What's Next? Ebola Colonies?

[MineralMan]

With the nurse in New Jersey living in a tent in a parking lot, with no amenities, it looks like the plan is to treat people who have been exposed to Ebola like lepers. Maybe they can create some Ebola tent colonies in the middle of a desert somewhere and just put people there and wait to see if they die.

Unclean! Unclean!

We live in a nation led by many stupid people, it seems. Some of those stupid people are considering running for President. Uff da!

[magical thyme]

1. hey, she has a porta-potty. What did you expect? The Ritz?

[MineralMan]

2. Well, at the Ebola Tent City somewhere in the

Nevada desert, they could just dump some canvas and poles and provide a few shovels. Let the people dig their own latrines and erect their own tents. After all, how dare they come into the United States after, you know, hanging around with people with Ebola in god-forsaken West Africa? The very idea!

[FSogol]

3. Send them all to Ebola Island!

Gotta agree: "We live in a nation led by many stupid people, it seems. Some of those stupid people are considering running for President"

I often felt the GOP want a country where poor starving children begged at restaurant windows. Never thought I'd see tents of possibly infectious patients in NJ parking lots.

[Avalux]

4. I know you're being sarcastic, but I can see it happening.

When the experts are ridiculed and medical decisions are made by politicians - essentially ignorance overrules the facts - it's very troubling and doesn't bode well for our future. The stupidity is showing up here in droves.

[MineralMan]

5. Yes, sarcastic, but you're right.

When we ignore evidence-based information and react based on irrational fears, the individual takes it in the shorts every time. This is the Republican way. And the Libertarian way, too. Sadly, all too often, some Democrats, too succumb to fear and dread and forget about the needs of individuals they don't even know.

Fortunately, President Obama has put the pressure on Governor Christie and he has relented in his moronic response to the issue.

[Ms. Toad]

6. There is a middle ground that must be respected

when there is a high risk of death because of a misstep - and the lack of evidence is just that - a lack of evidence rather affirmative evidence proving transmission is impossible.

New York and New Jersey are political theater. The concept of providing something more than self-monitoring, however is a necessary one. 2 of the 3 health care workers who recently developed Ebola felt the first symptoms (fatigue, at a minimum - and more based on some reports) 2-3 days before they self-quarantined themselves. That has to stop.

There is evidence that Ebola can live on surfaces even in isolation wards which are cleaned frequently, it is presumed to be slightly higher in places which are not cleaned frequently. The virus is present in sweat and saliva, two bodily fluids most of us encounter on a regular basis. Every peer-reviewed article I have read refuses to exclude the possibility of transmission of virus in the early symptomatic stage, or via things directly touched by someone with Ebola.

Given that the evidence cannot exclude the possibility of transmission in those early stages, we need a practice which ensures individuals with known exposure to Ebola are isolated from the very first signs of Ebola. If (as appears from recent cases) even medical workers are unwilling to do that - then there needs to be some enforcement mechanism. (Two of the three recent infections reported fatigue or grogginess at least 2 days before developing a fever.)

What is going on in New Jersey is political theater - putting a nurse in a tent in what appears to be a parking deck - is atrocious. If she really had a fever (a concern which was dispelled pretty quickly by a more accurate thermometer), there is no reason she could not have been put in a room in the hospital. If hospitals are safe enough to treat Ebola patients, they are safe enough to treat someone who (at the time) was presumed to have Ebola.

In home quarantining - perhaps enforced by random phone calls to a land line, coupled with reporting not only temperatures but response to questions regarding a range of other symptoms including fatigue, muscle aches, or malaise, might be a reasonable balance between the very low risk - and the exceedingly high potential consequences of blinding ourselves to the fact that the risk is low but non-zero.

[MineralMan]

7. Of course there is a middle ground.

The New Jersey isolation wasn't that. Fortunately that's over with. But, I'll ask you this question: In the two cases of the nurses from Dallas, how many people did they infect? Also, please explain why Duncan's relatives who lived in the same apartment with him have not contracted Ebola?

Even most people working with patients in West Africa are not contracting Ebola. Ebola spreads in conditions where proper protection is difficult, if not impossible. Where proper protective measures are in place, Ebola subsides and disappears for the most part. Ebola will eventually get back under control in West Africa. Measures are finally being put in place to assist with that.

If Ebola victims are not contagious until they are actively symptomatic, as appears to be the case, then self-monitoring is sufficient, I believe. I'm quite sure that anyone who is self-monitoring is very worried about contracting this ugly disease and will report symptoms promptly so they can get the treatment that has saved people like the two nurses and the doctors who were treated. Wouldn't you?

