Patterico's Pontifications

10/15/2014

Second Health Care Worker Tests Positive for Ebola in Dallas

Filed under: General — Patterico @ 6:29 am



The Texas Department of State Health Services has announced in a press release that a second health care worker has tested positive for Ebola in Dallas:

A second health care worker at Texas Health Presbyterian Hospital who provided care for the first Ebola patient diagnosed in the United States has tested positive for the disease.

The health care worker reported a fever Tuesday and was immediately isolated at the hospital.

Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored. The type of monitoring depends on the nature of their interactions and the potential they were exposed to the virus.

The worker was among those who took care of Thomas Eric Duncan after he was diagnosed with Ebola.

The preliminary Ebola test was run late Tuesday at the state public health laboratory in Austin, and results were received at about midnight.

As I told you last night, the Los Angeles Times has reported that the hospital was unprepared to deal with this, and essentially had no protocol. Nurses say: “There was no advanced preparedness on what to do with the patient. There was no protocol; there was no system.” This is in marked contrast to what Obama had promised on September 16, when he said: “We’re working with hospitals to make sure that they are prepared, and to ensure that our doctors, our nurses and our medical staff are trained, are ready, and are able to deal with a possible case safely.”

Citizen, have no fear. Your friendly federal government is on the case.

242 Responses to “Second Health Care Worker Tests Positive for Ebola in Dallas”

  1. Ding.

    Patterico (9c670f)

  2. It would have been empty political theater for Barack Obama to actually do anything other than make press statements about how wonderful his administration is handling everything.

    And then repair to the golf course for a victory round.

    Steve57 (4d34f4)

  3. I question the timing:

    http://www.breitbart.com/Breitbart-TV/2014/10/15/Watch-NY-Times-Reveals-Secrets-of-WMD-Cover-up-in-Iraq

    FlusterCuck Obola has more up his sleeve?

    gary gulrud (46ca75)

  4. THe reserve army needs to be put on alert and one of the prepositioned navy ships in SD needs to be put out to sea and those who are and/or exposed – put on it with full medical care.

    We have to stop this or it will kill everyone in contact in 6 months – Dallas will eclipse all our war casualties if a case OUTSIDE the hospital and immediate family is reported in the next few days.

    The scoffing that people are overreacting is the same as the Climate change experts – don’t question the obvious – all 16 doctors of Doctors without Borders are dying or dead in the last month, they were the best equipped unit there.

    The unthinkable has happened – so now what do we do? Compound the problem with further naval gazing? Time for the non doctors to take over as soon as the first outside case is transmitted this becomes no longer a fight against disease but a fight for survival

    EPWJ (db4127)

  5. navel, not naval was thinking of steve57 🙂

    EPWJ (db4127)

  6. Bond yields are in full collapse this AM.

    The October surprise(s) keep rolling on.

    gary gulrud (46ca75)

  7. Obama had promised on September 16, when he said: “We’re working with hospitals to make sure that they are prepared, and to ensure that our doctors, our nurses and our medical staff are trained, are ready, and are able to deal with a possible case safely.” 2.
    Steve57 (4d34f4) — 10/15/2014 @ 6:44 am

    It would have been empty political theater for Barack Obama to actually do anything other than make press statements about how wonderful his administration is handling everything.

    He was probably briefed also about what they were doing, so it was true, as far as it went.

    Of course, Obama has no conception of differential competence – by him, someone is either qualified to do a job, or not – nor does he know so much himself, nor has he ever done much indepedent study or independent reading * – so he never double checks or cross-examines his briefers, nor does he have anybody else independently evaluate it – like having five people who know something more about the subject look at things and get their opinions..

    He just accepts everything he is told, most of the time, and only concerns himself with how to make a better argument at best.

    This is through and through, on all matters, with Barack Obama, with very few exceptions.

    He relies entirely on whoever happens to be in charge. Except maybe when it’s more a political than a technical decision.

    So – he never examined or got a second of third opinion from anyone as to whether the working together with hospitals was actually good enough. It was good enough for the people who held the job, and so it was good enough for him.

    To say otherwise would imply someone is incompetent, and competence for Barack Obama, is determined by resumes and tests, which is probably what he has been told all his life, and once someone passes a minimal threshhold, they are all equal, differentiated only by how hard they work. You’ve heard him say it – work hard.

    Obama also hates to reverse himself on anything, regardless of whatever was the original reason he was for something. As Emersen said, consistency is the hobgoblin of little minds Barack Obama.

    So he must close the Guantanamo Bay terrorist prison, before January 20, 2017.

    I don’t think this is much a factor with regard to ebola for Barack Obama. The problem there is just simply his inability to conceive of differential competence.

    A doctor is a doctor is doctor – and if he didn’t believe that, narrow networks would have bene a problem for him. He doesn’t exercise any greater choice wih his own doctors, either, that I know of.

    * independent study or reading: That would only have made trouble for him, anyway, in the past. If he came to any conclusions as to how he should vote or what he should strive for, that was different from what everybody else on the same political escalator with him was for, it would create difficuties for hs conscience. Better just to take direction.

    Sammy Finkelman (6f9c3d)

  8. There will be more.

    SarahW (267b14)

  9. EPWJ (db4127) — 10/15/2014 @ 6:53 am

    We have to stop this or it will kill everyone in contact in 6 months

    That’s what it does NOT do, pretty obviously. It’s alessere degree of danger than that, but it is not nothing.

    There’s anumber of thinbgs I need to comment on.

    For one thing, I do not see why everybody or some people are defending the hospital, which is probably gulty of malpractice. And if it isn’t, malpractice should be redefined.

    The unthinkable has happened – so now what do we do?

    You’ve got to get rid of the molasses that hampers medical progress. With this diseaxed actually you could tolerate it, except a lot more people will die.

    Sammy Finkelman (6f9c3d)

  10. “The problem there is just simply his inability to conceive of differential competence.”

    With the possible exception of David Petraeus.

    Sammy Finkelman (6f9c3d)

  11. maybe this is one of those things where if you test positive it means you *don’t* have it

    happyfeet (a785d5)

  12. What would be your reaction if you woke up to “Ebola Quarantine Zone” spray painted on an exterior wall at your gated community?

    The cops are treating it as misdemeanor vandalism. The residents are pissed that their money hasn’t isolated them from petty crime that’s supposed to happen to other people.

    Apparently nobody is looking into potential substantiation of the graffiti itself.

    Chris (0ba377)

  13. I still think strong and appropriate action on what we do know, and minimal energy on speculation is what is needed.
    If Lagos, Nigeria, can contain a cluster of cases arising from one hospitalized patient,
    then so can the US, unless stupidity and incompetence carry the day.
    Perhaps the people in Lagos were more concerned with getting results than posturing and PR, perhaps they have people who know how to be heavy handed when you need to be. IDK

    The world will be much better off shutting down all travel in and out of the affected countries and focusing energy and effort to control things there. A few cases here and there in the US, Western Europe, and a case in another area of the world with little resources, and they will be too busy fighting their own problems, which didn’t need to be, and West Africa, and then other parts, will be disastrous.

    It’s starting to be like watching a train wreck in slow motion.

    MD in Philly (f9371b)

  14. that’s almost banksyesque Mr. Chris

    happyfeet (a785d5)

  15. If anyone is keeping level headed, it will be interesting to see the details of the Dallas workers who come down with it. Did they all have contact with Duncan when in was intubated and not using respirators? Are any janitorial staff who handled contaminated waste? Are any clerical staff that happened to walk down the same hallway?
    If people don’t panic, the answers to those questions would be interesting and possibly quite important.

    Meanwhile, more people have died from Enterovirus D68 that may well have been distributed throughout the US by illegal immigrants from Central America.

    MD in Philly (f9371b)

  16. This Dallas hospital is effectively dead in the water. By the sheer luck of the draw Duncan showed up at their place rather than somewhere else. Who will choose to allow their loved ones to be treated there now? Who will want to even work there when it is now becoming so obvious that the health care workers were not prepared for ebola, were not properly equipped or trained, and that the new infections of the 2 workers came AFTER Duncan was visibly sick/ diagnosed– not at the time he was initially seen and erroneously discharged from the emergency room. I’m very afraid there are going to be more direct care ebola test “positives” from this single eff-up. This hospital may be the first, but it will not be the last U.S. hospital to face this crisis

    The CDC has failed in its sole responsibility and reason for existence–to try to stop the introduction and spread of infectious disease in this country. Its director has been exposed as a slimy snake. Any of us who might need hospitalization or treatment in any hospital or emergency setting for any reason over the next months(years?) are going to be nervous. This is another example of what happens when “healthcare” is subject to politics–not common sense.

    elissa (a5826a)

  17. It would appear that antibody transfer is becoming a significantly positive resource in the treatment of this disease. That’s very hopeful.

    Chris (0ba377)

  18. ==THe reserve army needs to be put on alert and one of the prepositioned navy ships in SD needs to be put out to sea and those who are and/or exposed – put on it with full medical care.==

    Who exactly do you propose to provide this “full medical care” out at sea when the ebola caregivers thus far -both here and abroad- appear to be dropping like flies?

    elissa (a5826a)

  19. It would appear that antibody transfer is becoming a significantly positive resource in the treatment of this disease. That’s very hopeful.

    What are troops should be doing in Liberia is hunting down natives who have recovered from ebola and shipping them back here so we can harvest their blood plasma.

    nk (dbc370)

  20. MD

    Uh this is not disrespect but Nigeria contains with a machine gun, they killed whole villages hamlets constantly even for malaria. The very idea that despotic countries with violence on a scale we cannot even imagine can do something like this is far reaching

    No one is rushing to Nigeria to study the Nigerian solution…

    EPWJ (c12453)

  21. There was a post yesterday from somebody saying that Ebola care was going to become “being tied down to a bed in the middle of a room”. I don’t know how serious that person was, but I am sure that is about it in Africa these days, isolating people with Ebola, giving them Gatorade to drink, and hoping for the best is about it, and if they could do that effectively to minimize the spread of the outbreak it would be great success.

    If we have many cases in the US, it may be that care is limited to supportive care without ICU measures like ventilators. IV fluids, not left wallowing in your own vomit and stool, experimental meds if available, and that’s about it.

    I am surprised that there have been no additional cases from family and friends of Mr. Duncan, unless some have become ill but have isolated themselves from medical care thinking they are better off on their own. (“You go to the hospital and then you die”.)

    MD in Philly (f9371b)

  22. If Obama were smart, he’d already have a few hundred already under lock and key in Area 51 in case any high-ranking government officials or Democrat big-money donors come down with it. Every government in the world should, but they’d need local cooperation to identify them and kidnap them. I see a big business opportunity for slave traders, here.

    nk (dbc370)

  23. The Obama administration’s polices regarding Ebola are fundamentally based on on Obama’s desire to institute Single Payer and his philosophy of never letting a crisis go to waste. That people will die is just a price of progress that he is willing to have them pay.

    Stephen Macklin (de2190)

  24. MD in Philly (f9371b) — 10/15/2014 @ 7:26 am

    If Lagos, Nigeria, can contain a cluster of cases arising from one hospitalized patient,
    then so can the US,

    There’s no sign that’s not going to happen. There was more than one case in Nigeria.

