, a Liberian national who became the first person diagnosed with Ebola in the U.S. He died Oct. 8.

“Unfortunately, in our initial treatment of Mr. Duncan, despite our best intentions and a highly skilled medical team, we made mistakes,” the prepared testimony reads. “We did not correctly diagnose his symptoms as those of Ebola. We are deeply sorry.”

Varga will say the team of medical professionals was “devastated” when Duncan succumbed to the disease, adding it is “hard to put into words” the sorrow the team felt.

Varga also plans to mention the two nurses, both of whom contracted the deadly virus after caring for Duncan. He will say the team is “hopeful” about the progress of Nina Pham, the first nurse diagnosed and also will mention the second patient.

“A lot is being said about what may or may not have occurred to cause Ms. Pham to contract Ebola,” he will say. “She is known as an extremely skilled nurse, and she was using full protective measures under the CDC protocols, so we don’t yet know precisely how or when she was infected. But it’s clear there was an exposure somewhere, sometime. We are poring over records and observations, and doing all we can to find the answers.”

Varga will tell lawmakers the hospital group has made changes since its first encounter with Ebola, saying that the hospital was prepared to treat Ebola but fell short on diagnosing it.

“As a result, following Mr. Duncan’s initial admission, we have changed our screening process in the (emergency department) to capture the patient’s travel history at the first point of contact with (emergency department) staff,” he will say.

Varga will also say the hospital system is also conducting further training sessions with its staff and communicating and collaborating with federal, state and local agencies

Fauci will also testify before lawmakers on the federal government’s response to the crisis. According to prepared testimony, Fauci will say that although his agency is an “active participant” in attempting to stop the outbreak, it is still in the “early stages” of determining how best to treat and prevent Ebola.

“As we continue to expedite research while enforcing high safety and efficacy standards, the implementation of the public health measures already known to contain prior Ebola virus outbreaks and the implementation of treatment strategies such as fluid and electrolyte replacement are essential to preventing additional infections, treating those already infected, protecting health care providers, and ultimately bringing this epidemic to an end,” he will say.
 

[Crafty_Dog]

http://www.truthrevolt.org/commentary/coulter-well-tell-you-how-dangerous-ebola-after-election

[Crafty_Dog]

second post

http://www.dhs.gov/news/2014/10/16/written-testimony-cbp-house-energy-and-commerce-subcommittee-oversight

[Crafty_Dog]

Third post

Six Reasons to Panic
Jonathan V. Last - The Weekly Standard
October 27, 2014, Vol. 20, No. 07

As a rule, one should not panic at whatever crisis has momentarily fixed the attention of cable news producers. But the Ebola outbreak in West Africa, which has migrated to both Europe and America, may be the exception that proves the rule. There are at least six reasons that a controlled, informed panic might be in order.

(1) Start with what we know, and don’t know, about the virus. Officials from the Centers for Disease Control (CDC) and other government agencies claim that contracting Ebola is relatively difficult because the virus is only transmittable by direct contact with bodily fluids from an infected person who has become symptomatic. Which means that, in theory, you can’t get Ebola by riding in the elevator with someone who is carrying the virus, because Ebola is not airborne.

This sounds reassuring. Except that it might not be true. There are four strains of the Ebola virus that have caused outbreaks in human populations. According to the New England Journal of Medicine, the current outbreak (known as Guinean EBOV, because it originated in Meliandou, Guinea, in late November 2013) is a separate clade “in a sister relationship with other known EBOV strains.” Meaning that this Ebola is related to, but genetically distinct from, previous known strains, and thus may have distinct mechanisms of transmission.

Not everyone is convinced that this Ebola isn’t airborne. Last month, the University of Minnesota’s Center for Infectious Disease Research and Policy published an article arguing that the current Ebola has “unclear modes of transmission” and that “there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.”

And even if this Ebola isn’t airborne right now, it might become so in the future. Viruses mutate and evolve in the wild, and the population of infected Ebola carriers is now bigger than it has been at any point in history—meaning that the pool for potential mutations is larger than it has ever been. As Dr. Philip K. Russell, a virologist who oversaw Ebola research while heading the U.S. Army’s Medical Research and Development Command, explained to the Los Angeles Times last week,

I see the reasons to dampen down public fears. But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man. .  .  . God knows what this virus is going to look like. I don’t.

In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it.

Yet what’s really scary is how robust the already-established transmission mechanisms are. Have you ever wondered why Ebola protocols call for washing down infected surfaces with chlorine? Because the virus can survive for up to three weeks on a dry surface.

How robust is transmission? Look at the health care workers who have contracted it. When Nina Pham, the Dallas nurse who was part of the team caring for Liberian national Thomas Duncan, contracted Ebola, the CDC quickly blamed her for “breaching protocol.” But to the extent that we have effective protocols for shielding people from Ebola, they’re so complex that even trained professionals, who are keenly aware that their lives are on the line, can make mistakes.

By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published.

(2) General infection rates are terrifying, too. In epidemiology, you measure the “R0,” or “reproduction number” of a virus; that is, how many new infections each infected person causes. When R0 is greater than 1, the virus is spreading through a population. When it’s below 1, the contamination is receding. In September the World Health Organization’s Ebola Response Team estimated the R0 to be at 1.71 in Guinea and 2.02 in Sierra Leone. Since then, it seems to have risen so that the average in West Africa is about 2.0. In September the WHO estimated that by October 20, there would be 3,000 total cases in Guinea, Liberia, and Sierra Leone. As of October 7, the count was 8,376.

In other words, rather than catching up with Ebola, we’re falling further behind. And we’re likely to continue falling behind, because physical and human resources do not scale virally. In order to stop the spread of Ebola, the reproduction number needs to be more than halved from its current rate. Yet reducing the reproduction number only gets harder as the total number of cases increases, because each case requires resources—facilities, beds, doctors, nurses, decontamination, and secure burials—which are already lagging well behind need. The latest WHO projections suggest that by December 1 we are likely to see 10,000 new cases in West Africa per week, at which point the virus could begin spreading geographically within the continent as it nears the border with Ivory Coast.

Thus far, officials have insisted that it will be different in America. On September 30, CDC director Thomas Frieden confirmed the first case of Ebola in the United States, the aforementioned Thomas Duncan. Frieden then declared, “We will stop Ebola in its tracks in the U.S. .  .  . The bottom line here is that I have no doubt that we will control this importation, or this case of Ebola, so that it does not spread widely in this country.”

The word “widely” is key. Because despite the fact that Duncan was a lone man under scrupulous, first-world care, with the eyes of the entire nation on him, his R0 was 2, just like that of your average Liberian Ebola victim. One carrier; two infections. He passed the virus to nurse Pham and to another hospital worker, Amber Joy Vinson, who flew from Cleveland to Dallas with a low-grade fever before being diagnosed.

(3) Do you really want to be scared? What’s to stop a jihadist from going to Liberia, getting himself infected, and then flying to New York and riding the subway until he keels over? This is just the biological warfare version of a suicide bomb. Can you imagine the consequences if someone with Ebola vomited in a New York City subway car? A flight from Roberts International in Monrovia to JFK in New York is less than $2,000, meaning that the planning and infrastructure needed for such an attack is relatively trivial. This scenario may be highly unlikely. But so were the September 11 attacks and the Richard Reid attempted shoe bombing, both of which resulted in the creation of a permanent security apparatus around airports. We take drastic precautions all the time, if the potential losses are serious enough, so long as officials are paying attention to the threat.

(4) Let’s put aside the Ebola-as-weapon scenario—some things are too depressing to contemplate at length—and look at the range of scenarios for what we have in front of us, from best-case to worst-case. The epidemiological protocols for containing Ebola rest on four pillars: contact tracing, case isolation, safe burial, and effective public information. On October 14, the New York Times reported that in Liberia, with “only” 4,000 cases, “Schools have shut down, elections have been postponed, mining and logging companies have withdrawn, farmers have abandoned their fields.” Which means that the baseline for “best-case” is already awful.

In September, the CDC ran a series of models on the spread of the virus and came up with a best-case scenario in which, by January 2015, Liberia alone would have a cumulative 11,000 to 27,000 cases. That’s in a world where all of the aid and personnel gets where it needs to be, the resident population behaves rationally, and everything breaks their way. The worst-case scenario envisioned by the model is anywhere from 537,000 to 1,367,000 cases by January. Just in Liberia. With the fever still raging out of control.

By which point, all might well be lost. Anthony Banbury is coordinating the response from the United Nations, which, whatever its many shortcomings, is probably the ideal organization to take the lead on Ebola. Banbury’s view is chilling: “The WHO advises within 60 days we must ensure 70 percent of infected people are in a care facility and 70 percent of burials are done without causing further infection. .  .  . We either stop Ebola now or we face an entirely unprecedented situation for which we do not have a plan [emphasis added]”.

What’s terrifying about the worst-case scenario isn’t just the scale of human devastation and misery. It’s that the various state actors and the official health establishment have already been overwhelmed with infections in only the four-digit range. And if the four pillars—contact tracing, case isolation, safe burial, and effective public information—fail, no one seems to have even a theoretical plan for what to do.
(5) And by the way, things could get worse. All of those worst-case projections assume that the virus stays contained in a relatively small area of West Africa, which, with a million people infected, would be highly unlikely. What happens if and when the virus starts leaking out to other parts of the world?

Marine Corps General John F. Kelly talked about Ebola at the National Defense University two weeks ago and mused about what would happen if Ebola reached Haiti or Central America, which have relatively easy access to America. “If it breaks out, it’s literally ‘Katie bar the door,’ and there will be mass migration into the United States,” Kelly said. “They will run away from Ebola, or if they suspect they are infected, they will try to get to the United States for treatment.”

It isn’t crazy to see how a health crisis could beget all sorts of other crises, from humanitarian, to economic, to political, to existential. If you think about Ebola and mutation and aerosolization and R0 for too long, you start to get visions of Mad Max cruising the postapocalyptic landscape with Katniss Everdeen at his side.

(6) While we’re on the subject of political crisis, it’s worth noting that the politics of Ebola are uncertain and dangerous to everyone involved. Thus far, there’s been only one serious political clash over Ebola, and that’s concerning the banning of flights to and from the infected countries in West Africa. The Obama administration refuses to countenance such a move, with the CDC’s Frieden flatly calling it “wrong”:

A travel ban is not the right answer. It’s simply not feasible to build a wall—virtual or real—around a community, city, or country. A travel ban would essentially quarantine the more than 22 million people that make up the combined populations of Liberia, Sierra Leone, and Guinea.

When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else.

We don’t want to isolate parts of the world, or people who aren’t sick, because that’s going to drive patients with Ebola underground, making it infinitely more difficult to address the outbreak. .  .  .

Importantly, isolating countries won’t keep Ebola contained and away from American shores. Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries, and that we will have more patients who develop Ebola in the U.S.

Not terribly convincing, is it? Wildfires, in fact, are often fought by using controlled burns and trench digging to establish perimeters. And it’s a straw-man argument to say that a flight ban wouldn’t keep Ebola fully contained. No one says it would. But by definition, it would help slow the spread of the virus. If there had been a travel ban in place, Thomas Duncan would have likely reached the same sad fate—but without infecting two Americans and setting the virus loose in North America. And it’s difficult to follow the logic by which banning travel from infected countries would create more infections in the United States, as Frieden insists. This is not a paradox; it’s magical thinking.
Frieden’s entire argument is so strange—and so at odds with what other epidemiologists prescribe—that it can only be explained by one of two causes: catastrophic incompetence or a prior ideological commitment. The latter, in this case, might well be the larger issue of immigration.

