Second Dallas Health Care Worker Tests Positive For Ebola
Another health care worker in Dallas is being treated for exposure to the Ebola Virus.
A second health care worker who treated Thomas Eric Duncan at Texas Health Presbyterian Hospital before he died has apparently tested positive for Ebola:
The authorities in Texas reported on Wednesday that a second health care worker involved in the treatment of a patient who died of the Ebola virus had tested positive for the disease after developing a fever.
The worker, who was not identified by name, had been “among those who took care of Thomas Eric Duncan after he was diagnosed with Ebola,” a statement from the Texas Department of State Health Services said.
Mr. Duncan, a citizen of Liberia, one of the three West African nations most stricken with the disease, died a week ago.
“Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored,” the statement said.
The patient had also been isolated, the statement said. It said initial tests were carried out late Tuesday at the state public health laboratory in Austin, Tex., and added that “confirmatory testing on a separate specimen will be conducted by the Centers for Disease Control and Prevention in Atlanta.”
The statement came a day after officials in Dallas said they were now monitoring 76 health care workers at Presbyterian Hospital who treated or cared for Mr. Duncan or who might have handled blood specimens from the time he was admitted to the hospital on Sept. 28 to his death last Wednesday.
After the news last week that the virus had spread to a nurse now identified as Nina Pham, who just yesterday was upgraded from “critical” to “good” condition while she remains under treatment in the same hospital, this would seem to indicate that American health care workers are under the same kind of risks that health care workers in Africa have been under while fighting this latest outbreak. The most obvious conclusion is that this means that, somewhere, the precautions that were being taken while treating Mr. Duncan were insufficient to prevent the virus from being spread to health care workers. This could be because the protective gear itself was insufficient, because the workers didn’t follow procedures sufficiently exactly to prevent some residue of bodily fluid from coming in contact with their unprotected skin or other body parts, or that it is far more difficult for hospitals that aren’t equipped with the kind of high-level isolation wards that exist at places like Emory University and a few other select areas around the country are far less equipped to handle a disease like this. Indeed, there are only four hospitals, with roughly two dozen beds between them, that contain the kind of bio-containment facilities that would be idea for treating someone who is infected with Ebola and contagious. Outside of those facilities, if a statement from the union representing nurses at the hospital is to be believed, the arrangements are much more jury rigged:
The Texas hospital where two health care workers contracted Ebola while caring for a patient had guidelines that were “constantly changing” and didn’t have protocols on how to deal with the deadly virus,” a nurses’ union claims.
“The protocols that should have been in place in Dallas were not in place, and that those protocols are not in place anywhere in the United States as far as we can tell,” National Nurses United Executive Director RoseAnn DeMoro said Tuesday night. “We’re deeply alarmed.”
Texas Health Presbyterian Hospital Dallas treated Thomas Eric Duncan before his death from Ebola last week. Nurse Nina Pham, who cared for him, is being treated for the virus.
(…)
On the day that Duncan was admitted to the hospital with possible Ebola symptoms, he was “left for several hours, not in isolation, in an area where other patients were present,” union co-president Deborah Burger said.
Up to seven other patients were present in that area, the nurses said, according to the union.
A nursing supervisor faced resistance from hospital authorities when the supervisor demanded that Duncan be moved to an isolation unit, the nurses said, according to the union.
Claim: The nurses’ protective gear left their necks exposed
After expressing concerns that their necks were exposed even as they wore protective gear, the nurses were told to wrap their necks with medical tape, the union says.
“They were told to use medical tape and had to use four to five pieces of medical tape wound around their neck. The nurses have expressed a lot of concern about how difficult it is to remove the tape from their neck,” Burger said.
Claim: At one point, hazardous waste piled up
“There was no one to pick up hazardous waste as it piled to the ceiling,” Burger said. “They did not have access to proper supplies.”
Claim: Nurses got no “hands-on” training
“There was no mandate for nurses to attend training,” Burger said, though they did receive an e-mail about a hospital seminar on Ebola.
“This was treated like hundreds of other seminars that were routinely offered to staff,” she said.
One issue that hospitals like this face, of course, is that they don’t necessarily have the proper facilities to deal with a patient like Duncan in the kind of isolated environment that would be ideal, so jury rigging ends up becoming necessary. There’s not too much that can be done about that, of course, because upgrading hospitals to the kind of status that a place like Emory University has when it comes to bio-containment would be costly and would take time. Since we don’t necessarily have the time to do that at this point, it seems clear that there will have to be changes in how hospitals deal with people who are suspected of being possible Ebola patients, otherwise the risk continues that health care workers will be at risk of coming down with the disease.
Partly in response to these reports, the C.D.C. is now saying that they intend to act differently in response to future potential Ebola cases in the United States:
DALLAS — The director of the federal Centers for Disease Control and Prevention said on Tuesday that the agency planned a more robust response to any future Ebola cases in American hospitals, saying for the first time that quicker and more concerted action on its part might have kept a Dallas nurse from becoming infected by the virus.
The acknowledgment came on a day when a nurses’ union released a scathing statement that it said was composed by nurses at the Dallas hospital where the nurse, Nina Pham, 26, contracted Ebola. The statement told of “confusion and frequently changing policies and protocols,” inadequate protection against contamination and spotty training.In the
“Were the protocols breached?” asked Deborah Burger, a co-president of the union, National Nurses United, reading the statement. “The nurses say there were no protocols.”
Officials at the hospital, Texas Health Presbyterian Hospital, defended their efforts to “provide a safe working environment,” but said they would review any concerns raised by nurses.
C.D.C. officials, responding earlier to the broader criticisms about their handling of the Ebola cases in Dallas, pledged to dispatch within hours a newly created response team to any hospital that had a confirmed case of Ebola, and they increased the amount of expertise, oversight and training at the hospital where the nurse treating Thomas Eric Duncan, 42, who had Ebola, became infected.
They have sent some of the world’s leading experts on Ebola to Dallas, as well as two nurses from Emory University Hospital in Atlanta who cared for Ebola patients safely and who will train hospital staff members on infection control and the use of protective gear.
