Patterico's Pontifications

10/2/2014

Reports: Ebola Patient May Have Come in Contact with Up to 80 People, Vomited on Ground Outside Apartments

Filed under: General — Patterico @ 7:06 am



So those folks at the hospital in Dallas told us yesterday that the Ebola patient had come into contact with “12 to 18″ people:

Duncan, who is in his mid-40s, came in contact with 12 to 18 people after developing symptoms of the deadly disease, health officials said Wednesday during a news conference at Presbyterian.

I mocked the “12 to 18″ formulation last night as being reflective of people who didn’t seem to have quite as firm a handle on things as our government would have you believe. And guess what?

About 80 people came into contact with U.S. Ebola patient Thomas Eric Duncan or one of his family members before he was hospitalized, Dallas County health officials said Thursday.

However, not all of them were necessarily in close physical contact with the Liberian national, Dallas County’s Health and Human Services director Zachary Thompson said. That number is in addition to the 12 to 18 people who had direct contact with Duncan, including some school-age children, Texas Gov. Rick Perry said Wednesday.

So they don’t say the 80 came in contact with him — but they don’t say they didn’t, either. And:

Two days after he was sent home from a Dallas hospital, the man who is the first person to be diagnosed with Ebola in the United States was seen vomiting on the ground outside an apartment complex as he was bundled into an ambulance.

Who cleaned that up? What precautions did they take? Are they one of the 12? Or the 18? Or the 80? Or are they outside that select group?

All of our wonderful protections didn’t keep this guy from flying here, even though a New York Times piece seems to make it pretty clear that he knew he had been exposed:

Mr. Duncan’s case began with him playing the part of good Samaritan on another continent. Mr. Duncan — a Liberian national in his mid-40s who had come to America to visit relatives in Dallas — had direct contact with a woman stricken by Ebola in Monrovia, the Liberian capital, on Sept. 15, days before he left Liberia for the United States, the woman’s parents and Mr. Duncan’s neighbors said.

The family of the woman, Marthalene Williams, 19, took her by taxi to a hospital with Mr. Duncan’s help after failing to get an ambulance. Ms. Williams was turned away for lack of space in the hospital’s Ebola treatment ward, the family said, and they took her back home in the evening, hours before she died. Mr. Duncan helped carry her because she was no longer able to walk. In the taxi, Ms. Williams, who was seven months pregnant, had been convulsing.

When did he make his plane reservations? Your alert media is right on top of it, I am sure.

Also, someone in Hawaii has been placed in isolation to be monitored for Ebola. (H/t redc1c4.)

No matter. Obama and your federal government have it under control. Now stop asking questions.

Or, to put it less sarcastically, I will quote John Hayward: “But there’s no reason for anyone to look down their noses at those who worry that the authorities will make mistakes or withhold information, for they have already done both.” Which, I will add, was utterly predictable from the outset.

45 Responses to “Reports: Ebola Patient May Have Come in Contact with Up to 80 People, Vomited on Ground Outside Apartments”

  1. Ding.

    Patterico (5e9fda)

  2. Your fault, you ‘effed up and trusted us.

    gary gulrud (46ca75)

  3. Just put the lime in the coconut, drink it all up. https://www.youtube.com/watch?v=Tbgv8PkO9eo

    nk (dbc370)

  4. And because the CDC has such a firm handle on this, we’re not going to shut down travel from West Africa, or quarantine all travelers from or through there.
    We are mad.

    askeptic (efcf22)

  5. 4. Stark, raving even.

    gary gulrud (46ca75)

  6. Julia Pierson will be assuming responsibility for emergency response for the CDC.

    daleyrocks (bf33e9)

  7. What happened to the precautionary principle?

    You should see the brain dead march of the climate zombies, whenever the precautionary principle involves closing down a multi-million dollar powerplant. It’s Dawn of the Dead with Ed Begley Jr. and Daryl Hannah out front, bugling the charge.

    But when it’s an actual existential threat, crickets from the pp crowd.

    If Papertiger were the King, the original do-gooding Christian doc, who went adventuring to Africa for Jesus, would have been shot between the eyes right on the tarmac as he got off the plane.

    Not because I’m a heartless dictator, but because it would have sent a message to would be ambulatory pathogenic vectors thinking of hopping the border.
    That King James guards the hygiene of his people jealously.