    There were so many because the ebola patient was really sick. He was given special permission by the Liberian government to travel outside of Liberia and attend a conference in Nigeria. He still did not infect anybody on the plane, because he was being very careful to stay away from people, as video proved. (Although that’s the case, he also may have been in denial that his disease was ebola.)

    Sammy Finkelman (6f9c3d)

  25. DALLAS — The hospital that treated Ebola victim Thomas Eric Duncan had to learn on the fly how to control the deadly virus, adding new layers of protective gear for workers in what became a losing battle to keep the contagion from spreading, a top official with the Centers for Disease Control and Prevention said Tuesday.

    “They kept adding more protective equipment as the patient [Duncan] deteriorated. They had masks first, then face shields, then the positive-pressure respirator. They added a second pair of gloves,” said Pierre Rollin, a CDC epidemiologist.

    http://www.washingtonpost.com/national/health-science/dallas-hospital-learned-its-ebolo-protocols-while-struggling-to-save-mortally-ill-patient/2014/10/14/32ff2414-53cf-11e4-892e-602188e70e9c_story.html?hpid=z1

    elissa (a5826a)

  26. FWIW I’m beginning to think that the old way of dealing with contagion in Africa was better. People isolated themselves in their villages and outbreaks burned themselves out.

    Now infected people are flocking to hospitals in cities and infecting many others, including doctors and nurses. This is the problem with the Duncan case: He fled through several airports in two countries to a busy hospital in a densely populated city, exposing hundreds of people. The loss of life here, wholly unnecessary and allowed by government policy, and the economic and civil destruction, I fear, will be terrible. And yes, that hospital is done for. I wouldn’t go there for a hangnail.

    Patricia (5fc097)

  27. MD in Philly It’s starting to be like watching a train wreck in slow motion.

    Not in the United States or Europe really, where we can expect repeated isolated cases of ebola, sometimes spreading to up to half a dozen to a dozen other people, but no epidemic.

    But in Liberia…

    Right now, about 1 in every thousand people in Liberia has an active case of ebola. (or the number could be two or three times as much but the principle is the same)

    The number of active infections is doubling approximately every three weeks, or maybe more exactly that would be multiplying by the square root of 2 every 10 days, since the typical incubation period, they say, is 8 to 10 dats.

    A very crude calculation, based on the fact that 2 to the 10th power is approximately 1,000, tells me that by mid May of 2015 every person in Liberia will have gotten ebola. Obviously, that won’t happen, because you start running into herd immunity, and people are not evenly distributed and evenly at risk, but the way we are heading, sometime between March and August of next year Liberia will be saturated wiith ebola. And Sierre Leone will not be far behind, with Guinea trailing.

    We will end up with 40 hot spots – It’ll be eliminated from some, and then there will be mnore hot spots. We need a rapid test for ebola, and the use of anti-viral as a prophylactic.

    Those who make calculations say, that if 70% of ebola patients can be isolated enough to
    prevent them from infecting anybody else, the remaining 30% will not infect enough people to have at least one new case for every old case. (the average would have to be over 3 per ebola case)

    You’d need a lot less than breaking even for it to subside.

    Sammy Finkelman (6f9c3d)

  28. CDC Director Thomas Frieden expressed regret Tuesday that his agency had not done more to help the hospital control the infection. He said that, from now on, “Ebola response teams” will travel within hours to any hospital in the United States with a confirmed Ebola case. Already, one of those teams is in Texas and has put in place a site-manager system, requiring that someone monitor the use of personal protective equipment.

    “I wish we had put a team like this on the ground the day the first patient was diagnosed,” he said. “That might have prevented this infection.”

    Yeah, Tom. We wish so, too.

    elissa (a5826a)

  29. Sammy, you did not read my post carefully. I know and said there was more than one case in Nigeria, but it was a contained outbreak that began with one hospitalized person.

    MD in Philly (f9371b)

  30. ” nor does he know so much himself, nor has he ever done much indepedent study or independent reading”

    Obama is a better infectious disease guy than the CDC. Ask him.

    Also, Obama can’t stand the thought that Bush is held in higher esteem in Africa than he is

    At issue is the enormous popularity of George W. Bush in Africa, a love affair that highlights how little, by comparison, Mr. Obama has done for that continent. As The New York Times reported in 2013, Bush “is seen as a lifesaver who as president helped arrest a deadly epidemic [AIDS] and promoted development of impoverished lands.” As The Times noted, “During a final trip as president in early 2008, Mr. Bush was warmly greeted by huge crowds of the sort he never saw at home anymore.”

    It’s all about image, like everything else with this guy.

    Mike K (90dfdc)

  31. I know bloggers hate it when commenters point out typos, but I’m going to anyway. That last sentence in the article… you spelled “feral” wrong.

    John Hitchcock (f55f84)

  32. > You’d need a lot less than breaking even for it to subside.

    Eventually it will burn itself out because everyone in the effected area is dead. :{

    aphrael (af3e66)

  33. http://www.nytimes.com/2014/10/13/opinion/how-to-quarantine-against-ebola.html Someone proposed an ebola test. The false negative and false positive rates are better now than they were in the year 2000, but the problem is arranging for any of that to actually happen and make sure it is done safely and accurately.

    There is a fourth strategy, although it will need to be evaluated and deployed carefully. Since the 1990s, novel methods have allowed doctors to detect viruses in the pre-symptomatic phase of an infection, often with remarkable sensitivity and precision. One of these involves the polymerase chain reaction, or P.C.R., a chemical reaction that amplifies pieces of a virus’s genes floating in blood by more than a millionfold, which is what makes early, pre-symptomatic infections identifiable. The technique is not particularly cumbersome:

    As an oncologist working with blood cancers, I have been using variants of it to detect subclinical infections in patients for nearly a decade.

    A 2000 study in The Lancet illustrates the power of this approach. Twenty-four “asymptomatic” individuals exposed to Ebola were tested using P.C.R. Eleven of the exposed patients eventually developed the infection. Seven of the 11 tested positive for the P.C.R. assay; none of the other 13 did. In 2004, virologists at the Centers for Disease Control and Prevention further refined this method to increase its sensitivity. The test now requires only a teaspoon of blood. The sample is transported, on ice, to a centralized lab. Results are back in a few hours.

    Technologies like this allow us to imagine a new form of quarantine. Rather than relying on primitive instruments, indiscriminate profiling or questionnaires, we should consider running a pilot program to test asymptomatic travelers using sensitive P.C.R.-based techniques. Obviously, such technologies are expensive, but the cost is not prohibitive. A typical P.C.R. reaction, including labor, costs between $60 and $200 (we have already spent 100 times more disposing of the contaminated sheets from the home Mr. Duncan stayed in). [that’s well below the cost of an airplane ticket – SF]

    Since the test takes about a third of the time of a trans-Atlantic flight, the flight would become the quarantine…..

    ….One major issue with this kind of rapid-testing quarantine is the phenomenon of false positives. But P.C.R.-based testing for Ebola has a low false-positive rate (three per 1,000), and its accuracy could be further improved by focusing on patients who come from particular geographic regions or by using more refined questionnaires. The second problem is false negatives: missing actual carriers of the infection. And yet, at four false negatives per 1,000, the detection rate might be sufficient to keep Ebola from becoming epidemic in the United States. Even the presence of such a testing and tracking system would act as a deterrent to those who wish to evade detection.

    A rapid-testing quarantine would be expensive, but a pilot program might teach us much more about how to move forward. It certainly does not solve the civil liberties questions of quarantining, but it makes them vastly more palatable.

    Sammy Finkelman (6f9c3d)

  34. the ebola-tainted glass

    is half full

    happyfeet (a785d5)

  35. 29. MD in Philly (f9371b) — 10/15/2014 @ 8:12 am

    Sammy, you did not read my post carefully. I know and said there was more than one case in Nigeria,

    I know you said that. You said cluster of cases. When I mentioned there was more than one ase, I meant people had contracted it outside of the hospital (unless I am wrong about that)

    but it was a contained outbreak that began with one hospitalized person.

    My point was that that patient had infected more people than Duncan did, or more immediate cases resulted from him, and I said that was because he was very sick. How much more easier, then, would it be to contain the outbreak in Dallas. I said there’s no sign that containment is not going to happen here too.

    We’ve had fewer cases.

    Sammy Finkelman (6f9c3d)

  36. elissa (a5826a) — 10/15/2014 @ 7:40 am

    the ebola caregivers thus far -both here and abroad- appear to be dropping like flies? </I

    They are not dropping like flies. The vast majority of caegivers do not get ebola, and their chances are related to how much contact they had with, or how often and how close they were to a patient.

    Approximately 60 people were involved in Duncan's care and there are so far only two cases. That's not "dropping like flies."

    Of course an infection rate of 3% is not something that can easily be tolerated, if the infection has a high mortality rate.

    Sammy Finkelman (6f9c3d)

  37. 36. Just STFU Sammy. The only thing worse than a dumbsh!t is a lying dumbsh!t.

    gary gulrud (46ca75)

  38. Revised protocols for combating Ebola?

    Am I missing something here. It is my understanding that, much like the graduated response to the handling of hazardous materials, there was set of graduated protocols in place for caring for infectious patients. If these protocols were still being taught, then it should have been a simple matter for the CDC to advise the health authorities of the correct protocol.

    Davod (b656c4)

  39. We have top men working on it right now. Top. Men.

    Mitch (341ca0)

  40. Good news:

    Second infected healthworker got on a plane the 10th and 13th, traveled from Dallas to Cleveland and back again.
    Where o where did he/she get the impression that such travel after exposure to deadly contagion, presented no risk to anyone else? https://twitter.com/samsteinhp/status/522406106921201666

    SarahW (267b14)

  41. PS. I apologize if my 8:49 am post is redundant. The learning process with regards to the protocol for handling Ebola patients was eating at me, so I wrote my comment prior to reading the other comments.

    Davod (b656c4)

  42. Also, a company [Stericycle] cited for mishandling of medical waste and improperly disposing it in public landfills, has been given a DOT contract to transport ebola medical waste from Dallas.

    We’re in the best of hands, y’all.

    SarahW (267b14)

  43. “should have been a simple matter for the CDC to advise”

    Couda shoulda woulda.

    Should have made sure. Should have been there. This was patient zero. Lets observe how prepared an ordinary hospital is…

    SarahW (267b14)

  44. The second nurse’s name is Amber Joy Vinson RN. she was on Frontier Airlines flight 1143 from Cleveland Ohio to DFW on Oct. 13.

    Rorschach (61bf43)

  45. There actually is someone in the world that knows how to deal with this epidemic and guess where they are ?

    Liberia.

    Today, Firestone Liberia is working to extend its effective methods in curbing the spread of disease throughout the country by collaborating with the Liberian Ministry of Health and Social Welfare, the Centers for Disease Control and Prevention, and the World Health Organization. Even more, the company is generously donating funds to others who war against the disease. In September, Bridgestone Corporation, Firestone’s parent, divided $1 million among Samaritan’s Purse and UNICEF.

    How odd that a competent organization in Africa is controlling this. Socialism and its variants can be hazardous to your health.

    Mike K (90dfdc)

  46. The post accurately documents the Cesspool in Chief, Prezzy We Got This, in his default mode, the government is here to protect you offal, so put a sock in it.

