Patterico's Pontifications

10/10/2014

You Knew This Was Coming

Filed under: General — Dana @ 5:11 pm



[guest post by Dana]

As if having a man die of Ebola in Dallas wasn’t enough for Americans to grapple with, there is now the accusation of racism being made against Dallas Presbyterian Hospital’s treatment of Thomas Eric Duncan.

First up, Jesse Jackson in full tragedy-exploitation mode mocks the faith while simultaneously playing the race card:

“What role did [Duncan’s] lack of privilege play in the treatment he received? He is being treated as a criminal rather than as a patient,” Jackson wrote in a story for the Huffington Post this week. “As followers of Jesus, we are called to work for the day when those with privilege, most often white people, have greater access to better medical care than those whom Jesus calls ‘the least of our sisters and brothers.'”

Next up, Dallas County Commissioner John Wiley Price:

“We know what happened at Presbyterian happened, and it’s historically what has happened in this community, if a person who looks like me shows up without insurance, they don’t get the same treatment” Price said.

The hospital defended its actions in a statement:

Our care team provided Mr. Duncan with the same high level of attention and care that would be given any patient, regardless of nationality or ability to pay for care.

And finally, piling on stupid, Salon’s Joan Walsh blames Gov. Rick Perry:

“It’s probably no accident, either, that it happened in Rick Perry’s Texas,” Walsh writes. “More than 1.5 million Texans, with a median income of $833, are going uninsured because Perry rejected Medicaid funding. Medicaid wouldn’t have helped Duncan, but it might help someone exposed to him. Right now Youngor Jallah, the woman who got Duncan to the hospital when his symptoms worsened, says she doesn’t have Medicaid or any health insurance.”

–Dana

Wow, so even Duncan’s family is piling on:

The family of Ebola victim Thomas Eric Duncan lashed out at Texas hospital officials Thursday, calling for an investigation of his care and asking why he had not been given experimental drugs sooner.

“He is a poor black man,” his nephew Josephus Weeks told MSNBC. “I believe [the hospital] didn’t believe he deserved the care that everyone else should get.”

One guess who influenced them

120 Responses to “You Knew This Was Coming”

  1. Hello.

    Dana (4dbf62)

  2. Ima need a Juice Voxer to splain this one to me.

    daleyrocks (bf33e9)

  3. Pro tip: One should never take seriously the demented musings of Ms Walsh and Mr. Rev. Jackson. They unhinged crazy people.

    elissa (b69310)

  4. i’m kinda over Mr. Duncan already

    happyfeet (a785d5)

  5. no edits the Puffington Host do they, or they would have caught the error,

    narciso (ee1f88)

  6. They’re also carpetbaggers. But goodness, why have we not heard yet from Sheila Jackson Lee? She’s a Texan and she’s always good for a noteworthy quote or two.

    elissa (b69310)

  7. “Black America must have better access or we won’t have any success… America must fight this disease or it will be brought to its knees… we must fight the Ebola or we will lose our soul…ah”

    – Jesse Jackson

    Colonel Haiku (2601c0)

  8. I’m getting really, really tired of the Black Grievance Industry’s incessant attempts to drum up more-and-ever-more instances of Victimhood.

    I’m waiting and praying for the day one of these Race Hustlers throws an Outrage Party and nobody shows up. (It almost-sorta happened at Ferguson when ol’ Jesse asked the protestors to open their hearts and wallets, and they started booing at him. That gave me a moment of hope, but it faded pretty darn quickly.)

    A_Nonny_Mouse (a033b8)

  9. Update added.

    Dana (4dbf62)

  10. They’re obviously looking for money, Dana. Geesh this man was a guest in our country, he had an extremely unusual and rarely seen illness, he exposed hundreds of others to disease and now the family are the victims??

    elissa (b69310)

  11. we could send them a selection of russell stover brand fine chocolates

    i saw some on sale at cvs

    happyfeet (a785d5)

  12. Absolutely, elissa. It’s appalling that this is their response. It’s an unbelievably ungrateful response. How do they think he would have been treated had he not lied and gotten on that plane?

    Dana (4dbf62)

  13. Great.
    The guy brings us Ebola and we are supposed to pay his relatives off because they are black.
    *bleep* off

    steveg (794291)

  14. Papertiger’s proposal no longer sounds as crazy as it did last week.

    nk (dbc370)

  15. I missed it, nk, what did he propose?

    Dana (4dbf62)

  16. I suspect the hospital was hesitant to allow family members to visit him BECAUSE HE HAD EBOLA!

    DejectedHead (9b0c64)

  17. not just ebola – turns out he had terminal ebola, which is the worst kind

    happyfeet (a785d5)

  18. There are times I would like to just say that something is so preposterous that it does not deserve a reply,
    and this is one of those times.

    In another way, it probably doesn’t deserve a reply as it would be useless. Anyone who already thinks such things cannot be reasoned with, to change their opinion would be like deprograming a cult member.

    MD in Philly (f9371b)

  19. Everyone is asking why the hospital sent him home the first time as if he had only malaria. I think it is because all of the staff had heard the CDC say “it will not come here” and in the ER doctors tend to go with what they think is most probable. So if “it will not come here” is known by the higher authorities then “It must be malaria” is the most probable. In other words the CDC prepared the hospital to fail.

    Dr Dave (0c818d)

  20. Dr. Dave,

    You have a good point, but we have seen already that just because President Obama said something once before that doesn’t make it a valid excuse now.

    Really, I’m not sure if he would have fared any better had he been kept initially. The main reason to identify a patient with Ebola early is to isolate and prevent the spread of the disease. There is no available treatment known to improve survival if begun early, only experimental things which may actually do more harm than good.* The advantage of medical care in the US rather than Liberia is not that we have better Tylenol or IV fluids that make you better 3 days from now, it is that when the IV fluids are not enough you can give medicines that support the blood pressure, that when the kidneys fail you can use dialysis, that when the lungs fail you can be put on a respirator, all of those things which give a better chance of hanging on.

