Ebola: California is latest state to impose 21-day quarantine for those exposed to Ebola
Source: San Jose Mercury News
California on Wednesday became the latest state to order a 21-day quarantine for travelers who have been in close contact with Ebola patients.
In an attempt to avoid the criticism lodged against New York, New Jersey and Maine that had blanket quarantine orders, however, California will allow county health agencies to impose the quarantine on a case-by-case basis.
By working with county health departments to assess the individual risks, the California Department of Public Health said it "respects the individual circumstances of each traveler while protecting and preserving the public health."
Quarantine can range from observation and monitoring to the "limitation on his or her freedom of movement."
Read more: http://www.mercurynews.com/bay-area-news/ci_26823793/ebola-california-is-latest-state-impose-21-day
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FarPoint
(12,293 posts)I think its a wise choice to error on the side of caution, conduct through practice drills etc...we can always revise the plan once everyone is on the same page and ready to turn the page with confidence.
There are too many opinions, labile moods mixed with confusion at this point. I respect the lethality of this virus and want safety to rise to the highest bar as when that higher standard is met, confusion with disappear.
Kelvin Mace
(17,469 posts)and Duncan probably would have survived if he had been hospitalized when he first became symptomatic. I see lots of conflicting opinions among people with no expertise in Ebola, the true experts are pretty unanimous in their view that quarantines are counterproductive.
LisaL
(44,972 posts)If we were to get a lot of patients, our survival rate is for sure to go downhill.
Darb
(2,807 posts)We got it, thanks.
Kelvin Mace
(17,469 posts)The key to survival is EARLY detection and aggressive support treatment. Irrational quarantine policies will result in people lying to and avoiding health officials, thus giving the the disease more time to spread. The fastest way to to have a public health crisis is to place public health officials in an adversarial position with the public.
DallasNE
(7,402 posts)2 cured at UNMC in Omaha, 3 cured at Emory in Atlanta and 1 cured at NIH while Duncan died in Dallas. That makes the success rate 85.7%. The Dr. in NYC is too early to count either way but he has been described as stable and that is good news.
The 21 day waiting period for those traveling with the nurse from Dallas to Cleveland expires tomorrow and for those on the return trip it expires 3 days after that. This puts us past the prime time for coming down with the virus but not yet completely out of the woods but it does leave me cautiously optimistic. The 3 close contacts in NYC are just entering the highest risk 4-5 day period so we need to keep our fingers crossed that it goes well for them.
FarPoint
(12,293 posts)Yet, the learning curve in the US these days is a slow curve to turn. Once a universal plan has been successfully implemented, the the standards can be tapered back. The ball was dropped in the beginning by both the Texas Hospital, by claiming, assuring they were up to speed on effective Ebola patient/staff protection; then the same for the CDC for assuming the Texas hospital was up to speed.
The CDC could have and should have had a CrisisTeam sent into the Texas hospital to coordinate the set up. ..regardless of the hospital claim.
This scenario warranted my opinion to raise the bar high for containment and safety. Next, we can taper back. Housing should be equal to Marriott Residence Inn...that tent was an abomination.
Kelvin Mace
(17,469 posts)Current CDC policies based on science also take the reality of human behaviour into consideration:
1) If people know they will now lose an additional 3 weeks of work if they volunteer to help in Africa, they will be much less inclined to go. People have to eat and have to pay the bills and many use vacation time to cover their absence so they continue to draw a paycheck. Some agencies offer stipends, but that rarely covers the actual loss of income. To contain the outbreak in Africa, we need MORE teams of doctors and nurses, not less. Cut back on the number of people being deployed and you make things harder to control. The longer the outbreak continues, the greater the risk to the rest of the world.
2) If people know they will be imprisoned (a gilded cage is still a cage) upon return from outbreak countries regardless of exposure risks, they will lie about where they have been and who they were around. This means that people who are actually infected will slip through unmonitored with exponentially greater risk to the public.
3) Quarantining people stigmatizes them, with potential consequences to their future income and social life. CT has decided to imprison an IT professional who helped set up a tracking database for the Liberian government. He spent his entire time shuttling between his hotel and the government health office and never came near anyone who was sick. But now he must spend 3 weeks in his apartment with an armed policeman at his door who is there to prevent him from leaving and to keep visitors away. In this day when policeman can shoot people at the slightest provocation, how safe is it to have an armed person at your door who may have a Fox News understanding of Ebola?