    These thugs talk out of both sides of their mouth simultaneously and expect credit for a free supply of air.

    gary gulrud (46ca75)

  47. The thing about strange and deadly contagion with unpredictable onset of symptoms is that if you want to shut it down and nip it in the bud, you SHUT IT DOWN. You overreact, not try to go about one’s business and saying “no cause for alarm”.

    Overdress careworkers. Over-protect. Over-monitor. Over-restrict. Cut off routes for the virus to travel.

    Isolate, Isolate, Isolate.

    SarahW (267b14)

  48. Hopefully the CDC and hospital is exploring whether Amber and Nina did similar jobs at the hospital and/or if there were any duties they shared in Duncan’s treatment. I also hope the hospital is thinking about what to do and not relying on the CDC.

    DRJ (a83b8b)

  49. SarahW (267b14) — 10/15/2014 @ 8:54 am

    Where o where did he/she get the impression that such travel after exposure to deadly contagion, presented no risk to anyone else?

    From people who underestimate the incubation period.

    The good news is, if he underestimated the incubation period, and if it is also true, as seems likely, that somebody else is highly unlikely to be infected until some time after the incubation period is over, then, by the same token, only people who make the same mistake of underestimating the incubation period should worry.

    The period of time till when someone becomes infectious is even longer than the incubation period. For illustration, Duncan appears not to have infected anyone outside of the hospital.

    Someone here makes a good point that people flocking to doctors in Liberia and Sierre Leone could be counterproductive and spreading the virus. Otherwise no one very sick would leave whereever they are, and you probably have to be very sick to have a high risk of infecting somebody else, and normally such people would stay in bed where they are.

    The second Dallas worker almost certainly also didn’t infect anyone else. This is a slow-motion /i> train wreck (in Liberia)

    Sammy Finkelman (6f9c3d)

  50. I did read the comments of a doctor who discussed how the Africans handled Ebola outbreaks when they were restricted to villages in the interior. When someone in a village contracted Ebola the villagers would quarantine the village until the outbreak was over. People from other villages would keep the village supplied with provisions. This process worked for a long time.

    Davod (b656c4)

  51. #48, Sarah: And take the blinders off the data collectors. Why not, for example, test every care giver from the Dallas hospital for the Ebola virus every other day whether or not they exhibit the defined symptoms. At worst you’d be giving the testing labs a bit of a taste of what things might be like in a few months, and you would almost certainly learn something useful.

    bobathome (5ccbd8)

  52. Sammy, She could easily have stayed put. Someone should have ordered her to stay put. Right now, it’s the only way to be sure, and very very cheap to accomplish. Two days to twenty-one is the possible incubation period. Not to mention the possibility that, aside from her person, her clothing or personal items are actually contaminated.

    She was caring for a patient with a high viral load, probably at the end-stages of the killing contagion. How much risk she posed others doesn’t matter much when she could have made it zero risk. ZERO it is. Stay home.

    SarahW (267b14)

  53. Any of us who might need hospitalization or treatment in any hospital or emergency setting for any reason over the next months(years?) are going to be nervous.

    Now is the time to evaluate hospitals near you. You should disregard the local community hospitals, which are less likely to be trained and usually cannot handle things out of the routine. Regional medical centers are sometimes great and sometimes bureaucratic swamps (like the one in Dallas).

    There are only two hospitals near me I would consider (UCLA Westwood or Cedars-Sinai) and if I had to choose a hospital at random, I’d go for a teaching hospital as it is usually well-stocked with smart people and less hide-bound than average.

    Kevin M (b357ee)

  54. so her co-worker has Ebola, but that doesn’t stop her from flying on a commercial flight and now she’s got it? I’d always heard “Texas knows how”… it appears that’s not the case.

    http://pjmedia.com/instapundit/196704/

    Colonel Haiku (2601c0)

  55. test every care giver from the Dallas hospital for the Ebola virus every other day whether or not they exhibit the defined symptoms”

    Simple enough to effect, although not without risk to the tested; but besides costing money it probably would have caregivers feel bad. It would have to be a volunteer thing. The isolation should not have been voluntary.

    SarahW (267b14)

  56. I have this sense of deja vu.

    Stu Redmond (b357ee)

  57. I’ve grown increasingly sick of all these sick people with their sicknesses. It appears I’ve swallowed the Bitter Pill.

    Colonel Haiku (2601c0)

  58. I saw that article too Davod and there’s some wisdom there. We absolutely cannot treat this casually in the US, like we are doing now. It’s like the CDC and president have a grandiose idea of how we can fight this. Go about your business! Travel! Take your temp every day! We’ve got it!

    That’s not cutting it.

    Isolation, isolation, isolation, as Sarah said, is the only way. I remember a doctor saying to me once regarding some medical treatment: go with the tried and true every time.

    Patricia (5fc097)

  59. Hospitals are terrible places to be and one should stay out of them as far as possible.
    They are dirtier than ever, risky, and guided by all sorts of metrics and human-animal games that you don’t want to be a part of.

    Sometimes there is no getting out of it. Make sure you have private help and a babysitter.

    SarahW (267b14)

  60. I wonder if the PC disease will be killed by Ebola.

    Kevin M (b357ee)

  61. Second case? Try three. A third person has tested positive to Ebola. 75 are being monitored. And which country is this again?

    The Emperor (61e53a)

  62. and Amber Joy Vinson, RN should never ever get a second bag of peanuts… EVAH!!!

    Colonel Haiku (2601c0)

  63. teh Chimperor…

    Colonel Haiku (2601c0)

  64. SarahW,

    Is there any explanation why the Ebola blood tests were not given to ANY of these workers until now?

    Kevin M (b357ee)

  65. So, its official, we have an outbreak.

    Why should any deaths that result not be hung around Obola’s neck?

    How many have to die during practice Fire Marshal?

    gary gulrud (46ca75)

  66. you cannot wear white when yer doin’ the Funky Ebola!

    Colonel Haiku (2601c0)

  67. But what if the tried and true is also racist, Patricia?

    Steve57 (4d34f4)

  68. Not only that, Stu… it feels like this has happened before.

    Colonel Haiku (2601c0)

  69. Kevin M (b357ee) — 10/15/2014 @ 9:15 am

    Now is the time to evaluate hospitals near you.

    There are hospitals that have good infection control, for infections in general, and there are hospitals that don’t, and that should be a good proxy for the ability to contain ebola, but I think the information is partially secret.

    http://www.kaiserhealthnews.org/stories/2011/may/28/varney-npr-hospital-acquired-infections-california.aspx

    …Under laws in more than two dozen states and new Medicare rules that went into effect earlier this year, [2011] hospitals are required to report infections, risking their reputations as sterile sanctuaries, or pay a penalty. That’s left hospital administrators weighing the cost of ‘fessing up against the cost of fines….

    ….Yet, about 90,000 patients still die each year from preventable infections resulting from routine surgeries and hospital care, according to the U.S. Centers for Disease Control and Prevention. Examples include infections resulting from contaminated tubes that deliver food and medications, and catheters that remove urine. Staph infections, which can be deadly, are a particularly serious problem….

    .,…Starting this year, [2011] hospitals have to reveal their catheter-associated blood stream infections if they want their Medicare bills paid in full. Next year, [2012] they’ll have to report surgical-site infections. The list will grow longer in the coming years.

    Rapp anticipates that nearly all U.S. hospitals will comply. Now, only half volunteer their data, he said.

    Still, the stigma of unclean wards and fear of lawsuits can make hospitals reluctant to report. When the law went into effect in California, 19 hospitals out of 400 didn’t send in any data. State regulators, who acknowledge the first year of data collection was riddled with errors, are not imposing penalties.

    There are other concerns: Competitors may undercount, making more honest players look bad, and some hospitals simply do more surgeries or have sicker patients, said Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association.

    I would say the most impoortant statistics would be staph infections and infections after surgery.

    .You should disregard the local community hospitals, which are less likely to be trained and usually cannot handle things out of the routine. Regional medical centers are sometimes great and sometimes bureaucratic swamps (like the one in Dallas).

    There are only two hospitals near me I would consider (UCLA Westwood or Cedars-Sinai) and if I had to choose a hospital at random, I’d go for a teaching hospital as it is usually well-stocked with smart people and less hide-bound than average.

    Sammy Finkelman (6f9c3d)

  70. Hey Co’nel. Still smoking that expired weed I see. 🙂

    The Emperor (a2886c)

  71. 62. …And which country is this again?

    The Emperor (61e53a) — 10/15/2014 @ 9:23 am

    The racist one.

    The only reason I don’t want to catch Ebola is because I can’t stand having a strong black man in the White House.

    Apparently the reason why Thomas Duncan didn’t get a transfusion from Dr. Brantly had something to do with incompatible blood types.

    Natch. It’s typical of those racist white Texans to deliberately have the wrong blood type when a black man is involved.

    Steve57 (4d34f4)

  72. This is getting REALLY serious: Obama has cancelled a fundraising trip!

    Kevin M (b357ee)

  73. SarahW,

    Is there any explanation why the Ebola blood tests were not given to ANY of these workers until now?
    Kevin M (b357ee) — 10/15/2014 @ 9:25 am

    “Monitoring” appears to be monitoring for symptoms. Though I have not found anything suggesting that blood testing was done on potentially exposed persons who have no symptoms, maybe they have done some testing and not talked about it.

    If they have not done any pre-symptomatic testing of exposed persons, I presume avoiding the cost of the test, wtih the presumption that the testing wouldn’t be of much use, is the reason. But I’m just presuming.

    SarahW (267b14)

  74. http://www.leapfroggroup.org/media/file/CRHospitalSafetyRatings.pdf

    August 2012 Consumer Reports. The hospitals they don’t have data for far outnumber those that they do have data for, and they seem to have no hospitals in Texas, but a lot in California. In fact, they only seem to have data for hospitals in some states, although they don’t cite that as a reason.

    Overall, they rate just 18.47% or less than one in every 5 hospitals.

    From page 24 (page 5 of 21 of the PDF):

    Why some hospitals aren’t listed

    We have safety Ratings for 1,159 of the 6,268 hospitals in the U.S. Not included are:

    • Veterans Affairs and children’s hospitals because
    the government doesn’t require them to participate
    in a survey of patients that we use to determine
    ratings for communication.

    • Some specialty hospitals because they don’t treat
    patients with conditions used in our readmissions
    rating. That includes such hospitals as the Hospital
    for Special Surgery in New York and the University
    of Texas M.D. Anderson Cancer Center in Houston.

    • Hospitals that don’t have enough data, have data
    we consider too old, have data discrepancies, or
    don’t report their data in a way we can use. That
    includes many hospitals, including some familiar
    ones, such as Duke University Hospital in Durham,
    N.C.; Emory University Hospital in Atlanta; Henry
    Ford Hospital in Detroit; Johns Hopkins Hospital in
    Baltimore; the University of Chicago Medical Center;
    and the University of Colorado Hospital in Aurora.

    That includes all hospitals in most states!

    Sammy Finkelman (6f9c3d)

  75. US News ranks Texas Presbyterian Hospital as the 5th best hospital in Dallas. I know the rankings don’t tell us everything but I’ve had family members in hospitals in Dallas, and there are better facilities. Having said that, I wouldn’t go to a big Dallas hospital at all, if I could avoid it. Charity cases have made their healthcare system over-priced and over-burdened — and ObamaCare isn’t going to cure it for reasons I won’t go into here.

