Ebola in New York now

RJM62 said:
The necessity for such exacting precautions as you describe really doesn't bolster my confidence in the consistently-downplayed official statements regarding the disease's communicability.
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Then I don't think you understand the limitations of the protections offered by PPE, short of donning the heaviest grade rubberized suit and gloves, which pose their own health and safety risks to the user.

When you're handling patients at their sickest stages, where the viral concentrations are at their peak, one small splash of bodily fluid into the eyes while removing a glove could be enough. This is a far different risk than exposure to a drop of sweat from someone with very low load viral loading at the beginning stages of symptoms.
 
Henning said:
If communicability was easier than claimed, we would have a major issue with more locally infected patients at this point. As it is the numbers we have are well within the parameters of normal statistical outliers of the model the CDC has always presented. What the future may bring to this may change things, but at this point the CDC claims as to low communicability seem to be holding up.
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Not if you want to do some good scaremongering.

Just waiting to see if any Ebola patient Halloween costumes will be showing up at the door next week.
 
Check in the spring, how many people in 'Merica have died of Ebola compared to the flu. Flu will win hands down. Lots of hot air concerning Ebola.
 
Jimmy cooper said:
Check in the spring, how many people in 'Merica have died of Ebola compared to the flu. Flu will win hands down. Lots of hot air concerning Ebola.
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I'm waiting to see what really happens when flu season gets here. How many panicked folks are going to hit the ERs wanting to be tested for Ebola when they really have the flu?
 
Matthew said:
I'm waiting to see what really happens when flu season gets here. How many panicked folks are going to hit the ERs wanting to be tested for Ebola when they really have the flu?
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How about just a cold? This is really why it needs a political/PR person as Ebola Czar, it's not about controlling the disease, it's about controlling the fear.
 
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Henning said:
How about just a cold? This is really why it needs a political/PR person as Ebola Czar, it's not about controlling the disease, it's about controlling the free.
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Dunno that we need an Ebola Czar. But the Surgeon General (vacant right now, I think) would normally be that person.

Putting the CDC guy in front of cameras is not helping. I understand your point - he's probably very, very, competent at understanding communicable diseases, and his organization is probably loaded with some of the best doctors in those fields that you can find. But he's not best suited for dealing with the lowest common denominator of TV viewers out there.
 
Meanwhile, one of the nurses from Texas was declared Ebola-free and released today. President Obama had her come meet him at the White House.

So far, one dead in the US and a lot more cured.
 
I agree, a strong surgeon general could handle this concern better than the appointed czar.
 
steingar said:
Oh no, another case! Egad, the epidemic! Egad, the humanity!

Of course, the one guy who died was fevering, vomiting, and bleeding out the eyes in the same small apartment as form other people who didn't get it. But lets worry ourselves ragged! Ebola!
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You know, I really, really hope you don't have to eat these words some day, really.

Seems to me, doctors, medical personnel and others who unselfishly go into the midst of the ebola hot zone might start thinking about being unselfish when they get back home and isolate themselves from the public for 21 days voluntarily.
 
We better hope ebola doesn't get anywhere near exponential growth.



exponential-growth-fills-stadium-with-water-in-minutes.jpg



This is an example of exponential growth in one minute increments.

It’s 1pm. Imagine a normal sized football stadium. In this stadium you are sitting on the seat at the very top of the stadium, with the best overview of the whole stadium.

To make things more interesting, imagine the stadium is completely water-tight.

The question is, if a drop of water is added to the stadium and then one minute later it doubles in size to two drops, and then one minute after that it doubles again to 4 drops, and so on.. doubling in size every minute, how much time do you have to leave your seat and get out of the stadium before the water reaches your seat at the very top?

Think about it for a moment. Is it hours, days, weeks, months?


The first drop of water lands right in the middle of the field, at 1pm.

You have exactly until 1:49pm. It takes less than 50 minutes to fill a whole football stadium with water! This is impressive!

But it gets better:
At what time do you think the football stadium is still 93% empty? Take a guess.

The answer: At 1:45pm. So, you sit and watch the drop growing, and after 45 minutes all you see is the playing field covered with water. And then, within four more minutes, the water fills the whole stadium.

This means that you think you are safe because it seems that you have plenty of time left, whereas due to the exponential growth you really have to take immediate action if you want to have any chance of getting out of this situation.

Think about that… let it sink in…
 
PaulS said:
You know, I really, really hope you don't have to eat these words some day, really.