Ebola has the potential to reshuffle American attitudes to immigration. If you agree to seal the borders to mitigate the risks from Ebola, you’re implicitly rejecting the “open borders” mindset and admitting that there are cases in which government has a duty to protect citizens from outsiders. Some people on the left admit to seeing this as the thin end of the wedge. Writing in the New Yorker, Michael Specter lamented, “Several politicians, like Governor Bobby Jindal, of Louisiana, have turned the epidemic into fodder for their campaign to halt immigration.” And that sort of thing just can’t be allowed.

What would happen in the event of an Ebola outbreak in Latin America? Then America would have to worry about masses of uninfected immigrants surging across the border—not to mention carriers of the virus. And if we had decided it was okay to cut off flights from West Africa, would we decide it was okay to try to seal the Southern border too? You can see how the entire immigration project might start to come apart.

So for now, the Obama administration will insist on keeping travel open between infected countries and the West and hope that they, and we, get lucky.

At a deeper level, the Ebola outbreak is a crisis not for Obama and his administration, but for elite institutions. Because once more they have been exposed as either corrupt, incompetent, or both. On September 16, as he was trying to downplay the threat posed by Ebola, President Obama insisted that “the chances of an Ebola outbreak here in the United States are extremely low.” Less then two weeks later, there was an Ebola outbreak in the United States.

The CDC’s Frieden—who is an Obama appointee—has been almost comically oafish. On September 30, -Frieden declared, “We’re stopping it in its tracks in this country.” On October 13, he said, “We’re concerned, and unfortunately would not be surprised if we did see additional cases.” The next day he admitted that the CDC hadn’t taken the first infection seriously enough: “I wish we had put a team like this on the ground the day the patient, the first patient, was diagnosed,” he said. “That might have prevented this infection. But we will do that from today onward with any case, anywhere in the U.S. .  .  . We could have sent a more robust hospital infection-control team and been more hands-on with the hospital from Day One.”

The day after that Frieden was asked during a press conference if you could contract Ebola by sitting next to someone on a bus—a question prompted by a statement from President Obama the week before, when he declared that you can’t get Ebola “through casual contact, like sitting next to someone on a bus.”

Frieden answered: “I think there are two different parts of that equation. The first is, if you’re a member of the traveling public and are healthy, should you be worried that you might have gotten it by sitting next to someone? And the answer is no. Second, if you are sick and you may have Ebola, should you get on a bus? And the answer to that is also no. You might become ill, you might have a problem that exposes someone around you.”

Go ahead and read that again.

We have arrived at a moment with our elite institutions where it is impossible to distinguish incompetence from willful misdirection. This can only compound an already dangerous situation.

[ccp]

She makes some good points but I don't agree with her by and large about the larger issues.
She describes in detail how difficult it is too deal with such a deadly communicable virus in a safe way.  But than proceeds to describe how our system has failed us in dealing with it to perfection.

Why is it always someone else's fault?  I do agree with at least trying to stop Ebola in Africa.  That is my big beef with the liberals on this issue.  I think it is really because stopping immigration from these countries would conflict with their narrative that immigration is not a threat to us.  Like the adenovirus that just coincidently becomes an epidemic for the first time ever in the US but is found endemically in S America.

******I'm a Hazmat-Trained Hospital Worker: Here's What No One Is Telling You About Ebola
 
Posted:  10/17/2014 10:18 am EDT    Updated:  10/18/2014 12:59 pm EDT   
 
Ebola is brilliant.

It is a superior virus that has evolved and fine-tuned its mechanism of transmission to be near-perfect. That's why we're all so terrified. We know we can't destroy it. All we can do is try to divert it, outrun it.

I've worked in health care for a few years now. One of the first things I took advantage of was training to become FEMA-certified for hazmat ops in a hospital setting. My rationale for this was that, in my home state of Maine, natural disasters are almost a given. We're also, though you may not know it, a state that has many major ports that receive hazardous liquids from ships and transport them inland. In the back of my mind, of course, I was aware that any hospital in the world could potentially find itself at the epicenter of a scene from The Hot Zone. That was several years ago. Today I'm thinking, by God, I might actually have to use this training. Mostly, though, I'm aware of just that -- that I did receive training. Lots of it. Because you can't just expect any nurse or any doctor or any health care worker or layperson to understand the deconning procedures by way of some kind of pamphlet or 10-minute training video. Not only is it mentally rigorous, but it's physically exhausting.

PPE, or, personal protective equipment, is sort of a catch-all phrase for the suits, booties, gloves, hoods and in many cases respirators worn by individuals who are entering a hot zone. These suits are incredibly difficult to move in. You are wearing several layers of gloves, which limits your dexterity to basically nil, the hoods limit the scope of your vision -- especially your peripheral vision, which all but disappears. The suits are hot -- almost unbearably so. The respirator gives you clean air, but not cool air. These suits are for protection, not comfort. Before you even suit up, your vitals need to be taken. You can't perform in the suit for more than about a half hour at a time -- if you make it that long. Heat stroke is almost a given at that point. You have to be fully hydrated and calm before you even step into the suit. By the time you come out of it, and your vitals are taken again, you're likely to be feeling the impact -- you may not have taken more than a few steps in the suit, but you'll feel like you've run a marathon on a 90-degree day.

Getting the suit on is easy enough, but it requires team work. Your gloves, all layers of them, are taped to your suit. This provides an extra layer of protection and also limits your movement. There is a very specific way to tape all the way around so that there are no gaps or "tenting" of the tape. If you don't do this properly, there ends up being more than enough open pockets for contamination to seep in.

If you're wearing a respirator, it needs to be tested prior to donning to make sure it is in good condition and that the filter has been changed recently, so that it will do its job. Ebola is not airborne. It is not like influenza, which spreads on particles that you sneeze or cough. However, Ebola lives in vomit, diarrhea and saliva  -- and these avenues for infection can travel. Projectile vomiting is called so for a reason. Particles that are in vomit may aerosolize at the moment the patient vomits. This is why if the nurses in Dallas were in the room when the first patient, Thomas Duncan, was actively vomiting, it would be fairly easy for them to become infected. Especially if they were not utilizing their PPE correctly.

The other consideration is this: The "doffing" procedure, that is, the removal of PPE, is the most crucial part. It is also the point at which the majority of mistakes are made, and my guess is that this is what happened in Dallas.

The PPE, if worn correctly, does an excellent job of protecting you while you are wearing it. But eventually you'll need to take it off. Before you begin, you need to decon the outside of the PPE. That's the first thing. This is often done in the field with hoses or mobile showers/tents. Once this crucial step has occurred, the removal of PPE needs to be done in pairs. You cannot safely remove it by yourself. One reason you are wearing several sets of gloves is so that you have sterile gloves beneath your exterior gloves that will help you to get out of your suit. The procedure for this is taught in FEMA courses, and you run drills with a buddy over and over again until you get it right. You remove the tape and discard it. You throw it away from you. You step out of your boots  --  careful not to let your body touch the sides. Your partner helps you to slither out of the suit, again, not touching the outside of it. This is difficult, and it cannot be rushed. The respirators need to be deconned, batteries changed, filters changed. The hoods, once deconnned, need to be stored properly. If the suits are disposable, they need to be disposed of properly. If not, they need to be thoroughly deconned and stored safely. And they always need to be checked for rips, tears, holes, punctures or any other even tiny, practically invisible openings that could make the suit vulnerable.

Can anyone tell me if this happened in Dallas?

We run at least an annual drill at my hospital each year. We are a small hospital and thus are a small emergency response team. But because we make a point to review our protocols, train our staff (actually practice donning/doffing gear), I realized this week that this puts us ahead at some much larger and more notable hospitals in the United States. Every hospital should be running these types of emergency response drills yearly, at least. To hear that the nurses in Dallas reported that there were no protocols at their hospital broke my heart. Their health care system failed them. In the United States we always talk about how the health care system is failing patients, but the truth is, it has failed its employees too. Not just doctors and nurses, but allied health professionals as well. The presence of Ebola on American soil has drawn out the true vulnerabilities in the health care system, and they are not fiscally based. We spend trillions of dollars on health care in this country -- yet the allocation of those funds are grossly disproportionate to how other countries spend their health care expenditures. We aren't focused on population health. Now, with Ebola threatening our population, the truth is out.

The truth is, in terms of virology, Ebola should not be a threat to American citizens. We have clean water. We have information. We have the means to educate ourselves, practice proper hand-washing procedures, protect ourselves with hazmat suits. The CDC Disease Detectives were dispatched to Dallas almost immediately to work on the front lines to identify those who might be at risk, who could have been exposed. We have the technology, and we certainly have the money to keep Ebola at bay. What we don't have is communication. What we don't have is a health care system that values preventative care. What we don't have is an equal playing field between nurses and physicians and allied health professionals and patients. What we don't have is a culture of health where we work symbiotically with one another and with the technology that was created specifically to bridge communication gaps, but has in so many ways failed. What we don't have is the social culture of transparency, what we don't have is a stopgap against mounting hysteria and hypochondria, what we don't have is nation of health literate individuals. We don't even have health-literate professionals. Most doctors are specialists and are well versed only in their field. Ask your orthopedist a general question about your health -- see if they can comfortably answer it.

Health care operates in silos -- we can't properly isolate our patients, but we sure as hell can isolate ourselves as health care workers.

As we slide now into flu season, into a time of year when we are normally braced for winter diseases, colds, flus, sick days and cancelled plans, the American people has also now been truly exposed to another disease entirely: the excruciating truth about our health care system's dysfunction -- and the prognosis doesn't look good.

Note: In response to some comments, I would like to clarify that I am FEMA-trained in level 3 hazmat in a hospital setting. I am a student, health guide and writer, but I am not a nurse.*******
 

[Crafty_Dog]

 Evaluating Ebola as a Biological Weapon
Security Weekly
Thursday, October 23, 2014 - 03:00 Print Text Size

By Scott Stewart

Over the past few weeks, I've had people at speaking engagements ask me if I thought the Islamic State or some other militant group is using Ebola as a biological weapon, or if such a group could do so in the future. Such questions and concerns are not surprising given the intense media hype that surrounds the disease, even though only one person has died from Ebola out of the three confirmed cases in the United States. The media hype about the threat posed by the Islamic State to the United States and the West is almost as bad. Both subjects of all this hype were combined into a tidy package on Oct. 20, when the Washington Post published an editorial by columnist Mark Thiessen in which he claimed it would be easy for a group such as the Islamic State to use Ebola in a terrorist attack. Despite Thiessen's claims, using Ebola as a biological warfare agent is much more difficult than it might appear at first blush.
The 2014 Outbreak

In the past, there have been several outbreaks of Ebola in Africa. Countries included Sudan, Uganda, the Republic of the Congo and the Democratic Republic of the Congo, and several comparatively small outbreaks occurred in Gabon as well. In most cases, people who handled or ate animals infected with the disease started the outbreaks. "Bushmeat," or portions of roasted meat from a variety of wild animals, is considered by many to be a delicacy in Africa, and in a continent where hunger is widespread, it is also a necessity for many hungry people. After several months of medical investigations, epidemiologists believe the current outbreak most likely began when a two-year-old child in Guinea touched or perhaps ate part of an infected animal such as a bat or monkey.