“I wish we had put a team like this on the ground the day the patient, the first patient, was diagnosed,” Dr. Thomas R. Frieden, director of the C.D.C., said at a news conference Tuesday. “That might have prevented this infection. But we will do that from today onward with any case, anywhere in the U.S.”
He added, “We could have sent a more robust hospital infection-control team and been more hands-on with the hospital from Day 1.”
Officials said they were now monitoring daily 76 health care workers at Presbyterian Hospital who treated or cleaned up after Mr. Duncan or might have handled blood specimens from the time he was admitted to the hospital on Sept. 28 to his death last Wednesday. “There were 76 people who had some level of contact and therefore are being actively monitored,” Dr. Frieden said.
(…)
Dr. Frieden said the agency’s Ebola response teams would be deployed anywhere in the country starting on Tuesday. “We will put a team on the ground within hours, with some of the world’s leading experts in how to take care of and protect health care workers from Ebola infection,” he said, adding it would include specialists in other fields.
Obviously, some kind of action in this regard will have to be necessary. The vast majority of American health care workers have no experience at all dealing with Ebola, or indeed anything all that remotely like it, so education and training are going to be absolutely necessary. One obvious concern, of course, is the fact that we are heading into flu season and the initial signs of Ebola — fever, headaches, muscle weakness, etc. — aren’t all that dissimilar from the flu. Differentiating between the two is going to become important going forward since one generally would only require some medication, or just plain old bed rest, and the other requires more aggressive and isolated treatment. Hopefully, the new C.D.C. procedures will help in this regard, but it’s obviously a cause for concern that health care workers around the country could find themselves somewhat overwhelmed in trying to diagnose and deal with a virus that, until now, they’ve had no real reason to be concerned about.
The fact that the virus has spread to a second health care worker is definitely cause for concern, and one can only hope that health officials are keeping close watch over the other health care workers who treated Mr. Duncan to make sure that they aren’t infected as well, and to get them into treatment as soon as possible if it turns out that year. However, it’s also worth noting what we aren’t seeing from the Duncan case. So far at least, we aren’t seeing any evidence that the family members and others who had contact with Duncan before he was admitted to the hospital have shown any signs of being infected with the virus. While it’s probable that Duncan was not as contagious at that point than he was after he was admitted, this should disspell fears that the virus is spreading via more than contact with bodily fluids. At this point, then, focus of concern ought to be at the point of the health care system and, of course, at the point of trying to determine if someone who may have had contact with west Africa arriving in the United States may be showing early signs of the disease. These aren’t necessarily easy things to do, but they are things that seem at least to be manageable.
When the original patient has admitted to Texas Health Presbyterian Hospital, I pointed out that the management of the hospital was risking the financial survival of their hospital if they screwed up. Now it appears that Texas Health Presbyterian Hospital really did screw up and probably will not last much longer under its current name, management, or business plan.
Any hospital who wants to hold on to an Ebola patient instead of transferring them to Emory (or the other specialized centers) is insane. It should be obvious by now that Ebola is much harder to deal with than was orginally claimed and that if 100% complaince is the only way to keep the staff from becoming infected, then such patients should only be cared for at places that have enough redundant systems to get 100% compliance.
Is it time to admit that the CDC has spent way, way too much time and energy telling people to not panic, and it’s time for them to focus on making sure there’s no reason for people to panic?
Article:
Doug:
Except they HAD the facilities. They just, for some insane reason, wouldn’t use them.
Since AIDS was God’s wrath for “homosexual lifestyles”, how long can it be before some corrupt television preacher reveals that Ebola is God’s punishment for allowing women to work outside the home?
@Jenos Idanian #13:
No.
SATSQ.
This seems to be mostly a case of typical institutional behavior combined with ignorance and incompetence. The CDC has standards in place. But given the lack of perceived risk and enforcement, it would be normal for equipment to be missing, training to be skipped, etc. After all, so what? People are busy, it takes time, no one really cares. Then, the thing that no one thought would ever happen, happens. They get a biosafety level 4 patient. Now, the hospital has two choices. The first is that they can be cautious and admit that they are unprepared, and transfer the patient or request immediate assistance, equipment, etc. Or they can be overconfident, and try to shift the blame to if things don’t go well.
It appears that they chose the latter.
One interesting aspect of this is these nurses having to communicate anonymously through a national union they don’t belong to since they’re not allowed to unionize themselves. According to those anonymous claims their for-profit management had failed to train their employees (besides suggesting they look at the CDC training site on their own time), failed to quickly quarantine Duncan, failed to distribute their protective gear on the first day of quarantined care, failed to require masks even afterward, disastrously failed to deal with medical waste, failed to adequately respond to their employees strongly voiced concerns, etc. Unfortunately for these healthcare workers any redress or oversight of the facility is controlled entirely at the state level.
The lesson the CDC seems to have taken from this is they can’t trust local facilities to have consistently trained their workforce on their equipment, or to even be operating a minimally safe working environment, so in order to minimize panic caused by local incompetence they need to, if possible, transfer patients to facilities they already know they can trust, or get their own experts on site to offer monitor, offer advice and aid in care.
@Neil Hudelson: Do you REALLY need a list of just how the CDC has failed thus far?
Let’s just take the case of Nina Pham. She’s the nurse who is currently fighting Ebola. When she was diagnosed, the CDC announced that her infection was because she had failed to follow the CDC protocols, but couldn’t say just how. Then, after several medical professionals started putting the CDC’s protocols to tests that they failed, the CDC came out with new protocols.
Or Dr. Nancy Snyderman. She went to Africa to report on Ebola, and her cameraman was exposed. She and her entire team were put on “voluntary” quarantine, until Dr. Snyderman decided that she could safely go out for take-out. She’s now on a less voluntary quarantine.
Or the family of Mr. Duncan. They, too, were put on “voluntary” quarantine until they started also going out and about.
Or how they treated Mr. Duncan’s apartment. Numerous officials were allowed in and out of the apartment without protective gear, both while the exposed family was there and after, but before it was decontaminated.
One possible interpretation of their conduct is that they have decided that they can either try to prevent a panic, or try to prevent an epidemic, and they’re throwing their resources against the panic. That’s not their job. Their job is to control diseases, and ones like Ebola should be at the top of their list. Instead, they’ve spent billions on other matters.