    I think Texas Presbyterian is located near downtown so I think there are many lower-income patients who take public transportation to this hospital and use the ER for primary care. It’s common for Texas ERs to evaluate patients and send them home with instructions to see a doctor the following day. That’s what Texas Presbyterian did with Duncan, but he didn’t go to a doctor for 2 days — and then only to return to the ER. Texas ERs have dual functions for decades — emergent care for broken bones and car wrecks, and primary care for lower income people. They weren’t trained or expected to provide specialized evaluations like this, and I doubt many hospitals outside NYC have been, but they will be now.

    DRJ (a83b8b)

  76. It’s looking increasingly likely that the hospital’s Ebola infection problem stems from its treatment of Duncan, not seeing him in ER. Don’t you think Texas Presbyterian Hospital did everything the CDC told it to do after the diagnosis? We know the CDC sent a team to the hospital and I can’t imagine the hospital refused to do anything they said to do. Thus, when it comes to Duncan’s treatment, I blame the CDC and not the hospital for any failures there.

    DRJ (a83b8b)

  77. avoiding the cost of the test

    BWAAAAAHAHA!

    As you’ve pointed out the costs right now are ginormous, with the Dallas medical center shedding patients faster than you can say “Gesundheit!” The costs of such tests are probably less than the costs of the time of the committee members that decided not to conduct them.

    Kevin M (b357ee)

  78. DRJ,

    I looked at the hospital on Google Earth and the nearby residential neighborhoods are immaculate with largish houses and lots. It is not inner city by any stretch.

    Kevin M (b357ee)

  79. Steve57 (4d34f4) — 10/15/2014 @ 9:34 am

    Apparently the reason why Thomas Duncan didn’t get a transfusion from Dr. Brantly had something to do with incompatible blood types.

    That’s not what the family was told, or it didn’t get communicated, and what about other ebola survivors, even if they are not in the United States?

    http://www.nytimes.com/2014/10/11/us/thomas-duncan-had-a-fever-of-103-er-records-show.html

    Mr. Duncan’s nephew, Josephus Weeks, who provided the records to The A.P., said on CNN on Friday that his uncle would have received better treatment by the hospital had he been white. “They treated him the way they did because of the color of his skin,” Mr. Weeks said.

    Mr. Weeks said he had requested that the hospital take certain steps to help Mr. Duncan survive, including having him transferred to Emory University Hospital in Atlanta and giving him blood transfusions, but he said he was turned down.

    You know, I think the Duncan family may have a real malpractice case here, if malpractice can be defined as not turning someone over to better doctors.

    Perhaps they have consulted a lawyer who thinks he’d have better success with a misbegotten civil rights lawsuit, which he is maybe more used to do.

    They treated him this way because he was poor, and had no insurance. But this case wa sin the news, and somebody would have bene found to pay for anything they proposed.
    t g

    Sammy Finkelman (6f9c3d)

  80. DRJ (a83b8b) — 10/15/2014 @ 9:41 am

    We know the CDC sent a team to the hospital and I can’t imagine the hospital refused to do anything they said to do.

    The family requested that he be transferred to Emory, and the hospital refused to do so. Had it bene smeone else, it’s very posisble a way would have been found to do so, despite any bureacratic obstacles and costs, and in his case, if it cost money, the money would have been found. Somebody would have donated it if the hospital had asked. But they didn’t want to let go of the case.

    Sammy Finkelman (6f9c3d)

  81. SarahW (267b14) — 10/15/2014 @ 8:57 am

    That is not a bug, that is a feature!

    felipe (b5e0f4)

  82. Testing takes upwards of three days to do and there are only a dozen places where it can be done. Texas presbetyerian is not one of them. by the time results come back the person would have frank symptoms and would be in isolation anyway.

    Rorschach (61bf43)

  83. Kevin M,

    Downtown hospitals often exist in diverse neighborhoods. This hospital is located east of Preston Hollow where George Bush lives, and northeast of Highland Park which is one of the wealthiest areas of Dallas. It’s also adjacent to lower income neighborhoods of Northeast Dallas, and the hospital workers regularly volunteer in clinics to help their lower-income neighbors.

    DRJ (a83b8b)

  84. the request to transfer to Emory has to be balanced against the risk of further contaminating others.

    Rorschach (61bf43)

  85. ==We know the CDC sent a team to the hospital and I can’t imagine the hospital refused to do anything they said to do. Thus, when it comes to Duncan’s treatment, I blame the CDC and not the hospital for any failures there.==

    DRJ did you see my posts at 25 and 28 related to this from the WAPO article?. Based on the director’s admission I am not sure the “team on the ground” arrived when you seem to suggest it did. There was, and continues to be much floundering as far as I can see. I gather from several sources that the CDC was all about tracking down possible interactions with others that Duncan might have had outside the hospital, but they were not involved in the protocol of Duncan’s treatment.

    elissa (a5826a)

  86. The Texas Department of State Health Services lab in Austin was only licensed to do ebola testing 5 weeks before Duncan’s test, and it appears it may be the only lab in Texas that does this test. Duncan’s test was reportedly the first ebola test done in that lab, and it was positive.

    DRJ (a83b8b)

  87. Citizen, have no fear. Your friendly federal (feral) government is on the case.

    One important correction to Pat’s last sentence Yoda Makes!

    Yoda (d89de1)

  88. The market seems to be mirroring the flail, bouncing off a rail at down 125 to one at down 350.

    Unexpectedly.

    gary gulrud (46ca75)

  89. http://blogs.dallasobserver.com/unfairpark/2014/10/presbyterian_hospital_business_suffers_after_enacting_emergency_preparedness_measures.php

    They sent medical students and non-essential workers home.

    While the hospital declined to comment on what exactly the removal of these workers entails, the move can be likened to the emergency preparedness plans which remove non-essential personnel from the hospital in the event of a natural or man-made disaster. Not only does the move indicate the hospital’s level of concern for further spread within the hospital, the potential for spread is now considered an emergency…

    It’s the big unknown that clearly has administration at the nonprofit hospital so scared that they’re willing to incur revenue losses. And Fleming says in just the two weeks since Duncan fell ill, these losses are likely substantial.

    The hospital also diverted emergency room traffic starting Sunday. “No ambulances were being brought there. Now typically that happens when your ER is packed, but by diverting they were trying to keep people away from there,” says Fleming.

    Sammy Finkelman (6f9c3d)

  90. Colonel Haiku,

    Letting Amber Vinson travel does seem stupid. Reports indicate the Texas Presbyterian workers are “self-monitoring” which means they probably aren’t under any restrictions, and legally I doubt they can be restricted without a court order. The reports also say Amber Vinson had gone home to visit her family in Akron. Perhaps she traveled to Akron before Nina was diagnosed, when the risk seemed lower. I also wonder whether she’s young like Nina. If so, her first instinct may have been to go home after the stress of caring for an ebola patient. I doubt she would have done that if she had any idea she might have the disease.

    DRJ (a83b8b)

  91. I suspect that any discrimination showed towards Mr Duncan Ebola bringer must have come from the fact that he was getting karma for how he knew he had Ebola and knowingly brought it to America, in the name of getting treatment. I think hospital folks just didn’t give a hoot what happened to him. ThAnks to him we now have three confirmed Ebola cases in the USA. Way to go, Duncan!

    The Emperor (3ef653)

  92. #76

    I see US News rates my local first choice quite highly.

    UCLA Medical Center
    Rank in California: 1
    Number of specialties ranked in top 10 nationally: 10

    Kevin M (b357ee)

  93. I can’t find out anything.

    The chairman of emergency medicine at Texas Health Presbyterian Hospital Dallas seems to have been featured in U.S. News and Report, but it doesn’t seem to say anything.

    http://health.usnews.com/doctors/mark-till-398698

    Sammy Finkelman (6f9c3d)

  94. elissa,

    Whether the CDC had a team there or not isn’t the issue to me, if they were in contact with each other. Don’t you think the hospital and CDC were talking about what to do?

    DRJ (a83b8b)

  95. Sammy,

    Texas Presbyterian can’t transfer patients to other hospitals (like Emory) without the hospital’s consent. Do you have a link that says Emory agreed to take Duncan as a patient?

    DRJ (a83b8b)

  96. Emperor–

    Be fair. If you thought you might have been exposed to Ebola in Liberia, wouldn’t you want to get to a real hospital for treatment. It’s not clear that he was symptomatic when he left Liberia; certainly the exit interviewer didn’t stop him.

    The problem was that he was turned away in Dallas without testing. If they had run the blood tests and seen he was positive THEN, before he was vomiting and leaking Ebola from every orifice, the result would likely have been different. He also might have survived.

    There is PLENTY of blame to go around here.

    Kevin M (b357ee)

  97. DRJ – Duncan’s family was still asymptomatic last time I heard anything, which was a day or two ago. Not sure how to calculate the incubation period, though. Duncan was taken to the hospital on the 28 of Sep, so that means 21 days from their last direct contact with him is coming up on the 19th. But they were left in that contaminated apartment, so I presume they will be monitored for a longer period.

    SarahW (267b14)

  98. Sammy Finkelman (6f9c3d) — 10/15/2014 @ 9:44 am

    Stop it, Sammy.

    It is entirely possible that they asked for such things, and they were turned down, and the “turned down” part for blood transfusion was because of incompatibility, and Not because Duncan had “black blood and Brantley had “White blood”.
    So stop it.

    MD in Philly (f9371b)

  99. Also, elissa, on October 1, 2014, the CDC announced it had sent a team to Texas to investigate Duncan’s case. The team also was there to:

    The CDC team now is:

    Making sure the patient is receiving treatment and is isolated;

    Interviewing the patient and close contacts, such as family members, to obtain detailed information on their travel history and exposures;

    Ensuring the hospital uses appropriate infection control measures;

    Identifying people who had close contact with the patient and
    interviewing them,
    monitoring them to see if they become ill,
    collecting and testing specimens from them, if needed, and
    requesting that they monitor their health and seek care if they develop symptoms; and

    Monitoring the health status of healthcare providers who cared for the patient

    Any hospital following strict CDC infection control recommendations and that can isolate a patient in their own room with a private bathroom is capable of safely managing a patient with Ebola.

    If the CDC wants to claim now that it didn’t have a team in Dallas or that its team wasn’t there to help the hospital contain the infection, so be it. It’s what I’ve come to expect from government bureaucrats.

    DRJ (a83b8b)

  100. Hospitals are an endangered resource in the age of Obamacare. Many have been cutting staff and trying to trim costs but, being the worst administered organizations on earth, they are screwing it up. The Mission Hospital story in Mission Viejo finally hit the local news. I spent 25 years working there, including starting the trauma center there in 1979. I hate to see what the dopes running it have done to it.

    This story is far deeper than the story in the local paper. We will start to see more of these stories if Ebola crops up elsewhere, and it will.

    Mike K (90dfdc)

  101. nobody’s ever gotten ebola on a golf course

    think about it

    happyfeet (a785d5)

  102. There is PLENTY of blame to go around here.
    Kevin M (b357ee) — 10/15/2014 @ 10:11 am

    Agreed.