The source of the disease means it is highly unlikely that some malevolent actor intentionally caused the latest outbreak. Besides the fact that the current outbreak's cause has been identified as a natural one, even if a transnational militant group such as the Islamic State was able to somehow develop an Ebola weapon, it would have chosen to deploy the weapon against a far more desirable target than a small village in Guinea. We would have seen the militants use their weapon in a location such as New York, Paris or London, or against their local enemies in Syria and Iraq.

As far as intent goes, there is very little doubt that such a group would employ a biological weapon. As we noted last month when there was increased talk about the Islamic State possibly weaponizing plague for a biological attack, terrorist attacks are intended to have a psychological impact that outweighs the physical damage they cause. The Islamic State itself has a long history of conducting brutal actions to foster panic.

In 2006 and 2007, the Islamic State's predecessor, al Qaeda in Iraq, included large quantities of chlorine in vehicle bombs deployed against U.S. and Iraqi troops in an attempt to produce mass casualties. The explosives in the vehicle bombs killed more people than the chlorine did, and after several unsuccessful attempts, al Qaeda in Iraq gave up on its chlorine bombings because the results were not worth the effort. Al Qaeda in Iraq also included chemical artillery rounds in improvised explosive devices used in attacks against American troops in Iraq on several occasions. Again, these attacks failed to produce mass casualties. Finally, according to human rights organizations, the Islamic State appears to have recently used some artillery rounds containing mustard gas against its enemies in Syria; the group presumably recovered the rounds from a former Saddam-era chemical weapons facility in Iraq or from Syrian stockpiles.

The problem, then, lies not with the Islamic State's intent but instead with its capability to obtain and weaponize the Ebola virus. Creating a biological weapon is far more difficult than using a chemical such as chlorine or manufactured chemical munitions. Contrary to how the media frequently portrays them, biological weapons are not easy to obtain, they are not easy to deploy effectively and they do not always cause mass casualties.
The Difficulty of Weaponization

Ebola and terrorism are not new. Nor is the possibility of terrorist groups using the Ebola virus in an attack. As we have previously noted, the Japanese cult Aum Shinrikyo attempted to obtain the Ebola virus as part of its biological warfare program. The group sent a medical team to Africa under the pretext of being aid workers with the intent of obtaining samples of the virus. It failed in that mission, but even if it had succeeded, the group would have faced the challenge of getting the sample back to its biological warfare laboratory in Japan. The Ebola virus is relatively fragile. Its lifetime on dry surfaces outside of a host is only a couple of hours, and while some studies have shown that the virus can survive on surfaces for days when still in bodily fluids, this requires ideal conditions that would be difficult to replicate during transport.

If the group had been able to get the virus back to its laboratory, it would have then faced the challenge of reproducing the Ebola virus with enough volume to be used in a large-scale biological warfare attack, similar to its failed attacks on Tokyo and other Japanese cities in which the group sprayed thousands of gallons of botulinum toxin and Anthrax spores. Reproducing the Ebola virus would present additional challenges because it is an extremely dangerous virus to work with. It has infected researchers, even when they were working in laboratories with advanced biosafety measures in place. Although Aum Shinrikyo had a large staff of trained scientists and a state-of-the-art biological weapons laboratory, it was still unable to effectively weaponize the virus.

The challenges Aum Shinrikyo's biological weapons program faced would be multiplied for the Islamic State. Aum Shinrikyo operatives were given a great deal of operational freedom until their plans were discovered after the 1995 sarin attacks on the Tokyo subway. (The group's previous biological weapons attacks were so unsuccessful that nobody knew they had been carried out until after its members were arrested and its chemical and biological weapons factories were raided.) Unlike the Japanese cult, the Islamic State's every move is under heavy scrutiny by most of the world's intelligence and security agencies. This means jihadist operatives would have far more difficulty assembling the personnel and equipment needed to construct a biological weapons laboratory. Since randomly encountering an infected Ebola patient would be unreliable, the group would have to travel to a country impacted by the outbreak. This would be a difficult task for the group to complete without drawing attention to itself. Furthermore, once group members reached the infected countries, they would have to enter quarantined areas of medical facilities, retrieve the samples and then escape the country unnoticed, since they could not count on randomly encountering an infected Ebola patient.

Even if Islamic State operatives were somehow able to accomplish all of this -- without killing themselves in the process -- Ebola is not an ideal biological warfare vector. The virus is hard to pass from person to person. In fact, on average, its basic reproductive rate (the average amount of people that are infected by an Ebola patient) is only between one and two people. There are far more infectious diseases such as measles, which has a basic reproductive rate of 12-18, or smallpox, which has a basic reproductive rate of five to seven. Even HIV, which is only passed via sexual contact or intravenous blood transmission, has a basic reproductive rate of two to five.
Ebola's Weakness as a Weapon

The Ebola disease is also somewhat slow to take effect, and infected individuals do not become symptomatic and contagious for an average of 8-10 days. The disease's full incubation period can last anywhere from two to 21 days. As a comparison, influenza, which can be transmitted as quickly as three days after being contracted, can be spread before symptoms begin showing. This means that an Ebola attack would take longer to spread and would be easier to contain because infected people would be easier to identify.

Besides the fact that Ebola can only be passed through the bodily fluids of a person showing symptoms at the time, the virus in those bodily fluids must also somehow bypass the protection of a person's skin. The infectious fluid must enter the body through a cut or abrasion, or come into contact with the mucus membranes in the eyes, nose or mouth. This is different from more contagious viruses like measles and smallpox, which are airborne viruses and do not require any direct contact or transfer of bodily fluids. Additionally, the Ebola virus is quite fragile and sensitive to light, heat and low-humidity environments, and bleach and other common disinfectants can kill it. This means it is difficult to spread the virus by contaminating surfaces with it. The only way to infect a large amount of people with Ebola would be to spray them with a fluid containing the virus, something that would be difficult to do and easily detectable.

Thiessen's piece suggested that the Islamic State might implement an attack strategy of infecting suicide operatives with Ebola and then having them blow themselves up in a crowded place, spraying people with infected bodily fluids. One problem with this scenario is that it would be extremely difficult to get an infected operative from the group's laboratory to the United States without being detected. As we have discussed elsewhere, jihadist groups have struggled to get operatives to the West to conduct conventional terrorist attacks using guns and bombs, a constraint that would also affect their ability to deploy a biological weapon.

Even if a hostile group did mange to get an operative in place, it would still face several important obstacles. By the time Ebola patients are highly contagious, they are normally very ill and bedridden with high fever, fatigue, vomiting and diarrhea, meaning they are not strong enough to walk into a crowded area. The heat and shock of the suicide device's explosion would likely kill most of the virus. Anyone close enough to be exposed to the virus would also likely be injured by the blast and taken to a hospital, where they would then be quarantined and treated for the virus.

Biological weapons look great in the movies, but they are difficult and expensive to develop in real life. That is why we have rarely seen them used in terrorist attacks. As we have noted for a decade now, jihadists can kill far more people with far less expense and effort by utilizing traditional terrorist tactics, which makes the threat of a successful attack using the Ebola virus extremely unlikely.

Read more: Evaluating Ebola as a Biological Weapon | Stratfor

[Crafty_Dog]

http://www.newyorker.com/magazine/2014/10/27/ebola-wars

[Crafty_Dog]

Doctors Without Scruples
And why are soldiers being quarantined?
By
James Taranto
October 29, 2014
103 COMMENTS

Kaci Hickox, the nurse who was briefly quarantined at a Newark, N.J., hospital after flying into the state en route from Ebola-ravaged Sierra Leone, now says she won’t comply with the three-week home-quarantine requirements in her home state of Maine. “She doesn’t want to agree to continue to be confined to a residence beyond the two days,” her New York-based lawyer, Steven Hyman, tells the Bangor Daily News.The Associated Press quotes Hyman as saying: “She’s a very good person who did very good work and deserves to be honored, not detained, for it.”

At least two other medical professionals have acted as if public-health rules don’t apply to them. The New York Post reports that physician Craig Spencer—like Hickox a volunteer for Doctors Without Borders, in his case in Guinea—“lied to authorities about his travels around the city . . ., law-enforcement sources said”:

    Spencer at first told officials that he isolated himself in his Harlem apartment—and didn’t admit he rode the subways, dined out and went bowling until cops looked at his MetroCard the sources said.

    “He told the authorities that he self-quarantined. Detectives then reviewed his credit-card statement and MetroCard and found that he went over here, over there, up and down and all around,” a source said.

And let’s not forget Nancy Snyderman, a Princeton, N.J., physician who entered voluntary quarantine after a fellow traveler to Liberia was diagnosed with Ebola. On Oct. 9 the Planet Princeton website reported that “Snyderman allegedly was seen sitting in her car outside of the Peasant Grill in Hopewell Boro this afternoon. A reader reported that a man who was with her got out of the car and went inside the restaurant to pick up a take-out order. Another man was in the back seat of her black Mercedes. Snyderman had sunglasses on and had her hair pulled back, the reader said.”

The state issued a mandatory quarantine order, and on Oct. 13 Snyderman “issued an apology to the public . . . but did not indicate that she had violated the voluntary confinement agreement . . . or take personal responsibility for the violation.”

At least Doctors Without Borders is off the hook for Snyderman. She works for NBC as chief medical correspondent.

Meanwhile, the Defense Department has announced that all U.S. servicemen “returning from areas affected by Ebola in West Africa” will be subjected to “a 21-day monitoring period.” As noted here yesterday, that has already been the de facto policy. The Pentagon press release doesn’t use the word “quarantine,” but every media report we’ve seen does.

The statement quotes a Pentagon spokesman as saying Secretary Chuck Hagel “believes these initial steps are prudent, given the large number of military personnel transiting from their home base and West Africa and the unique logistical demands and impact this deployment has on the force.” It’s hard to disagree, though one might add: and the irresponsible, if not downright dishonest, behavior of various civilian medics.

But of course Hagel’s announcement means that the Obama administration has two directly opposite policies on Americans returning from Ebola lands: quarantine for those in uniform, laissez-faire for civilians. And “laissez-faire” doesn’t quite capture it: The administration not only is not imposing a quarantine on civilians but is actively pressuring states to refrain from doing so. Hickox was released after—and possibly because of—that campaign.

What accounts for the double standard? Or, as a reporter put it to President Obama yesterday: “Are you concerned, sir, that there might be some confusion between the quarantine rules used by the military and used by health care workers and by some states?”

Let’s go through the president’s response point by point.

“Well, the military is a different situation, obviously, because they are, first of all, not treating patients.”

According to the Washington Post, some of them will “test samples for presence of the virus,” but if they are not going to have direct contact with Ebola sufferers, that would seem to militate against quarantining them upon return.

“Second of all, they are not there voluntarily, it’s part of their mission that’s been assigned to them by their commanders and ultimately by me, the commander in chief.”