What actually happened between the CDC and Texas has yet to be fully explored, but forcing the CDC on Texas was not an option. This was a state who has a governor with secessionist sympathies and who is openly hostile to the federal government and public health institutions.
FarPoint
(12,293 posts)I empathize as well. If everyone becomes focused using the same standard successfully, the sooner the quarantine protol parameters can be modified. It's sort of the triage concept...The adaptation has to be methodical in my opinion. Modification, tapering and adaptation can likely occur 30 days after everyone is on the same page with protocols and safety...
Kelvin Mace
(17,469 posts)for this type of thing. Doctors Without Borders and the WHO have followed them with great success for years. The hospital in Texas, for whatever reason, failed to follow the protocols properly, and the result was one death and two infections.
Mandatory quarantines will cause far more harm than good, will discourage people from helping, and encourage people at risk to lie in order to protect their freedom, their financial situation and their reputations. We either react to a danger with rational science or fear.
LisaL
(44,972 posts)Kelvin Mace
(17,469 posts)and contacted the CDC when he became symptomatic, as per established protocols. If someone connected to him, who was not in intimate contact with him while symptomatic, turns up positive for Ebola, we will need to change the protocols.
It's for dinner! Step right up and eat some raw chicken...you know you want some.
If you can't handle this, tune in to fox news for all the fear. We will never let you down, we have more fear than cnn could ever spew!
OH MY God, gay people live in my county, do they vote?
Tune in tomorrow, or miss all the fear you deserve!
passiveporcupine
(8,175 posts)is travelers who have been exposed to an Ebola patient, not admitting it when they get here, for fear of being locked up for 21 days, even though they believe themselves to be completely healthy.
That's going to work really well.
If they are monitored for 21 days (or however long that takes) it would keep them more inclined to cooperate, and confine themselves if any symptoms do arise...until someone can come and get them.
Xithras
(16,191 posts)People know that answer "Yes", they'll be locked away for 21 days. If you answer "No", you can go on about your business and nobody will pay attention to you. The standard answer, from nearly everyone, is going to be "No" for that reason alone.
This is why monitoring is a far better solution. Most people won't mind their local health department checking in on them for a couple of weeks to ensure that they're virus free. NOBODY wants to be locked up or deprived of their freedom.
These quarantine rules are creating a situation where lying is the BETTER answer. That's a pretty big problem.
uppityperson
(115,677 posts)
SunSeeker
(51,523 posts)Last edited Thu Oct 30, 2014, 02:47 PM - Edit history (1)
California is far from perfect.
But it is home. Sigh.
HeiressofBickworth
(2,682 posts)New York has 2 cases of Ebola. Just to be on the safe side (without any medical expert input), let's quarantine any passenger who has been in New York. Every state could do that. (heavy sarcasm)
This fear-mongering is getting tedious. Each case of Ebola in the US can be directly attributed to exposure to an actively symptomatic patient from an African country with wide-spread Ebola. With the exception of Mr. Duncan, each has been treated before they reached the extreme contagion stage of the disease.
Won't everyone just calm the fuck down......
LisaL
(44,972 posts)Who still died.
We have limited supplies and personnel. If Ebola were to spread, we are in big trouble.
Darb
(2,807 posts)I said we got it, thanks................again.
LisaL
(44,972 posts)Darb
(2,807 posts)Every goddamn thread you instill a bit of EEEEEBBBBOOOOLLLLLLAAAAA!!!!!!
What's your deal? Besides not liking it when someone ridicules your blatant cowardice.
Kelvin Mace
(17,469 posts)involved in Duncan's treatment was 76 according to the CDC.
http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/
Two people were infected and survived. The reason for their infection was probably inadequate training, but we will have to wait for a full review before it can be determined with any accuracy. Since then, hundreds, people have been involved in the treatment of the other five patients in proper isolation settings by properly trained staff and we have seen ZERO new cases.
Non-rational quarantine policies have serious consequences for people subject to them. There is talk in this story of putting all of these people on the TSA's "no fly" list, which in my opinion would be stupid and could destroy these people's careers.
ebbie15644
(1,214 posts)should all 50 of them be quarantined?
vlakitti
(401 posts)Who on earth is going to turn themselves in to be berated and "monitored" by hysterics?