    *You have drugs that have gone through years of testing and get FDA approval, only to have some side effects then show up, all the lawyers get rich, and the drug is taken off of the market. People like to have it both ways, blame drug companies for selling unsafe drugs and then expect them to give something out when it hasn’t even been tested yet.

    MD in Philly (f9371b)

  21. MD, your comment about the post and not worth responding to and that to try to reason with such people would be like deprograming a cult member made me think of this: I listened to Laurie Garrett, Senior Fellow for Global Health Council on Foreign Relations on NPR today. She was discussing Ebola and commented on the similarities between HIV and Ebola, looking at them as stigma-inducing. This is a paraphrase of her comments:

    It’s like HIV in a number of ways…as HIV got tied up with stigma against homosexuals and now Ebola has its own stigma against black people. Liberians are at the same risk with their neighboring countries, therefore we should keep all Africans out or build a wall around the continent to keep them out sort of approach. It could become the sort of situation where everybody with black skin is being pulled aside at airports and having special tests done to them. And all of this could have terrible ramifications for them, much as Ryan White’s house was burned down for the crime of being a hemophiliac who had a contaminated blood transfusion. And he was 7 years old.

    She believes that blacks stand to be singled out if Ebola spreads and they will experience the same isolation and discrimination that HIV sufferers once endured.

    Your comment made me think of this because while these are three individuals who are making ridiculous assertions in the post, I wonder how widespread and pervasive that thinking is? In light of the post, it’s of concern because if Ebola spreads, would our leaders become more concerned about the possible exclusion of a group of people (even if it is reasonable due to fear of Ebola, not color of skin) and would our leaders use their power to stifle reactions thus losing focus (implying they are focused on the essentials) on what is really important in the fight against the virus, all for the sake of making sure groups of people are not met with fear and hostility? After all, fear makes people behave very badly.

    Dana (4dbf62)

  22. I missed it, nk, what did he propose?
    Dana (4dbf62) — 10/10/2014 @ 6:37 pm

    Shooting ebola sufferers the minute they get off the plane.

    I know, I know.

    nk (dbc370)

  23. Yikes!

    Dana (4dbf62)

  24. the house burning happened to those three little kids in Florida what got AIDS kinda like how Mr. White got it cause of they had the hemophilia

    happyfeet (a785d5)

  25. she was relatively clear headed when she wrote the emerging plagues, Ryan White was infected, because there was no containment of the blood supply, a relevant quote:

    You don’t like terrorists? Try negotiating with a virus. A virus exists only to find a carrier and reproduce. That’s all it does and it does it quickly. It has no political views, it has no religious beliefs, it has no cultural hang-ups. And it has no respect for a badge. It has no concept of time or geography. It might as well be the Middle Ages, except for the convenience of hitching a ride on a metal tube flying from meal to meal to meal. That’s how a plague begins. So you still want to be the first one through the door?

    narciso (ee1f88)

  26. Dana,
    Thanks for listening to NPR (I guess) so I don’t have to.
    Years ago in a brief period of time I heard them tells lies about JC Watts, Miguel Estrada, and Charles Pickering, and decided I would listen to them no more.

    You are correct in suggesting that something does need to be said lest the craziness take over.

    The problem is, I think, that the time to have said something has been the last 40 years and not playing to the race-hustler band wagon as has been made worse by our President these last 6 years. The attitudes have been planted, watered, and fertilized and are blooming, soon to bear fruit.

    From my experience, there are times when some feel as if some patients are not worth their efforts, but I have never seen it because of race. It is because people have been so abusive and irresponsible with their own lives that people think, “Heck, they never cared about their life, why should I work harder to keep him/her alive than they were willing to?” I DO NOT say that as if I think it is justified, I don’t, but if one wants to be truthful, that has been my experience. Are there some people who would include race in such a calculation? It’s a country of 300 million people, some of them downright evil, so I assume there are some, but by no means is it the norm.

    MD in Philly (f9371b)

  27. I enjoy some of NPR’s offerings, MD. Lots of interesting stuff. Of course, one is wise to have their ears open and listen carefully (politics), but Science Friday is usually pretty interseting.

    My point is, that as you say, these unfortunate and destructive attitudes have been planted, watered, and fertilized and are blooming, soon to bear fruit, thus the potential for disaster between Ebola spreading and some racial polarization is real. And while this administration holds office, it makes it of more concern.

    Dana (4dbf62)

  28. Jesse Jetstream in another episode of his endless quest to demonstrate he’s not out to pasture. Wake me when its over.

    Every country has its vices and pathologies. Its distressing how readily Duncan’s relatives have absorbed some of those ambient here. The sheer gracelessness of their remarks astounds.

    One thing you can pray for is the presence of mind and the patience not to make a complete ass of yourself when the going is rough.

    Art Deco (ee8de5)

  29. You think Duncan’s relatives picked up their aggressive panhandler mentality in Texas, Art Deco? Seriously?

    nk (dbc370)

  30. Dana, I’m happy for you to enjoy aspects of it, but for me:
    1) If I already don’t know the subject, even if science and math, I will remember that they can’t be trusted
    2) If I already know the subject, there is no reason to listen
    If nothing else, the 4th type of lie, deceit by omission, can be eagerly applied with science as well as politics.

    Otherwise, yes, I think we agree that it is a mess with potential to get much worse.
    I did say originally that I would like to just ignore some things,
    but, yes, too often ignoring things just allows them to flourish.

    MD in Philly (f9371b)

  31. Personally, I am opposed to a horrific bleeding death much more than people accusing me of racism. Of course the former is less likely than the latter. I hope.

