Good News On The Ebola Front In The U.S., But The Real Battle Is In Africa
America's "Patient Zero" doesn't appear to have spread Ebola very far, but continued vigilance is called for. And, we need to focus on the part of the world where there really is an Ebola Crisis.
Most of the people outside of Texas Presbyterian Hospital who had contact with Timothy Eric Duncan before he was admitted to the hospital and diagnosed with Ebola have been released from quarantine:
DALLAS — At least one chapter of the Ebola saga neared a close Sunday, as most of the dozens of people who had direct or indirect contact here with Thomas Eric Duncan, the Liberian man who died of Ebola, had been told by officials that they were no longer at risk of contracting the disease.
Mr. Duncan’s fiancée, Louise Troh, who nursed him in their cramped apartment while he suffered from diarrhea and who was put under state-ordered quarantine, was set to be declared Ebola-free by officials at the end of Sunday. So, too, were the paramedics who drove an ailing Mr. Duncan to a hospital and health care worker who drew or processed his blood. And a mandatory quarantine was lifted for a homeless man who later rode in the same ambulance as Mr. Duncan before it was disinfected.
The 21-day monitoring period ended Sunday and Monday for nearly all the roughly 50 people. It concludes as federal health officials are tightening the guidelines for the protective gear worn by health care workers treating Ebola patients.
(…)
In a statement, Ms. Troh expressed relief that the Ebola threat in the Texas cases was drawing to a close, but sadness over the death of Mr. Duncan.
“We are so happy this is coming to an end, and we are so grateful that none of us has shown any sign of illness,” Ms. Troh said in the statement. “We have lost so much, but we have our lives and we have our faith in God, which always gives us hope. Even though the quarantine is over, our time of mourning is not over. Because of that, we ask to be given privacy as we seek to rebuild our home, our family and our daily living.”
Ms. Troh — along with her 13-year-old son, Timothy, and the two young men who shared the apartment with her and Mr. Duncan — were removed from the contaminated apartment several days after Mr. Duncan was hospitalized. They were moved to a residence provided by a local benefactor.
Local leaders and Ms. Troh’s pastor, the Rev. George Mason, had been looking for a place for them to move but had trouble finding a landlord willing to rent to them. They appeared to have found a single-family rental home for them to move into temporarily. Their old apartment was gutted, and many of their personal belongings were incinerated. “What she wants more than anything else is to get out of there with those boys and, in her language, be an American,” the pastor said. “She’s an American and she wants to live her life and be respected because she’s done nothing wrong.”
An unnamed Dallas philanthropist plans to donate tens of thousands of dollars to Ms. Troh, the officials said.
Michael Wayne Lively, 52, never met Mr. Duncan, but he rode in Ambulance No. 37, and that was all it took to drastically change his life for three weeks. Paramedics used that ambulance to ferry Mr. Duncan to Presbyterian on Sept. 28, but before it was taken out of service and decontaminated, they answered the call to pick up Mr. Lively.
Originally from Lumberton, Miss., Mr. Lively has been a homeless drifter in Dallas for years. After Mr. Duncan was diagnosed with Ebola, Mr. Lively was being monitored but went missing for a time, spreading fear throughout Dallas that a man at risk of Ebola was wandering the city. He was found, and handed a state-issued order forbidding him to leave Presbyterian hospital and to receive visitors without prior approval.
The order — known as a communicable disease control order — was similar to the one handed Ms. Troh and the three others in the apartment. If Mr. Lively and the others did not comply, they were threatened with criminal prosecution or civil court proceedings. Officials said a total of seven people have received the orders in Dallas — Ms. Troh and the three others; Mr. Lively; and two community members.
All of those whose monitoring was coming to an end had been potentially exposed to Mr. Duncan before he was admitted and put into isolation at the hospital on Sept. 28. They have been released from monitoring in stages. At least 14 of them had been released by Saturday. Others were released Sunday afternoon and some, like Ms. Troh, were released midnight Sunday. A few others may be released after Monday, officials said.
This is certainly good news, and ought relieve public concerns about the virus being spread easily from person to person given that these are people who were in direct contact with Mr. Duncan prior to his admission to the hospital and that none of them have shown any signs of the virus. For example, it should allieviate any fears that the people who were on flights with Amber Ray Vinson from Dallas to Cleveland and back last weekend were in any serious danger, or that anyone who may have had casual contact with her or Nina Pham, the other nurse who has been diagnosed with the disease, prior to their admission to the hospital last week are in serious risk. That doesn’t mean that these people shouldn’t be advised of the potential risk and told to report any symptoms they might experience, of course, but it does suggest that if they do develop a fever and fatigue that it’s more likely to be the flu than it is to be the Ebola virus.