They need to step up and do their jobs. And that job is NOT PR.
@Anon Person:
Have you looked at the CDC procedures for Ebola infection containment in a healthcare setting? I have.
Number one, they only recommend a private room with a private bathroom. Closed door/posted/restricted entry. If generous, a guard to ensure proper PPE for those who enter.
No anteroom to doff/don PPE, no separation of contaminated items from the public hallway, etc.
Now if the hospitals had any sense, they’d forget the politically motived weak procedures and adapt the recommendations for an African setting using the available medical equipment substitutions for the jury-rigged ones in the pamphlet.
@Jeremy R:
the problem seems to be in the looking to the public-sector government agency for good advice. Even then, the procedures intimated by the sealing of the neck of the gowns were more than the CDC recommended.
@Jenos Idanian #13:
Don’t worry, Jenos, they’ll switch to pushing panic over an epidemic after the election. Just 3 weeks to go.
@Jeremy R:
Texas health Resources is a nonprofit orgnization. Before you begin to repeat progressive talking points at least try to do a little research. http://www.texashealth.org/Facts
do you ave a cite for the training and waste handling?
Speaking of panic, don’t you guys (Jenos, JKB) need to simma down a bit before going balls out on the CDC? Only TWO cases in the United States, both contracted from treating the same patient.
Why, yes, let us take this opportunity to pound the CDC…
(Ridiculous.)
I think that the problem is the absence of socialized medicine. Here in Brazil, a Guinean that had fever was promptly isolated by federal authorities and then flown to a specialized hospital in Rio.No need to worry about what a hospital in the interior of the country would do with someone with Ebola.
@edmondo: Edmondo – The official representative of the grievance industry.
@James Pearce: Not that long ago, Obama assured us that there was almost no chance Ebola would come to the US.
Then we were told that one case had been found, but it was being handled professionally and thoroughly and seriously.
Then we were told that one medical care worker had been infected, but she had somehow violated the established protocols, and if we just followed the protocols everything would be fine.
Then we were told that the protocols were improving. No admission that the old ones were insufficient, just that the new ones were better.
Then we find out that a second health care worker has been exposed, but no worries, it’s in the best of hands.
We’re getting spin by the barrel here. We’re getting tons of reassuring words. What we’re not getting is reassuring actions and developments.
But hey, everything has a silver lining, right? The companies that make containment suits are reporting record sales…
@Jenos Idanian #13:
The cases are occurring in the great state of Texas, a deeply Republican state governed by a Republican. Its the state and local governments of Texas that supervise the hospital, not the CDC. If the hospital is fumbling the ball, then its fault of Texas, not the CDC that is to blame.
So, Im afraid you are blaming thre wrong folks. As usual.
@stonetools: Really?? So if Thomas Eric Duncan had family in Mass or Cali, or Illinois that he visited rather than Texas you are suggesting the results would have been different? You can’t really be that naïve….or maybe you can.
@stonetools: Sorry, you don’t get to play that card. Under the Katrina precedent, it’s on the feds.
Snark aside, I’m not interested in blame-throwing right now. What I want is the CDC to do THE ONE JOB THEY HAVE, and to do it competently. That’d be a good change of pace.
@James Pearce:
The only way to get government technocrats to do right is to make them fear for their phony baloney jobs.
Government, especially socialistic government that works hard to suppress any private alternative, can be the most oppressive since those that work in the agencies do not prioritize doing a good job, but rather their personal biases and preferences.
BTW, today is National Hand Washing Day
The single most effective means to control disease is hand washing. In many poorer countries, such as India, soap is a precious commodity and not used for hand washing. Boosting economic growth in these societies so that soap become ubiquitous can save millions of children. Hand washing cuts child diarrhea by half, pneumonia by one third. Those two are the largest causes of death of children under 5. Soap is also effective against Ebola as it is a lipid enveloped virus.
Wash your hands, often and well.
@JKB: Next year’s CDC budget line item
#2746 – $1 billion dollars to provide soap and promote hand washing in 3rd world countries
@Jenos Idanian #13: You know, Jenos, it might be a good time to step away from whatever media source you’re mainlining and head out in the real world for a minute.
“We were told?” Geez, man. Look, if someone told you “protocols” would prevent the spread of a pathogen, you’re a fool to believe it. SD has it right: Ebola is much tougher to deal with than previously thought.
Maybe instead of throwing the CDC in with the alphabet soup of government agencies you hate, you should calm down, take a breath, and let the pros handle it.
@Andre Kenji:
Yes, if only the US had a federal agency empowered to take over infectious disease cases, and had access to specialized facilities. We could call this agency the Center for Disease Control.
@JKB:
Yeah, the government is awful, et cetera, et cetera.
I bet you’re a sight to see on karoake night. Doesn’t matter what music’s playing, you’re up there singing “Free Bird.”
@Jenos Idanian #13:
The reason they’re making the rounds constantly reassuring everyone, and repeating the facts of how the virus is transmitted, is because they’re dealing with a host of spectacularly irresponsible politicians and media personalities trying their hardest to incite mass panic. They need the public not behave as an irrational mob, for example pulling children from school, shunning businesses, and spreading often inaccurate personal information on who should be avoided (as happened in Dallas).
From Rand Paul publicly fear-mongering about a ship full of 3,000 ebola infected troops, to Scott Brown imagining ebola infected terrorists crossing from Mexico, to Gohmert accusing the President of sending troops to be infected, to Michael Savage and his “President Obola” moniker, to practically the entire Fox lineup telling their audience not to trust information coming from gov’t authorities on the subject, to Fox publishing demented garbage like this:
http://www.foxnews.com/opinion/2014/10/09/ebola-outbreak-why-obama-is-allowing-ebolaphobia-to-spread/
@JKB: It’s possible that the CDC guidelines need to be strengthened, but the hospital didn’t even follow those.
@JKB: First, I’m not completely sure that the CDC can force a hospital to transfer a patient. I’m pretty sure, however, that the CDC has no enforcement power, so can’t enforce it’s guidelines.
