Patterico's Pontifications

10/17/2014

Rand Paul: At Least This Patterico Guy Got the Facts Right

Filed under: General — Patterico @ 7:27 am



As I told you last night, Senator Rand Paul accurately cited the CDC’s advice on Ebola and got pilloried for it by the Associated Press and other outlets. However, he did find one outlet that he says got it right:

Screen Shot 2014-10-17 at 7.18.12 AM

I was considering changing my slogan to: “Patterico: higher standards than the AP!” . . . but it just doesn’t sound that impressive, does it?

UPDATE:

66 Responses to “Rand Paul: At Least This Patterico Guy Got the Facts Right”

  1. Ding.

    Patterico (9c670f)

  2. OHHH, You’re bookmarked now!

    Chris (0ba377)

  3. Patterico is my first read every morning! With the help of your mainline bloggers the story is fleshed out, corrected (occasionally,) sourced, and put in a useful perspective.

    bobathome (5ccbd8)

  4. A well deserved accolade, Mr. Frey. Reading is fundamental.

    elissa (9cc421)

  5. I hope your server is ready…

    Expect an influx of trolls too.

    (and congrats on the high-profile notice!)

    Dan (00fc90)

  6. Well-deserved nod by Mr. Paul!

    Patricia (5fc097)

  7. Will having a U.S. Senator reading you mean an end to free books for us small potatoes?

    nk (dbc370)

  8. Congrats and well deserved.

    Tanny O'Haley (066e8f)

  9. One error frequently committed by “experts”–confusing ‘infectious’ with ‘contagious’.

    Ebola is extremely infectious requiring a dose of 1-10 virions to confer contraction whereas many highly contagious airborne viral diseases may require a dose of 1000.

    Johnny don’t learn.

    gary gulrud (46ca75)

  10. I hope the czar thing just isn’t true.

    SarahW (267b14)

  11. Rand Paul is just trying to swing your vote away from Ted Cruz.

    Obviously (eb6c08)

  12. Kudos. FWIW I trusted content from Patterico before it was cool

    Mike S. (f5d617)

  13. C’mon Man! You can’t expect the Associated Press to get every little detail exactly right. This is an election year after all, and Rand Paul isn’t exactly running on a Democrat ticket, now is he? So, don’t get your knickers in an uproar over tiny insignificant trifles. Relax, live a little, listen to Obama’s inaugural speech, have a nice glass of PC kool-aid, and remember it doesn’t matter if you like Ebola or not, it’s coming to an airport near you, and you can bet your life the President will see to it.

    ropelight (393fab)

  14. Very cool, P.

    DRJ (a83b8b)

  15. You need to add this to your “What they’re saying” file on the sidebar.

    DRJ (a83b8b)

  16. how much did this cost you?

    😎

    redc1c4 (589173)

  17. Maybe you should send him one of them Libertarian books.

    Kevin M (b357ee)

  18. meanwhile, in other good news, someone now on the watch list is on a cruise ship and the officials in Belize won’t let her off to get on an ambulance plane back here.

    redc1c4 (4db2c8)

  19. Good start for Attorney General, Mr. Patterico.

    mg (31009b)

  20. Just found this at the WHO website:

    WHO is alarmed by media reports of suspected Ebola cases imported into new countries that are said, by government officials or ministries of health, to be discarded as “negative” within hours after the suspected case enters the country.

    Such rapid determination of infection status is impossible, casting grave doubts on some of the official information that is being communicated to the public and the media.

    http://tinyurl.com/kx66ns7

    Danube River Guide (48fb95)

  21. Rand Paul says prosecutors and law enforcement in general give blacks “disproportionate” sentences.

    DN (395a7b)

  22. You might want to speed up work on those tax receipts.

    Kevin M (b357ee)

  23. Prosecutors and law enforcement in general give everybody disproportionate sentences. Because the legislatures tell them to. It just shows more among black convicts because they very disproportionately commit most of the crimes. Especially recidivist crimes where their prior convictions are factors in aggravation calling for a stiffer sentence.

    nk (dbc370)

  24. Well, AG Eric Holder has been hard a work since he took office making sure Black Panthers caught on video tape intimidating Senior Citizens and preventing them from voting in Philadelphia get off with slaps on the wrist.

    ropelight (393fab)

  25. Actually, this is not quite true:

    Just found this at the WHO website:

    WHO is alarmed by media reports of suspected Ebola cases imported into new countries that are said, by government officials or ministries of health, to be discarded as “negative” within hours after the suspected case enters the country.