Perhaps the president is unaware that the U.S. does not have military conscription. Which we suppose would be understandable, since Obama was 11 when the last draftee reported for duty.

“So we don’t expect to have similar rules for our military as we do for civilians. They are already, by definition, if they’re in the military, under more circumscribed conditions.”

Press secretary Josh Earnest had developed that argument further at a briefing two hours earlier:

    There are a wide range of sacrifices that our men and women in uniform make for the sake of efficiency and for the sake of uniformity and for the success of our military.

    So to take a more pedestrian example than the medical one that we’re talking about, there might be some members of the military who think that the haircut that’s required may not be their best, but that’s a haircut that they get every couple of weeks because it is in the best interest of their unit and it maintains unit cohesion.

We’ll return to the point, but let’s note here that taking servicemen out of circulation for three weeks obviously does not promote efficiency, and that instituting a policy that applies only to the relatively small number of servicemen stationed in Ebola lands obviously does not promote uniformity. That leaves only the catchall “success of our military” category to justify the quarantine.

Back to Obama:

“When we have volunteers who are taking time out from their families, from their loved ones and so forth, to go over there because they have a very particular expertise to tackle a very difficult job, we want to make sure that when they come back that we are prudent, that we are making sure that they are not at risk themselves or at risk of spreading the disease . . .”

It sounds here as if the president is continuing his justification of the military quarantine, but it turns out the “volunteers” he means here are the Doctors Without Borders types, who, he said in his prepared statement “are doing God’s work over there.” (Maybe, but didn’t God say something about bearing false witness?) The sentence continues:

“. . . but we don’t want to do things that aren’t based on science and best practices. Because if we do, then we’re just putting another barrier on somebody who’s already doing really important work on our behalf. And that’s not something that I think any of us should want to see happen.”

All of which leaves unanswered the central question: If a policy of quarantining returning personnel runs counter to “science and best practices,” how does it promote, in Earnest’s phrase, “the success of our military”?

Absent a satisfactory answer to that question, the answer to the question “Why are you quarantining servicemen?” seems to boil down to: “Because we can.” Because it is in the nature of military service to demand a considerable sacrifice of personal freedom. But if the administration viewed that as sufficient justification, it would not have pressed for legislation abolishing restrictions on service by homosexuals.

Anyway, we know of no one who denies that Hagel had the authority to establish the quarantine policy, absent a contrary order from the commander in chief. But the White House also concedes that states have the authority to order quarantines for civilians.

At his Monday press briefing, Josh Earnest answered a reporter’s question about the absence of “an overarching federal policy that rules” by saying this: “You can sort of take this up with James Madison, right? We have a federal system in this country in which states are given significant authority for governing their constituents. That is certainly true when it comes to public safety and public health.”

What is at issue, then, is the administration’s purely discretionary decisions to order quarantines for servicemen and lean on states not to order them for civilians—a contradiction with no obvious basis, and no basis the World’s Greatest Orator and his spokesman have managed to articulate, in philosophy, law or science.

Either servicemen are being subjected to burdens with no basis in “science or best practices,” or the administration is risking public health by prioritizing the personal comfort of civilian medical workers. Why in the world are they doing this?

Odd as it to say about this administration—especially with an election less than a week away—it’s hard to imagine the motive is political. CBS News reports that 80% of respondents in a new poll “think U.S. citizens and legal residents returning from West Africa should be quarantined upon their arrival in the U.S. until it is certain they don’t have Ebola”; just 17% disagree. (Though to be sure, that 17% is almost double the proportion describing themselves in another recent poll as “enthusiastic” about Obama.)

Let us suggest two practical distinctions, either or both of which may explain the disjunction in policy. The first is that forestalling the military quarantine order would have required Obama to overrule a recommendation of the Joint Chiefs of Staff—that is to say, to make a decision. Pressuring the governors, by contrast, involves only behind-the-scenes kibitzing and public bloviation.

The second is snobbery. Recall that quote from Nurse Hickox’s lawyer: “She’s a very good person.” She and others like her, according to the president, are doing God’s work, and—in pointed if inaccurate contrast to military servicemen—are “experts.” The logic would go something like this: You can’t quarantine her. She’s one of us.

[G M]

As usual, the rules don't apply to the anointed of the left.

[ccp]

Who refuses quarantine:

"You could hug me, you could shake my hand [and] I would not give you Ebola," she said.

My response:  How many nurses and doctors have died of Ebola?

Hero?   "Liberal" is more like it.

That said I predict the whole Ebola thing will die (no pun intended) down in a couple of months.   The peak of the epidemic was when we start reading WHO predict there could be 1.7 million cases by January.  The WHO always makes wild predictions that herald the peak of epidemics.   OTOH fear mongering is better then poo pawing the real dangers.

[Crafty_Dog]

http://www.nytimes.com/2014/11/28/world/africa/despite-aid-push-ebola-is-raging-in-sierra-leone.html?emc=edit_th_20141128&nl=todaysheadlines&nlid=49641193&_r=0

[G M]

https://www.sfgate.com/news/article/Ebola-outbreak-now-at-105-cases-and-bordering-13181274.php

Ebola outbreak now at 105 cases, and bordering countries are on alert
Lena Sun and Lenny Bernstein, The Washington Post Published 4:16 pm PDT, Friday, August 24, 2018
 
 
 
 
MPONDWE, Uganda - On Tuesdays and Fridays, an estimated 19,000 people stream down the hill from Congo's North Kivu province to cross the border into this small town, many of them headed to a sprawling open-air market.

In recent weeks, crossing the border has become more difficult as Ugandan health authorities have beefed up precautions against the spread of the Ebola virus. An outbreak centered in North Kivu is responsible for 105 confirmed or suspected cases, including 67 deaths, according to Robert Redfield, director of the U.S. Centers for Disease Control and Prevention, who has just returned from the area.

Uganda is determined to keep the deadly hemorrhagic fever from spreading to its side of the border. Before travelers are allowed through, they must step in small tubs of chlorinated water to disinfect their shoes, and their temperatures are taken with no-touch thermometer guns aimed at their temples.

Uganda moved quickly, imposing the precautions a week after the latest outbreak was declared Aug. 1. It has found six suspected cases at this crossing, but laboratory tests cleared them all.

Recommended Video:
A World Health Organization team arrived on Thursday in the northeast Democratic Republic of Congo to coordinate the response to a new Ebola outbreak. It is a region that has seen large movements of displaced people in the civil war. In a euronews exclusive the WHO's Deputy Director-General of Emergency Preparedness and Response said he is concerned about security: "It is an active conflict zone, so we will be doing public health operations really across the frontline in order to stop this outbreak," said Dr. Peter Salama. " The other factor that is concerning us is, of course, it is very close to borders, in this case, particularly the border with Uganda" Last month the country declared the end of another outbreak in Equateur province, some 2,500 km away. On the positive side, that experience can help contain the spread of the epidemic throughout the region. "Any of the surrounding countries did put a lot of preparedness processes and supplies, and personnel in place," said Dr. Salama, "so they are, certainly, much better prepared than in the past". Ebola is transmitted by direct contact with the blood and body fluids and results in sudden, high fever. It's deadly if not treated, with a mortality rate of 90 percent.

Media: Euronews
"So far, we have not gotten any case of Ebola," Ithungu Honorata, a nurse who oversees the screening effort, said Friday. "But we don't want it to come to Uganda."

The latest Ebola outbreak, Congo's tenth, was declared just a week after a smaller one was quelled in another part of the country. It comes four years after the Ebola epidemic in Liberia, Sierra Leone and Guinea killed more than 11,000 people, sickened more than 28,000 and sparked panic about travel in other parts of the world, including the United States.

The current outbreak is still escalating, according to Redfield and workers at nongovernmental organizations that have rushed in to treat victims and interrupt the spread of the disease.

"Really, in two weeks, we've gone from 24 cases to 105 cases," Redfield said, mainly because many health workers at a hospital in the town of Mangina, where the outbreak began, became infected when they treated early patients without recognizing that they had Ebola and therefore did not take adequate precautions. The disease spreads through contact with the bodily fluids of victims, putting health workers and patients' family members at greatest risk.

"In the next couple of weeks, we'll have greater clarity" about the scope of the problem, Redfield said.

"The scary thing is that we are above 100 cases already," said Michelle Gayer, director of emergency health for the International Rescue Committee, a nonprofit organization that is helping in the region. But she said it will be another week before health authorities can begin to assess fully how bad the outbreak may become.

"Everyone is concerned, rightfully so, that there are still cases coming," said Karin Huster, emergency coordinator for Doctors Without Borders, who is in Beni, a city in the affected area of Congo.

Several factors make this outbreak challenging. Years of conflict between militias and the government have put large numbers of people on the move and weakened the region's health infrastructure. The instability also makes it difficult to travel to outlying areas where cases have been discovered, such as Oicha, without military protection.

But unlike four years ago, when Ebola tore through a portion of West Africa, authorities now have a vaccine and several experimental treatments that were developed in the interval. Redfield said that nearly 3,000 people have been vaccinated, with 400 to 600 more receiving the vaccine each day. About a dozen confirmed cases have been treated with two experimental therapies, including one developed at the U.S. National Institutes of Health. All of the treated patients are alive, he said.

The most successful way to halt an outbreak of this kind is to track down all the contacts of everyone infected with the virus and test them for exposure. Those people are isolated and treated if they are infected and vaccinated if they are not. The contacts of those contacts must be found and assessed as well in a process known as "ring vaccination."

Four years ago, the World Health Organization and the United States were accused of moving too slowly to intervene in the West African epidemic. This time, both have moved quickly into the area. And Doctors Without Borders opened a 70-bed treatment center in Mangina on Aug. 14, while the Alliance for International Medical Action has a 40-bed center in nearby Beni. A third is being built, Redfield said.

So far, Redfield said, it is not necessary to test travelers at U.S. ports of entry, in part because there are no direct flights to the United States from the affected region and screening of outgoing travelers is being conducted. Four years ago, debate raged about whether to cut off all travel from West Africa to the United States. President Donald Trump, then a private citizen, was an outspoken advocate of that position, tweeting that the United States should not allow two infected American missionaries back into the country for treatment.

Kent Brantly and Nancy Writebol were admitted to U.S. hospitals and survived after receiving intensive care.

At the Congo-Uganda border crossing, Alphosine Kahindo, 47, was on her way to the market, a 12-hour trip on foot from her home in Kisima, to buy fish and soap and to sell a milky-white alcoholic drink made from fermented corn. She said that her uncle is sick and that her brother died in the current outbreak. She did not attend his funeral, she said, because of the fear of infection.

"I was longing to go, but I couldn't," she said.

At the market, vendors are also aware of the outbreak. Malik Meredith, 45, was selling piles of plump baby eggplant. "No one is sick here," she said. "But we are fearing it."

- - -

Bernstein reported from Washington.

[G M]

https://www.lmtonline.com/news/article/Like-a-horror-film-The-efforts-to-contain-13449195.php

Just one international flight away...



https://www.youtube.com/watch?v=UG8YbNbdaco

[Crafty_Dog]

 

[G M]

https://www.lmtonline.com/news/article/Like-a-horror-film-The-efforts-to-contain-13449195.php

Just one international flight away...



https://www.youtube.com/watch?v=UG8YbNbdaco

https://raconteurreport.blogspot.com/2018/12/ebola-2018-update-lying-with-statistics.html

[ccp]

one day we will hear that they have been bringing infected health workers to the US for treatment.