@Jenos Idanian #13: Note that the CDC does not have the power to involuntarily quarantine someone. Only the state has the power: http://www.cdc.gov/quarantine/aboutlawsregulationsquarantineisolation.html
Let’s make this nice and simple:
Hello, Centers for Disease Control and Prevention? You have one job. Here’s a disease that needs controlling and preventing. You’ve had plenty of years and plenty of money to get ready to do your one job. We realize this isn’t as fascinating and as important as handguns or fat lesbians or helping Hollywood, but it is your one job. Get doing your job.
@JKB:
And…I agree with JKB.
@Jack:
Well they are blue states, state and local governments there are better funded and managed and their health systems are better, so…yeah?
@Jenos Idanian #13: Your attempts to politicize this disease are probably the most disgusting things I’ve seen you post. There are hundreds of curable diseases that people in this country die from every day – there’s no guarantee that the medical system can catch and contain every single one of them. People die from the flu, people die from infected toenails, people die from MRSA. And guess what, sometimes healthcare professionals catch them. Doctors Without Borders, who have been treating the Ebola victims since the beginning, and has vast knowledge of the precautions necessary to treat them, has had 16 of their workers infected and 9 of them died. Your infantile ravings disrespects all the hard work and sacrifice of the people trying to do something.
@JKB:
In the literal or the metaphorical sense?
@stonetools:
For all of the people who claim that California or any blue state would do better. Please do not make me dig up all of the stories of the incompetence of the emergency rooms in California, NY, or DC. Here is an example: http://articles.latimes.com/2013/oct/23/local/la-me-patient-20131024
Ebola is not a red or blue state issue, it is not an issue of for profit or not for profit hospitals, it is an issue of asking healthcare workers to do complicated procedures that are outside their normal routine and asking them to do it perfectly. I doubt that the management and leadership of most hospitals is up to the task.
@beth: Your attempts to politicize this disease are probably the most disgusting things I’ve seen you post.
Beth, just how have I been politicizing it? By asking the Centers for Disease Control to do their fecking jobs?
The politicizing has been on those who want to find a way to blame Republicans — or, at least, make sure Democrats aren’t blamed.
I don’t give a crap about that right now. I want them to do their jobs. The one that’s right there in their name.
@Jenos Idanian #13:
So for years Republicans have been cutting funding to the CDC and NIH-including funding that might help CDC get funding for a crisis because they thought, “Big Gumint doesn’t need all that money, billionaires do.”
Now that there’s a crisis, CDC should now be super efficient?
Just goes to show the kind of infantile approach to life of conservatives.
Guess what, big guy. You don’t starve an agency of funding, then spin around and berate it for not being on top form. Funding matters:
I suppose you now expect the NIH to come up with a vaccine overnight as well , right? Your sudden concern for disease control now would be laughable if the situation wasn’t so tragic
And more:
So conservatives, who have maniacially pushed for austerity in any and all circumstances and who were enthusiastic about sequestration, should just STFU about CDC readiness. They got just the CDC readiness they asked for.
For all the talk about government money equalling a vaccine. The government has been studying malaria since World War II and has funded the research during good times and bad. Over 600K people die every year from Malaria. Yet, there is no vaccine but there has been a huge number of false promises. The idea that a budget cut a couple of years ago is why there is no vaccine for Ebola is laughable. The DOD has been studying the disease for 20 years and I doubt if their budget has been cut that much.
@superdestroyer:
So I have to choose between believing Dr. Francis Collins, co-mapper of the human genome and likely future Noble Prize winner or some guy on the Internet…
Think I’m going with the doctor.
We have a winner.
@stonetools: I thought we were not supposed to politicize this crisis, but if you’re gonna go out on that limb, I guess it’s my obligation to saw it out from under you.
First up, Bobby Jindal — who’s an expert on health care policy — points out that the CDC has followed some seriously effed-up priorities over the past few years.
Next up, the CDC’s budget was TRIPLED from 2001 through 2010. That changed when President Obama imposed his sequester. For those who don’t like to deal with reality, that period covers the entire Bush administration and six years of Republicans controlling both Houses of Congress.
Third, the latest case was a nurse who also treated Mr. Duncan, Patient Zero. Apparently she didn’t think it was a bad idea to get on a round-trip airline flight right after he died, and no one told her it was a bad idea. So now the CDC is trying to track down all the passengers on her later flight, and I guess they’re hoping she wasn’t contagious on the earlier one.
We know what works: quarantine. But we haven’t even said no more direct flights from the Ebola hot zones so far.
I’ve said, cynically, that only scandals and crises that don’t cause deaths get the attention; when there are actual American bodies, it’s no big deal. Christie and the bridge v. Fast and Furious, for example. But it’s getting harder and harder to say that is cynicism when it keeps happening.
Come on, CDC. Get your goddamned act together and DO YOUR JOBS.
Malaria, unlike Ebola, is not caused by a virus.
I don’t understand why the world is doing more, except it’s in the faraway black heart of Africa, rather than in Ukraine, Italy, or Argentina.
It is clear our hospital’s are critically unprepared to deal with this outbreak, and with our globalized world we ARE going to see more cases.
Several things we ought to be doing:
1. Taking this outbreak seriously and providing funding for every hospital healthcare worker to get training on treating and protecting themselves from what is obviously a highly infectious disease for healthcare workers.
2. Quickly fund and build more special isolation hospital beds as we currently have in Georgia, Montana, Nebraska, etc.
3. Most importantly, the world, not just the US, needs to step up work building more beds and hospitals in West Africa, and we need to supply funding so that Liberia’s healthcare workers CAN receive $700 a month and personal protective gear. Is that really too much to ask?
Also, in this age when our soldiers are put on a pedestal as though overseas adventurism protects our freedom and entitles them to be somehow more American or be the only ones entitled to comment on American foreign policy, maybe this will make it clearer that healthcare workers here and in West Africa are just as brave, putting their lives on the line to fight a horrific disease. They should be entitled to similar societal reverence and guarantees that we will take care of them.
Well, if quarantine is the answer, why not quarantine Texas? That’s where most of the Ebola cases in the US are at present. And if their hospitals don’t have the facilities to take care of everything, why, they should have planned better!