Seems to me, doctors, medical personnel and others who unselfishly go into the midst of the ebola hot zone might start thinking about being unselfish when they get back home and isolate themselves from the public for 21 days voluntarily.
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Too late, NY and NJ are now imposing 21 day quarantines on health workers that give of their time and expertise to help in those third world countries, and the May impose it on any traveler coming for there. They may eve apply it to anyone arriving at their airports, even if the people don't live there (which represents a logistics issue), meaning they effectively impose it on the rest of the country.

Out of "an abundance of caution", of course. Despite the high cure rate here, and the very low infection rate.
 
RJM62 said:
The incessant mantra of official assurances that Ebola's really not very contagious seem inconsistent with the fact that medical professionals who are experts in infections disease control, who observed the established protocols, and who used the best-available protective gear, are still becoming infected. To me, it hints of at least the possibility of political correctness trumping science.

Does anyone know at what point post-exposure the blood test for Ebola is reliable? A quarantine requirement for returning travelers might (or might not) be excessively intrusive, depending on whether the experts are right or wrong in their understanding of the disease's contagion potential. But a blood test would be reasonable if, in fact, it were reliable within a short time frame from exposure.

Rich
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There are several diagnostic tests for Ebola, but I think RT-PCR (reverse transcriptase, polymerase chain reaction) is what has been done for the US patients in the current epidemic. It's sensitive and specific enough that there haven't been any false positives or negatives yet in Europe or the US, I think (but am not certain). A test that identifies a patient prior to them being viremic enough to be infectious is certainly something folks are searching for, but I don't think enough folks have tested positive by the technique to know how it correlates with infectivity, except that by the time patients are sick enough to present to a hospital (or febrile but not that sick in the cases of Vinson, Pham and Spencer), they're testing positive.

Don't discount the information re transmission based on thousands of patients in Africa, over numerous outbreaks spanning almost four decades.

The fact that no one, outside of a hospital, has contracted Ebola anywhere except Africa is telling re transmission in the community setting. That was true of those who shared an apartment with Duncan for days as he became seriously ill, the husband of Romero in Madrid, the family of Vinson, boyfriend of Pham, etc. If one is in health care, dealing with bodily fluids from sick patients, it's clearly a different story.
Don
 
RJM62 said:
The incessant mantra of official assurances that Ebola's really not very contagious seem inconsistent with the fact that medical professionals who are experts in infections disease control, who observed the established protocols, and who used the best-available protective gear, are still becoming infected. To me, it hints of at least the possibility of political correctness trumping science.

Does anyone know at what point post-exposure the blood test for Ebola is reliable? A quarantine requirement for returning travelers might (or might not) be excessively intrusive, depending on whether the experts are right or wrong in their understanding of the disease's contagion potential. But a blood test would be reasonable if, in fact, it were reliable within a short time frame from exposure.

Rich
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Apparently, the protocol wasn't advanced and the protective gear was poor.

http://www.syracuse.com/news/index.ssf/2014/10/dallas_nurses_say_ebola_patien.html
 
wsuffa said:
Too late, NY and NJ are now imposing 21 day quarantines on health workers that give of their time and expertise to help in those third world countries, and the May impose it on any traveler coming for there. They may eve apply it to anyone arriving at their airports, even if the people don't live there (which represents a logistics issue), meaning they effectively impose it on the rest of the country.

Out of "an abundance of caution", of course. Despite the high cure rate here, and the very low infection rate.
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Other airports will just get busier handling the international arrivals.
 
Henning said:
Other airports will just get busier handling the international arrivals.
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Yup. The humanitarian docs from NY/NJ will fly out of Hartford. Then drive home to NY/NJ diseased or not. I know the gov'ts powers are currently unlimited but I wonder how far the lock everyone with a fever up for three weeks deal can go.
 
Matthew said:
I'm waiting to see what really happens when flu season gets here. How many panicked folks are going to hit the ERs wanting to be tested for Ebola when they really have the flu?
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Look at it from a different angle. What happens if flu season gets here and a bunch of people get ebola and think; oh well, it's just the flu. How many people in this country go to work sick so as not to miss a payday.
 
JOhnH said:
Look at it from a different angle. What happens if flu season gets here and a bunch of people get ebola and think; oh well, it's just the flu. How many people in this country go to work sick so as not to miss a payday.
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The opposite is going to be the reality, every sniveling kid will be brought into the ER in an ambulance under containment protocol. The fear is the epidemic.
 