After the last uproar when they foolishly did this (sorry the CDC can pontificate how smart it was to do that )
they probably will simply not publicize it this time.

Although maybe this tie Trump will say no unlike Bama

[G M]

one day we will hear that they have been bringing infected health workers to the US for treatment.

After the last uproar when they foolishly did this (sorry the CDC can pontificate how smart it was to do that )
they probably will simply not publicize it this time.

Although maybe this tie Trump will say no unlike Bama

https://raconteurreport.blogspot.com/2018/12/questions-i-get-questions.html

[G M]

https://raconteurreport.blogspot.com/2018/12/ebola-update.html

SUNDAY, DECEMBER 30, 2018
Year End Ebola Update




















As multiple commenters have observed, we've brought an M.D. exposed to Ebola in DRC, but asymptomatic and not contagious, back to Nebraska for observation.

Ok, fine, so far.

This is how it's supposed to work for everyone exposed, even TV spokeshole doctors and whiny Mimi Crybabypants "nurses" who think they should have the right to run hither and yon and hopefully not start infecting people when they pop a fever. Or not. Because they're special, and the sun shines out of their anuses, apparently. Contrary to quarantine policy and black-letter health laws going back 700 years.

Sending the guy to quarantine at Nebraska Medical Center is fine too, as it's home of one of the four BL-IV treatment centers with the 11 actual BL-IV beds extant in North America, should that become necessary, and their patient becomes symptomatic.

The gaping flaw in what they're doing is that they plan to observe Doctor Oopsie for two weeks - fourteen days.

But Ebola Virus Disease incubates for between 1 and 25+ days, NOT JUST 14 DAYS(!), and while 99% of cases appear in 25 days or less, 1% of cases don't show up until after 25 days.
(Another very small but non-zero percentage of persons exposed are asymptomatic, but may still carry the disease and be infectious without symptoms. Nobody is talking about that last part, either, because if you pretend it doesn't exist, you don't have to deal with it. Until you do.)

Geniuses in action, right there.














It will be cold comfort to anyone subsequently infected if they stop checking Dr. Oopsie on Day 15, and he doesn't become symptomatic, and thus infectious, until Day 18, or 23. Especially if he celebrates the end of his quarantine at the mall or movie theater, coughing out virus onto random passersby.

If you're going to half-ass a quarantine (and clearly, they ARE doing exactly that in this case), better to not do one at all, and just tell people to kiss their asses goodbye, because - EXACTLY LIKE IN 2014 - TPTB are playing roulette with the entire populace, because for them, that's more convenient.

Sleep tight.
And cross your fingers.


 
Oh, and that Congo outbreak itself?
 
As we warned, it's accelerating out of control, growing from 503 cases on 11/30 to 692 cases as of 12/21, a week ago. IOW, more new cases in the last 21 days than the total number of cases for the first ten weeks from August to mid-October.
The experimental vaccine is still, AFAIK, 100% effective, but the outbreak has blown through every containment ring like a brushfire in a gasoline-soaked forest.
 
Buckle up. 2019 is looking seriously fugly.
 
And that doctor is just the first case we're watching.
He won't be the last.

UPDATE:
And for those unwilling to follow this closely, bringing him here is not the problem.
Bringing back 12 or more symptomatic patients is the problem - because we don't have that 12th Ebola bed - as is cessation of his/their infection monitoring before the likelihood of infection gets to at least a 99% chance of safety.

And if you bring 100 exposed people back, that statistically guarantees that one of them will be the 1% long period incubation that you'll release into the wild here, and we're off to the races.

A quarantine has traditionally meant 40 days ("You could look it up." - Casey Stengel), and that standard should apply yet again, in this case. Six weeks' surveillance, not two.
Anything less is rolling the dice, and we're all the chips in that wager.

[Crafty_Dog]

Well, that's a cheery way to start the new year , , ,

[G M]

http://raconteurreport.blogspot.com/2019/02/feb-2019-ebola-update-cheery-thoughts.html?m=1

This is a good time to contemplate decamping from urban areas.

[G M]

https://raconteurreport.blogspot.com/2019/05/ebola-2019-update.html


https://raconteurreport.blogspot.com/2019/05/ebola-faq-file.html

[Crafty_Dog]

I saw a hair raising report about this last week in DRC.  Thanks for staying on top of it here.

[G M]

https://www.strategypage.com/on_point/2019051595229.aspx

On Point: Congo's Global Epidemic War



by Austin Bay
May 15, 2019

The Democratic Republic of Congo's daily hell of poverty, assorted wars, ethnic antagonism, frail government institutions, porous borders, cultural superstitions, meddling neighbors and corrupt elites provide a one-stop-shop example of the wicked conditions afflicting the globe's less-developed regions, sub-Saharan Africa in particular.

Unfortunately for all homo sapiens living within 200 kilometers or so of a major airport anywhere on this planet, the Ebola virus epidemic afflicting eastern Congo constitutes a deadly, international, mass-casualty threat to human life.

And there are political predators who would like to see this plague seed global fear and death.

Before I address that point, note that all of the grave political, cultural and economic ills I mentioned in this column's first sentence are means of magnifying the Ebola epidemic's regional and global threat.

You may not know this. But the predators know this. The difference (I hope) between you and the predators is that they are megalomaniacs and you are not.

Let me reinforce this point with a weapons of mass destruction (WMD) analogy. Whether the sane among us are trying to contain nuclear and chemical weapons proliferation or a deadly disease with a high fatality rate, war frustrates the best attempts to contain the mega killers.

I'll stipulate that nuclear weapons kill en masse those near ground zero, while disease is less point-specific, even diseases that are potential biological weapons of mass destruction.

The sad fact of human death is we all die one by one, whatever the cause. Despite Hiroshima, viral and biotic contagions are by far history's worst mass killers of human beings. The Black Death killed 1 in 3 Europeans. There's some debate on the exact figure but not on the bottom-line effect.

Now futurist critics pay attention. Mass extinction by asteroid impact could supplant plagues, but our brains are in the process of creating planetary defenses to destroy space-rock killers. Ironically, possible defenses include missiles destroying killer asteroids with nuclear weapons.

The sci-fi perspective is speculative. The Ebola plague in Congo's North Kivu and Ituri provinces is now and in our face.

In August 2018, the World Health Organization (WHO) declared the eastern Congo outbreak an epidemic. As of May 12, WHO reports 1,705 Ebola cases, 1,617 confirmed and 88 probable. There are 1,124 confirmed deaths and 456 survivors. (WHO's media office sent me those statistics May 14.)

Now for more context, historical and operational: The eastern Congo Ebola epidemic is history's second deadliest. In casualty terms, the 2013-2016 West Africa Ebola outbreak surpasses the current eastern Congo epidemic. West Africa was a slaughterhouse. There were 28,000 cases reported, and at least 11,300 people died.

But West Africa's outbreak didn't confront terrorists with a global mass murder agenda who think Ebola is a weapon of mass destruction their terror attacks can unleash.

Enter the Allied Democratic Forces (ADF), a Ugandan Islamist-jihadi outfit that murders throughout eastern Congo.

According to a StrategyPage.com, on Feb. 24, gunmen attacked an Ebola clinic in the North Kivu city of Butembo. "The men hurled rocks then burned clinic supplies and water and sanitation equipment," it said. On Feb. 27, attackers struck a Butembo clinic with several infected patients, "and a gunfight ensued. Some infected patients ran away in order to escape the gun battle."

The jihadi ADF was likely responsible for the attacks.

Medical aid agencies in eastern Congo contend local police and the Congolese Army are not capable of defending the clinics and medical personnel.

ADF jihadis must be pleased with that perception.

But good guys get a say. Though the epidemic has not abated, the Congolese government and WHO epidemic containment efforts have been generally successful.

The UN says it need additional resources (to include medical personnel) to contain the virus and keep it from spreading to neighboring countries.

To promote that good end, UN peacekeepers in Congo need to eliminate several hundred ADF jihadis -- for the good of your health and humankind.

[G M]

https://www.france24.com/en/20190527-villagers-kill-ebola-health-worker-eastern-dr-congo

Of course.

[G M]

https://raconteurreport.blogspot.com/2019/06/june-ebola-update.html

SATURDAY, JUNE 1, 2019
June Ebola Update




















Per the latest WHO weekly outbreak bulletin, the 10 month Ebola outbreak continues unabated in DRC.

The Good
They've vaccinated nearly 125K people, with an experimental vaccine that appears to confer >99% effectiveness against Ebola. (For the 1K or less people who contracted it anyways, don't worry, most of them are dead now.)

The Bad

1) Despite vaccinations, progressing at some 1000 per day, for a non-zero number of cases (currently it's something like 5% of all new cases), they have no effing clue where a given case originated, and thus no wild idea whom to vaccinate, or how to throw up a suitable containment ring around them, or how the virus got past them.

2) They are tracing contacts in 17 health zones. The problem with that is there are 22 health zones (think of counties) with active Ebola cases in the last couple of weeks. Imagine being missed by 17 out of 22 cars as you cross in a crosswalk, and you begin to appreciate why this is a problem.

In the five other zones (23%) where there is zero contact tracing, they have no idea what the disease is doing.

The Ugly

In this current outbreak, in 50% of cases, fever as a presenting sign is completely absent.
(Fever, we remind you, is how grade-school dropout customs screeners in 126 countries check people at the airports for Ebola before letting them in. Including our TSA wizards here in the U.S. It's really the only thing they can check that can be mastered by 80 IQ government employees worldwide. Sleep tight.)
Short of laboratory testing everyone (which they aren't and cannot do in nearly 1/4 of the Hot Zone in DRC), and a 40-day quarantine, cases will continue to multiply.
And they are.

Let's look at that over time, since we're at the 10-month anniversary of this outbreak today:

Index case      Aug 1
2 cases           Aug 1
4                      Aug 1
8                      Aug 1
16                    Aug 1
32                    Aug 3
64                    Aug 3
128                  Aug 31
256                  Oct 15
512                  Dec 3
1K                    Feb 24
2K                    May 12
4K                    probably about Aug 1

That would be an 11 on the 34-point Scale Of Whether It's Time To Panic, with 34 being Global Extinction Event. And headed to 12 at about 100 new cases/wk, give or take.

And we repeat, as the virus doesn't kill overnight, the correct  death ratio number, we pound home, is not the WHO/Wikistupidia math-retarded posted lie of 65% of dead vs. infected, it's those dead now vs. number infected 21 days ago, which gives a consistent and far more reliable lethality percentage around 75%.

USAMRIID and CDC refer to that level of lethality as a "slate-wiper"; it erases populations.

And bear well in mind "surviving" Ebola means you now have it functionally forever, and get to suffer the sequellae of Post-Ebola virus syndrome. {TL;DR: You're still screwed, and life, as you knew it, is over. You aren't going back to your old life ever again. Short answer: don't catch it to begin with.}

Note that by the time it was confirmed as an outbreak this time, it had already doubled 4 times, meaning it probably started two to four weeks earlier, at minimum, but no one noticed until literally 20 people dropped dead with blood shooting out of all orifices. Nominally, on Day One. Proof of this is that it doubled two more times in the next 48 hours.
Growth slowed notably, mainly because the vaccine and ring vaccination slowed the brushfire down. At first.