    Ag80 (eb6ffa)

  32. In the 1940′s, I. F. Stone, a “progressive” New York city editor/publisher, said ; “I have complete confidence in the veracity of the stories reported in the newspapers – except for those of which I have direct personal knowledge – those I find to be horribly wrong.”

    I believe that should apply to all media outlets. If journalists do a poor job on what you do know, how can you trust them on what you don’t know?

    Who can you trust? No one?

    Tanny O'Haley (066e8f)

  33. If you check my suggestion NK referred to you’ll see it was applied equally toward the Doctor.

    So I’m insane but not a rasccccist.

    papertiger (c2d6da)

  34. In that wee bit of time between Duncan’s arrival and expiration, I feared the liberals would try and puff the guy up into a human interest hero, overcoming great odds in the quest for survival, and thus encourage other self serving Typhoid Mary’s to make the trip.

    Thank you Thomas, for checking out early before the NYTimes editorial team could get the copy to print.

    papertiger (c2d6da)

  35. Tanny,
    I never saw that quote that I can remember, thanks.
    It predates the Murray Gell-Mann Amnesia Effect, which I am more familiar with, often refer to/quote, and which I have first hand knowledge of on several occasions:
    http://www.patheos.com/blogs/geneveith/2011/08/the-murray-gell-mann-amnesia-effect/

    MD in Philly (f9371b)

  36. As an aside, when I searched for that, I found all kind of links that talk about it, but a link to the original Crichton essay was not in at least the first two pages of results. Is that just how the algorithm of Google works, or is there a way to “cut to the chase”? Are there any search engines that are different? I tried duckduckgo a bit and didn’t find it any better.

    MD in Philly (f9371b)

  37. duckduckgo is a flea market (factory seconds) product of Google. I gave up on it. There are many reasons an original essay may not have been entered into a database. From nobody bothered to put it into electronic form, to copyright restrictions, to deliberate suppression*.

    Try finding Edgar Wallace’s “The Canker in Our Midst”, an essay about pedophilia in the theatrical industry. You won’t. You will find critiques of it and even a Trojan Horse parody but not the essay itself.

    nk (dbc370)

  38. You think Duncan’s relatives picked up their aggressive panhandler mentality in Texas, Art Deco? Seriously?

    I have no reason to believe that poor countries with a large peasant population and with much of the town population scrabbling for a bare living in the informal economy inculcate an ‘aggressive panhandler’s’ mentality. There is not much to panhandle in Liberia and hard luck stories which are unusual and poignant here amount to mundane life there. See Theodore Dalrymple on some signatures of African societies as he knew them in Rhodesia and also among African immigrants in London. ‘Aggressive panhandling’ is not a salient element of these stories.

    Art Deco (ee8de5)

  39. MD,

    Thank you for the link on the Murray Gell-Mann Amnesia Effect. I also like the Mark Twain quote.

    “If you don’t read the newspaper, you’re uninformed. If you read the newspaper, you’re mis-informed.”

    Tanny O'Haley (066e8f)

  40. well Liberia wasn’t that bad off, till the scourge that began with Samuel Doe and continued through Charles Taylor, ravaged the country like a plague of locusts,

    narciso (ee1f88)

  41. well Liberia wasn’t that bad off, till the scourge that began with Samuel Doe and continued through Charles Taylor, ravaged the country like a plague of locusts,

    I used to know a schoolteacher in Rochester who lived there from 1961 to about 1966. “Salad days”, he said. Reinhold Niebuhr called the Americo-Liberians an ‘uncreative aristocracy’ and the True Whig Party was a monopolistic political machine, but the country was at peace, and, relative to the advanced industrial countries, much more affluent than it is today. William Tolbert during his time in office was making an effort to incorporate the ‘country people’ into the civil service as well.

    Art Deco (ee8de5)

  42. Tanny O’Haley (066e8f) — 10/11/2014 @ 7:30 am
    Indeed, that’s a good one to remember also.
    Seems true no matter which technological era, newspaper, radio, TV, internet.

    MD in Philly (f9371b)

  43. I wanted more detail on Jesse’s visit with Duncan’s family. Did they have a group hug and a good cry?
    When they kissed Jesse’s ring, was it covered with a hospital glove?

    How about when Thomas showed up at the door. Where they overjoyed by the happy surprise of reunion?
    Hugs and kisses for everybody? Or did they treat him like the plague, because they knew exactly where he came from, and why he was there?

    papertiger (c2d6da)

  44. So the FDA didn’t receive the hospital’s request to use experimental treatment until Oct 3, which was approved within a matter of hours. Duncan was admitted on Sept. 28. That’s a pretty significant timegap, with some saying the hospital had to be pressured by the family to do that. It took 5 days to even decide to request the use of the drugs.

    Contrasted with all the other US Ebola patients receiving experimental treatment on their first day of admission means something. I’m not sure it means racism though. It could just be a reflection of the unpreparedness (a more appropriate word might be “incompetence”) of our healthcare system in general.

    Chris (0ba377)

  45. If I were you, Chris, I’d write Jesse Jackson a check right this minute.

    nk (dbc370)

  46. Chris – there are about 738364849 differences between this situation and the prior case in the US. Most noticably, one did not lie about his status and exposure. Tiny details.

    JD (bc2e39)

  47. “That’s a pretty significant timegap, with some saying …”

    You have no idea if that is a pretty significant timegap, your are stating your asspull as fact.
    And the some saying part is classic passive aggressive mendacity. Some people say all sorts of things, doesn’t make it true, or even relevant. The family that is being advised by Jesse Jackson is not a stellar example of the “some” you are quoting.

    JD (bc2e39)

  48. Just how much faith do you put in your local hospital to treat you properly and try to save your life should you find yourself stricken with this disease? Would their response mirror Emory’s response, or Texas Presby’ response? Then try to figure out why.