    But instead we’re stuck with President Barack Ebola. Wouldn’t surprise me to find out later that Barry bought Duncan’s plane ticket.

    papertiger (c2d6da)

  8. it sucks that we have all this ebola at the same time hospitals are overwhelmed with that weird disease the illegal immigrant urchins brought in

    but we need to get used to graciously accepting third world problems and scourges here in failmerica

    this is who we are now

    happyfeet (a785d5)

  9. Close the border yesterday.

    Bugg (3a2abd)

  10. “President Barack Ebola”.

    That was worth reading.

    felipe (b5e0f4)

  11. you’d think the unions would be forcing the airlines to stop flying to ebola places out of concern for their union members

    ebola is really really bad for you and if you get the ebola your dues-paying days are likely numbered

    that’s how I see the logics here anyway

    but to be honest I should disclose that I’ve got an anti-ebola bias what underlies some of my assumptions

    happyfeet (a785d5)

  12. Apologies to John Mellenhead

    They come from the cities
    And they come from the smaller towns
    Flyin’ on jet planes and sweatin’
    Goin’ ralph, hork, blow
    P U K E in the U.S.A.
    P U K E in the U.S.A.
    P U K E in the U.S.A., yeah, yeah
    Pukin’ in the U.S.A.
    Well they said goodbye to their families
    Ralphed on all of their friends
    With the blood in their eyes
    And pustules all over their hands
    Some are grey and some are yeller
    you see ’em come, best be runnin’ feller
    Say a prayer to Jesus and then kiss yer ass goodbye
    Pukiin’ in the U.S.A, hey

    Colonel Haiku (ed365f)

  13. I’m worried that like too many things, the incomplete, sometimes incompetent, sometimes dishonest, nature of public dialogue these days may soon make things so chaotic in the public debate that it will be hard to make sense of it.

    In theory, had the CDC and other health officials been more honest, perhaps with themselves as well as the public, had ER staff had the thoughtfulness and time to be more careful, Ebola could remain a serious concern instead of yet another opportunity for anarchy of one degree or another.

    I’ve heard that Liberia has filed charges against the fellow for lying on his health questionnaire when boarding the plane.

    Perhaps Liberia and the rest of the world should require at least a 48 hour stay in a “quarantine hotel” before boarding a plane. I have no idea how easy or difficult it is to get out of Liberia on land and take an airplane from another country.

    I will quote John Hayward: “But there’s no reason for anyone to look down their noses at those who worry that the authorities will make mistakes or withhold information, for they have already done both.”
    True

    If Papertiger were the King, the original do-gooding Christian doc, who went adventuring to Africa for Jesus, would have been shot between the eyes right on the tarmac as he got off the plane.
    That’s the kind of response far on the other side that, I think, just contributes to making it all such a mess everyone is tempted to throw their hands up in the air.
    Though had King Papertiger told Mr. Graham that was his plan, they probably would not have chartered the plane.

    MD in Philly (f9371b)

  14. feets, how many of those illegal immigrant urchins that you love more than beans you got livin wif you?

    I can send you some extra sleeping bags.

    daleyrocks (bf33e9)

  15. meanwhile, it seems our host isn’t the only person not buying the hype.

    redc1c4 (abd49e)

  16. I don’t understand I’m anti-urchin I think they’re dirty

    and useless

    happyfeet (a785d5)

  17. Yes, so far Enterovirus 68 across the Rio Grande has cause more deaths in the US than Ebola, and far, far, far many more hospitalizations.

    MD in Philly (f9371b)

  18. > I have no idea how easy or difficult it is to get out of Liberia on land and take an airplane from another country.

    Not particularly, from what I understand. None of the countries in the region have particularly strongly protected borders.

    I was reading something yesterday (sadly I didn’t save the link and it’s practically ungoogleable) to the extent that one of the big concerns is that a lot of the villagers go do migratory work in the winter, and they don’t necessarily cross borders officially to do so – there are lots of tracks through the bush, and it’s impossible to secure them all.

    aphrael (001863)

  19. aphrael,
    That is my understanding, too, of land traffic between Liberia, Guinea, and Sierra Leone, which has contributed to the spread of Ebola.
    That could be dealt with by restricting travel from any of those 3 countries, even though travel from Liberia seems to be the most worrisome.
    So I guess the next question is how easy is it to get out of that group of 3 countries into a neighboring one, if the borders are just as porous.