(Considering that it looks like the hospital didn’t even follow the initial CDC protocols, don’t you think it’s a little rich blaming the CDC for this mess?)
But I’m sure the free market will take care of everything. Come on, Libertarians and Randites! Step up to the plate and show how much better your way is to solve everything! Chop chop!
@beth:
If this was not a serious matter, the shrill hysteria from the “drown government in a bathtub” crowd would be pretty funny. Suddenly its “Holy Crap Batman, this could affect me personally! Do something. Save me!!”
Now what I want to know is where in the Constitution does it even say we can have a public health entity like the CDC?
We have a country where health care is largely about profits, not health care. What could possibly go wrong?
@grumpy realist:
Here is something I found on the Heartland Institutes website discussing the Constitution and health care:
Let the marketplace handle it. Perhaps we can get chicken based compensation for services rendered in there somewhere.
@aFloridian:
Good post, top to bottom.
@grumpy realist: But I’m sure the free market will take care of everything. Come on, Libertarians and Randites! Step up to the plate and show how much better your way is to solve everything! Chop chop!
I’ve been waiting for someone to go there.
How about we simply tell the CDC to go back to studying fat lesbians and building sidewalks, and hire Firestone to handle the outbreak?
Oh, look, it’s a case of a Big Corporation doing a job that, supposedly, only the government could do… I thought that was NEVER possible.
@aFloridian: Yes, good post. I’d offer one little factoid: there have been quite a few hospitals and clinics built and staffed in Africa. Most of them have been built by Christian missionaries.
Meanwhile, the WHO has failed on an epic, tragic scale.
Radical thought: why not put the resources into things that have been shown to work? Even if they aren’t ideologically acceptable to the left?
@Jenos Idanian #13:
Guffaw. Since when? I know him as maybe an expert on exorcisms, but on public health and disease control? Please document.
LOlwhut? The Republicans were the ones who insisted on the sequester. Conservatives, including one Doug Mataconis, assured us that the sequester would do us no harm.
But anyway that stuff about the CDC budget tripling and Obama being blamed for sequester was lifted right from Rush Limbaugh, who all of a sudden wants you to know that the Republicans are down with government spending and against the sequester. Now that’s laughable.
Er, how do you know the bolded. Is that from your a$$ again?
Man, you are such an expert on disease control. That’s funny- because until a minute ago, no one knew you-or the Republicans–gave a d@mn about infectious disease control.
Look, adults are talking here. Drs. Fauci, Collins and Bell have laid out why Republican-ordered budget cuts have hurt readiness. Rush Limbaugh, Brit Hume and you should just listen to them and pray they find a way to get us out of the ditch that irresponsible Republican budget cuts got us into. Don’t worry, though , the adults-Obama and the Democrats-will rescue your sorry a$$es one again.
@stonetools:
Let see what is more probable: An a high level adminstrator is overpromising results in order to get more funding or that medical research is very hard and that there are many diseases that have been studied much longer than Ebola for which there is no vaccine.
I would put by money on the failure of medicine instead of the overpromise.
It was just announced that the second nurse will be flown to Emory University Hospital today.
@Andre Kenji:
But they have been studying a “vaccine” for malaria for decades. http://en.wikipedia.org/wiki/Malaria_vaccine but I guess nitpicking wording is more fun. Should one have to look up all the other viruses that do not have a vaccine to make the point.
@anjin-san:
Yeah, all of a sudden conservatives can’t get enough of Big Gumint. “Come on, Big Gumint, do something-especially something like quarantine, which takes away the liberty of a whole bunch of people!”
“And oh yeah, those budget cuts that we insisted on and celebrated in 2012? That wasn’t us. We love funding the CDC and NIH”.
Here’s another good one. For years the Republicans have been holding up the appointment of the Surgeon General, because he once asked for scientific studies of gun violence.Of course , since the NRA and Republicans hate nothing more than scientific studies of gun violence, that’s a non-starter , whatever his credentials.Now that Ebola has hit, some Republicans are yelling that the President needs to appoint an ebola czar-someone who should be responsible for US public health policy. You know, like a Surgeon General?
I only hope as things on, that people understand just how moronic these Republicans are. But I doubt it.
@superdestroyer: The difference between a parastic protozoan and a virus is not “nitpicking wording.” Except in a typical SD conversation:
SD: “Why can’t this incompetent administration put a man on Mars. It’s just a different country.”
Smart Person: “Mars isn’t a country. It’s a planet.”
SD: “Oh, so now you’re nitpicking wording. Just shows what a failure you are.”
@stonetools: Apparently she didn’t think it was a bad idea to get on a round-trip airline flight right after he died, and no one told her it was a bad idea. So
Er, how do you know the bolded. Is that from your a$$ again?
Apparently you missed the part I just bolded. Why don’t you pull your head out of your ass and actually read what you quote?
BTW, that whole “apparently” sentence was sarcasm.
@wr:
But the argument is with enough money they would have had a “vaccine” (immunization) for malaria but that the mean politicians are holding them back. It takes more than money.
@Jenos Idanian #13:
Sorry. Poe’s Law strikes again.
@Jenos Idanian #13: Sure–if you’ll admit that Rick Perry and the State of Texas fell down completely on this one. And if you’ll admit that Firestone has a hell of a lot more money to throw around on this sort of thing.
Why didn’t Texas have its act together from the beginning? Why was the hospital caught so flat-footed? Could it be because they didn’t want to pay the money needed?
@superdestroyer:
You can vaccinate against bacteria or viruses. But viral vaccines are much easier to target and much more effective (viruses only make a few proteins, unlike the thousands bacteria can produce, so they have a harder time evolving/mutating enough to avoid a vaccine).
@stonetools:
A czar? Isn’t that like a king? Why do we need a king in America?
For those who have not seen it:
Jon Stewart’s epic Gretchen Carlson smackdown
@superdestroyer: “But the argument is with enough money they would have had a “vaccine” (immunization) for malaria but that the mean politicians are holding them back.”
No, it’s that they would have had a vaccine for Ebola. Which is an entirely different matter.