    Such rapid determination of infection status is impossible, casting grave doubts on some of the official information that is being communicated to the public and the media.

    Danube River Guide (48fb95) — 10/17/2014 @ 9:38 am

    The sad part is that there are such devices capable of doing quick tests to 90% accuracy (developed and used by US military)in minutes to less than 1 hour–However, the US government prevents our hospitals from using such machines without a bunch of delays and paper work–Surprise!

    It does appear that the FDA has changed the rules in the last few days–An earlier article said that the hospital was specifically not allowed and would take something like a month to get approval to buy Ebola test films and put into diagnostic service (if blessed by FDA).

    Assuming article is accurate:

    Dallas hospital that treated three Ebola patients had machine that can detect disease in just minutes …but couldn’t use it because it wasn’t FDA approved

    The Film Array can screen for Ebola with 90 percent accuracy
    It is being using by US military doctors in West Africa
    Texas Health Presbyterian Hospital had one of the $39,000 devices but could not use it to diagnose diseases
    The military has given the Utah-based developer of the machine a $240million grant to perfect deadly virus detection

    The device costs $39,000 – a pittance by the standards of medical devices in hospitals – and was developed by Utah-based BioFire Diagnostics to test the genetic markers of a slew of gastrointestinal and respiratory viruses. It can use blood or saliva samples and it’s proven adept at quickly detecting Ebola, as well.

    Presbyterian Hospital acquired one two years ago, though it has been prohibited from using the device to diagnose patients because the Food and Drug Administration had approved it only for research use – and not for testing Ebola.

    This, despite the fact that BioFire Diagnostics has received a $240million grant from the Defense Department’s Joint Program Office for Chemical and Biological Defense to hone the device to detect Ebola and other deadly pathogens.

    The FDA has now approved the device for Ebola screening for research and has allowed hospitals to buy the necessary modifications to allowed their Film Array systems to detect the virus.

    BfC (8661e2)

  26. I haven’t heard so often about public vomit since my first tour in college.

    I was sorta legendary.

    But one 63 year-old Nigerian vomits and dies at JFK, and now a Sierra Leone visitor vomits all over a Pentagon lot.

    During the really cold weather this will not be pretty.

    gary gulrud (46ca75)

  27. Private entrance, immediate isolation, transfer to Presby, Presby denying everything. Uhuh. It’s either someone on the watchlist trying to avoid the media, or someone of excessive privilege.

    http://dfw.cbslocal.com/2014/10/17/new-patient-screened-positive-for-ebola-at-baylor-hospital-testing-not-confirmed/

    Chris (0ba377)

  28. 27. They’ve begun the full monty cover, to protect us.

    Wonder if anyone’s looked in on Duncan’s relatives.

    gary gulrud (46ca75)

  29. I’m betting it’s one of Presby’s Duncan care team.

    Chris (0ba377)

  30. Chris,

    I’m not sure it would be a privileged patient, although it could well be a healthcare worker or someone on the watch list. Instead, I think this is what many Texas hospitals are doing now. For instance, my hospital announced it has a private entrance for suspected ebola cases, with an attached isolation room and a caregiver who doesn’t work in any other area of the hospital. It’s going to cost a fortune, I’m sure, but it gives local residents confidence the hospital is taking this seriously.

    DRJ (a83b8b)

  31. Gary, they will start enforcing the privacy rules that started with HIV to keep it from us. “You don’t want the media here harassing you, do you?”

    Patricia (5fc097)

  32. 31. Patricia: Well, people in hazmats decontaminating apartments and spreading leaflets around the complex is not going to keep it completely secret for long.

    30. DRJ: How long do you think that entrance will remain private? I’m seeing articles everyday of fakers trying to get either attention or faster treatment, so I wonder what safeguards are in place at those private entrances.

    Chris (0ba377)

  33. and so it begins…

    nurses from Cleveland hospitals were on the plane with our now fully symptomatic Dallas nurse, who was only a *little* sick when they let her travel…

    redc1c4 (dab236)

  34. Facts? Obviously not a Democrat strength.

    kansas (ad6b2e)

  35. Private entrance, immediate isolation, transfer to Presby, Presby denying everything. Uhuh. It’s either someone on the watchlist trying to avoid the media, or someone of excessive privilege.

    The patient has not had a blood test. The patient was flagged for testing due to answers on a questionnaire. This is analogous to the deputy put in isolation and other heretofore false alarms.