    From allowing a flight from a hot zone to Duncan’s apparent denial or dissembling about contact with sick people, to the intake history screw-up, which was absolutely egregious (and typical of ER screwups) to the hospital’s resistance to putting Duncan in isolation on his second visit, there was a parade of significant and avoidable error that could have made a difference in outcome for Duncan and other people.

    SarahW (267b14)

  103. Word has it that somebody in Dallas is going to Emory. (Will both go somewhere?)
    I think that is a great idea,
    not that I think anybody will get care unavailable at Dallas,
    but it will be safer for personnel as already demonstrated,
    and give Dallas a bit of time to recover from the shock of events.

    MD in Philly (f9371b)

  104. I get that, SarahW. I’m not saying the family members won’t get sick, only that we know the healthcare workers have.

    DRJ (a83b8b)

  105. DRJ- Oct 1 is a few days after Duncan had been admitted, so it could be both that Dallas was initially alone in dealing with it, and the CDC arrived to help, a bit late.

    MD in Philly (f9371b)

  106. The Emperor (3ef653) — 10/15/2014 @ 10:02 am

    getting karma for how he knew he had Ebola and knowingly brought it to America,

    His family says he didn’t, (or that’s what he told them.) The women with ebola – she had pregancy symptoms, or they took it for a pregnancy problem.

    He told Louise (his ex-and maybe future girlfriend – intended bride – nobody knows – she’d been tryng to get him to come to America for years at least for a visit I guess) he would have died in Liberia if he had known he had ebola.

    And if he really did think he had ebola, why did he let himself be sent back home with a prescription for antibiotics? Why did it have to be members of his family who brought it up?

    It makes more sense that he was trying to run away from ebola, without thinking that he had it.

    he had avoided coming to America many years before.

    http://www.frontpageafricaonline.com/index.php/news/3243-the-real-eric-duncan-why-evd-transporter-lied-about-contact

    Mawatta Dunbar, with whom Duncan has a 19-year-old girl-child, is not sure what Duncan’s role was at Safeway although she says she heard that he hung around there a lot. Those who work there say he was a driver….By 1995, Dunbar says she became pregnant.

    Ironically, she recalls it was the same period that Duncan had another woman, Louise Troh pregnant. Troh, is now in Dallas, Texas and is said to be the one who sent for Duncan. Dunbar bore a girl who is now 19 while Troh bore a son, Kasiah Duncan. When the child turned three, Troh took him to America. He is a 19-year-old college student at Angelo State University in San Angelo, the MailOnline reported Saturday. Duncan, according to the report, had traveled to Dallas to marry Louise, which would have paved the way for him to stay in the USA permanently. [although he actually came on a tourist visa]..

    …Pregnancy and Ebola has been an intriguing aspect to the Ebola crisis ripping West Africa. It can be recalled that the late Patrick Sawyer also claimed that his sister was suffering from miscarriage when he took her to the Catholic Hospital in Congo town, until her death was diagnosed as Ebola related. Sawyer and several nurses and doctors, lost their lives after that episode.

    Similarly, Marthalene’s death aftermath has left a trail of infections and death. Her brother SonnyBoy also died as wells as many of those who came in contact with her. That list includes Wreh Kennedy, one of those who were helping Marthalene during her ailment.

    Sammy Finkelman (6f9c3d)

  107. ER docs often avoid a close or even any look at the intake history ER nurses/clerks use to triage patients. That wouldn’t excuse his own failure to take his own history. Since Duncan was ill, and very obviously accented and of African extraction, a question about international travel should have been on his own personal list, especially with ebola in the news and on the table. He was lazy. He was used to getting minor illness out of the ER. You can have malaria at your doctor’s office tomorrow, Mr. Duncan.

    SarahW (267b14)

  108. Sammy Finkelman #81:

    But they didn’t want to let go of the case.

    Per the CDC on October 1, 2014 (link at my comment 101):

    Any hospital following strict CDC infection control recommendations and that can isolate a patient in their own room with a private bathroom is capable of safely managing a patient with Ebola.

    Why should any hospital send its ebola patient to another hospital? After all, the CDC said anyone can do it. It’s only been since then that the CDC has admitted specialized regional centers might be a better way to treat this disease. What’s ironic is the CDC already has 4 specialized centers, but it didn’t use them.

    DRJ (a83b8b)

  109. RIght now its Abx and follow up with your personal physician in a week if you don’t improve.

    (I actually doubt he got instructions to visit another primary care MD right away).

    SarahW (267b14)

  110. ==Don’t you think the hospital and CDC were talking about what to do?==

    Frankly, no, based on what CDC director said, I don’t. But please don’t take my comments as criticism of the hospital alone. T think they were taken completely off guard.

    elissa (a5826a)

  111. and very obviously accented and of African extraction,

    Many Liberians have only light accents, not necessarily readily distinguishable from West Indians.

    Art Deco (ee8de5)

  112. He did, though.

    SarahW (267b14)

  113. MD in Philly (f9371b) — 10/15/2014 @ 10:12 am

    It is entirely possible that they asked for such things, and they were turned down, and the “turned down” part for blood transfusion was because of incompatibility, and Not because Duncan had “black blood and Brantley had “White blood”.

    So stop it.

    The New York Times article didn’t give either reason, just no reason.

    We don’t know there was an incompatibility.

    Maybe they just didn’t ask.

    Sammy Finkelman (6f9c3d)

  114. Question the fact that Ebola cannot be spread until patient shows symptoms Yoda does. If present in body virus is, chances are that it can be spread. Allergy sufferer sneezes, virus present in mucus is. While not as likely, spread it could be still with possible longer incubation period in person exposed because of lower viral load. Believe we are being lied to, Yoda does. Believe that at some magical moment of person first showing symptoms becoming infectious, Yoda does not. Does not common sense make, when one understands tenacity of viruses to propagate and infect. Believe PC is cause of this and to prevent “panic”, Yoda does! Like being paranoid is! Just because person paranoid is, does not mean person has no reason for being paranoid!

    Yoda (d89de1)

  115. From the WaPo: http://www.washingtonpost.com/blogs/plum-line/wp/2014/10/14/americans-are-terrified-of-ebola-which-could-make-it-harder-to-stop-ebola/

    So there are a few things to keep in mind as we think about this disease. The first is that politicians have almost nothing to contribute when it comes to keeping us safe.

    Neo (d1c681)

  116. elissa:

    ==Don’t you think the hospital and CDC were talking about what to do?==

    Frankly, no, based on what CDC director said, I don’t. But please don’t take my comments as criticism of the hospital alone. T think they were taken completely off guard.

    The CDC and the hospital were in contact about Duncan. The CDC recommended Duncan be tested for ebola on 9/28/2014:

    The person fell ill on Sept. 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on Sept. 26. After developing symptoms consistent with Ebola, he was admitted to hospital on Sept. 28. Based on the person’s travel history and symptoms, CDC recommended testing for Ebola. The medical facility isolated the patient and sent specimens for testing at CDC and at a Texas lab participating in the CDC’s Laboratory Response Network. CDC and the Texas Health Department reported the laboratory test results to the medical center to inform the patient. A CDC team is being dispatched to Dallas to assist with the investigation.

    The State Health lab’s results showing Duncan tested positive were completed at 9/30/2014 at 1:22 PM.

    This isn’t about the hospital, although I am concerned the ER doctor didn’t do her job that well. Using ERs as primary care facilities is common in Texas, so hospitals and the CDC need to take that into account when setting up their protocols.

    DRJ (a83b8b)

  117. What is clear that they gave dialysis, which may never have been done before in an ebola case, and which the CDC may never had anticipated might have been tried.

    Now the thing about dialysis is, I think, that it is always paid for in the United States. Correct me if I’m wrong.

    Specially arranged transportation to Emory, with the need to charter an airplane etc, and argue with federal bureaucrats, and with Emory itself, not so much.

    Blood transfusions, not part of the standard of care, maybe not so much either.

    Even though actually just about anything would have been paid for in this very unusual case, they may have followed their instincts about indigent patients. (And of course there might have been bad PR had the hospital insisted on being paid for everything, and they might have lost more money in donations than they gained in fees.)

    I would think the pride in the hospital would have caused them to want to have him survive, but maybe there was still something stopping them from going above and beyond the call of duty.

    Sammy Finkelman (6f9c3d)

  118. Is 70 health care providers caring for Duncan, and 2 ebola victims (so far), not enough sacrifice for you, Sammy?

    DRJ (a83b8b)

  119. SarahW,

    I don’t know if this report is accurate but it says Duncan was told to follow up with a physician the next day. I’ve been to the ER many times. This is standard instructions in many Texas ERs. They know they aren’t treating you. They are stabilizing you until you can go to a doctor in the next business day.

    DRJ (a83b8b)

  120. The real irony? Right this moment, Texas Health Presbyterian Hospital is probably the only US hospital that understands how to deal with Ebola. Everyone else still has lots of mistakes to make.

    Kevin M (b357ee)

  121. Time to commence ebola-hugging. COME HURR AND LOVE MEEEE.

    SarahW (267b14)

  122. pay it forward sister

    happyfeet (a785d5)

  123. ima take a vacation to get away from it all

    redc1c4 (34e91b)

  124. Daily mail probably has info straight from the family on that point DRJ. I tend to think it was standard followup advice. This bit made me angry, though: “A nurse’s note said Duncan told her he recently had arrived from Africa. That information did not make it to the attending physician.”
    That was in the history, in the Obammy-mandated EMR, and the physician had perfect access to it.
    Not only that, if he chose to shortcut and do his own evaluation, he avoided a very obvious question about international travel. He did have a marked liberian accent and it’s an obvious question when there is an “international person” or any question that a regular person might have had a history of travel out of the US. ER doc either reads or asks. He did neither. Not reading was typical.

    It’s okay to think of zebras and not horses in some circumstances and one of those is a sick person in the exam room who is from Africa.

    SarahW (267b14)

  125. But Frieden, Fauci, Collins, and Lurie have it all under control,

    narciso (ee1f88)

  126. Yoda (d89de1) — 10/15/2014 @ 10:38 am

    Believe that at some magical moment of person first showing symptoms becoming infectious, Yoda does not.

    I don’t either. I think it’s actually only sometime later.

    I am not at all surprised that nobody Duncan was in contact with in Dallas has come down with it, but hospitals workers did, and I don’t think that’s going to turn out to be untrue. (if ebola was anything like that, there’d be far more of it in Africa)

    By the time he was in the hospital, he was shedding copious amounts of virus particles all the time.

    Slight Caveat: Actually maybe there is a very small chance of infecting someone earlier, but the virus has to get out of the body somehow, and into somebody else, and there has to be enough of it. This does not happen very easily in the beginning, especially before symptoms, but I will grant you although the CDC may not) that it maybe could happen in one out of say, 150 cases of ebola infection.

    Think of a bell shaped curve with the vast majority of the shaded area (that being where ebola was transmitted) being to the right of the line which means a person is showing symptoms of ebola. No magic momentm but what they say is 99.4% true or whatever.

    I mean 3 or 4 standard deviations or more.

    This could happen especially if the person who gets it secondarily has a weak or immature immune system, like a baby.

    And I will state further, that in that case the person who transmits it to the baby, may never display symptoms of ebola, and will never be diagnosed with ebola.