But here’s, let’s try an experiment. Start with two sets of researchers. Each team is to come up with a vaccine. My team will have full funding. Your team will get no funding.
I’m sure your team will succeed first, because they’ll be completely free of the yoke of gummint and scary dark people, right?
@superdestroyer: I´m not picking words. Creating vaccines for for viruses is much easier.
This back and forth argument is stupid. There isn’t an Ebola vaccine because it was pretty rare and remote and not a priority. Now it is. And it will get done especially if Ebola breaks out here in the US.
I expect soon that this whole thing will be turned over to the military by executive order.To see how this will go we need only look at the infamous Kecksburg incident that occurred in Pennsylvania in the 1960’s. There are still many of us around who remember it. Some sort of spacecraft crashed out in the woods. The surrounding citizens rushed to the scene but were soon accosted by military personnel who proceeded to seize reporters’ and citizens’ cameras (unconstitutional), intimidate and push people around, detain people (unconstitutional ), seize property (unconstitutional), and control the press (unconstitutional). Later they floated some phony story that it was a meteorite, which no one bought. Documents about this have been classified with only blacked out, censored documents released.
It has happened before. It will happen again.
See “Kecksburg” incident. You will be shocked and amazed.
BTW, I’m late to the discussion but has anyone pointed out how stupid that nurse was to decide to get on a plane and travel. With lack of smarts like this, there will be no way to control an epidemic.
@Tyrell: Also see the documentary “Super 8”.
@Scott:
Since it is a BL-IV harazard there are only a couple of labs in the U.S. that can ever work on it, doing animal studies in BL-IV is very difficult, and the only way to test it would be in a third world country. Not exactly something that can be done quickly. Somehow I doubt that a CDC that lost control of anthrax can claim what a fast, efficient job that would have done. http://www.cdc.gov/media/releases/2014/p0711-lab-safety.html
I read the Hot Zone almost 20 years ago. The Ebola and other hemorrhagic fevers have been know for a while. My guess is that the spending was just used for other projects.
@Scott:
She should not strike anyone as someone who was going to follow all of the rules on precautions and contamination control. For her, the rules are probably for others.
Let’s see if there are a few things we can agree upon:
1) Fighting outbreaks of major diseases like this are a legitimate function of the federal government.
2) Thus far, there have been considerable failures of the public health system in handling this outbreak.
3) The CDC is the legally mandated body to manage this outbreak.
4) There should be nothing partisan about strenuously hoping they get their act together and do their jobs.
I’m going to repeat a sentiment I’ve said about Obama on numerous occasions: our current situation might not be their fault (and I believe it isn’t), but it is their responsibility. They need to step up and do their job. To paraphrase quite a few other people, “CDC, you had just one job, and this is it.”
Just a few weeks ago, we were hearing from the right about how ISIS was going to kill us all in our beds. Now we have ebola hysteria. I wonder what they will be terrified of next.
We should also consider the consequences of Texas not expanding Medicaid. Here’s one rather biased article:
I wouldn’t say that this was definitely a factor — people make mistakes all the time, and the hospital clearly made a lot of mistakes — but it is worth considering. Admitting someone is expensive, and if it is money the hospital expects to be unable to collect, that is going to skew the decision.
If we want hospitals to be more vigilant, who is picking up the tab?
@Jenos Idanian #13: You seem to keep ignoring the fact that the CDC does not have the legal authority to forcibly quarantine people. I posted the link in a previous post.
@Gustopher:
http://talkingpointsmemo.com/livewire/rick-perry-accepting-medicaid-expansion-like-putting-1-000-more-people-on-the-titanic
@anjin-san: Terrified ? I don’t know about that. How about some simple, common sense precautions that people are wondering why they haven’t been done yet. How about this: no one from the ebola countries gets in until they have been through the quarentine period ?
@Tyrell:
I’m curious Tyrell, why are’t you lobbying for a quarantine of Texas, an ebola state?
@Tyrell: Technically, we’re now an Ebola country. Do you support all Americans having a quarantine period before they can visit other countries?
How about a second to debate personal responsibility?
She’s a nurse who just handled an Ebola patient at his most infectious. Her colleague contracted it. She is running a fever of 99.5. She knows the symptoms of Ebola.
I don’t give two hoots in hell what the CDC told her or didn’t, she’s a moron and an irresponsible asshole for flying. Not to mention, what the hell is wrong with her family, friends, and fiance?
“Hey guys- busy week handling the Ebola patient that died. Can’t wait to see ya tomorrow! Love ya, bye!”
I dunno about you, but my friends and family would have told me to keep my lily white ass several thousand miles away.
@John Cole: How about a second to debate personal responsibility?
She’s a nurse who just handled an Ebola patient at his most infectious. Her colleague contracted it. She is running a fever of 99.5. She knows the symptoms of Ebola.
I don’t give two hoots in hell what the CDC told her or didn’t, she’s a moron and an irresponsible asshole for flying. Not to mention, what the hell is wrong with her family, friends, and fiance?
I have an alternate perspective. She’s a professional, but the CDC are (theoretically) THE experts. She had doubts about getting on the plane, so she sought advice and information from the authorities whose ONLY JOB is to handle this crap. And they are giving out VERY BAD ADVICE.
It seems that the CDC is spending half its time telling us that there’s no need to panic, and the other half its time screwing up and giving out confusing, conflicting, or just plain wrong advice.
WHY CAN’T THEY GET THEIR SHIT TOGETHER?
Less than a month ago Obama (most likely acting on the advice of the CDC) told the country that there was a very slim chance that Ebola would come to the United States. It’s here.
He also said that our hospitals and medical system were prepared and trained to manage any outbreaks safely, and any cases would be quickly contained, isolated, and dealt with. (Again, probably relying on the advice of the CDC. I can’t imagine he’d make such sweeping statements without getting some cover.) Then we saw the incredibly sloppy Mr. Duncan’s case was handled, both in and out of the hospital. One nurse came down with Ebola, and nurses’ groups started saying “hey, we haven’t been trained and equipped to deal with this safely.” Now another nurse has come down with it.