    Again, Duncan was shut up in the hospital 19 days ago and his relatives relocated 15 days ago and no confirmed cases of Ebola bar from the hospital itself. Ebola usually shows up within six or seven days of infection.

    Art Deco (ee8de5)

  36. nurses from Cleveland hospitals were on the plane

    So what?

    Art Deco (ee8de5)

  37. meanwhile, in other good news, someone now on the watch list is on a cruise ship

    That person is not ill. That person is a lab tech who likely had non-refundable tickets.

    Art Deco (ee8de5)

  38. BfC

    You can get a positive for Ebola that fast but you cannot assume someone is negative for ebola that rapidly.

    Danube River Guide (48fb95)

  39. See this guidance from the WHO website–also at the previous link–here:

    Two negative RT-PCR test results, at least 48 hours apart, are required for a clinically asymptomatic patient to be discharged from hospital, or for a suspected Ebola case to be discarded as testing negative for the virus.

    Danube River Guide (48fb95)

  40. Well earned praise!

    Dustin (801032)

  41. Where is Pham’s boyfriend? Why won’t they say if he’s tested negative or positive?

    SarahW (267b14)

  42. vomiting on a cruise ship is de riguer.

    Colonel Haiku (2601c0)

  43. So what?

    i take it you are unclear on how communicable diseases, which are called that for a particular reason, spread.

    you are also apparently unaware that, contrary to the bull5hit being spewed by the Obola regime, we’re really not sure just how this outbreak is spreading, nor are we certain when patients become infections, as the casualty rate for DWB makes clear.

    so yeah, being worried that other care givers might have been exposed, and that they, even now, may be exposing others, is absolutely nothing to be concerned about.

    WTF was *i* thinking?

    redc1c4 (cf3b04)

  44. casualty rate for DWB makes clear.
    Actually, I tried to find a “rate” and associated information about the cases and I couldn’t. Any additional information you can find would be most appreciated.

    Speculate all you want (I am getting angry about this and am choosing to not use language I would otherwise like to employ, i.e., I’m getting angry about this recurrent theme)
    the problem is that people have not taken seriously what is known, not some mystery that is unknown.
    And even the one unknown that has been brought up is not mysterious, the mechanics and characteristics of droplets/aerosols/ and virus particles for a patient on a ventilator maybe substantially different than previous patients never cared for with such technology.

    A negative PCR test only means a negative PCR test, that at the moment in time the test was performed, there were not enough virus particles around to make a positive test (or some other complication that gave a negative result instead of a “true” positive result). The possibility remains that the person has Ebola but is early in the infection and the number of virus particles are too few. In the event of a suspected case showing symptoms, I guess the idea is that after 48 hours of symptoms from Ebola there should be enough virions in the blood to be detected.

    MD in Philly (f9371b)

  45. Who is more proactive than the CDC?

    Male strippers, that’s who.

    http://hotair.com/archives/2014/10/17/male-strippers-on-ebola-infected-nurses-flight-pretty-appalled-by-cdcs-irresponsibility/

    And look there at the end, CDC told them to stay 3 feet away from others.

    DejectedHead (13c12c)

  46. Very nice – but I’ve seen it already. 😉

    bridget (37b281)

  47. MD, I averaged the number of deaths as a function of those diagnosed with Ebola for the last 4 outbreaks. The results are a death rate of just over 4 of every 5 or a little better than 80%.

    ropelight (393fab)

  48. ropelight, I’m not talking about an Ebola death rate, I’m talking about the infection rate of DWB/MSF, not just how many infections, but out of how many workers, and the circumstances and characteristics of those infected and those not.
    It seems to me that you are repeatedly implying we do not know enough about Ebola because the DWB people are getting it to.
    I think that is only good as a superficial point that may be readily explained by known factors.

    MD in Philly (f9371b)

  49. @ MD,
    There does seem to be some opinion that we really do not know definitively that airborne transmission is impossible. To the contrary, at least some informed opinion suggests that it is possible. Two cites, one older, one not:
    http://wwwnc.cdc.gov/eid/article/11/3/04-0981_article

    http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola

    I may be mischaracterizing “airborne”, not being a medical professional, but there are historical infections which are, to say the least, unexplained by the direct-contact theory. I suppose all could be the result of procedural errors, but then, they could also be something more insidious.
    Anyway, I think the essential point is that we really do not know with certainty that “direct contact” as commonly understood or commonly explained in the present CDC vernacular is accurate.
    Your point that ventilators change the game is one that frankly I had not heard mentioned before but which is one of those head-slappers. Thanks.