    Chris (0ba377)

  49. Then try to figure out why.

    I already have. It’s because our health care system is broken and we need a national single payer system run by Rainbow-PUSH.

    nk (dbc370)

  50. Besides, Jesse Jackson’s mistress’s mink coat is getting out of fashion and she’s been demanding a sable if he wants to keep on getting that little something extra.

    nk (dbc370)

  51. “Contrasted with all the other US Ebola patients receiving experimental treatment on their first day of admission means something.”

    Chris – What experimental treatment did those other patients receive and was it available to Duncan?

    daleyrocks (bf33e9)

  52. Of course it’s broken, way too many layers of bureaucracy and middle managers to be effective. No doubt. And you’re right about another thing. I’ve always said we need single payer healthcare, where the patient is the one person responsible for his or her own care.

    The question remains: which response would your local hospital more closely resemble? Emory’s or Texas Presbyterian’s? Would your hospital wait five days to request use of potentially life saving drugs and would you be ok with that?

    Chris (0ba377)

  53. Good News

    looks like we’ll have another case to compare & contrast with Duncan’s….

    oh, and Clay Jenkins is a mendoucheous twatwaffle… he’s quoted as saying:

    “You cannot contract it by walking by people on the streets,” he said. “There is nothing about this case that changes that basic premise of science

    yet the state response seems to indicate otherwise:

    Dallas Mayor Mike Rawlings said the Dallas Fire Department’s rescue hazmat team has decontaminated any open areas of the health care worker’s apartment complex.

    “Police are standing by to make sure no one enters that apartment complex,” he said.

    Rawlings said officials have knocked on every door within a block of the apartment and have spoken with every person that came to the door. Reverse 911 calls have been made to residents within four blocks of the apartment complex and printed materials have been left at each door, he said.

    my favorite part, as a healthcare w*rker myself, was this:

    Dr. Daniel Varga, of the Texas Health Resource, said the worker was in full protective gear when they provided care to Duncan during his second visit to the hospital.

    yeah, nothing to see here, and no reason to worry.

    idiots.

    redc1c4 (589173)

  54. Hell, Chris, half the time you’re lucky if the anesthesiologist does not stick the oxygen tube down your esophagus instead of your larynx. Do not attribute to malice that which can be accounted for by incompetence. Did you know that George Washington’s doctor bled him to death?

    nk (dbc370)

  55. 51. daleyrocks, two of the US patients received Zmapp, another received TKM-Ebola, and Duncan received brincidofovir (sp). All of the treatments must receive FDA approval, and that’s not in dispute. What is in dispute is why the hospital chose not to seek approval for any of them for DAYS after the patient was admitted. And that leads me to ask, how would your hospital respond in similar circumstances? Would you accept that it’s SOP for you to lay in a hospital bed for 5 days with a potentially fatal condition before treatment was administered?

    Chris (0ba377)

  56. Whom are you working for, Chris? Jesse Jackson or the Duncan family’s med mal lawyer.

    nk (dbc370)

  57. 54. nk, did you not read my inital post? I think incompetence was the salient point.

    Chris (0ba377)

  58. You’re all making excuses and trying to rationalize why Duncan didn’t receive experimental treatments for a solid week while under the hospital’s care. Why are you doing that, instead of addressing the WHY it happened and how you would prevent the same from happening to you?

    Chris (0ba377)

  59. You can load your shotgun with anything you want, incompetence or malice, but tell us what you are hunting for.

    nk (dbc370)

  60. Why are you doing that, instead of addressing the WHY it happened and how you would prevent the same from happening to you?

    My plan it to form The PULL Coalition, get tens of millions in government handouts, give myself a big fat salary, and fly to Switzerland whenever I needed medical care.

    nk (dbc370)

  61. Different doctors, different case, different clinical judgment, different drugs in the supply chain. Why is this sinister? The medications in question are all of uncertain utility and all medications are poisons to some degree.

    Art Deco (ee8de5)

  62. 51. daleyrocks, two of the US patients received Zmapp, another received TKM-Ebola, and Duncan received brincidofovir (sp).

    Chris – There was no more supply of Zmapp so that treatment was out. I know nothing about TKM-Ebola or whether its use had been considered successful. Was it?

    daleyrocks (bf33e9)

  63. A second case of Ebola is now confirmed in Dallas. The health care worker is said to have been in the proper outfit while treating Duncan, so this should be quite a surprise. Of course the CDC asserts that the victim “breach[ed] protocol”. This is without any evidence other that the fact that they contracted the disease. The family of the worker is in seclusion, the public areas in the apartment building occupied by the worker are being decontaminated by the Dallas Health authorities (presumably without pressure washers), the apartment and its contents are being decontaminated, and everyone within four blocks, who was also home at the right time, has been contacted and encouraged to watch their temperatures for the next 21 days. So everything is just fine.

    Meanwhile Doctor Aileen Marty recently returned from 31 days in Nigeria and she reported that she was not interviewed on her flight back to the U. S., which included a landing in Germany. Dr. Marty had a number of suggestions including skipping hand shakes which I found interesting. When she got back to her house, she took all her clothes and washed them outside the house in strong bleach before letting anything into the house. She monitors herself daily, and I’m sure she’s counting the days before she can be assured that she hasn’t endangered her friends and family.