All that being said, there remain a number of people who are still under some form of quarantine or monitoring, and others who have been informed about the fact that they were near Ms. Vinson during her travels:
Dozens of others continue to be monitored. On Sunday, federal officials released updated numbers and said they were monitoring 149 people total, including the contacts of Mr. Duncan as well of Ms. Pham and Ms. Vinson. Most of those 149 are health care workers who treated Mr. Duncan. But some of them are passengers on a Frontier Airlines flight that Ms. Vinson took from Cleveland to Dallas the day before she showed symptoms. The federal Centers for Disease Control and Prevention has said passengers on that flight, and those on Ms. Vinson’s first flight from Dallas to Cleveland, were at low risk.
Ohio health officials reported Sunday that they had been in touch with 153 people across 16 counties who might have contacted Ms. Vinson during her visit there around the time Ms. Pham was diagnosed, but before it was determined that she, too, had Ebola. None of the 153 had been diagnosed with Ebola, but three were under quarantine, the state reported. It was unclear whether the Ohio numbers were included in or separate from the federal monitoring.
The people most at risk, of course, are the remaining health care workers who treated Mr. Duncan along with Pham and Vinson but, so far at least, none of them appears to have developed any symptoms of Ebola. If that continues, then it is entirely possible that this Ebola “outbreak” that started with Mr. Duncan will be coming to an end very soon. That’s unlikely to reduce the level of concern, and given the fact that someone who has been in west African or had contact with someone who has will walk into an Emergency Room at some point somewhere in the United States. Because of that, we ought to make sure that the medical system at all levels is prepared for such an eventuality and that the apparent mistakes that were made at Texas Presbyterian when Mr. Duncan presented himself for treatment, and after he was admitted, are recognized and appropriate changes are made to ensure that they won’t happen again. This includes, most of all, making sure that medical professionals are up to date on how to recognize early signs of the disease and that they know what to do about it in terms of early treatment. At this point, the C.D.C.’s plan, appears to include designating certain hospitals around the country as the locations where anyone diagnosed with Ebola would be treated, and presumably these would be hospitals that have the resources to create even in makeshift form the kind of isolation areas that are needed to treat a disease like this safely. Assuming the number of future cases remains low, this seems at first glance like a logical plan but obviously we’ll have to see how it works out if it has to be implemented.
Beyond the domestic response, though, it remains the case that the fight against Ebola has to be fought on the ground in western Africa. As I noted last week, some of the projections for what could happen to that area if the disease continues to spread as it has been are quite alarming, and if they come true then its inevitable that other nations in that region would be at risk no matter how tightly the tried to control their air and land borders. From there, the world would become more at risk of the disease spreading into areas where it could become a serious problem. It’s one thing for Ebola to show up in Europe or the United States, where health systems are sophisticated and, when functioning properly, able to control the spread of a disease like this. It would be quite another for the disease to show up in a teeming metropolis like Lagos in Nigeria, or in one of the large cities filled with poor people living in poor conditions in South America, India, or Asia. In that kind of environment, Ebola could spread through a large population quickly before anyone could get a handle on it. So, if we’re going to stop Ebola from becoming a serious worldwide threat, we’ve got to take it on where it is, and that means going to western Africa.
So you can literally sleep next to someone who has Ebola and not catch it yourself.
I guess the newsertainment complex is going to have to find something else over which to obsess.
The real problem is that the more people who get infected, the greater the mutation rate of the virus is. The more it mutates, the greater the chances of it mutating to a far more easily transmissible disease where even our “sophisticated health systems” have difficulty controlling it’s spread. So yes, we need to fight it where it is now, not just close our borders and pray.
“This is certainly good news, and ought relieve public concerns about the virus being spread easily from person to person given that these are people who were in direct contact with Mr. Duncan prior to his admission to the hospital and that none of them have shown any signs of the virus.”
Unless some politicians view it as being in their interest to come up with new scare stories (“ISIS is sending Ebola-infected people through our porous border with Mexico”), and sensation-grabbing networks pass them along with no criticism.
Does this mean that our right winger friends will now be saying that the incompetent CDC is actually doing a great job containing a nasty virus while preserving civil liberties? That smells an awful lot like freedom.
The irony here with all the media hysteria is that the government actually has this under control, although a private hospital screwed up – but the government ultimately fixed things. And they did so without banning all flights from Dallas.