In that second case, she started showing early symptoms. So she did what any sensible person would do — she called the CDC and asked their advice. She did so repeatedly. (My hunch is that she wanted to get back to Texas, where her own hospital was already experienced in handling Ebola, but I’m speculating here.) And the CDC said, effectively, “that’s only a very slight fever. Go ahead and get on the plane. Only worry if it goes another degree higher.”
So now we have a planefull of people who were exposed to Ebola because a nurse trusted the CDC.
Mr. Cole, the IRS has a policy that you are liable for any tax mistakes. Even if you call the IRS and follow their advice and their advice is wrong, you’re still liable even if you do what the IRS representative tells you. (I find that reprehensible, but I’m not interested in debating it; I’m just using it as a fact.) Now it seems that the same principle applies to the CDC — go ahead and ask their advice for dealing with Ebola, but if you don’t trust their advice, go ahead and trust your own best judgment.
To repeat my earlier statement:
WHY CAN’T THEY GET THEIR SHIT TOGETHER?
Again, I don’t think this is Obama’s fault. I might reconsider that later, but we can argue about that later. (At least, I hope we can.) But it is his responsibility. The CDC answers to him.
HE NEEDS TO MAKE THEM GET THEIR SHIT TOGETHER.
(Can the CDC director be impeached?)
@Jenos Idanian #13:
1) It is also a function of the state government and the state government is the one that has the most power to act quickly and decisively. As has been pointed out a couple of times above, the CDC cannot forcibly quarantine. They can ask for a voluntary quarantine, but that is the extent of their authority on that front. The governor on the other hand, can enforce a quarantine. He has thus far chosen not to.
2) The failures have mostly been at the state and local level. Your primary complaints have been about quarantine, which again is the governor’s responsibility.
3) Their roll is to coordinate response, provide information. They have done reasonably well on that front despite the fear mongering by many in the media that are much more interested in sensationalizing a story than providing real information.
There shouldn’t be. I am curious why all the sturm and drang about the CDC and none for the governor or Texas? Perry could have called for the quarantines you think should have happened as soon as he heard about the voluntary quarantine asked for by the CDC. He could have quarantined all hospital staff that had any contact. He could have done any number of things and he did not.
As it stands now, exactly two people were infected both of whom dealt with Mr Duncan in the late stages of his illness. One of them is improving and the other likely will. If that is as far as this ”outbreak” spreads, then I think it is safe to say that it was handled reasonably effectively.
@Jenos Idanian #13:
I seem to remember him saying there was a very slim chance that there would be an outbreak here. I can’t seem to find any quote at the moment with a baby tugging at my arm. Do you have a cite for that quote, or do you consider three cases an outbreak?
Do you really believe there is anything approaching even a 0.001% chance that an ebola outbreak in the US would be so serious as to preclude that?
@Grewgills: 3) Their roll is to coordinate response, provide information. They have done reasonably well on that front despite the fear mongering by many in the media that are much more interested in sensationalizing a story than providing real information.
No, they haven’t. They’ve given BAD information, repeatedly.
Here’s the CDC’s own page on the matter. They do have the authority:
(Relevant citation bolded by me)
Texas’ health department needs a swift kick in the ass. I’m wondering if they were getting advice from CDC — normally, that would be a good first step, but that’s turning out to be an iffy proposition.
And Dallas County Judge Clay Jenkins, who took two aides to visit Patient Zero Duncan’s family in his apartment without protective gear and before it was decontaminated, should be quarantined for 21 days for Ebola, and the rest of his life for sheer stupidity.
@Grewgills: Do you really believe there is anything approaching even a 0.001% chance that an ebola outbreak in the US would be so serious as to preclude that?
I don’t wanna bet on that. I’m a big believer in “hope for the best, plan for the worst.” And there’s some shit you do NOT give any slack on. Ebola, to me, is one of those things.
We have about 130 people who were exposed on Monday on that airplane, and God only knows where they are. (Well, God and, we hope, the CDC.) Plus everyone that second nurse came into contact right before and after the flight.
Think about the last viral video to go around. Then think about why the metaphor used to describe how rapidly those spread among people is a virus, like Ebola. Think about malicious computer programs that propagate themselves across the internet. They’re also metaphorically called “viruses.”
There’s a reason why viruses are used for that particular metaphor.
@Jenos Idanian #13:
From that page
Notice the CDC authority is for international and interstate travel. That could have applied to Mr Duncan, but would have had to have been a full scale screening well beyond the take your temp screening and would have been very expensive. It could also have applied to the nurse that took a plane. It could not have applied to the family remaining in Dallas or any of the other exposed parties that remained in Texas. Again, your outrage seems to have only one real target, the CDC. Until I specifically mentioned it to you directly exactly none of your outrage was directed anywhere else. Why is that? Why haven’t you been down on the Texas health department or governor Perry with near the ire you have directed at the CDC?
Aetna CEO Mark Bertolin is making 30million+ this year. When are we going to realize that our health care priorities are sadly out of whack, and put our focus on actual health care – health care for all? As it is, we are allowing a small number of people to bleed the system in order to become fabulously wealthy.
@Jenos Idanian #13:
Ebola simply isn’t all that virulent a virus. None of the family Duncan stayed with, who were in extended and close contact even after he was symptomatic, contracted the virus. None of the people he contacted before the very end stages of the disease contracted the virus. Ebola doesn’t spread near so easily as the flu or a computer virus. Acting as though it is highly communicable is either ignorant or dishonest. It is terrible if you get it, but with modern medicine it is about 25% fatal, not the 40%+ we are seeing in Africa. Fears about this are radically overblown.
@Grewgills: Gee, what a surprise. The CDC is saying conflicting things on the same page. The question is, which part is relevant — the part you quoted, or the part I quoted?
And the Interstate Travel aspect on the outbreak has been satisfied already — three times. First, when Mr. Duncan flew into Texas; second, when Nurse Amber Vinson got on that plane from Cleveland to Texas on the advice of the CDC. Finally, Ms. Vinson has been transferred to a hospital in Atlanta.