    MD in Philly (f9371b)

  20. My sense is that the border from Liberia into Ivory Coast is fairly porous, as is the border from Guinea into Mali.

    None of these countries can really afford the infrastrucutre to keep their borders from being porous.

    aphrael (001863)

  21. Though had King Papertiger told Mr. Graham that was his plan, they probably would not have chartered the plane.

    Fair warning! Absolutely. God bless you on your one way journey, Dr. Brantly.

    papertiger (c2d6da)

  22. The real Ebola liquifies all of you in about two days, is airborne and is said to be the worst thing known to man.

    This “Marberg” (sp?) is related but not the real deal… Around 65% mortality rate.

    Colonel Haiku (ed365f)

  23. Well we drank champagne and danced all night
    Under Liberian candlelight
    Ebola smiled and put me on her knee
    Said pretty boy yer comin’ home with me

    Colonel Haiku (ed365f)

  24. I pushed her away
    I walked to the door
    I fell to the floor
    I got down on my knees
    Then I bled from my orifices

    Colonel Haiku (ed365f)

  25. And that’s the day that they took me away
    And I never knew it would be that way with Ebola
    La-la-la Ebola

    Colonel Haiku (ed365f)

  26. The neighborhood of dallas where his apartment is located became a near third world country as a result of the mid 1980’s real estate crash. Okay maybe not that bad, but a lot of 1 or 2 bedroom apartments renting of $500-$600 a month. Slightly below lower class housing. lot of minorities, immigrants etc living in the area.

    A CPA (debac0)

  27. The infectious disease experts, geniuses that they are, are carefully cleaning up the vomit by the Ebola case with A PRESSURE WASHER !!!!! Way to go big guys ! That should pretty well fix that neighborhood for the next 21 days.

    Also, the ambulance was PUT BACK IN SERVICE after dropping him off at the ER, then after somebody thought about it, isolated and sealed off. I wouldn’t want to be the guy on the next trip after Ebola man.

    Mike K (90dfdc)

  28. the Strain is turning out to be a documentary of sorts, sans the strigoi stingers.

    narciso (ee1f88)

  29. BTW, has there been any reportage on whether or not those at the hospital that sent the Ebola patient home after his first visit there have experienced any discipline or new training?

    askeptic (efcf22)

  30. The question is:

    What kind of consequences from mistakes that are reasonable to expect are likely?

    It is not easy to start an out of control epidemic.

    Sammy Finkelman (d22d64)

  31. http://www.thedailybeast.com/articles/2014/10/02/america-s-patient-zero-was-trying-to-save-a-pregnant-ebola-victim.html

    It just occurred to me that the immune system of pregnant women is somewhat lower. But still, her 17-year old brother got it.

    Sammy Finkelman (d22d64)

  32. askeptic (efcf22) — 10/2/2014 @ 3:03 pm
    I am sure they have been excoriated, grilled, and cussed at, whether any official reprimand, I don’t know.
    It sounds as if he told one person (“a nurse”) that he had been from Africa, but that info didn’t get passed on to others.
    Unfortunately, it is common for bits of info to fly here and there in the less than ideal organization of an ER. Generally, each nurse, aide, resident physician and staff physician may be taking care of a different subset of patients, overlapping with others.

    MD in Philly (f9371b)

  33. At that time, becaus ethey had never experienced a case of ebola, and because they didn’t understand what’s going on in Liberia and Sierre Leone, nobody understood that being in Liberia, especially in Monrovia, the capital, was a risk factor worth paying attention to.

    (The hospital in Hawaii says the patient doesn’t have teh histiry, nor even the clinical symptoms, that would point to ebola..

    Sammy Finkelman (d22d64)

  34. The people in Dallas should have known exactly what to look for, Sammy. Six months ago, maybe not, but in these days, yes, definitely.

    Someone in Hawaii must be not be telling the truth, through design or ignorance, I have no idea.

    MD in Philly (f9371b)

  35. Even apart from the details, when discussing symptoms of an infectious disease, the question as to “Does anybody else have this?” is routine.