JOhnH said:
Look at it from a different angle. What happens if flu season gets here and a bunch of people get ebola and think; oh well, it's just the flu. How many people in this country go to work sick so as not to miss a payday.
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Silver lining if Ebola fears get employees paid sick days. Nah this is America you have to come to work but wear a garbage bag over your head for the safety of others...:rolleyes2:
 
ClimbnSink said:
Silver lining if Ebola fears get employees paid sick days. Nah this is America you have to come to work but wear a garbage bag over your head for the safety of others...:rolleyes2:
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Well, businesses will have to hire replacement workers, so unemployment will go down. Win-win. :rolleyes::rolleyes:
 
SFDukie said:
There are several diagnostic tests for Ebola, but I think RT-PCR (reverse transcriptase, polymerase chain reaction) is what has been done for the US patients in the current epidemic. It's sensitive and specific enough that there haven't been any false positives or negatives yet in Europe or the US, I think (but am not certain). A test that identifies a patient prior to them being viremic enough to be infectious is certainly something folks are searching for, but I don't think enough folks have tested positive by the technique to know how it correlates with infectivity, except that by the time patients are sick enough to present to a hospital (or febrile but not that sick in the cases of Vinson, Pham and Spencer), they're testing positive.

Don't discount the information re transmission based on thousands of patients in Africa, over numerous outbreaks spanning almost four decades.

The fact that no one, outside of a hospital, has contracted Ebola anywhere except Africa is telling re transmission in the community setting. That was true of those who shared an apartment with Duncan for days as he became seriously ill, the husband of Romero in Madrid, the family of Vinson, boyfriend of Pham, etc. If one is in health care, dealing with bodily fluids from sick patients, it's clearly a different story.
Don
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My issue is that Ebola has been transmitted by nasal secretions in non-human primates. To my knowledge, the respiratory and immune systems of other primates are not that different from our own, so I have to assume that that route of infection is at least in the realm of possibility for humans.

As someone who was born and raised in New York City, I can't think of a place where you're more likely to inhale someone else's sneezed snot than on the subway. During rush hour, it's so cramped that you can sometimes feel the heartbeat of the person squished up behind you. It's certainly more cramped than any health care facility I've even seen.

Rich
 
RJM62 said:
My issue is that Ebola has been transmitted by nasal secretions in non-human primates. To my knowledge, the respiratory and immune systems of other primates are not that different from our own, so I have to assume that that route of infection is at least in the realm of possibility for humans.
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I don't think you know enough about the viral loading conditions, proximity factors, and duration of exposure of those studies to reason they should be extrapolated to the non-medical care exposure environments of which you appear to be so concerned.
 
I don't think any of us know, point is some are suspect of the experts story filtered through the gov. The doc in NY fiancee is getting a three week vacation, there could be dozens or hundreds of unreported others getting jacked up for three week R&R. How the hell would we know?
 
Sleepingsquirrel said:
Is it unreasonable to expect a 21 day quarantine upon arrival in any country when it likely that one has been exposed to a disease?
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Apparently not. Governor and Mayor seem to agree that's where NYC is headed whether the rest of the country has any common sense, or not.
 
RJM62 said:
My issue is that Ebola has been transmitted by nasal secretions in non-human primates. To my knowledge, the respiratory and immune systems of other primates are not that different from our own, so I have to assume that that route of infection is at least in the realm of possibility for humans.

As someone who was born and raised in New York City, I can't think of a place where you're more likely to inhale someone else's sneezed snot than on the subway. During rush hour, it's so cramped that you can sometimes feel the heartbeat of the person squished up behind you. It's certainly more cramped than any health care facility I've even seen.

Rich
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Hell on Earth. Why do people live there like rats?
 
Recently somewhere I read that the highest population of rats in a metro area in the U.S., is supposedly D.C. metro.

I chuckled and wondered if it was Internet BS or a good joke about politicians.

But wouldn't it be nice if they could help us with the overpopulation problem we have today of too many politicians? :)
 
denverpilot said:
Hell on Earth. Why do people live there like rats?
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Well, I was born there. Others move there for career reasons. What I never understood was why some people actually like it. I don't think Jeannette and I were split for five minutes before I put the business up for sale and started looking for a place in the country. But to each his own, I guess.

denverpilot said:
Apparently not. Governor and Mayor seem to agree that's where NYC is headed whether the rest of the country has any common sense, or not.
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Which also seems excessive to me and highlights why I have zero trust in the official information: It's filtered through politics. How are you supposed to believe politicians, especially those two, and even more especially in an election year when one's up for re-election and both belong to a party whose incumbents, in many races, are facing stiff challenges? Talk about a perfect storm in terms of trying to get any factual information, free of political shading, from government officials.

Moreover, most of the scientists themselves work directly or indirectly for the government, which can simply slap a classified label on anything they don't want the people to know if it doesn't serve their current political purposes, and thus prevent the scientists from freely providing that information to the public. In most cases they're not allowed to, anyway. There are "public information officers" whose job it is to provide the filtered version to the public at large.