    I hope General Rodriguez (WESTCOM) is paying attention to this. He’s got 3000 or 4000 troops in Liberia now (he wasn’t too sure about the number in the interview I saw) and they will all need the full bleach treatment. And it would be a good idea to quarantine them for 21 days when they return before they are allowed to see their families.

    bobathome (2aebbb)

  64. Yes. The CDC says there was obviously a “breach of protocol” that allowed Duncan’s health worker to become infected (even though that person was said to have been using full protective gear) , but they cannot say what that breach was, or when/how it occurred. How convenient to blame a vague breach of protocol rather than admit they have no clue how this virus is actually being transmitted or what strange and new adaptations it may be undergoing. What a mess.

    elissa (45dbad)

  65. You’ll recall that Dr. Kent Brantley, the American doctor who contracted the disease in Liberia and has fully recovered (we hope) was also wearing full protective gear while treating ebola patients there and was personally highly experienced with ebola. Did he also contract it via a “breach of protocol”? Maybe, but that just seems highly unlikely to me.

    elissa (45dbad)

  66. In the grand tradition of Josef Mengele our DearLeader is sending 3000 or 4000 guinea pigs under the command of General Rodriguez into West Africa to test the “protocols” that the CDC thinks are so effective. Isn’t it wonderful to live in an age where everything known to our predecessors can be ignored and all we have to do is follow the pure light of “government science” which invariably confirms that our good intentions are all that is needed.

    bobathome (2aebbb)

  67. A second case of Ebola is now confirmed in Dallas. The health care worker is said to have been in the proper outfit while treating Duncan, so this should be quite a surprise.

    The mean incubation period for Ebola is six or seven days. Duncan was put into isolation on the 28th of September. In the 14 days intervening, the number of people he infected between the 19th and the 28th of September is still holding at zero. The other people in his household were quarantined on 3 October. The number of people infected by this crew between the 19th of September and the 3d of October is still holding at zero. The hazmat crew completed their work on the family apartment on 8 October. No one is yet infected.

    Art Deco (ee8de5)

  68. One of my favorite movies is “The Andromeda Strain,” based on a 1970s novel by Michael Crichton about a very deadly microbe (which causes human blood to turn to powder) embedded in a NASA craft returned from deep space. There are scenes where the characters are in a very elaborate, secretive high-security underground germ warfare facility and going through decontamination. The protocol depicted there of how protective outerwear should be handled would be the only one I’d have most confidence in. IOW, it’s likely the nurse in Texas got infected during the process of removing her isolation suit.

    Mark (c160ec)

  69. I denounce myself. But then I didn’t vote for the guy who’s last name can be turned into an Ebola joke with only minor tweaking.

    Just try to do the same thing with “Romney.” It can’t be done.

    Steve57 (e409e4)

  70. elissa – The system worked except when it didn’t. Nothing to see there.

    daleyrocks (bf33e9)

  71. #36, Doc: I am transitioning into Windows 8.1 and as part of the deal, I find that Bing is my search engine. It is terrible. Quite often to navigate to a new page I just type the url of the desired website. With my explorer in it’s default configuration, I find that typing in the url windon generates a pulldown list of targets. If I click on one of the pulldowns, I’m directed not to the website but to the Bing search page, where the url is again displayed. I expect that if I click on that link, then Bing gets a few cents from the target. So I no longer use the pulldown, I just press Enter. And when I do use Bing to research something, it is much worse than Google. Nothing but commercial sites that are nothing more than intermediate search engines for several pages.

    bobathome (2aebbb)

  72. Oh, daleyrocks, my bad. I did not realize Janet Napolitano was in charge of the CDC.

    elissa (45dbad)

  73. Chris – lay out all of the salient differences between the doctors that contracted Ebola elsewhere, and the patient that lied about it before entering America. Go.

    JD (bc2e39)

  74. It is cute how Chris thinks we would be better equipped to handle this, and the liar would have received better care under single payer. It is also cute how he thinks that single payer would be more efficient with less “middle managers” under single payer. Care to document and quantify that for us?

    JD (bc2e39)

  75. I just found this quote from Dr. Friedan of the CDC:

    “We’re deeply concerned about this new development … I think the fact that we don’t know of a breach in protocol is concerning because clearly there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients.”

    Which is to say that the “protocol” is supposed to prevent the spread of the disease, and since this nurse got the disease, she didn’t follow protocol. Good intentions are all that matters … and a willingness to lie whenever it makes you feel better.

    bobathome (2aebbb)

  76. It could be the nurse that’s lying.

    nk (dbc370)

  77. If you google “tautology” you’ll come up with a picture of Dr. Friedan.

    Steve57 (e409e4)

  78. ==It could be the nurse that’s lying.==

    You typed that with a straight face, right, nk?

    elissa (45dbad)

  79. breech of protocol, defective protective gear, unknown mechanism of transmission…

    a quarantine would have avoided all these possibilities. you can’t spread what isn’t there.

    redc1c4 (a6e73d)

  80. If we had a UK-like health care system, we would no doubt be employing the Monrovia Care Pathway for all suspected Ebola cases. Basically dehydration, kidney failure, starvation, death. This the humane progressive solution to all sorts of difficult situations that otherwise require expensive care. Once the patient falls into a coma, they do appear to be at peace and reconciled to their fate. Just don’t let them call 911 before they become comatose. This could lead to some embarrassment when the ME declares cause of death as dehydration 8 hours later.

    bobathome (2aebbb)

  81. 74. JD: They’re all human beings, they were all confirmed to have Ebola, and they were all under the care of the US healthcare system. All but one of these humans received experimental treatments immediately after diagnosis. All but one of these humans lived. What differences between them are you suggesting are critical to the outcome?

    Chris (0ba377)

  82. “Oh, daleyrocks, my bad. I did not realize Janet Napolitano was in charge of the CDC.”

    elissa – Oh no, I was referring to our world class health care system which was not world class when President Blameshifter took office so he had to break and fundamentally transform it or something but now it is apparently world class according to what he said Friday and we have an all-hands-on-deck approach to dealing with this national security threat which is just behind golf, fundraising, global warming, pivoting to jobs for the 19th time, gun control, unilaterally changing the status of illegal immigrants, pay equity, and ISIS on his list of priorities:

    “Because of the measures that we’ve put in place, as well as our world-class health system and the nature of the Ebola virus itself – which is difficult to transmit – the chance of an Ebola outbreak in the United States is extremely low.”

    daleyrocks (bf33e9)

  83. 62. daleyrocks: Seeing as how Duncan is the only one to die, it would appear the TKM-Ebola treatment was successful (administered to Dr. Sucra).