    That’s what seems to have been the case with the index case in Guinea that started it all.

    That’s what I think. Someone who never develops a full–fledged case of ebola may transmit to someone who does.

    But, by and large, it doesn’t get transmitted until well after symptoms have shown up. So if you are trying to end an epidemic you can maybe more or less ignore those exceptions because it won’t happen often enough to affect your projections. There will just be one or two more unfortunate people. The HIV positive person, or the baby, of course, will not transmit it further until after manifesting symptoms.

    Sammy Finkelman (6f9c3d)

  127. 122. DRJ (a83b8b) — 10/15/2014 @ 10:54 am

    Is 70 health care providers caring for Duncan, and 2 ebola victims (so far), not enough sacrifice for you, Sammy?

    What they didn’t sacrifice, is routine.

    Sammy Finkelman (6f9c3d)

  128. hi Mr. red sorry i missed lunch this whole move is hectic and with the move date getting moved up I kinda came close to dropping the ball

    but it looks like it came together

    i’d hoped movers would be gone by now

    i’ll head out early tomorrow morning instead of today cause i still have running around to do

    happyfeet (a785d5)

  129. btw, you can NOT isolate a patient in the average hospital room, even if it’s a private one: modern HVAC systems make that impossible, as does room design.

    unless the room is sealed, with a negative pressure gradient, and the air output & exhaust systems isolated from the main runs, and furthermore, with the exhaust being deconed prior to being released, all you’er doing is blowing virus bodies all over the place. and you’ll need a negative pressure airlock/personnel decon area as well…

    never w*rked anywhere that had that sort of set up. closest i’ve been was an IV room with Class 1000 HVAC and 3 Class 100 hoods that ran 24/7/365. the air was so clean in there that going outside after several hours inside, the first couple breaths of outside air actually hurt going in.

    redc1c4 (34e91b)

  130. “A nurse’s note said Duncan told her he recently had arrived from Africa. That information did not make it to the attending physician.”

    That statement is now inoperative.

    Sammy Finkelman (6f9c3d)

  131. that’s okay feets: i’ve been stood up by cuter folks than you… 😎

    happy trails

    redc1c4 (34e91b)

  132. Possible 42-day incubation period? Am I reading this right?

    Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval.

    Chris (0ba377)

  133. http://www.nytimes.com/2014/10/11/us/thomas-duncan-had-a-fever-of-103-er-records-show.html

    — The medical records of the Liberian man who died of the Ebola virus, released Friday by the man’s family, raised new questions about the treatment he received when he first sought care at a hospital here.

    The man, Thomas Eric Duncan, 42, had a high fever — his temperature was 103 degrees — during his four-hour visit to the emergency room of Texas Health Presbyterian Hospital on Sept. 25, according to 1,400 pages of medical records that Mr. Duncan’s family provided to The Associated Press. Mr. Duncan reported severe pain, rating it an eight on a scale of one to 10. His fever was marked with an exclamation point in the hospital’s record-keeping system, The A.P. reported….

    …The reported details about his condition contradicted the hospital’s previous description of Mr. Duncan’s first visit. Hospital officials had said that Mr. Duncan had a temperature of 100.1 degrees and that his symptoms “were not severe at the time he first visited the hospital emergency department.”

    On Friday, Wendell Watson, a spokesman for Texas Health Resources, the organization that oversees the hospital, said in a statement that it continued to “closely review and evaluate the chain of events related to the first Ebola virus diagnosis in the United States.” But the statement did not directly address Mr. Duncan’s 103-degree fever or the hospital’s initial claims that he had had a lower temperature of 100.1.

    I gather, from some other news articles, that some of the thinking now is that his temperature had shot up while he was in the emergency room. (He was there for four hours) It was apparently measured at least twice.

    I guess the hospital decided to believe the first reading, or 103 degrees was not high to hospitalize. Or possibly the temperature information was not updated on whatever the doctor saw.

    Sammy Finkelman (6f9c3d)

  134. From the same story – the claim about the woman Duncan took to a hospital on Sept 15:

    Not even her family members knew” she had Ebola, Ms. Lloyd said at a news conference in Washington. “She had no symptoms at all of Ebola. She had pregnancy symptoms.”

    This is Saymendy Lloyd, described as an “activist” who became a spokeswoman for Louise Troh, the mother of his son.

    It does seem to be the case maybe that a pregnant woman with ebola, may appear to be just suffering a miscarriage. That’s going to be the first symptom, and people may not realize that that’s ebola. The Liberian VIP who flew to Nigeria, Patrick Sawyer, apparently contracted ebola the same way – from a pregnant women who apparently was miscarrying. Probably one of the American doctors, too. That will fool people.

    But since her brother came down with ebola, they should have understood what it was in a few days.

    Sammy Finkelman (6f9c3d)

  135. On the “low risk list”, y’all. Free to travel at will.

    SarahW (267b14)

  136. 133. Having a hard time tracking down a hard number for Isolation Wards+US or Infectious Disease Hospitals or BSL-4 Biosafety Labs.

    I’m thinking a couple hundred patients and the US will be at capacity.

    gary gulrud (46ca75)

  137. SarahW 139:

    We talked about that possibility 3 days ago in this thread.

    DRJ (8b9d41)

  138. IIRC, the old guy who survived in the Andromeda Strain did so because he drank a lot…

    anyone else wanna join me for a another round of shots?

    redc1c4 (34e91b)

  139. 136. Oh, well, that bites.

    gary gulrud (46ca75)

  140. #141: i’m thinking you’re being over optimistic with your bed count… and the labs won’t be set up for patient care.

    redc1c4 (34e91b)

  141. 136. Chris (0ba377) — 10/15/2014 @ 11:24 am

    Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval.

    Sub-clinical or never identified cases may make the incubation period look longer than what it is, but they won’t assume an infection came from a sub-clinical or unknown case – instead they will assume a long incubation period.

    The book “Level 4: Virus Hunters of the CDC” by Jose[h B. MCCormack M.D. and Susan Fischer-Hoch M.D. Barnes and Noble updated edition 1999 – first edition 1996) says the incubation period for ebola is 5 days.

    Now they are saying 8 to 10 days.

    The book “Plagues and Peoples” by William H. McNeill (Doubleday? 1976) doesn’t have anything about ebola – or AIDS – of course, but even a later paperback edition, published sometime in the 1990s with a new additional introduction or afterward, doesn’t mention it, although he does explain why of course AIDS is not in it.

    Sammy Finkelman (6f9c3d)

  142. gary gulrud (46ca75) — 10/15/2014 @ 11:41 am

    I’m thinking a couple hundred patients and the US will be at capacity.

    Could be – but we won’t reach a couple of hundred patients, unless they start having very loose standards for isolation, and then don’t put people who other people really need to be isolated from in isolation.

    Sammy Finkelman (6f9c3d)

  143. it’s obvious, at least to me, that the only thing we really know for sure about Obola is that it kills a whole lot of people…

    the rest of our “knowledge” appears to be rather shaky, which is unsurprising. therefore, the intelligent thing to do when dealing with it would be to be overly cautious and treat it like the deadly threat it is, with every possible restriction, protection and safeguard we can think of, starting with quarantines of the infected areas, here & there.

    unfortunately, instead of intelligent people, we have “experts” making the decisions…mostly based on political considerations.

    redc1c4 (34e91b)

  144. under texas tort reform the family and nurse will have to prove gross negligence that the hospital knowing and deliberately exposed nurses to ebola and sent ebola patient home or law suite will be thrown out of court! bill o’reilly on is they legal explained it last night on his show.

    tortoise (8331f4)

  145. Also, if one Duncan got into the US carrying this infection, others have too. How many more are walking around now?

    Patricia (5fc097)

  146. SarahW (267b14) — 10/15/2014 @ 11:33 am
    As usual, the headline is misleading. They were wearing protective gear, but not a “Hazmat” type. The article shows what is supposed to be the appropriate protective gear…but it looks to me that it is disposable gear, not gear that can be decontaminated prior to taking it off. But that is from the little info we have.

    I read previously that WHO declares an Ebola outbreak over when 42 days have gone by without a new case. I assumed that was not suggesting an incubation period as long as 42 days, but allowed for 2 cycles of potential infection to go by.

    MD in Philly (f9371b)

  147. The nurse is guilty. Even if she was on (inappropriately) a low-risk list, and free to travel, she still had to call in and report her temp. By the time of her return flight, she had a fever.

    SHE HAD A FEVER.

    And knew about Pham.

    SarahW (267b14)

  148. That’s some major league denial right there.

    SarahW (267b14)

  149. maybe she knew, and went home to say goodbye…

    predictable behavior that should have been allowed for in the response…
    but forced isolation would have bad optics, and people might panic.

    like they are doing know, knowing that infected people might be anywhere in the country.

    heckofaj*b, Obola.

    redc1c4 (269d8e)

  150. there’s always a silver lining: if this does spin out of control, which is looking more & more possible as the days go by, Obola’s place in history will be sealed.

    even the MFM won’t be able to spin this one in favor of their Precious.

    redc1c4 (269d8e)

  151. argggh…”know” = “now”

    they say one of the first signs is mental confusion… but at least i’m not running a temp.

    yet.

    redc1c4 (269d8e)

  152. MD, 151. The WHO article I linked says 19 in 20 infections develop within 21 days after exposure, and with 98% of cases occurring 1-42 days, that leaves 1 in 50 cases that develop after 42+ days. Is 1 in 50, or even 1 in 20 outliers reason enough to reconsider the 21 day quarantine rule?

    Chris (0ba377)

  153. We actually know a good amount about Ebola, but we haven’t applied what we know.
    Isolate patients and patients suspected,
    caretakers need to use an extremely precise protective measures, including suits that can be decontaminated prior to removing,
    limit travel by those who may have possibly been exposed, so in the event they get sick, there is a limited number of people who need to be further isolated

    In other words, treat it like a deadly disease with no cure with no room for mistakes.
    Don’t speculate about things you don’t know (airborne spread) while ignoring what you know.
    E.g., there is low risk of a planeload of people getting it from airborne spread,
    and/but
    there is too much risk allowing people on the plane who might have it to spread to a few by exposure to bodily fluids.

    On top of that, think about new challenges, like aerosols with mechanical ventilation.

    MD in Philly (f9371b)

  154. 145. Sigh, story of my life, unbridled optimism.

    gary gulrud (46ca75)

  155. It seems strange to me that the incubation period runs from a few days to over 42 days. I do not know how they decide if a case 40 days out of a known contact in a local area was from that known contact or some unknown exposure in the setting of an outbreak.
    I have things to do other than research it.

    MD in Philly (f9371b)

  156. Sammy @ 146. I remember back in the 70s-80s when these hemorrhagic fevers were explained that the consensus was that these types of viruses couldn’t possibly be the end of the world because of the speed it kills its victims, that there is simply not enough time between exposure and death to do a whole lot of travel, making the diseases too efficient for their own good. I recall 2-3 days of actual violent illness before death, and maybe 2-3 days of incubation before illness developed. I wonder what has changed from then and now to stretch these periods out to 2-3 weeks of incubation and 2-3 weeks of illness.