And then the local superstition and ignorance kicked in, they started stealing bodies from morgues, burning Ebola treatment centers, and chasing the health teams out at gunpoint, and all hell has broken loose, probably never to be contained, because we don't have the 82nd Airborne in hazmat suits available to shoot idiots at gunpoint to get this back in the bottle.

You know this because it keeps escaping to neighboring health zones and provinces, having now moved some 100 miles outward.
It has surged notably since March of this year, both in terms of numbers, and affected areas. That is an ominous sign.

Bear in mind once again that this area is
a) equatorial jungle, literally right on the Equator
b) listed in all maps relevant as "ungoverned"
c) listed in all relevant maps as "armed conflict zone"

The UN and all local organizations are using their usual headless chicken, thrashing about, but to little effect, and the literature continues to try and paint a happy picture, while ill-concealing their ultimate despair that they'll get ahead of this one.

It continues to be a slow roll-out compared to 2014, but is notably picking up steam.
1000 vaccinations a day is great when you have 100 cases.
When you're working on 2200 cases and counting, and nearly 1/4 of the regions you need to be in are untouched by any effort, the horse left the barn, and you're just marking time on three sides while the whole show departs through the gaping holes in containment.

It's going to get much worse, much faster, probably in a week to a month, when cases start popping up farther afield, where there are no resources or testing, let alone contact tracing, and the percentage of cases with no clear infection chain will go from single digit percentages to mid-double digits rapidly.

And now comes unconfirmed word that we have a number of potential infected refugees in custody on the Southern border of the US. Nobody's saying they have Ebola, just getting all flustercated because they might. {Emphasis added for clarity. -A.}

My default answer is to ignore these reports until it's confirmed, because most of them are indeed false reports, so we'll wait and see how it pans out, as you all should.

But if it breaks out here, we have 11 BL-IV beds, max, to adequately contain that outbreak.
For reference, Mexico has zero beds.
I repeat, Mexico has zero beds.

If it breaks out south of the border, one case becomes 100 cases in about a month, tops, (probably more like a week to ten days) and then the flood of refugees coming here becomes a tsunami (actually, we're there now completely without a pandemic to drive it faster, so picture that when it gets turned up to 11). At that point, f**k a wall. The only way you stop that flow is AC-130s doing minigun sweeps of anything moving within 1/4 mile of the international border, which is going to be hard on the millions of people who already live inside that zone on both sides of the line.



So if Mexico gets one active case, you can cancel Christmas.
America (North, and particularly Central and South) becomes Africa at that point.
Ditto if we get more than 10 cases here in the U.S.

We saw what happens when people at the local big hospital tried to be Emory or Nebraska or The Vault at USAMRIID: it fails, and you knock a 1000-bed major tertiary care facility out for months, for the whole community.
And the virus doubles, despite your best efforts.

With EVD, close isn't good enough, and only counts with horseshoes, hand grenades, and nuclear weapons.

I'm working, and have been, in level I and II trauma centers, and major high-volume ERs my entire career. More since 2014 than before, BTW.

And I'm here to tell you, by the numbers:

1) We aren't ready to deal with this, in any meaningful way, any better than in 2014
2) By "we" I mean any hospital in any city anywhere in North America, and
3) when, not if, this breaks out here, it's going to take out health care as you know it in every affected city, starting with the people who work in them, then patients and visitors. Hospitals will become abbatoirs, morgues, then ghost towns.
4) 911 responders (firefighter rigs and EMT units, and to a lesser extent, law enforcement) will become potential carriers to spread the disease back into the community.
5) anybody, anywhere, with whatever certifications, who tells you anything different is either lying out their ass at both ends, or doesn't know what they're talking about, and anything further they say can be completely discounted as utter bullsh*t from someone too stupid to live, or irredeemably evil.

Good times, huh?

That means no ER, no 9-1-1, no 50 other things people come to hospitals or call the police and fire department to handle. Trauma, heart attacks, strokes, diabetic emergencies, appendicitis, and the whole plethora of modern medicine.
Imagine the police not wanting to get within 20 feet of people on a stop or a call.
Car accidents will become morgue calls.

Because Ebola.

The Monster

The little filovirus in the masthead for these updates is magnified tens of thousand times, in pics that have been around since the mid-1970s.
A period at the end of this sentence would be a ball of virus that numbers 100,000,000 of them.
The number necessary to give you full-blown Ebola is one.

We don't know in what species Ebola resides between outbreaks. Anywhere. Ever.
We don't know how it gets transmitted from them to humans.
No idea whatsoever.

Flecks of infected blood from a human victim who has it can be coughed and sneezed 25', and may linger in the air for up to 10 minutes afterwards.
And that's only considered droplet precautions, because those particles are heavier than air, and eventually settle, unlike true airborne precautions, for something like TB, or pneumonic plague.

Your body won't care which it is if you suck in one of those droplets at the movie theater, theme park, supermarket, or mall, whenever you simply breathe it in anytime you walk within 25' of anywhere anyone has coughed in the last 10 minutes.

Have fun at WalMart, Target, the airport, a theme park, a movie multiplex, a ballpark or auditorium, and the supermarket then.

And before someone starts asking (again?!) about how to "deal" with this, by suiting up:
1) You need a 20-piece hazmat ensemble, a spotter to put it on and take it off, a metric fuckton of disinfectant and disposable items, including gloves, splash-proof goggles, gloves,  suits, gloves, hoods, gloves, booties, gloves, droplet barrier masks, and gloves.
2) One break in protocol will be a terminal error.
3) And potentially expose everyone you come into contact with to the virus.
4) And require you to start all over again getting suited up for, or deconned out of, any hot zone
5) Oh, and lest we forget, it's June, and the ensemble inside is hot-as-fucking-hell, and gives the average person maybe two hours' time before they're ready to pass out from heat stroke, before we factor in dehydration, claustrophobia, and sheer panic.
6) Did we mention that hot, tired, dehydrated, exhausted, and panicky people make fucktons of sloppy mistakes?
7) Did we also mention that one mistake can get you and everyone you love or contact killed?

So yeah, fuck the idea of working in hazmat gear. Professionals hate it. With all the resources mentioned above you'll never have.
You?
You don't stand a chance.

Proper protective equipment for Ebola, we repeat and belabor, is several lengths of military-grade concertina, warning signs, a shotgun and supply of buckshot, and small breakable containers with a suitable flame accelerant, for emergency decontamination beyond the perimeter.

Chance of Ebola sneaking up your driveway and into you behind such a perimeter: 0%.

Odds of seeing this material again before the end of the year: better than even.

Happy Summer, kids!
Now do you see why I don't want to bring this up any more frequently?

[Crafty_Dog]

GM:

I posted your article on another forum.  One of the other members of the forum responded thusly:

"I won't say that he's wrong, and in fact I am inclined to think that he's probably more right than wrong about the ebola situation. But one thing that always must be kept in mind is that this particular character is an absolute master of hyperbole, who was banned from the other place I hang out due to his antics and overall douchebagginess. In other words, he gets off on creating argument and controversy. Doesn't mean he's always wrong, just that he never found a pile of shit that he didn't think needed more stirring.

"In the interest of full disclosure, I've butted heads with him on two different forums over a period of several years and neither of us is likely to make the other's Christmas card list, so take me with a grain of salt too if you wish. The other thing he's a master of is staying just barely within whatever terms of use he's posting under in terms of personal attacks. He survived at each of the other places for years even despite moderators who wanted to get rid of him; the forum owner at the last place finally exercised his royal prerogative even though the guy wasn't technically in violation of any rules other than a blanket "don't be an ass" rule."

[G M]

GM:

I posted your article on another forum.  One of the other members of the forum responded thusly:

"I won't say that he's wrong, and in fact I am inclined to think that he's probably more right than wrong about the ebola situation. But one thing that always must be kept in mind is that this particular character is an absolute master of hyperbole, who was banned from the other place I hang out due to his antics and overall douchebagginess. In other words, he gets off on creating argument and controversy. Doesn't mean he's always wrong, just that he never found a pile of shit that he didn't think needed more stirring.

"In the interest of full disclosure, I've butted heads with him on two different forums over a period of several years and neither of us is likely to make the other's Christmas card list, so take me with a grain of salt too if you wish. The other thing he's a master of is staying just barely within whatever terms of use he's posting under in terms of personal attacks. He survived at each of the other places for years even despite moderators who wanted to get rid of him; the forum owner at the last place finally exercised his royal prerogative even though the guy wasn't technically in violation of any rules other than a blanket "don't be an ass" rule."

I'm not a Virologist and my formal medical training is nothing past First Aid/CPR and Tactical Lifesaver (The LE version of the military's Combat Lifesaver).  I've read books for laypersons on the topic of Ebola (I thought "The Hot Zone" was really good) and what he has written jibes with my understanding of the topic.

The author is caustic and I certainly do not agree with everything he has written, but when he posts something I see as worthwhile, I share it.

[Crafty_Dog]

Agreed.

[ccp]

like we did back when I participated in '14 through 16:

https://www.conservativereview.com/news/large-numbers-coming-border-ebola-ridden-african-countries/

egads!   

[G M]

like we did back when I participated in '14 through 16:

https://www.conservativereview.com/news/large-numbers-coming-border-ebola-ridden-african-countries/

egads!   

Thankfully that won’t stop them from getting EBT cards, Obama phones, public housing and public schooling!

[G M]

https://bayourenaissanceman.blogspot.com/2019/06/ebola-rampaging-superstition-and.html

Wednesday, June 5, 2019
Ebola, rampaging superstition, and a complete ignorance of fact

I've pointed out in the past that the reason the Ebola epidemic continues to spread in Congo is largely due to the primitive, superstitious tribal culture in that part of the world.  Unfortunately, many First World readers have no conception of just how primitive and superstitious that culture really is.  It's so far removed from our reality that it's inconceivable to many of us.

Now comes a report on child soldiers in the Congo that may help some readers understand the problem better.

The potion was powerful stuff: the grown-up rebels who had given it to the boys, smearing it on their beanpole bodies every day for a week, had promised it would make them invincible.

Still, the first time he went into battle Jean-Paul wanted to be sure. Stripping off his clothes, he fought the enemy naked.

The magic seemed to work.

Not only has he lived to see his 13th birthday, but he has emerged more or less unscathed from repeated engagements with the Congolese army over a period of nearly two years.

“I knew that as long as I remained naked, I could be sure that the charms worked,” he told the Telegraph last week.

His friend Phillipe, a year older and wiser, also holds with the magic. And why not? Unlike Jean-Paul who went into battle with a mere hunting rifle, he was been given far more powerful weapons: three eggs and a calabash gourd.

“When I threw the eggs they turned into bombs and the enemy was killed by the fire,” he said. “I killed many people that way.”

Alive today, there was, and remains, no reason for him to question it all.

. . .

Commanders wasted no time in wielding the sorcery to their advantage. On the battlefield they deployed girls as young as seven in matching red frocks to the front line.

Swishing their magic dresses to scoop up the army’s bullets, they protected not only the boys standing behind them with their hunting rifles, eggs and pieces of wood that turned into AK-47s but also the men, armed with proper weapons, who brought up the rear.