    Chris (0ba377)

  84. “All but one of these humans received experimental treatments immediately after diagnosis.”

    Chris – Brantley was diagnosed with Ebola in Africa. When did he receive Zmapp?

    daleyrocks (bf33e9)

  85. “62. daleyrocks: Seeing as how Duncan is the only one to die, it would appear the TKM-Ebola treatment was successful (administered to Dr. Sucra).”

    Chris – Sure. That must be the only reason. Go with that.

    daleyrocks (bf33e9)

  86. 75. JD: apparently you’re not even reading the entirety of my posts at face value, nevermind any subtle snark they may contain.

    Chris (0ba377)

  87. 86. Daleyrocks. You asked whether the treatment was effective. I answered. Now what “reason” to what problem are you suggesting I apply this to?

    Chris (0ba377)

  88. 85. Daleyrocks: If I recall, zmapp was sent to Africa as soon as his and Whitebol’s diagnoses were confirmed.

    Chris (0ba377)

  89. 59. nk: what am I hunting for? At this point, it’s a survey of all of you to see which excuse most satisfies you as to why you’ll have to wait 5-6 days in a hospital for potentially life-saving treatment. Because obviously you’re all OK with that delay in certain circumstances.

    Chris (0ba377)

  90. anyone stupid enough to think “single payor” healthcare is a good idea hasn’t been paying attention to the VA scandal or has never been to a county hospital, let alone a military one.

    i had a “doctor” rule out phlebitis in my leg one year, simply because sending me into town to a real hospital, where they could do the definitive test to rule it out, vice cellulitis, because it would have cost the Army money to do so.

    instead, he gave me a sub-clinical dose of erythromycin, which, BTW, makes you more sensitive to sunburn (think high desert, August, in the field) and sent me back to the dirt.

    when i got back to civilization 10 days later, the FIRST thing Kaiser did was test for clots, then put me on massive antibiotics. because the quack had been teasing the bug, it took two courses of therapy to eliminate the infection…

    anyone with an IQ larger than their hat size pushing single payor is thinking they will be part of the privileged class that will not be in line with the masses.

    either that or they’re just not thinking.

    redc1c4 (a6e73d)

  91. #90, Chris: A little work (a tiny tiny bit of work) will lead you to any number of stories about the difficulty of manufacturing additional ZMapp. Here’s one. They used all of their supplies for the first two patients who were treated at Emory. Currently, they have two projects underway to make additional supplies, one using tobacco leafs, and the second a first attempt at growing cell cultures that will manufacture the drug. There are other experimental drugs, but ZMapp seems to be the one that worked. Duncan’s misfortune was that the ER released him when he first exhibited symptoms and told the nurse that he had been to Liberia recently. That is inexcusable, but it is not a conspiracy. And it pales when compared to standard operating procedure in the UK, where designated classes of patients are assigned the Liverpool Care Pathway route to an early death.

    bobathome (2aebbb)

  92. 91. Red: my definition of single payer = only one person is responsible for his care: himself. What’s your definition?

    Chris (0ba377)

  93. 92. Bob: Zmapp is not the only experimental treatment. An itsy-bitsy teeny tiny little bit of work would reveal that to anyone with an internet connection.

    Chris (0ba377)

  94. There’s just one problem with your brutal, insightful take-down of bob.

    He beat you to the punch.

    92. …There are other experimental drugs, but ZMapp seems to be the one that worked.

    bobathome (2aebbb) — 10/12/2014 @ 10:43 am

    I suppose you were too busy being witty to notice that.

    Steve57 (e409e4)

  95. I suppose you were too busy trying to be witty to notice that.

    FTFY! 😎

    redc1c4 (a6e73d)

  96. What’s your definition?

    the one used in the healthcare industry, of course…

    redc1c4 (a6e73d)

  97. 95. Steve: I guess that explains why Dr. Sucra survived Ebola using the experimental treatment TMK-Ebola.

    Or, why 12 of 15 people in Africa survived after being treated with an HIV drug.

    Or, why numerous others have improved or survived with antibody transfusions.

    So I take it now that “They’re all out of ZMapp” is an acceptable excuse as to why you or Red will have to wait 5-6 days for treatment if you are stricken with this disease.

    Chris (0ba377)

  98. Chris – Read my link below. Brantley got Zmapp nine days after diagnosis, Whitebol a similar period. Sacra also received experimental treatment after being flown to Nebraska after diagnosis in Africa, directly contradicting your assertions in #82. Five of the seven patients receiving Zmapp have survived.

    The first person known to have been diagnosed with the disease on U.S. soil, Thomas Duncan, is receiving a drug called Brincidofovir, according to his nephew Joe Weeks. So is the second Ebola patient to be treated in The Nebraska Medical Center’s Biocontainment Unit, freelance cameraman Ashoka Mukpo.

    “After looking at the data on this drug, collaborating with the CDC and FDA and speaking with the patient and his family, we decided this was currently our best option for treatment,” Dr. Phil Smith, medical director of the Biocontainment Unit, said in a statement Tuesday. “Every patient is somewhat different, and we believe Brincidofovir is the best choice.”

    The biopharmaceutical company Chimerix got approval from the FDA for emergency use of Brincidofovir on Duncan on Friday.