    Chris (0ba377)

  157. 152, 154. History will record “They(We) were not worthy of the Won. And God smote them.”

    gary gulrud (46ca75)

  158. #160: viral mutation… is there anything it can’t do?

    redc1c4 (269d8e)

  159. Chris (0ba377) — 10/15/2014 @ 12:20 pm

    I wonder what has changed from then and now to stretch these periods out to 2-3 weeks of incubation and 2-3 weeks of illness.

    Well, they say that’s exactly the kind of mutation you should expect (although they talk in termns of lethality, not incubation period)

    Sammy Finkelman (6f9c3d)

  160. #159: optimism is its own punishment.

    redc1c4 (269d8e)

  161. bend over and kiss your a*s good by.

    tortoise (8331f4)

  162. In the 70’s and 80’s it had been first discovered.
    Since the 90’s I imagine, it has been clear (as far I can tell) that what protected the rest of the world was the isolation of outbreaks, and that it was only a matter of time before somebody got infected and transported it to a heavily populated area.

    What people (myself, anyway) did not expect is that those that should have known better let the urban outbreak be undertreated and get out of control and let people travel all over the world from the epicenter.

    MD in Philly (f9371b)

  163. #161: also, if the virus has mutated to a longer incubation period, that could lead to increased total lethality, due to the virus being able to spread farther before being notices, which exposes more people, increasing the pool of potential victims…

    you;ll have to excuse me now. i need to go google “how to be a hermit in the 21st century”

    redc1c4 (269d8e)

  164. Even person who has recovered from Ebola virus is contagious via some body fluids (e.g.breast milk, semen). The seminal fluid of recovered males contains transmissible virus for up to seven weeks. I presume this makes the normal incubation period less clear cut a measurement – pinpointing exposure and duration of latent infection harder to measure.

    SarahW (267b14)

  165. Very good point, sarahW;
    which is a specific example of my question, maybe it isn’t so much a 42 day incubation period as much as an undocumented exposure.

    MD in Philly (f9371b)

  166. Meanwhile, ISIS is obtaining chemical weapons in Iraq that were never there…
    http://www.powerlineblog.com/archives/2014/10/the-times-report-on-chemical-weapons-in-iraq-its-no-blockbuster.php

    MD in Philly (f9371b)

  167. Sign up at Healthcare-dot-gov right away! You DON’T want to find yourself without health insurance when you gets the Ebola.

    Icy (46be8c)

  168. The UN says we have 60 days or it’s too late (New York Post headline)

    http://nypost.com/2014/10/15/ebola-infections-outpacing-health-authorities-efforts-un-official/

    The United Nations warned Tuesday that the world has less than 60 days to stem the deadly Ebola epidemic — as ghoulish marketers began cashing in on the crisis with creepy, Ebola-inspired Halloween costumes.

    what I think he means is that in 60 days the outbreak will be just too big to handle by the means proposed.

    “We either stop Ebola now or we face an entirely unprecedented situation for which we do not have a plan.”

    OK. So makeup a new plan.

    1) Give unexposed people in Africa Vitamin A , folic acid, calcium etc.

    2) Recruit recovered people to be near patients.

    3) If you can’t do anything for people, or isolate them, let them stay at home.

    4) Use anti-virals on medical personnel. BEFORE they can get exposed.

    5) Mass production of ebola antibodies – scientific rigor be damned. Also the anti-virals/

    6) Quick evaluation of any new treatment.

    7) Statins! (for ebola cases)

    8) Try to create ebola free zones. Circles with pie shaped wedges cut in them. The center should contain people free of it.

    9) Rapid testing – again scientific rigor – hyper rigor – be damned.

    we know how to doall of these things.

    Sammy Finkelman (6f9c3d)

  169. good thing we have the best & brightest w*rking this issue…

    it finally occurred to the CDC that maybe not letting high risk potential patients fly commerical might be a good idea.

    barn, door, horse, some assembly required.

    good thing this is only a #JVvirus

    redc1c4 (269d8e)

  170. it’s nothing short of amazing how the willfully ignorant amongst us think they can create “the brilliant plan that will save us all” by spewing mendoucheous BS which only tangentially intersects with reality.

    redc1c4 (269d8e)

  171. Me, I’m heading for the price club to get me some canned soup and a flashlight.

    SarahW (267b14)

  172. Best wishes and godspeed to Harlan Ellison, science fiction grandmaster, as he works to recover from a stroke that he suffered last week.

    http://www.latimes.com/books/jacketcopy/la-et-jc-harlan-ellison-stroke-20141014-story.html

    Icy (46be8c)

  173. dang it, Icy, Ellison is toast now that he’s come too close to your icy grasp.

    Colonel Haiku (2601c0)

  174. One thing’s for sure… if/when I come down with teh Ebola Fever, the one thing I won’t need is MORE COWBELL.

    Colonel Haiku (2601c0)

  175. Let’s start a pool: first country to quarantine the USA because of ebola, and when. I pick Japan and in time for the Sunday news broadcasts.

    Heck of a job, 0!

    htom (412a17)

  176. I dunno, DRJ… maybe she deserves the benefit of the doubt… but, in general, Texas has not shined during this episode… at least not per the accounts I’ve read.

    Colonel Haiku (2601c0)

  177. I’m just going to point this out one time. If I were King, we would have shot the first one on the tarmac.

    How many dead people you think it will take till President Ebola resigns?

    papertiger (c2d6da)

  178. Icy–

    See what a lifetime of edginess and anger will do to you…

    Kevin M (b357ee)

  179. Let’s start a pool: first country to quarantine the USA because of ebola, and when.

    I pick Israel.

    Kevin M (b357ee)

  180. If you’ve recently treated a patient with Ebola and your first instinct is to hop on a plane, you may be a Texan…

    Colonel Haiku (2601c0)

  181. Russia will… just because Putin would get get a chubby.

    Colonel Haiku (2601c0)

  182. “Nurses were forced to use medical tape to secure openings in their flimsy garments, worried that their necks and heads were exposed as they cared for a patient with explosive diarrhea and projectile vomiting, said Deborah Burger of National Nurses United.”

    what a way to go out…

    Colonel Haiku (2601c0)

  183. How many dead people will it take till MSNBC reports on the story, given that there is no way to spin it as anything but a direct result of President Ebola’s open border policy?

    Over/under 20?

    papertiger (c2d6da)

  184. IIRC, the old guy who survived in the Andromeda Strain did so because he drank a lot…

    Nope. Because his blood was alkaline from a peptic ulcer he was self-treating with Sterno. But, as they found with the baby, hyperventilation works just as well. Panic and wail like a baby! It could save your life.

    nk (dbc370)

  185. the Andromeda Strain was supposed to be a warning, as was Omega Man, Outbreak, the Stand, and Del Toro’s latest:

    http://therightscoop.com/shep-smith-on-ebola-everything-is-wonderful-and-you-have-nothing-to-worry-about/

    narciso (ee1f88)

  186. 181. Colonel Haiku (2601c0) — 10/15/2014 @ 1:27 pm

    but, in general, Texas has not shined during this episode… at least not per the accounts I’ve read.

    You mean the hospital, or the state?!

    Sammy Finkelman (6f9c3d)

  187. Dracula, too, don’t forget Dracula. Those swarthy foreigners coming over here to infect our women with their foreign cooties.

    I’ve read way too much fiction to respect any of those guys as prophets. Kind of like a million monkeys typing, any one of them could possibly produce something you could relate to. It impressed the heck out of my daughter, though, when I recognized a short story she was recently assigned in 7th grade English as being from Evan Hunter a/k/a Ed McBain (Blackboard Jungle; 87th Precinct).

    nk (dbc370)

  188. 181. Let’s be fair, most probably Blue State refugees have tainted the lot.

    gary gulrud (46ca75)

  189. There is a photograph in the New York Times of Saturday October 11, 2014 page A6 of what is on the outside of a health clinic in Waterloo, just north of Freetown in Sierre Leone.

    HEALTH RIGHT CAMPAIGN

    FREE HEALTH CARE ANTHEM

    I am very sickly,
    My head and feet are aching;
    Mother take me to care,
    Let my Government treat me
    Let me not die of disease.

    I am very sickly; {semicolons?]
    My body runs high temperature;
    Father take me to care,
    Let me get my treatment free,
    So that I will live to serve.

    I am very sickly.
    I want to see the Doctor
    Parents take me to care
    Let me enjoy my human rights.
    ,

    The last line is obscured by a stretcher holding a (dead) body.

    Perpendicular to him, outside of the picture frame, was anthoer patient,
    still alive, but rigid, motionless and prostate. Inside the clinic, dozens
    of patients were crwded in seeking treatmebt for other illnesses.

    The reporter saw a man arrived there on Frodya with his 4-year old daughter,
    who was very sickly, but had her eyes open. She had high fever, diarreah and
    had vomited, and was rigid in his arms. And he himself was exhibiting ebola
    symptoms. He had come there from more than 100 miles away in a taxi with
    other people.

    A nurse, a few feet away, which the reporter writes, is close enough to be
    infected shouted angrily at him: “Are you trying to spread the virus?

    But he was too sick to answer.

    In another section of waterloo, he found burial team workers who said they
    had caretr away 15 corpses for burial in less than a week and they were
    taking another one now, spraying it with chlorine as they left.

    The community chief (not sure what kind of an official this is) denied that
    ebola was present and attributed the deaths to witchcraft.

    Sammy Finkelman (d22d64)

  190. 192. “a million monkeys typing”

    Take a bow, Sam.

    gary gulrud (46ca75)

  191. 1) I am most decidedly NOT the Kiss Of Death.

    2) Mr. Ellison’s edginess and anger has managed to see him through 80 years on this mortal coil.

    We should all be so lucky.

    Icy (46be8c)

  192. 116. …The New York Times article didn’t give either reason, just no reason.

    We don’t know there was an incompatibility.

    Maybe they just didn’t ask.
    Sammy Finkelman (6f9c3d) — 10/15/2014 @ 10:36 am

    Well, then. If the sainted NYT didn’t mention any reason, Sammy, it’s best to just rely on a guy who is related to parties on one side of a lawsuit (if he isn’t himself a party) to feed you what must be unbiased and impartial information about the subject of the suit. Because that was in the NYT.

    Here’s a fun fact, Sammy. The universal donor blood type for whole blood is O negative, but the universal donor for plasma is different. The universal donor for plasma is AB.

    http://www.redcrossblood.org/SED/Universal-Platelet-Donor

    People with type O-negative blood are the universal donor for whole blood.

    http://www.redcrossblood.org/donating-blood/types-donations/plasma-donation

    Should You Be a Plasma Donor?

    If you are a donor with Type AB blood: In addition to donating platelets, your blood type makes you an ideal candidate for donating plasma.

    Type AB plasma is universal which means your plasma can be received by anyone, regardless of their blood type.

    You want to know how I learned that fun fact, Sammy? By not waiting for the NYT to get around to reporting the facts, that’s how.

    Steve57 (4d34f4)

  193. Colonel Haiku,

    I think you misunderestimate Texas. We’re not brilliant and we don’t get things perfect the first time. Rick Perry should have been your first clue on that. What Texans have is determination — we stick to things and we aren’t afraid to mess up, get back up, and try again. I think we will handle this ebola outbreak, and I don’t think we’re going to rely on the federal government to fix it. (If anything, relying on the feds was our first mistake.) However, please note that Dallas is a city governed by Democrats, so it may take a little longer than usual to fix this.