Ebola should be easily contained in any modern, civilized, first world country. Heck, even Texas managed it.
Now Nigeria has been declared Ebola-free after 42 days with no new cases:
http://www.bbc.com/news/world-africa-29685127
If the facts won’t allow you to fear-monger…just ignore the facts.
http://www.politifact.com/punditfact/statements/2014/oct/19/george-will/george-will-claims-sneeze-cough-spread-ebola/
Democrats: This is a serious thing but a very minor threat which our system is more than capable of coping with.
Republicans: Aiiiieeee! Run! Run! Oh My God it’s the End Times! Infected Mexicans are overwhelming the borders! Close the airports! We’re all gonna dieeeeee!
Round Number 972 of: Why Democrats should be running government and Republicans should be running a roadside petting zoo.
@C. Clavin: Over on the Ebola Czar thread I referenced the dictionary definition of “hack” as someone who succeeds despite doing mediocre work. I almost added jokingly that the definition was illustrated with a picture of George Will. I decided not to as Will is well regarded by some people, although I have no idea why. You’re link contains a line that perfectly captures Will,
@michael reynolds: Dunno…you can catch some nasty stuff from those goats.
Maybe they should stick to aquariums? But no piranhas or electric eels, those things are dangerous.
@michael reynolds: Why do you hate cute, fuzzy animals?
A little off-topic, but related to Republicans forever freaking out, the Turks are now supporting the Kurds in Kobani, a result of excellent work by SecState Kerry and Mr.Obama. The IS boys have walked nicely into a trap, committing heavy resources to a fight that leaves them exposed in the desert to US and allied air power.
The “unworkable” Obama strategy seems to be kind of working. Local forces + air power = a contained and degraded IS.
@michael reynolds: Are you claiming our clueless, lead from behind President is lucking into the outcome he wanted? Again.
While there is always concern about mutation, Frieden did address this in response to questions about it. I think the caveat to his response is that the current outbreak in Africa represents many more patients who were infected in all other total outbreaks.
Tom Frieden, MD, MPH says:
August 9, 2014 at 9:22 pm
Thank you for your comment. Yes, we are aware of limited experimental work that has raised the possibility of aerosol transmission among animals in a laboratory setting. However, this theory is not substantiated by what we currently know about the spread of Ebola among humans. From the information we have gathered through active work in disease-affected countries, we have no evidence to suggest that the disease in this outbreak has spread through means other than droplets and contact.
In Africa, medical care frequently is delivered in clinics or households with far more limited resources – that is, little or no protective equipment, no running water, no climate control, no floors, inadequate medical supplies – than those available in developed countries. These conditions in Africa contribute to the spread of Ebola among people. We believe that meticulous adherence to proven infection control measures can protect people against the spread of Ebola. We continue to monitor the situation closely.
Also, we are tracking the genome of this virus, and have not seen significant evolution to date. Furthermore, since it was first isolated more than 40 years ago, there has been little genomic change.
Steve
@michael reynolds:
Another Roadside Attraction?
Captain Kendrick’s Memorial Hot Dog Wildlife Preserve?
Does this mean that Republicans can now acknowledge that Obama saved the country from Ebola?
Seriously, I hope that the media takes at least 3 seconds to reflect on their disgraceful role in fear-mongering the Ebola “crisis.” Okay, 3 seconds are up.
So apparently ebola isn’t the next Black Plague (pun intended) brought to us on purpose by Obummer. Guess right wing media is wrong once again. And somehow we were able to contain it without declaring a quarantine (how is that possible Jenos?) or banning flights.
Kudos go to the CDC,NIH, and above all the health care workers who got their heads down, followed protocol, and bravely treated the patients who were infected or suspected to be infected with ebola. (I’m hoping we can pre-emptively retire the so called ebola czar who doesn’t seem to have much to do now)
And d@mn the right wing fear mongers who tried to foment panic over this disease. They richly deserve all the ridicule we can heap on them.
Now that the disease has been contained to West Africa, I expect the usual right wing morons to start bleating about CDC and NIH budgets again and how spending money to beef up health services in Third World countries is “something we can’t afford.” You would think they would learn, but these right wing morons never learn.
@steve:
You would think that since many conservatives say that evolution is “just a theory”, they wouldn’t be worried about this possibility. But the fear mongers are all down with evolution, now that they can hype it for political gain.
@stonetools: Three weeks to the midterm. These guys can fearmonger without basis in fact for three weeks standing on their heads. It’s not like the supposedly liberal MSM is going to call them on it.