    The Friday mentioned directly above is October 3, five days after Duncan was admitted to the hospital. Other patients in fact received experimental drugs later than Duncan, not sooner after diagnosis. Your thesis is completely wrong.

    daleyrocks (bf33e9)

  99. Or, why 12 of 15 people in Africa survived after being treated with an HIV drug.

    Does the term ‘multi-causal explanation’ mean anything to you?

    Art Deco (ee8de5)

  100. 98. …So I take it now that “They’re all out of ZMapp” is an acceptable excuse as to why you or Red will have to wait 5-6 days for treatment if you are stricken with this disease.
    Chris (0ba377) — 10/12/2014 @ 11:05 am

    The above perfectly encapsulates your lame attempts to make some sort of connection where none exists.

    Now, if you’re not getting ZMapp, you’re not being treated for Ebola.

    Not quite.

    Steve57 (e409e4)

  101. Chris, whether you know it or not, or meant it or not, there is a sense that you have suggested some malevolent intent about the way Mr. Duncan was treated.
    I find that revolting and disgusting if that is the case, and totally unwarranted and uncalled for. I am withholding judgment on that, assuming the possibility that you truly are interested to know and understand, though I could go through my reasons to doubt that.

    Some have already made helpful responses (and some have commented about their search engine wows as well, thank you).

    There are multiple reasons why there has been a difference that I can think of without elaborate research:
    1) The individuals involved (and not malevolence).
    A) It is my understanding is that it was Franklin Graham, head of the organization that Brantley worked under, who decided “to do whatever he could” to help those who worked under him, that made the push to obtain and use ZMapp. I doubt if anyone in the development and supply line of the drug, nor government officials, would have suggested use of the drug as it was “not ready for prime time”. But someone who was who was knowledgeable, understood the risks, and in a desperate situation came knocking down their door to get it.
    B) Researchers generally have a “research” ethos. They are interested in designing trials, getting data, and working by protocols. They are distant from the care of people. I could go on about this as a separate phenomenon of our age of materialism and assembly-line technology, the immediate act is divorced from the end goal and people do not keep the end goal in mind, in this case, treating people with illness to make them better. By nature, these folk are not looking for someone to try their drug on outside of a standard protocol. Hence, the importance of Brantley’s non-researcher boss advocating for him.
    C) Doctors generally have a “do it as proven” ethos. Some of this is good, as in wanting to not cause harm, some of it is CYA, as if you do something like everyone else does, you can’t be blamed too much if it doesn’t work. So again, rarely is a doc going to advocate for something new and unproven unless it is within a carefully designed protocol. (More about his later.) Again, the importance of a non-doctor boss advocating for Brantley.
    D) After those points are considered, then you have the individual physicians involved and who is likely to “look at a glass as half-full” and those who are likely to “look at it as half-empty”, “what have we got to lose” vs. “what do we have to gain”. No right or wrong answers there.
    2) The difference between the access to the “first line” experimental drug as opposed to the “second line” experimental drug. For whatever combination of reasons that I have not researched, ZMapp was the drug that was first chosen/became available for use. (I assume this was some combination of expected safety, expected efficacy, and availability). Once the ZMapp was used up, then there is a new calculation of cost-benefit analysis.
    First, one must realize that in the setting of unknown risk of treatment and unknown potential to do good, the best case scenario would be to withhold treatment initially and hope that Duncan was one of the 50% or so that would be expected to survive (with this strain of virus) without any specific treatment whatsoever, so even if the drug was sitting in the cabinet in his room, there would have been initial reluctance to use it.
    Second, my assumption, and likely the assumption of those involved in Mr. Duncan’s care, is that the same people complaining about his not getting an experimental treatment sooner would have also been the first people complaining had he been given an experimental treatment early with evidence significant of major side effect doing harm. In the calculation of “Do we want to catch hell for trying something risky?” or “Do we want to catch hell for doing what is the standard of care?”, most people who are risk averse, and their hospital legal counsel, would pick the latter.

    Those are some initial reasons to consider without assuming malevolence or ineptness, and it has taken me almost a half hour to get it out with my “skills”.

    MD in Philly (f9371b)

  102. Two of Chris’s comments:

    51. daleyrocks, two of the US patients received Zmapp, another received TKM-Ebola, and Duncan received brincidofovir (sp). All of the treatments must receive FDA approval, and that’s not in dispute. What is in dispute is why the hospital chose not to seek approval for any of them for DAYS after the patient was admitted. And that leads me to ask, how would your hospital respond in similar circumstances? Would you accept that it’s SOP for you to lay in a hospital bed for 5 days with a potentially fatal condition before treatment was administered?

    74. JD: They’re all human beings, they were all confirmed to have Ebola, and they were all under the care of the US healthcare system. All but one of these humans received experimental treatments immediately after diagnosis. All but one of these humans lived. What differences between them are you suggesting are critical to the outcome?

    My understanding of the reports is that — as bobathome said — there is no more ZMapp supply, which is why it wasn’t available for Duncan, or for Dr. Richard Sacra, the third US ebola victim who was successfully treated in Nebraska with TKM-Ebola, or for Ashoko Mukpo, the reporter and ebola victim being treated in Nebraska. Brincidofovir, the drug used on Duncan, is the same drug they are using on Ashoko Mukpo in Nebraska.

    I’m not sure you’re right when you claim that Texas Presbyterian Hospital did nothing for 5 days. According to this Reuter’s report, there are limited choices and Duncan was sicker than the other ebola patients, so that limited their choices even more. The report says Duncan’s family was informed about and aware of the experimental choices. We don’t know for sure because of privacy laws, but I’m sure the hospital was evaluating and conducting tests during the first days of Duncan’s treatment. It’s possible the doctors recommended and/or the family initially chose to go with supportive care because of the risks of the available treatments.