The child soldiers – known as the “Baby Police”– were killed in their thousands, but total numbers were not evident to individuals. And anyway, with magic there is always an explanation.

Jean-Paul said he believed the children who died met their fate because they had not followed the rules. Perhaps they had eaten meat, or had sex, or had worn underwear while fighting, he explained.

. . .

Going from village to village, they set up baptism sites, known as tshiota, to indoctrinate child recruits.

At these, children were given bitter potions made from the powder of bark from three trees, often mixed with human blood and ground-up bones. The remainder, made into a paste, was brushed onto their bodies with the promise it would give them superhuman powers.

Sometimes, as in Jean-Paul’s case, they swallowed three live red ants before marching round a fire and chanting the words “In the name of the Kamuina Nsapu” [the 'magical' name of the tribal militia], an incantation they would intone repeatedly in battle.

They may have been outgunned, but even the army’s elite Republican Guard seemed to fear the magic. Sometimes they did mow down the girls in their red dresses and the egg-throwing boys. But often they turned and fled.

There's much more at the link.

This is the sort of superstition that aid organizations and health care workers are dealing with in north-western Congo.  It's a level of ignorance that makes it easy to persuade locals that the aid organizations are actually spreading Ebola, a "white man's disease";  that they're killing people in their hospitals, rather than trying to treat them;  and that their medicines and health care measures are designed to bewitch and/or enslave people rather than help them.  It's no wonder that attacks on aid agencies and workers are so frequent, and sometimes deadly;  and it's no wonder that the Ebola epidemic in the Congo is now out of control.

There is literally no reasoning with such people, because they're not capable of reasoning in any logical, rational sense of the word.  Their lives - their entire world view - is/are bound up in, and encompassed by, and permeated with superstition and witchcraft.  If their shaman, or witch-doctor, or whatever, says to them that they must or must not do something, they'll obey their spiritual leader rather than health care authorities, because it's patently obvious to them that the former knows so much more than the latter.

That's why this outbreak of Ebola scares me so much.  It's perilously close to breaking out of its geographic boundaries, despite months of intensive efforts to contain it.  The reason is precisely what I've said above.  Local people don't believe in Western medicine;  in fact, they'd rather flee from it.  In doing so, they're going to spread Ebola into Uganda (which has "10,000 [border] crossings each day" to and from the Congo - and that's just the ones who go across legally, rather than walk through the bush).  South Sudan, Rwanda and Burundi are also threatened.  From there, it's a hop, a skip and a jump to Kenya, with its international airport at Nairobi and its many flights per day to Europe and the Far East.  From there to the USA is no distance at all in terms of air travel.

Be afraid, people.  If you're not, you don't understand the situation.  This could turn very nasty, very quickly, and there's almost nothing effective we can do to stop it if it does.  Even an international travel ban would have only limited effect, given how easily African refugees, particularly Congolese, can cross (and are already crossing) our borders illegally.

Peter

[G M]

https://raconteurreport.blogspot.com/2019/06/told-you-so.html

[DougMacG]

https://raconteurreport.blogspot.com/2019/06/told-you-so.html

[Ebola]  "We're f**ked"

[ccp]

with regards to the Congolese coming in from the Southern border
I don't understand how they are getting there .

Who is bringing them?

Do we really know it has been more than 21 days since they have been in Africa?

How would or could we even know that?

The CDC will be dead (no pun intended ) quiet and of course the Dems just yawn.  Those bastard Dems .

[DougMacG]

with regards to the Congolese coming in from the Southern border
I don't understand how they are getting there .

Who is bringing them?

Do we really know it has been more than 21 days since they have been in Africa?

How would or could we even know that?

The CDC will be dead (no pun intended ) quiet and of course the Dems just yawn.  Those bastard Dems .

Yes, those bastard Dems.  The intended consequence of no borders is new voters.  Unintended consequences include free flow of drugs, terrorists, rape, child trafficking and diseases.

[G M]

with regards to the Congolese coming in from the Southern border
I don't understand how they are getting there .

Who is bringing them?

Do we really know it has been more than 21 days since they have been in Africa?

How would or could we even know that?

The CDC will be dead (no pun intended ) quiet and of course the Dems just yawn.  Those bastard Dems .

Yes, those bastard Dems.  The intended consequence of no borders is new voters.  Unintended consequences include free flow of drugs, terrorists, rape, child trafficking and diseases.

I'm sure our professional journalists will be sure to ask various dems about this!

*Crickets*

Oh.

[G M]

https://raconteurreport.blogspot.com/2019/06/where-problem-is.html

SATURDAY, JUNE 15, 2019
Where The Problem Is


















Frequent commenter Nick asks:

"Aesop, you know I'm with you on this topic, and I've been adding to my long term bulk food storage every two weeks...

But, the MSF guys are all volunteers, and they not only go to work, but do so at a loss financially.

Most africans are not particularly diligent or methodical but they seem to manage the deconn, donning and doffing reasonably well.

Given the conditions on the ground in this and the last outbreak, how can we reconcile what you (and I for that matter) expect, with the lived experience of the medical teams in africa? After all, there are LOTS of Drs and staff involved, and no or few reported deaths among staff, and none among the Drs.

I don't think the vaccine is the difference because we didn't have widespread losses among the foreign Drs and staff last time around either. (the one nurse iirc, and that from a social engagement not work)

I agree that it's the knock on effects that would be so devastating here or other first world countries due to the dependence on infrastructure and Just In Time delivery.

We also have the experience in Dallas of the guys POWER WASHING the index patient's effluvia off the walk, and the patient's own family who were closeted with him in the apartment, yet none of them got sick.

Is it possible that it's harder to spread this than we think? It can't be luck every time...."

Serious questions deserve thoughtful answers.
My response:

1) They manage donning and doffing pretty well, because they have five times the staff we'll allocate, because none of them are drawing paychecks. From 2014:
The Ebola epidemic caused an increasing demand for protective clothing. A full set of protective clothing includes a suit, goggles, a mask, socks and boots, and an apron. Boots and aprons can be disinfected and reused, but everything else must be destroyed after use. Health workers change garments frequently, discarding gear that has barely been used. This not only takes a great deal of time but also exposes them to the virus because, for those wearing protective clothing, one of the most dangerous moments for contracting Ebola is while suits are being removed.
The protective clothing sets that MSF uses cost about $75 apiece. Staff who have returned from deployments to Western Africa say the clothing is so heavy that it can be worn for only about 40 minutes at a stretch. A physician working in Sierra Leone has said: "After about 30 or 40 minutes, your goggles have fogged up; your socks are completely drenched in sweat. You're just walking in water in your boots. And at that point, you have to exit for your own safety ... Here it takes 20–25 minutes to take off a protective suit and must be done with two trained supervisors who watch every step in a military manner to ensure no mistakes are made, because a slip up can easily occur and of course can be fatal." Link
Do that math: $75 x 24 hrs/day, x 30 days, per patient. Times 6-10 staff members. At minimums, that's $324,000 per Ebola patient, just for the protective ensemble. and that's 4320 protective gear ensembles. For each patient. 25-75% of whom will die anyways.

Generating, if each suit only weighs 2 pounds, some eight tons of highly infectious medical waste, which no one in this country wants or knows how to handle, short of open pit gasoline fires.

Asking for a friend:
Which way do the prevailing winds blow from the nearest hospital?
How are the people living downwind in the Ash Zone going to feel about that?
Just curious.

2) "Pretty well" is a relative term:

In August 2014 (two years before the outbreak was over!), healthcare workers represented nearly 10 percent of cases and fatalities—significantly impairing the capacity to respond to an outbreak in an area already facing severe shortages. By 1 July 2015, the WHO reported that a total of 874 health workers had been infected, of which 509 had died. Link

As of 30 April 2019, there have been 92 health care workers in the Democratic Republic of the Congo infected with EVD, of which 33 have died. Link
 And MSF's precautions are done in a no-sh*t Hot Zone. An unknown number of those helping are "survivors" of the current outbreak, each time, with obvious immunity going forward (with all the caveats about EVSyndrome for such "survivors").

We are not being trained in their MSF protocols here, we're trained to CDC protocols.
You know, the ones that got two nurses here infected within 21 days, despite doing everything the CDC thought was sufficient. Which is exactly how well Ebola spreads in the wild, with zero precautions.

BLUF: The CDC guidelines are the same as slam-dancing naked with Ebola-riddled corpses.

The same CDC that gave an infectious nurse permission (WTF?) to take commercial air home, knowing someone with a fever (which she had) was infectious to everyone at the airport and flight she came into contact with, including the guys that handled her baggage.

( "Hey, we're the Government, rules of Nature, like physics and epidemiology, don't apply to us, Because we say so.")

It isn't that Ebola is less effective at transmission than we thought, it's that early, before you're literally coughing out your lungs, vomiting out your esophageal tract, and sh*tting your intestinal walls out, it's a somewhat (but unknown amount) less infectious than the final stages.

That's a pretty fine razor to skate on barefoot.
That was the luck we were living on with Duncan, with both nurses he infected, with Dr. Dumbass in NYFC, and with exposed-but-not-infected-roommate-of-Ebola-victim Nurse Mimi Crybabypants.

[The later two, failing actual 40-day-lockdown-hard-isolation quarantine, should by rights have been shot on sight for breaking quarantine, gross professional negligence, and 20,000 counts of attempted murder.(I.e., if you point a gun at someone and pull the trigger because you thought it might be loaded, but it wasn't, you're still fully legally culpable in 50 states and 7 territories for the attempt.)
If somebody capped them both tomorrow, on their own, it would still be justifiable homicide IMHO.]

And if/when this gets here, some medical professionals will decide they're Special Snowflakes, and don't need to follow all the rules, and don't have to be quarantined, because it violates their rights or harshes their mellow, and exactly like the family from DRC that sneaked into Uganda, they'll transplant the outbreak to others. And we won't find out for another 3-21 days, on average, and some not for longer, by which point it's already an epidemic shitshow here.

That should be a shoot-on-sight situation, followed by burning the corpses immediately, after obtaining a blood sample under BL-IV precautions.

But this is America, and we're too squeamish to do that, and we'll end up killing people with kindness by not doing it. (Like letting infectious nurses travel commercial air, rather than sending a BL-IV jet to whisk her and her stuff into full containment. Like your government did in 2014.)

Also, the people working with Ebola in Africa for MSF are only providing palliative care, i.e. assistance for the 80-90% who're going to die, to do so less uncomfortably than they would in a rut by a dirt road.

They aren't taking blood samples, starting IVs, or 57 other things. Their height of care is a cool cloth for the forehead, a cup of water (which becomes the next bout of projectile vomitus), and trying to contain the piles of bloody diarrhea being launched into bedding and over at the patient on either side.

And they burn the entire treatment center when they're done, down to the concrete pad (unless, like in DRC, the locals don't wait until its over, as they've already done over 40 times during this outbreak, and killing or injuring over 80 health workers there, which is why 25% of the affected areas in DRC have zero MSF or WHO presence). Now, think of your local ghetto 'hood or barrio. Think it will be better here??