@gVOR08:
More like 15 days.
@C. Clavin: Oops. Thank you. Even easier for them.
@michael reynolds:
Last week Michael was telling us how ISIS had retreated from Kohbani because ISIS was a paper tiger that couldn’t stand up to the Kurds. This week they the Kurds need reinforcements to keep from being overrun and suddenly the spin is that the plan all along was to lure ISIS into a trap.
Don’t bother. They’re here.
Yes, a triumph for the technocrats. That’s why, even today, the CDC is working on what personal protective equipment (PPE) is needed to protect healthcare workers. As well as, updating their recommended procedures to include an anteroom where medical personal can safely put on and remove the PPE, contain infectious waste and disinfect.
We are saved? But only because Ebola has turned out to be a not very virulent threat.
How many people had to go into quarantine or surveillance because of poor judgement by the supposed “experts” early on?
This is a bit concerning. Seems if we do a travel ban, it should probably mostly against idiot Westerners. I’ve known quite a few Europeans who had no sense of public health and readily partook of the local indigenous sex trade with the need of Western medicine afterwards. No doubt some Americans do this as well. But some fool had a prostitute in Liberia then spends two weeks in his European home before traveling to America… Would he evade a travel ban?
@JKB: Historically? Probably happens every time…..
What we really should be yelling about is our damn tendency to NOT carry out as much R&D as possible for cases like this. I’m sure all the money that we’re pouring into what we’ve had to do here in the US, plus all the equipment/manpower that’d being sent to Africa, would have more than enough paid for the development of a vaccine, which would have avoided all of this.
A stitch in time saves nine. Much more efficient.
@Stormy Dragon:
What I have said consistently, from the start, is that ISIS is a paper tiger, that they have no practical strategic options, and that Mr. Obama’s policies are the correct ones.
In fact, ISIS did retreat from large sections of Kobani. They still hold sections of it, but less than they did. And they lost this ground despite the fact that the only ground forces opposing them were outgunned on the ground.
I am not in any way “spinning” to make it seem this was a master plan to lure ISIS to Kobani, that’s your misinterpretation. However, that’s where things are today. If the Kurds pushed ISIS back without reinforcements or weapons, I think it’s fair to suggest that they are likely to do even better with weapons and reinforcements. No?
ISIS may end up having taken a completely pointless, unnecessary beating. It was dumb. Al-Baghdadi is no Saladin (a Kurd). Now he’s learning what everyone except Army generals understand, which is that you can survive against air power in cities or in jungles or in mountains, but deserts are oceans, and air power rules over each.
Al-Baghdadi should have taken the desperate stab toward Saudi Arabia. He shot his wad on a pointless battle.
@JKB: “We are saved? But only because Ebola has turned out to be a not very virulent threat.”
Ebola hasn’t “turned out” to be a not very virulent threat. It is exactly what anyone with two braincells has known it to be all along. I suspect that even you knew this all along. But you, like so much of your party, chose to ignore the vast amount of real knowledge out there so you could spin hysterical fantasies in hopes of smearing the current administration, Democrats, and the very idea of government as a force for good.
If you have to lie to win, maybe you should think about switching sides.
@JKB:
So, I take it that you’re still scared to death, or at least, that you WANT to be?
All it took was 4 cases of Ebola in this country and Republicans and their supporters, and the entire so-called Main Stream Media fear-mongered the “crisis” and blamed the president for it. Well, it’s over, come out of your bunkers and breath the Ebola-free air.
@JKB:
You mean the ones Fox whipped up into a foaming at the mouth panic over ebola?
This is the well-established pattern: Republicans spread lies and panic about everything from Obamacare to gay marriage to the border to the deficit to marijuana legalization to inflation to ISIS to ebola and when they are shown to be wrong — and they are always wrong — we get this mewling, huffy, dishonest creeping away.
To take the obvious example: WHY HAS OTB not yet dealt with the fact that they were 100% wrong about Obamacare? Where is the accountability? Where is the intellectual honesty?
When you are wrong, wrong, wrong and wrong, decency requires you to admit it.
@grumpy realist:
You mean more of that hippie science BS?
@grumpy realist:
Hey, I’m all for having public hearings on what the NIH and CDC have been spending their budgets on. A long list of the “R&D” they did do.
Sadly, when you see the list of funded projects, it does read like a lot of “hippie science”.
Now, I know you are delusional. If government is a force for good, then why do we constantly have to fight to keep them from overrunning the Constitution, which imposes limits upon government?