When something like a contagious disease is concerned, it would be nice to be able to get actual truth, unfiltered by political considerations. That's not likely to happen through government sources. But it's also not to say that they're necessarily wrong. The official version could be 100 percent accurate. But I have to take anything that's been filtered through politicians with a grain of salt.

That's why I asked the earlier question (answered by Don) regarding how soon after exposure can infection be detected by lab tests. To me, a blood test, if reliable, would be a more reasonable, balanced approach to the problem than either the blanket assurances (that few people seem to be buying judging by the mass outcry by NYC residents for quarantines); or the knee-jerk mass quarantines that Cuomo and DeBlasio now want to impose in response to that outcry.

Rich

EDIT: I just read that New Jersey will also be imposing a quarantine for "all medical workers and other arriving airline passengers who have had contact with victims of the deadly disease in West Africa."
 
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Anyone interested, this is generally a much better source for info on outbreaks than the normal media which usually gets more wrong than right or has an agenda. I will say I'm a little leery of info posted there on Ebola as politics seems to have infiltrated this bureaucracy, but it is still better than info filtered through some moron reporter.

http://www.cdc.gov/
 
denverpilot said:
Apparently not. Governor and Mayor seem to agree that's where NYC is headed whether the rest of the country has any common sense, or not.
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Which is IMHO overkill. Especially since some credible reports indicate that they will apply the quarantine to all passengers traveling through their airports that visited those countries whether or not they are living/staying in NY or NJ. That means a defacto application of NY law to the rest of the country (sorta like they've done with travelers on delayed/canceled flights that have legally checked handguns). Personally, I'd rather rely on science than politics and hysteria.

Hypothetical based on real-life situation: Suppose the traveler from the US does business with the Liberian government & needs to meet with government officials. The business is a win-win for both the US and Liberia (and for national security of either/both countries. If the officials travel here, or the business executive travels to Liberia, there is a likelihood of a 21 day quarantine regardless of how unlikely exposure is. Would the risk be any different at all if the meeting took place in Brussels, Frankfurt, or some other country in the EU zone? Not at all - same meeting, same officials, same unlikelihood that there is/will be exposure. Yet there would be no quarantine.

We won't even talk about getting around the tracking process.

We lost more people in a single mid-air collision this week than we have lost in the US in the entire Ebola epidemic. Yet no calls to ban airplanes. We lost more folks in a single school shooting this week in the US than we lost in the US in the entire Ebola epidemic. Heck, we have more bubonic plague in the US than we have Ebola.

What the governors of NY and NJ have said is "we don't trust people coming in from those countries, so we have to impose government quarantines on them regardless of their chance of transmitting". In any other context, folks would be screaming about government control (see the gun debate).
 
Flying Viking said:
It's a huge Government conspiracy to suppress the calls for travel bans for rats. :mad2:
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There are, and have been travel bans on rats for centuries. You need 'derat' certificates for international travel. Rats are why it is so easy to transport cats internationally, the international rules exist still from the Bubonic Plague days.
 
Henning said:
There are, and have been travel bans on rats for centuries. You need 'derat' certificates for international travel. Rats are why it is so easy to transport cats internationally, the international rules exist still from the Bubonic Plague days.
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Bubonic plague does exist in the US....
 
JOhnH said:
Even in my veterinary hospital, I am REQUIRED to have formal training programs regarding every type of hazardous material we have on site. We have to have spill kits with masks, gloves, and all sorts of disposable clean up material. All new employees must undergo HAZMAT training prior to being allowed to go to work. AND every employee must undergo recurring training on an annual basis, and this training must be documented. We have to document how we identify and create hazardous waste and we have do document when and how all of it is disposed of. Our RED book has to contain all of our written procedures, contacts and receipts. Our MSDS book has to include information on almost everything in the hospital that you shouldn't drink or put in your eyes. We have been inspected by the Dept of Health three times in the past 18 months. (The second two we passed with flying colors). And this doesn't even include the inspections of our x-ray equipment. Or the fire prevention equipment inspection. Or the employment poster inspection. Or any of the dozen other inspections we undergo annually.

Are you saying that human hospitals are held to lesser standards?
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No, I saying. Do you have Ebola in your Red Book? How about the plague, etc. yes, you are trained in what you see daily, it's what you don't see daily that you lack all training on!
 
Gophers out west have bubonic plague, obviously transmission to humans is rare. But the plague is out there running around in the dirt.
 
We have it in our back yards and the camp grounds as well.

The hanti-virus is more likely to get you, I have 2 friends that got it, one survived.
 
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