    JCC (469de6)

  50. Thanks JCC for the links and thoughts. I know there has been a lot of discussion.

    My main point has been we first need to take seriously what we know about Ebola and implement it. That means we should be helping to quarantine Africa and not allowing people to seed the US population here and there.
    Second, extremely careful hazmat level decontamination procedures for HCW.
    We need to do those things first before we speculate about things we have no evidence for in the 40 years of taking care of Ebola patients.
    Much of the information about possible respiratory transmission was not only in animal models, but it artificial lab conditions.
    Those studies do suggest more precautions are warranted when a patient has a tube going into their lungs with forced mechanical ventilation. I did not first point that out, SarahW did, and I think it might have been also mentioned by someone else, who I didn’t recognize and don’t remember.

    I will be surprised if there are not some secondary infections from Duncan’s contacts in the community, but if there are not, that again reinforces that just being in the presence and breathing the same air does not get you Ebola.

    BTW, I just heard Ben Carson tell Hewitt that he would NOT be the “Ebola Czar” if asked, because “he couldn’t work for somebody he didn’t trust… he would need to have freedom to say what he thought needed to be said” (more or less a quote).

    He also said he thought Freiden and others are not being allowed to say what they really want to say.

    “Airborne transmission”, AFAIK, means that the virus is put onto the environment in a way that hovers in the air, that after the person has left the room, a new person entering the room can get the infection by breathing the air. “Airborne transmission” does not mean getting it when someone sneezes or coughs on you, those are ways or direct contact.

    MD in Philly (f9371b)

  51. Where is Pham’s boyfriend? Why won’t they say if he’s tested negative or positive?

    The privacy laws in effect now are designed to protect the patient totally, not the public.

    I don’t care what his name is, I just want to know–and I think we have a right to know–his condition.

    Patricia (5fc097)

  52. I wouldn’t be surprised or alarmed if he gets Ebola, and it would mean nothing we don’t already know.
    You control it by getting ahead of it and containing it. People sick get put into treatment under quarantine with precise measures to keep the care-takers safe.
    You isolate people exposed, don’t let them into the general public, until their 21 days are up (I believe 21 days is what they have traditionally used). The outbreak is over when there are no more exposed people in isolation.
    That hasn’t been done yet. Whether it is being done now is unclear.

    MD in Philly (f9371b)

  53. Gotta kiss the ring. You kidding me?
    It’s like Sinatra came and sat down at our table.

    Gotta kiss the ring.

    papertiger (c2d6da)

  54. for Doc:

    Newsday

    In another example of the disease’s relentless march, Doctors Without Borders said Tuesday that 16 of its staff members have been infected with Ebola and that nine have died. The toll highlights the high risk of caring for Ebola patients even at well-equipped and properly staffed treatment centers.

    and, it turns out i was wrong about the percentages, having either misread or been mislead by a news article, see here:

    The risk is real. The WHO said that as of October 1, 382 health care workers had developed the disease working in west Africa and 216 had died from it.

    Charities, and now governments, are scrambling for personnel to staff the missions where accompanying death, and not treatment, is for now the most pressing need.

    MSF, with 268 international staff and 2,900 nationals on the ground, said it is stretched to the limit and in some cases, has rejected government cash, urging states to send medical teams instead.

    “The hardest is that so much of the work will be relief, end-of-life care, and in the end very little treatment,” said Ivanova.

    The hardest “is realising that this is a disease that doesn’t forgive”

    1382/216 = 15.6% mortality rate, which isn’t that bad, unless you draw the short straw… DWB infection rate is 18/3168 = 0.0051 but their mortality rate is 9/16 = 56.3

    bottom line, the MSF/DWB numbers aren’t as bad as originally offered, but it would appear that the bug may have mutated somewhat, making it possibly easier to spread, but may have lost some lethality in the process.

    helluva a trade off, and makes me miss the good old days where my worst worry was screwing up and getting red death all over the inside of the chemo hood.