It isn't just HIPPA concerns that keep TPTB from showing you that bloody reality in each and every outbreak. People would be at the White House fence line with AR-15s and Molotovs in earnest, clamoring for POTUS to nuke Africa if they knew that and saw it on the Nightly Snooze on the major networks. You're being lied to daily, including by massive omission, and have been since forever. I post what I post because I figure people can handle the reality with the bark on. But in 2014, I had to drop it, because by Presidential Fiat Decree, the news media were told Not To Talk About Ebola Anymore. Leaving us with just the happygas from foreign sources (who largely also complied with the gag order) and the lying African nations' self-serving press releases that under-reported the breadth and depth of things, on purpose, by a minimum of 300%. Even the UN/WHO admitted that, during the outbreak, openly. "It'll be different this time." Sh'yeah, as if. Neither there, nor here.

And one of those factoids is that once it's more patients than our BL-IV beds can handle, the care and protocols and training become so sketchy as to constitute gross professional negligence on the part of all hands participating, from POTUS and the CDC director, down to the sloppy housekeeping person with a GED who'll be sent in to mop up after patients #16 to #Infinity, with half-assed don/doff training, protocols, faulty equipment, and insufficient staff.

Ebola's always going to find the weak links in any chain of infection.

In the West in general, the weak links are the chain itself.

Instead of screening this stuff and keeping it at arm's length, because of ignorance, deliberate stupidity, negligence, malpractice, and malign indifference to all of the above, the very people who stay and play with it are going to be the same ones who insure that everyone else gets it, mostly through accidental exposures like the two nurses in Dallas, along with the selfish and stupid infectees who won't seek treatment, and will keep sending sick kids to school and going to work until either one collapses shooting blood out their eyeballs.

That's before we even talk about the open borders and lackadaisical attitude towards quarantine that's been rampant non-stop from 2014 until now. This is deliberately engineering Ebola's arrival and release among the population, which we've already seem with measles, TB, Chikungunya virus, West Nile virus, and a witches' brew of other diseases we had formerly whipped here.

Verstehen sie?

We aren't set up for this, and we're doing nothing to stop it getting here (rather the opposite in fact).
And when it does, after those first 15 beds are occupied, we've done nothing anywhere close to adequate to handle things properly and nip it in the bud.

But everyone in charge pretends we've done exactly that, when nothing could be further from the truth.

Maybe you can bullshit the Low Information Viewers in flyover country, but you can't bullshit me or countless other doctors, nurses, and ancillary staff who'll be on the frontlines (for about 20 seconds, in my case) before we drop our clipboards where we're standing, and head for the parking lot.

I may make a bullshit excuse about not feeling well, I may pass off report on my patients to someone else who stays, but go I will, and I mean within minutes.

I can't collect paychecks at Forest Lawn, and I won't be helping anyone shitting my intestines into my scrub pants, and both of those are slam-dunk outcomes with the present (and perpetual) half-assed level of preparedness for Ebola or any one of 27 other pandemic-worthy infections at every hospital (but for a small part of a bare few) from Anchorage to Miami, and Maine to Hawaii.

Anyone wants to go to medical or nursing school, and go work on the frontlines of Ebola with WHO or the CDC, rolling the dice you'll live to retirement every time you scrub in or out, operators are standing by. (When every hospital has an actual 24/7 BL-IV capability, and staffs and supplies and trains for its use regularly - by which I mean more than once a year or three to salve their own charred consciences and pen-whip JCAHO's lackadaisical clipboard commandos - we can talk. Otherwise: F**K that noise. Sideways, with a rusty chainsaw.)

In such an epidemic, there is no such thing as a valiant death.
There's just death.

I'll do my damnedest to save your life if you come into my ER.
But I won't kill myself to do it, and I won't die for you because TPTB at every level are too half-assed and cheapskate to prepare for this as if it was Really A Thing, too stupid to know that, and too evil to care. That ain't in my contract, and unlike joining the Marines, I took no such oath, and it isn't part of the deal.

I don't know how many out of 4,000,000 medical practitioners will be that honest and tell you that up front.

I just did.

Unless you're one of the original few cases in the outbreak, before anyone knew it was here, so you didn't have the sense to self-quarantine while you were uninfected, if you come to the hospital with Ebola, you're de facto part of the problem, not the solution.

And you're probably going to die, and there's a better than even chance you had it coming.

To All Concerned:
Get. Your. Sh*t. Together.

Nobody else is going to save you if this gets here. Save yourself. Don't get it.
Because if you catch it, you're getting a Viking funeral, about a minute after you're dead.

Just like they do Over There.

[G M]

https://www.washingtonexaminer.com/news/border-patrol-agents-not-immune-to-onslaught-of-illnesses-plaguing-migrant-holding-centers

Border Patrol agents fall prey to illnesses plaguing migrant holding centers
by Anna Giaritelli
 | June 16, 2019 03:55 PM
 

EAGLE PASS, Texas — Some Border Patrol agents in Texas are concerned about exposure to Ebola by a migrant fleeing the Democratic Republic of the Congo for the United States.

But more of them are worried about other illnesses frequently popping up among detainees at stations across the southern border, according to union representatives.

Border Patrol’s holding facilities in the Del Rio and El Paso sectors, or regions, are inundated with sick detainees, as well as sick agents.

Jon Anfinsen is a National Border Patrol Council vice president and based in Del Rio, which includes Eagle Pass, where most Congolese are arriving. Anfinsen represents approximately 1,000 agents who are based out of 10 regional holding stations. Anfinsen has been an agent 12 years and said the number of people in custody and subsequent illnesses among that population is “unprecedented.”

“Scabies, chickenpox — we had one case of the mumps here in Uvalde. I wanna say we had measles — plenty of the flu, plenty of colds, body lice, just assorted. And some of these things, they spread like wildfires when you get into a cramped holding cell. It happens,” Anfinsen said.

The continuous breakouts — in part caused by the overcrowded conditions in facilities and difficulty quarantining each sick person — are taking both a physical and mental toll on agents.

“It’s not so much the workload. It’s the constant illnesses. We have a lot of agents who are sick. The other day I talked to agents from four different stations. And every single one of them had a cough,” Anfinsen said.

“I’ll go and I’ll help process. There was one day I spent processing and we had like 40 Guatemalans and Hondurans, and most of them had some kind of cough. And sure enough the next day, I’m sick — for a week,” he said. “It’s become the new normal, and you gotta just keep going and do your job because you can’t just not process them.”

National Border Patrol Council vice president and agent in El Paso, Wesley Farris, said the breakouts rarely stop, they just dwindle down for a period.

“It’ll go in waves. Scabies — strep throat was the last one. Strep throat happened at the Santa Teresa station [in New Mexico]. It was everywhere,” Farris said. “Active tuberculosis comes in fairly regularly. We had an incident of H1N1, swine flu, in Clint [Texas] with a juvenile. And then the ones that are most disruptive are the simple ones: regular flu or lice.”

Union officials in El Paso have urged the sector’s 2,500 agents to wear gloves and face masks whenever possible. Neither official could provide confidential data on the amount of agent sick time used in order to see the brevity of sickness claims among Homeland Security employees.

Farris said the sector has harped on taking basic precautions to stay healthy, but said they are not enough, especially as populations from other parts of the world, including Africa and Asia, continue to arrive at the southern border at rates higher than previous years, bringing with it mild and possibly more serious types of illnesses that are not native to the U.S.

Farris said if he had his way, he would bring in physicians from the Centers for Disease Control and Prevention as a proactive measure.

Both officials said migrants are currently screened after being taken into custody and transported from where they were found to a Border Patrol station. Some agents will ask migrants while they are in the field if they need medical help and will then acquire additional transportation if it is needed.

Once back at the station, either Border Patrol EMTs, medical personnel from the Coast Guard, or contracted doctors and nurses will take each person’s vitals and examine them for signs of illness. If a person is deemed to be in good standing, he or she will be released into a holding cell with others. All others will be sent to a hospital. Following hospital tests and possible treatment, the detainee is turned back over to Border Patrol. Quarantining is difficult because of the lack of space at stations, both men said.

Border Patrol does not do blood work as part of medical intake for incoming detainees. Anfinsen said even if they did do it, there is still a chance they or the hospital could miss something that is premature to be showing up in the blood.

The El Paso official said the contracted medical professionals and Coast Guard officials are doing their best, but deserve additional resources because of the risk posed to the general public by the release of hundreds of thousands of people this year.

“If I was running the ship, I would make medically screening people a higher priority,” he said. “At least 90% of people coming into this sector are coming in at one spot. I would get ahead of the game and set up what you call a hot zone — have medical right there.”

“We’re civil servants. It’s what we’re supposed to do in that regard — make sure we at least know [a person’s background]. We do it on the criminal side — we won’t release a criminal if they have an active warrant. We’ll check that. But we’re very reluctant to quarantine them medically,” he said.

Last week, the CDC announced the activation of an emergency operations center in an effort to help with the Congo's Ebola outbreak, the second-largest in history.

Farris said if the CDC is jumping in to help with a major outbreak overseas, the U.S. agency should “absolutely” deploy some resources to the southern border.

“You’re going to have to sift through thousands before you get one [major disease],” said Farris. “That’s my nightmare — that somebody does get sick — because I’m going to have to make the funeral arrangements. And it’s not going to be an agent, it’s going to be his 3-year-old kid at home who contracts Ebola or H1N1 because they’re little.”

[Crafty_Dog]

https://bigleaguepolitics.com/texas-medical-professional-migrants-quarantined-with-unknown-disease-10-year-old-girl-found-with-20-types-of-semen-in-her/

[G M]

https://bigleaguepolitics.com/texas-medical-professional-migrants-quarantined-with-unknown-disease-10-year-old-girl-found-with-20-types-of-semen-in-her/

Vibrancy! Diversity is our strength!

[G M]

https://www.bbc.com/news/amp/health-49025298

Nothing to see here. Move along.

[DougMacG]

https://www.bbc.com/news/amp/health-49025298

Nothing to see here. Move along.

I'm beginning to wonder if the Ocasio Sanders Warren Harris policies in place in the Democratic Republic of the Congo were not good for the people.

Also, isn't disease screening one of the key differences between legal (Republican) and illegal (Democrat) immigration?

Equality of health outcomes now means everyone gets ebola.

[G M]

https://www.bbc.com/news/amp/health-49025298

Nothing to see here. Move along.

I'm beginning to wonder if the Ocasio Sanders Warren Harris policies in place in the Democratic Republic of the Congo were not good for the people.

Also, isn't disease screening one of the key differences between legal (Republican) and illegal (Democrat) immigration?

Equality of health outcomes now means everyone gets ebola.

Well, except the rich and powerful in secure compounds, as always.

[G M]

https://www.google.com.fj/amp/s/abcnews.go.com/amp/International/2nd-ebola-case-confirmed-congolese-city-goma-home/story%3fid=64675333

Major transit hub.

[G M]

https://raconteurreport.blogspot.com/2019/08/ebola-update-august-2019.html

The good and bad news.

[Crafty_Dog]

https://www.armytimes.com/news/your-army/2019/08/08/the-cdc-shut-down-an-army-lab-thats-working-on-an-ebola-vaccine/?utm_source=Sailthru&utm_medium=email&utm_campaign=ARM%208.8.19&utm_term=Editorial%20-%20Army%20-%20Daily%20News%20Roundup