    This USA Today report addresses your concerns about the hospital’s choice of brincidofovir. The report quotes Thomas Geisbert, who helped develop TKM-Ebola, who claims brincidofovir works in the lab but not in animals tests. On the other hand, Duncan’s medical condition may have been so bad by the time he was admitted that it was too dangerous to try the only other experimental drug, TKM-Ebola:

    With no proven way to fight Ebola, doctors have to weigh a number of factors when choosing an experimental drug, including its potential to cause side effects in critically ill patients, said Amesh Adalja, an infectious disease specialist at the University of Pittsburgh Medical Center.

    Adalja notes that the Food and Drug Adminstration put a temporary hold on clinical trials of TKM-Ebola earlier this year in order to investigate the flu-like symptoms that some patients experienced as side effects. It’s possible that Duncan’s doctors considered these side effects and considered them too risky for someone on a ventilator who’s already on the “edge of death,” Adalja said.

    As for a delay in treatment, isn’t it possible the reason the hospitals in Atlanta and Nebraska were able to start treatment quicker could be because — unlike Duncan in Dallas — they knew they were receiving ebola patients in advance? I suspect those hospitals had already started the lab tests on the ebola patient’s blood samples, so they were ready to start treatment faster.

    Finally, I have to echo bobathome’s comment. Duncan’s release by the Texas Presbyterian ER seems incompetent at best, and I share your concerns. The Texas Presbyterian doctors were undoubtedly talking to their counterparts at the CDC, but I still wonder if they could have given Duncan a blood transfusion from a survivor like Brantly. (It could be that there were no compatible blood donors who had survived ebola in the US. If so, Duncan might have actually been better off staying in Liberia.) I also wonder why they didn’t try to move Duncan to Atlanta, where they have more experience, since no American doctors have experience with ebola. But every ER in the country and the world, including in your single-payer utopia, would have faced these questions and problems.

    DRJ (a83b8b)

  103. Chris, please, please, please, please,
    go into the practice of medicine yourself if you want to try irrational and unscientific treatments for diseases (lamivudine for Ebola).
    PLEASE!!!
    and shut up otherwise,
    please, shut up.

    MD in Philly (f9371b)

  104. Chris is the sort of genius who drives up the costs of healthcare, along with the morbidity and mortality rates.

    redc1c4 (2b3c9e)

  105. Chris, whether you know it or not, or meant it or not, there is a sense that you have suggested some malevolent intent about the way Mr. Duncan was treated.

    He means precisely that. And it’s silly and asinine.

    The physician I’m best acquainted put it this way: “You know there’s an x% chance that this drug will induce x% improvement in this patient; you also know that it’s more-likely-than-not to produce no improvement at all” (and may have ill effects). These sorts of things are judgment calls, quite apart from the uncertainty that’s going to attend a deficit of experience with this particular ailment.

    Chris talks like neither he nor anyone in his family ever had a perplexing medical problem.

    Art Deco (ee8de5)

  106. “Not quite. Writebol and Brantly received both transfusions and Zmapp in Africa, and then again in the US.”

    Chris – Not quite. The science mag link says Writebol got Zmapp in Africa, but not when relative to diagnosis. My point stands. The CNN link I provided states Brantly did not receive Zmapp until nine days after diagnosis which is not contradicted by any of your links.

    daleyrocks (bf33e9)

  107. “95. Steve: I guess that explains why Dr. Sucra survived Ebola using the experimental treatment TMK-Ebola.”

    Chris – The transfusions from Dr. Brantly may have helped. You have not mentioned those. BTW, it is Dr. Sacra, not Sucra.

    daleyrocks (bf33e9)

  108. Chris talks like neither he nor anyone in his family ever had a perplexing medical problem.

    If you already know it all, no problem can be perplexing, silly.

    Steve57 (e409e4)

  109. The transfusions from Dr. Brantly may have helped.

    Or any one of a myriad of unobserved factors.

    Art Deco (ee8de5)

  110. Chris doesn’t have the stones to call everyone racist. So he tap dances around it. Dropping hints. Implying that race had something to do with it. He is a passive aggressive Beta or Charlie troll.

    JD (bc2e39)

  111. That was presumptuous of me. Chris could be a he, she, or it.

    JD (bc2e39)

  112. Chris could be a he, she, or it.

    which is easily addressed by using the phrasing “s/he/it”…

    😎

    redc1c4 (2b3c9e)

  113. “Chris doesn’t have the stones to call everyone racist.”

    JD – Chris also does not read his own links.

    daleyrocks (bf33e9)

  114. Well here we go. My whole point was that there are many experimental treatments out there (transfusions and various drugs), and was appalled to learn that Duncan was not receiving any of them 5 days into his hospitalization. My assumptions included the belief that all others treated by US healthcare were treated with one or more of these fairly quickly after diagnosis. Another assumption included the belief that our more advanced US healthcare system is “well-prepared” to act quickly and expertly to treat this disease. Both assumptions were wrong, and I quickly allowed my “well-prepared” belief to be replaced with “incompetence of the system” in the ensuing discussion, but that does not change my reaction (appalled) at the delay of any experimental treatment, and would hope such delay is not experienced by myself or my loved ones should we become exposed.

    So there you go. Rag all you want, but I was wrong and just admitted it publicly.

    Chris (0ba377)

  115. My whole point was

    Your whole point is to impugn the motives of people making clinical judgments when you do not know the content of the patient’s medical files from bingo, or what they had available in the hospital pharmacy, or the skill set of the manpower on site, or anything of baseline factors (e.g. the patient’s general state of health). Just shut up.

    Art Deco (ee8de5)

  116. Wait, Art. Don’t go just yet, you missed this nice juicy, albeit small bit of flesh dangling off my left thigh. You better get it quick before someone else beats you to it.

    Chris (0ba377)

  117. Thanks Chris

    daleyrocks (bf33e9)


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