    (no, i never did: negative pressure is your friend when w*rking with dangerous stuff. %-)

    redc1c4 (589173)

  55. Whether it is being done now is unclear.

    “Kabuki Public Heath Theater”, another “We’re All Gonna Die” production, brought to you in living color by Obola Productions, a wholly owned subsidiary of SCOAMF Inc.

    redc1c4 (589173)

  56. Good news, everybody. Ebola is a hoax. It is not transmissible from person to person. It can only be injected by doctors when people seek medical treatment. Its purpose is not to kill Africans as some morons have suggested. You’re not going to depopulate Africa at the rate of 160 a day. Its purpose is to give an excuse to the West to put troops on ground in Africa. Read the whole thing: http://www.spiritscienceandmetaphysics.com/ebo-lie-man-living-in-ghana-confirms-ebola-is-a-hoax/

    nk (dbc370)

  57. /me breaks out the restaurant size roll of extra wide, heavy duty aluminum foil…

    remember everyone!!! shiny side out or it won’t stop the mind rays…

    step right up and help yourself!

    redc1c4 (589173)

  58. red-
    thank you very much for that information
    one thing to remember is that total number of infected HCW would include those infected before it was known to be Ebola, and perhaps some that contracted it from the daily living in an area heavily affected by it
    the other fine point for the DWB crew is that it includes 2,900 nationals on the ground,
    i.e., even the 0.5% infection rate is not among professionally trained docs and nurses
    and that is a lot of people to have been recruited who had never worked with Ebola before

    so I am going to stick with my thought that whether the virus has mutated to change its characteristics or not,
    one does not have to invoke that in light of other realities of this current outbreak

    MD in Philly (f9371b)

  59. and HCW are likely healthier to begin with than the average African and they had access to the best healthcare available early in their infection, i.e., the usual death rate is a function not only of the viral strain, but the underlying of the patient and the care available to the victims of it

    MD in Philly (f9371b)

  60. I am so relieved that the President has appointed a “talented messenger” like Plain to try to make the crazy propaganda coming from the Administration appear to be at least consistent. I have only two small doubts:
    (1) It is said he will report to two bosses, Rice and another lady with whom I, and you probably, am not familiar. Have you ever tried to work for two bosses? If you have, you are probably working at a failing organization. Quit.
    (2) One of Plain’s accomplishments was working at Joe Biden’s messaging. Biden’s messaging is, and has for a long time been, the laughingstock of the nation.

    Fred Beloit (e503e2)

  61. Hey Doc!
    someone else is wondering down the same path i’ve been musing on.

    redc1c4 (34e91b)

  62. Like I said elsewhere, Ebola virology is starting to resemble global warming, it can do anything.

    World experts should have been doing what they’ve known to do for 3 months now, instead of playing speculation games.

    It is real simple. You have an infection that is transmissible from person to person with normal every day direct contact, it kills at least 50% of those who get it, it is out of control in a significant part of one continent with over a million people and the ability of people to travel and spread it around the globe.

    Do you want to do what you know you need to do to control it,
    or to you want to hem and haw and argue and pontificate and speculate and politicize and let it disseminate to other parts of the world?

    That is my point and I will keep making it until there is another point worth making.

    MD in Philly (f9371b)

  63. I linked to this New York Times story two weeks ago:

    http://www.nytimes.com/2014/10/03/us/understanding-the-risks-of-ebola-and-what-direct-contact-means.html

    People can also contract the disease by touching infected fluids and then touching their eyes or mouth. The virus does not spread through the air, unlike measles or chickenpox. And Ebola does not invade healthy skin, so merely touching secretions does not mean an infection will follow. But washing hands or using an alcohol-based hand sanitizer is essential after any potential contact, to avoid spreading the virus to other people or to one’s own eyes or mouth.

    Ebola does not cause respiratory problems, but a cough from a sick patient could infect someone close enough to be sprayed with droplets of mucus or saliva. Droplets can generally fly about three feet, so people dealing with anyone who may be ill are told to stand at least three feet away, preferably six. Being within three feet of a patient for a prolonged time, without wearing protective gear, is considered direct contact, Dr. Frieden said.

    According to the C.D.C., the virus can survive for a few hours on dry surfaces like doorknobs and countertops. But it can survive for several days in puddles or other collections of body fluid at room temperature. It is not clear how long it may survive in soiled linens and clothing. Bleach solutions can kill it.

    But actually, Rand Paul sort of distorted the truth, and he knows that.

    Sammy Finkelman (c2bb62)

  64. But actually, he didn’t, and the post shows that.

    Patterico (d4f6b7)

  65. The beauty of this website is that its host has a high tolerance for contrary views. Contrary views can help us focus on topics, work through the issues involved, and understand where we disagree. They even help us come to a consensus. But some contrary views are so useless that they border on trolling.

    DRJ (a83b8b)

  66. DRJ (a83b8b) — 10/19/2014 @ 10:18 am

    I wish there was a way to like or thumbs up or thumbs down a comment. I’d give your well written comment a thumbs up.

    Tanny O'Haley (066e8f)


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