Yes, there is a happy medium, and it is self-quarantine and self-monitoring. So far, that has worked very well, indeed.

[Ms. Toad]

12. Because the risk is low, but it is not non-zero.

Just because a single family did not contract Ebola does not mean that every family will not. As for the health care workers - we have no clue yet. I suspect none, but we still won't know until the end of the costly monitoring period for the 160+ individuals who were in contact with them AFTER they noticed at least the first symptom (fatigue/grogginess).

Read some peer reviewed research. There are cases of transmission without any traceable direct contact between an Ebola patient and any other person with Ebola. There is one confirmed case and ~12 others that are routinely reported. There have been limited studies of whether the virus survives on surfaces in situations where there is regular cleaning - and they have found it present without any evidence of bodily fluids

Prior to the current overreaction regarding HIV and blood, the Red Cross (and others) - for a long time - denied that HIV could be transmitted via the blood supply, and many individuals - particularly people with hemophilia suffered because they were basing their blood collection and aggregation on the lack of evidence of transmission via blood.

The absence of research establishing affirmative infection via non-direct contact is not good enough here, because (1) the cost cost of monitoring contacts for all those in contact with exposed individuals who later contract Ebola is significant and (2) the cost in human lives - and medical costs - if our assumptions are wrong are unacceptable. This is particularly true because there is not merely an absence of affirmative evidence - but some positive evidence it occasionally occurs both via what little evidence has been collected - and the recovery of virus from dry surfaces)

Self-monitoring would be sufficient IF people could be trusted to self-monitor and stop all contact with others the minute they experience symptoms. I would have expected that to be the case with medical workers, but I was wrong in 2 out of 3 cases. Both the second nurse and the doctor continued to engage the public AFTER they felt the first symptoms (fatigue in one case, and grogginess in the other). Obviously self-monitoring didn't overcome wishful thinking that somehow that fatigue and general malaise was some other oddly coincidental health thing that just happened during the 21 days following their exposure to Ebola.

Enforced self-monitoring/quarantine might work - but it would need to be enforced via random daily phone calls to a land line, twice daily temperature - AND reporting on a check-list of other symptoms, including fatigue, grogginess, malaise - with self-quarantining (enforced - if necessary) once there are any additional symptoms.

[Bluenorthwest]

8. Reagan/Bush era Republicans called for such camps for HIV, openly and fully, Mike Huckabee in 92

as part of his campaign promoted the intense need for camps. 1992 he said that.

[MineralMan]

9. Yes. I remember that. Fortunately, no such thing occurred,

although HIV was very badly handled in many places. There are many horror stories connected with HIV. I remember them very well. We're not very good here in the US with scary stuff we don't understand. In fact, we're quite bad at that.

[Bluenorthwest]

10. That's why it was so vital to elect Bill Clinton in 92. Huckabee represented what was by then

an extreme even for Republicans, but the man retained his standing in spite of his extremism. The level of fear some will push is absurd. Huckabee was saying this shit 5 years after even Ronald Reagan said there was no risk from casual contact.
Huck's words, just for fun:
"If the federal government is truly serious about doing something with the AIDS virus, we need to take steps that would isolate the carriers of this plague.
It is difficult to understand the public policy towards AIDS. It is the first time in the history of civilization in which the carriers of a genuine plague have not been isolated from the general population, and in which this deadly disease for which there is no cure is being treated as a civil rights issue instead of the true health crisis it represents."

[MineralMan]

11. Huckabee is certifiable. I never saw him as any kind of serious

candidate for President. As it turned out, he wasn't. Our record with HIV/AIDS was abysmal. No question about it. It's better today, of course, and that's a good thing, but many people suffered unnecessarily for far too long due to the over-reaction and non-reaction. It's one of the thoroughly regrettable periods of our history.

[LeftInTX]

13. Without starting another thread - Cuomo's quarantine punishment

He meant his new memoir, “All Things Possible: Setbacks and Success in Politics and in Life,” which sold a total of 945 copies in its first week.

The governor added that anyone who did not observe the quarantine could be forced to read the book,

“If they don’t comply, by law we can mandate it — it’s legally enforceable,” Mr. Cuomo said. “I don’t believe it’s going to be a real issue, noncompliance: These are heroes.”

http://cityroom.blogs.nytimes.com/2014/10/27/ebola-live-blog-monday-updates/