Go bully the panic mongers. This cowardly shunning of courageous health care workers has evolved from stupid demagogy to a national disgrace.
California ought to try to be a bit more enlightened than New Jersey and Maine, for god's sake.
Darb
(2,807 posts)kidnapping. Did you read it?
Kelvin Mace
(17,469 posts)but still subject to one person's arbitrary opinion. We need one policy nationwide, not 50 different policies.
Darb
(2,807 posts)be close. But I am sure each county is in the process of coming up with a protocol to establish how much risk there is for each individual, and there is probably more than one person doing it.
California, again, sides with common sense and science over knee-jerk authoritarianism like , say......Jersey or Maine.
Kelvin Mace
(17,469 posts)58 according to my sources, which means 58 possible protocols. Again, not helpful.
candelista
(1,986 posts)Kelvin Mace
(17,469 posts)there are protocols in place from the CDC, the WHO and MSF, and they have been doing a great job for decades.
If Duncan had been seen at a hospital in a state not run by a governor with secessionist sympathies, who didn't hate the federal government and was not dismantling the public health system, he might still be alive and the two nurses who treated him might have never have become infected.
candelista
(1,986 posts)Kelvin Mace
(17,469 posts)the NY Post not the most reliable source. Fear-mongering is their middle name.
Second, who is their source that this happened? Since when are the police reliable when they intentionally leak to newspapers, especially the NY Post?
I'll wait until I see a report from a more reliable agency. I require more proof than "a source said".
candelista
(1,986 posts)They don't lie about everything. 
Kelvin Mace
(17,469 posts)They have a picture of the NYPD entering a building where the doctor lived, but nowhere in the story do they say the NYPD was the source.
The city’s first Ebola patient initially lied to authorities about his travels around the city following his return from treating disease victims in Africa, law-enforcement sources said.
Dr. Craig Spencer at first told officials that he isolated himself in his Harlem apartment — and didn’t admit he rode the subways, dined out and went bowling until cops looked at his MetroCard the sources said.
Detectives then reviewed his credit-card statement and MetroCard...
Spencer finally ’fessed up when a cop “got on the phone and had to relay questions to him through the Health Department,” a source said.
Officials then retraced Spencer’s steps...
Sure seems like it would be safe to assume it was the NYPD, but they are never mentioned by name in the story. No one goes on the record. Why? Well, because the leak was illegal and violated department rules. Also, did the police have a warrant to look at his credit card statements and metro card records?
Again, a more reliable agency that is willing to go on the record is what we should base our policy decisions on, not the NY Post and some asshat that is willing to break the law to get into the newspaper.
HockeyMom
(14,337 posts)Now Ebola but what next? Quarantine people with the flu? Force vax on adults and children for the "greater good of society?" Your body is no longer your own?
There are a lot of people today in this country who would like to see this happen. You hear it right here on DU from everything from Ebola to the flu.
People are being brainwashed by fear into compliance with an agenda. Remember that old slogan? We distort. You comply. Now where did I ever hear that?
Bragi
(7,650 posts)The logic for not implementing quarantines on health workers returning from West Africa is this:
1. Ebola cannot be transmitted other than by direct contact with body fluids of people who have contracted the disease and have the physical symptoms associated with the illness. (This is a medical fact. Suggesting other pathways for infection is unfounded speculation.)
2. The most important step needed right now to make the US and the rest of the world safe from the spread of Ebola is to stop the spread of the disease from where it is now present. (No-one who knows anything about the disease disagrees with this premise.)
3. Stopping the spread of the contagion from currently infected countries requires support from thousands and thousands of trained health workers who reside outside the infected zones. (The health care workers in the infected areas cannot control the spread of the disease without this outside support.)
4. If the US and other countries demand medically-unnecessary but public-confidence-boosting quarantine of health workers returning from infected areas, then this will discourage many/most health workers from volunteering to go to these places where they are needed to stop the spread of the disease. (This will increase the likelihood of the disease spreading outside currently infected areas.)
That's it. If logic and science do not prevail, and unneeded quarantines are put in place, then it is likely that reduced numbers of foreign health workers will lead to insufficient control of the disease, and its likely spread to countries with weak health systems. (Think India, or Pakistan, or the ever-impoverished Haiti, or some South American cities, etc.).
If this happens, the adverse global economic, political and social consequences will be enormous.