The reason I’m so focused on the CDC is twofold. First, this is their primary mission, and this is a legitimate duty of the federal government. Second, this is their main job. They have the assigned duty to research and prepare for cases exactly like this, and are supposed to be the go-to source for the best information. I don’t know for certain that the Texas officials contacted and consulted with the CDC when they realized it was Ebola, but I can’t imagine it otherwise. From what I read, when hospitals get suspected cases, they get the CDC involved as soon as possible to confirm the diagnosis.
And, quite frankly, I hold the state level to a lower standard, simply because I expect less from them. I’m a 10th Amendment believer — there are areas of responsibility for each level of government, from the federal government down tot the individual (we “govern” ourselves to a degree). And managing contagious diseases this dangerous, to me, fall under the federal government’s sphere.
@anjin-san: Aetna CEO Mark Bertolin is making 30million+ this year. When are we going to realize that our health care priorities are sadly out of whack, and put our focus on actual health care – health care for all? As it is, we are allowing a small number of people to bleed the system in order to become fabulously wealthy.
So? Are you proposing we confiscate his salary and use it on Ebola research? Does his pay come directly from the CDC or the federal budget? Is he using his money to develop and spread Ebola? Or are you just trying to use this to grind your axe over your personal grievances?
Aetna’s a publicly traded company. It’s currently trading at $73.57 a share. Feel free to buy some stock and complain how they’re paying the guy.
On that note, I’m calling it a night. I’ve been up for over 18 hours today.
@Jenos Idanian #13:
The information on the CDC page is not conflicting. They have quarantine power over those specific types of disease you quoted within the guidelines I quoted. Both parts are relevant, you left one out, I’m guessing because you didn’t read beyond the list because you assumed you knew what quarantine powers meant.
Mr Duncan was not symptomatic when he boarded the plane, so no cost effective screening would have caught him. Ms Vinson had a fever of 99.5, which is below the level at which there is much risk. Even so, that was a mistake on the part of someone at the CDC since she had contact with an ebola patient. It is not a large risk and I will be shocked if there is another case as a result, but more vigilance was warranted. Ms Vinson was not transported to Emory aboard a public passenger craft, so no, the third case was handled under appropriate protocols.
What exactly do you think the main job of the Texas board of health is? Isn’t this also a legitimate duty of the state government since they are the ones with the most immediate power to address it with forced quarantines etc?
Not only or even primarily. Frankly if a year ago anyone proposed giving the CDC the power to forcibly quarantine Americans they way you say they should have Republicans and Libertarians would have been screaming socialist tyranny from the rooftops. The CDC has a duty to provide information, aid, and coordination. The states have a responsibility to prepare their public health systems, hospitals, and to enforce any needed quarantines.
There needs to be one facility that handles all cases. It is apparent that a lot of hospitals would not could not handle ebola type procedures and precautions. The Duncan case was a breakdown at every step, beginning with letting him board a plane to the US without proper checks. People’s confidence in the CDC is gone. The talk on the street is skepticism and no trust in what the government says or does. That is the way it has been for the last few years. Fear and suspicion is creeping in.
@Grewgills:
Oh, I think we all know the answer to that one. That falls under the IOKIYAR rule.
Indeed. It’s interesting the way libertarians and “Constitutionalists” have gone dark on this. Where are the originalists calling parsing the Constitution and telling us that disease control is not one of the enumerated powers reserved to the Federal government? Why aren’t we being told about “free market” ways to deal with disease outbreak? Why aren’t we being told that scientific study of public health issues is not the federal government’s business? (actually, the new conservative tack is that ONLY certain public health issues should be studied by the federal government ).
Heh, I guess this is already a big concession by conservatives. Until about ten minutes ago they would have disputed even this.
@stonetools: Why aren’t we being told about “free market” ways to deal with disease outbreak?
Way ahead of you, dumbass. Shall we compare the efforts of Firestone vs. the latest act of gross incompetence of the CDC.
And I mentioned the Firestone example almost 24 hours ago.
@grumpy realist: Sorry, I missed your earlier comment.
Sure–if you’ll admit that Rick Perry and the State of Texas fell down completely on this one. And if you’ll admit that Firestone has a hell of a lot more money to throw around on this sort of thing.
First up, why does your acknowledgement of a truth bear upon my admission about anything? If it’s true, then what I say about something else is irrelevant.
Second, the NIH’s budget for 2014 was just over 30 billion. Firestone is part of Bridgestone, and Bridgestone’s total revenues for 2014 were a little over 28 billion. Their profit was just around one billion. Those are all in dollars, and based on current exchange rate for the Japanese yen. So you’re wrong on that comparison.
As far as your and stonetools’ assertion about how conservatives and libertarians are really just anarchists… I think an appropriate rebuttal would be to ask you what matters you consider NOT in the federal government’s bailiwick, and which matters should be the exclusive domain of the state or local levels of government?
@Jenos Idanian #13:
Dude, the Firestone people secured ONE plantation. Also too, they weren’t cocerned about complying with the US Constitution.
What the hell does that have to do with limiting outbreaks across an enire country. Scale matters, as does constiutional constraints.
A better example would be the Nigerian government , which did stop ebola cold.Here is how they did it:
Note: they didn’t order a quarantine.Also note: they had cental command and control of their national public and health system-just the kind of thing you conservatives deride as “soshulized medicine” and “Gumint tyranny.”
@stonetools:
If you start running a fever, head down to your local Firestone dealer. You can get your tires rotated while they check you out…
@stonetools: @anjin-san:
I was wondering if it would KILL the leftists to acknowledge that a private company actually did some good in this matter. Apparently the answer is yes.
Go back to your “big government cures everything” prayers. Sooner or later they’ll stop fecking up and start giving good advice. Just because they haven’t yet doesn’t mean it won’t happen…
@Jenos Idanian #13:
Your argument has hinged on the CDC failing, largely by not doing things it is not authorized to do. You should acknowledge that you were wrong on that issue. You should also acknowledge that if not quarantining Mr Duncan’s family and others within the state of Texas was a mistake, that it was governor Perry’s mistake, not the mistake of the CDC. That is the honest thing to do. If, on the other hand, you don’t think it was a mistake on Perry’s part to not quarantine the family and others I am curious why.