    MD in Philly (f9371b)

  36. President Ebola bids welcome to all who can afford the ticket from Ebola land.

    papertiger (c2d6da)

  37. As an additional thought, in defense of the medical staff, one would hope that the patient would say, “Oh, by the way, a week ago I helped carry someone who died of Ebola the next day.” I’m assuming that he did not say that, as I discussed earlier, that he might have been hoping that if the doctor said it was something else (not knowing the full history), maybe it was, and he could stay in denial.

    MD in Philly (f9371b)

  38. What kind of consequences from mistakes that are reasonable to expect are likely?

    Well, the Nigeria patient got enraged when told he had Ebola (He was an American), took off his pants and urinated on the staff.

    Of the health care workers he urinated on, Eight of the Nigerian hospital workers are now infected with Ebola, including the doctor who attended Sawyer. One, a nurse, has already died.

    That was last August and was my first post on Ebola.

    The ER nurse may have been the only one to see him as many smaller ERs are staffed with Nurse Practitioners and Physician Assistants. The ER doc is not seeing patients or all of them, anyway. Medical students, or at least mine, are all told to ask about travel when taking a history from anyone with GI symptoms.

    Mike K (90dfdc)

  39. I think Duncan did not realize what ebola looks like – probably thought it came on much more suddenly. He suddenly quit his job Sept 4 – left Liberia to avoid ebola, not to get cured.

    Sammy Finkelman (d22d64)

  40. Sammy, the man would have needed to be a d*** fool to “not know what Ebola looked like”. He might have planned to leave Liberia to avoid getting it, but then he helped carry an exhausted patient in and out of a taxi, when “the Ebola ward sent her home because they had no room for her”.

    papertiger (c2d6da) — 10/2/2014 @ 3:50 pm
    That makes absolutely no sense. The “current safeguards” have failed, time to do something more.
    Though, obviously, stopping flights from West Africa would not have stopped the Dallas patient from getting in. If the airlines were derelict and let an innocent passenger get Ebola from someone sitting on the plane next to them, hello lawyers. The same should be the fate of the president and his advisors on down.

    MD in Philly (f9371b)

  41. Mike K (90dfdc) — 10/2/2014 @ 4:37 pm

    Mike K., with what we are told now, that per the NYT he helped a friend get his sister to the hospital where she “was turned away from the Ebola ward because they had no room”, he must have suspected/feared that’s what he had, but withheld the information, hoping that if the doctor didn’t say it was Ebola, then it wasn’t Ebola.
    Until we here yet further confusing and conflicting info, I’m thinking the large part of the blame was on the patient for not divulging the obvious.

    MD in Philly (f9371b)

  42. GentleBeings – any discussion of blame accruing to either the Dallas patient or even the airline misses the critical point – it has been known for centuries that, when a region of the planet has some form of plague, responsible governments and jurisdictions require some form of quarantine of people arriving from any such area with a plague …

    And in this day and age of the increasingly (Progressive) Nanny State government, since the Nanny State has chosen to infantilise the citizenry, the Nanny State has *taken* responsibility for resulting outcomes … the recent (past few months) increasing occurrences of Ebola in West African countries has rational folk proposing that restricting travel *from* those regions into this country is a sensible precaution …

    If we are fortunate, we will manage to contain the recent incursion of Ebola into this country, without it being spread to more than a handful of people … we can only hope for that …

    With Pres’ent Obama, however, we have an Executive Branch head who has a track record of considering himself to be more expert than the experts available to him as advisers … which suggests that he will tell us, the legal residents of these United States, that there is nothing for us to worry about, since he has the situation under control … even while saying that, one can pretty much bet that he has no plans to go to visit the Dallas Patient anytime soon as a way to show how safe he believes it to be …

    Why we should be surprised by the feckless decisions about borders and safety by our current First Occupant is becoming harder and harder to justify … with his track record, this is just par for the course for him …

    Alastor (e7cb73)

  43. an Executive Branch head who has a track record of considering himself to be more expert than the experts available to him as advisers …

    There’s the pit. The chewy nougat. Because as bad a President as Joe Biden might be, he isn’t so dense that he thinks of himself as an expert, even in political science.

    Plagiarists know instinctively that they themselves can’t turn a phrase, write an article, give a speech, as inspiring as that other guy. He’ll take that other guy’s advice.

    papertiger (c2d6da)

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