    DRJ (a83b8b)

  194. It’s just impossible to know if there was an incompatibility if the NYT doesn’t report it.

    Steve57 (4d34f4)

  195. What people (myself, anyway) did not expect is that those that should have known better let the urban outbreak be undertreated and get out of control and let people travel all over the world from the epicenter.

    None of us knew what a wild ride we were on when the USA elected the smartest man ever to be president.

    There was no way he was going to ban Africans from travel when George Bush is still more popular in Africa then Obama.

    The Firestone plantation is still the best model for Africa.

    Mike K (90dfdc)

  196. Here’s one that slipped right under our noses. No word who she is, where she was exposed, where she fell ill, who else may have been exposed, and how she got to Emory.

    Chris (0ba377)

  197. I have already decided I’m canceling a trip back east in november if this thing is not under control by then. I think we will head into recession unless the govt shapes up.

    patricia (5fc097)

  198. Chris – clearly it is because of racism

    JD (38004f)

  199. You’re Texas proud, DRJ. I hope you’re right about Texans’ resilience. What this fiasco will ultimately prove is just how dysfunctional the federal government is… as if more evidence is needed.

    Colonel Haiku (2601c0)

  200. Well she was admitted long before Duncan became patient zero, so you have to assume she didn’t contract it here. Or else the government is lying about Duncan being patient zero. I’m betting on the latter.

    And JD, EABAD.

    Chris (0ba377)

  201. How very tolerant and not at all homophobic and anti-gay of you, Chris. Tsk tsk

    JD (38004f)

  202. I pity teh fool who ends up on Obama’s “E-Team”… I pity ‘im.

    Colonel Haiku (2601c0)

  203. Chris, thank you for the link with respect to the mystery Emory patient. The timing (early Sept) and her wording certainly suggests that she may have been involved in Dr. Brantley’s or Nancy Whitbol’s care there at Emory.

    BTW, there was a discussion here yesterday about the blood donations from Dr. Brantley. The following article link called his donation to Sacra “a unit of blood” and said he’d also received “a unit of blood” from the Liberian boy. That suggests to me it was not plasma as some speculated but maybe I am misreading the technical term. Unlike Sammy I don’t pretend to know anything about ebola treatment.

    http://www.ibtimes.com/ebola-outbreak-2014-survivor-dr-kent-brantly-donates-blood-dr-rick-sacra-help-fight-virus-1686154

    elissa (ec36fd)

  204. elissa,

    I’m no expert, either, but ABC says Brantly donated plasma. This website explains how plasma donation works:

    How do you get my plasma?
    Donating plasma is similar to giving blood. A needle is placed into a vein in your arm. Plasma is collected through a process call plasmapheresis and is conducted in cycles that may take up to an hour. Whole blood is drawn. The plasma is separated from the red blood cells and other cellular components. These are returned to your body with sterile saline solution to help the body replace the plasma removed from the whole blood.

    So they take a unit (or so) of blood and return all but the plasma to the donor. My guess is there isn’t the equipment in Liberia to do that, so Brantly brough with him a whole unit of blood from the 14-year-old for his transfusion at Emory.

    DRJ (a83b8b)

  205. (CNSNews.com) – Dr. Tom Frieden, director for the Center for Disease Control and Prevention (CDC), said during a telephone press briefing Wednesday that you cannot get Ebola by sitting next to someone on a bus, but that infected or exposed persons should not ride public transportation because they could transmit the disease to someone else.

    So you can’t get Ebola by sitting on a bus but you can transmit Ebola by sitting on a bus?

    Hoagie (4dfb34)

  206. Well sure — I mean, if that person turns and starts making out with you, or something.

    Icy (46be8c)

  207. I just heard a news report stating that the nurse did indeed contact the CDC – twice – asking if it were okay to fly with the low-grade fever. She was told by the workers at the CDC that she could.

    Dana (4dbf62)

  208. Hoagie, I think they need to replace Dr. Frieden with a more qualified spokesperson on this important subject. Someone with more experiences in evasion and talking points. Someone like Susan Rice, perhaps.

    elissa (ec36fd)

  209. Sure, why not,

    Amber Vinson repeatedly called CDC before flying, saying she had fever. CDC cleared her bc it was below 100.4 threshold, reports @DrLapook

    narciso (ee1f88)

  210. Dana,

    If true, the CDC officials are beyond belief. They are like 3-year-olds who stand there and tell us they didn’t eat the cookies, as the crumbs dribble from their mouths.

    DRJ (a83b8b)

  211. you cannot get Ebola by sitting next to someone on a bus, but that infected or exposed persons should not ride public transportation because they could transmit the disease to someone else

    Citizen Hoagie, if you are not capable of simultaneously entertaining two mutually contradictory concepts, you will be re-educated and demoted to prole. Now, repeat after me: My chocolate ration was increased to 4 ounces from 6 ounces.

    nk (dbc370)

  212. I said today that of course the nurse must have gotten the okay to fly. Another reason not to trust the Cdc.

    My question is, now that Ebola is here, is it here forever?

    patricia (5fc097)

  213. there’s this lady in the alley going through my dumpster where i threw out all my cases of bottled water

    she’s emptying each bottle so she can recycle it

    one. by. one.

    this is what she’s doing with her one God-given life

    I’m not taking the rest of it down til she’s gone

    I do NOT condone this trash-picking activity plus she looks like she could have ebola

    happyfeet (a785d5)

  214. Look who just got a clue.

    felipe (40f0f0)

  215. I thought Cali is having a water shortage. Why are you tossing cases of water, feets.? Can’t you give it to friends or donate it? WTF???

    elissa (ec36fd)

  216. I keep waiting for one of these clowns to use the word “Inconceivable” when describing the spread of Ebola.

    Kevin M (b357ee)

  217. feets should at least pour it in the bushes. Or the bag lady should. Environmental hooligans!

    Kevin M (b357ee)

  218. All your thought are belong us.`

    gary gulrud (46ca75)

  219. if the water is still good, i’ll take it. hell, even if it isn’t, i cn water my native plants with it

    call me, if you have my number or just add AT drunkenbastards DOT org to my nick. we’ll set something up quick, even if no tacos are involved.

    redc1c4 (b340a6)

  220. MOAR good news: Obola patient in Turkey(they apparently flew in from the Ivory Coast) causes hospital to be put under quarantine

    we’re all gonna die.

    redc1c4 (b340a6)

  221. elissa–

    We have an odd water shortage. SF has all the water it needs, having dammed half of Yosemite long ago. The Central Valley farms, not so much as there’s an endangered smelt in the SF Bay that needs the water.

    As for LA, the flood control channels (“rivers”) have lots of water flowing in them, yet there’s a drought. Reminds me of a movie. BTW, there’s a huge water bond issue on the ballot to build dams that won’t get built because the treehuggers won’t allow it and the money will simply go to fund the salaries/pensions of people planning future dams that won’t be built.

    Kevin M (b357ee)

  222. which is why you ALWAYS vote “NO” on bond issues here in #Failifornia

    redc1c4 (b340a6)

  223. 220. D’zat photo of Gay Crack Whore in front of Marine One strike anyone else as listless ‘tardhood?

    Oh, dayum, I so wanted to throw down tonight, of all nights. PH#CK! I need a blow.

    gary gulrud (46ca75)

  224. New post up on 2nd Ebola patient possibly calling CDC before boarding plane.

    Dana (4dbf62)

  225. 227. We have an odd water shortage. SF has all the water it needs…The Central Valley farms, not so much as there’s an endangered smelt in the SF Bay that needs the water.

    Kevin M (b357ee) — 10/15/2014 @ 5:24 pm

    You certainly do have an odd water shortage as according to Al Gore and Barack Obama and Settled Science (PBUH) it’s caused by Global Warming. Yet for a global phenomenon it’s catastrophic effects seem inexplicably confined to one state in just one country. And the catastrophic effects aren’t even being felt equally throughout that one state. Some parts of Kali have water, other parts don’t, and for some mysterious reason you mention this fish in connection to the parts that don’t.

    Clearly if the Delta Smelt have any bearing on the situation then it must mean Global Warming causes Delta Smelt. Delta Smelt are therefore undeniable proof that Global Warming exists.

    Personally, I think Delta Smelt deniers are worse than Holocaust deniers and should be thrown in prison for treason.

    Steve57 (4d34f4)

  226. the water was for in case of murgencies

    i had like a dozen cases in a storage thingy on my deck

    but i got it like 3 years ago so it’s been baking in the bottles for a long time

    long enough to where it would only be good for in case of murgencies

    i will buy newer more wholesome water in Chicago, though I’m not even sure what you prepare for in Chicago

    snows I guess

    vigorous snows

    happyfeet (a785d5)

  227. elissa (ec36fd) — 10/15/2014 @ 4:31 pm

    Michael Crichton spoke of “wet sidewalks cause rain” stories when it comes to the press understanding technical stuff. Unless an article seems to make a point of being technically detailed, I would assume that phrases are more often ambiguous than technically accurate.
    As I said previously, Brantley may well have received a unit of whole blood in Africa because they did not have the technical means of separating the plasma. I think originally, and in low tech circumstances today, the person receiving the transfusion is on the ground and the person giving it is in a cot above, and gravity makes the blood go from one arm into the other.

    MD in Philly (f9371b)

  228. Yep. Good link.

    MD in Philly (f9371b)

  229. i will buy newer more wholesome water in Chicago, though I’m not even sure what you prepare for in Chicago

    City water pressure in Chicago only goes up to 30 feet. In highrises, the building has to pump it up. So, if you live above the third floor in a highrise, you’ll need water in case of a power failure. But they are very rare. Illinois has nuclear power plants. And migratory smelt that you can catch every April and join-in on a mass fish fry on the beach.

    nk (dbc370)

  230. “though I’m not even sure what you prepare for in Chicago”

    feets – Apart from snow and bitter cold, you got your basic climate change, ebola, enterovirus D68, random workplace beheadings, etc., etc., same as anyplace else.

    daleyrocks (bf33e9)

  231. Good one, daley.

    DRJ (a83b8b)

  232. Thanks DRJ

    daleyrocks (bf33e9)

  233. The Walking dead. Season One. Everyone’s infected and walking aimlessly around, seeking whom they may devour. The whole town is desolate, not a single traffic anywhere. Stay tuned for more…..

    The Emperor (9229cf)

  234. No need to panic folks. You can’t get Ebola until the person infected gets really sick and discharges body fluids. So obey the following: don’t shake hands, wave instead. Wear gloves if you are gonna be in a public place. Practice extreme hygiene; wash your hands always, using sanitizes. Don’t touch sick people. Don’t eat bats and monkeys. No hugging. Wear a face mask if you have to use public transport and gloves. Be extremely careful, this shit ain’t no joke. Stay safe y’all.

    The Emperor (d25300)

  235. Excellent post, very informative. I ponder why the other experts of this sector don’t understand this. You must continue your writing. I’m sure, you have a huge readers’ base already!|What’s Happening i’m new to this, I stumbled upon this I have found It absolutely useful and it has helped me out loads. I hope to give a contribution & help other users like its aided me. Great job.

    KIDANE (cd01de)


Powered by WordPress.

Page loaded in: 0.1911 secs.