@JKB:
Just out of curiosity, are you ever right about anything? Could you name an example? Because all I’ve ever seen of you is you being wrong and then refusing to acknowledge it.
Has the USG impinged in any way on any of your rights in the real world? Have you been denied free speech? Freedom of religion? Freedom to assemble? Even the idiot “freedom” to swagger around with a gun and frighten people’s children?
Show me. Show me the real world, real impact, actual infringement of your liberties by government.
@JKB:
RIght. Why focus on lessons learned and better preparedness for next time when we could have more Republican show trials?
@michael reynolds:
Blah blah blah “pockets of dead-enders” blah blah blah “weeks rather than months” blah blah blah “anti-war efforts undermine troops” blah blah blah.
@JKB: Considering that your side hasn’t even figured out that evolution exists, I’m not interested in participating in a bunch of Republican show trials. Your side can keep out–if we had been putting NIH money into it, I’m positive your side would have been screaming bloody murder about “unnecessary research”. So keep quiet.
I’m talking about overall, what we Americans should be doing. We should have raised taxes on corporations, as well as moved money away from the military budget towards R&D in this and all other areas.
@Stormy Dragon:
Which imaginary person are you talking to?
@grumpy realist:
The private market has efficiently focused its resources on the next boner pill rather than a vaccine for Ebola.
@michael reynolds: Well, that’s what the private market SHOULD do. Boner problems affect millions of American men. Ebola has so far killed exactly one.
The problem isn’t the private market’s allocation of resources, it’s the assertion the private market should be the only way to allocate resources. There are times–which, I believe, are and should be relatively rare–the private market’s ways of prioritizing effort will not result in the most desirable outcome.
There are things which are relatively uncommon but can have huge impacts. Most of the time the market handles those, too–that’s why we have insurance. But even then, some things, like a vaccine for a relatively uncommon but horribly impactful disease like Ebola, still fall through the cracks. It is the government’s job to identify those things and devote resources to them when the private market won’t.
I don’t begrudge anyone their boner pills, although thank Bog I don’t need them. But boner pills and Ebola vaccines are two entirely different things that must be handled different ways.
@michael reynolds:
Yeah, it’s funny how investment in drugs and vaccines related to infectious disease dropped after the WTO agreed to let countries bypass patent protections on them:
http://en.wikipedia.org/wiki/Doha_Declaration
@JKB: “If government is a force for good, then why do we constantly have to fight to keep them from overrunning the Constitution, which imposes limits upon government?”
Imposes limits on the government IT ESTABLISHES.
Do you really not understand this?
@michael reynolds: Precisely. If Teh Free Market worked the way the idealists believe it does, we’d already have the Ebola treatments and vaccines out there, right?
Just another areas where libertarians get it wrong….
@Stormy Dragon:
You have evidence that Doha had that specific effect?
I’m going to guess not, but feel free to do your usual scat-throwing evasion.
CNN is on the “let’s frighten them ALL!” bandwagon
Sigh. I remember when they happened to be a real news agency. Now they’re just trolling for eyeballs.
Want some perspective? I just had an amusing time reading what was written only 5 days ago by alarmists on this very forum
@Tony W:
Oh and there was so much more to choose from. And not just on ebola.
We could find tens of thousands of words from the usual suspects warning that we were all gonna die from Ebola, Obamacare, ISIS, the “skyrocketing” deficit, children at the border, inflation, deflation, Sharia law. . .
There’s an almost endless supply of ill-informed pants-wetting from folks like Jenos and Guarneri and JKB and John425, none of whom is ever even slightly informed on the issues, but with brains stuffed full of Ailes brand puddin’ expound endlessly on stuff they know nothing about. Always wrong, and always ready to be wrong again and again and again and again.
@michael reynolds:
http://youtu.be/TXZrUMcjYK0
@Mikey:
Hah! I’ve never seen that, but I love that dude from The Thick Of It, an Iannucci-written series in the UK.
By the way, nothing against pudding. My daughter and I made butterscotch from scratch over the weekend. Buttery heroin in a parfait glass.
@michael reynolds: Capaldi’s doing a bang-up job as the Doctor. It’s a great change from the 10th and 11th Doctors who were both young, idealistic types. His Doctor is rather more edgy.
Good pudding is a great joy, that’s for sure. Just not between the ears…lol…
@Mikey: There’s an Australian children’s book called The Magic Pudding, written during the 1920s, which is a joy to read. (There’s one slightly dicey epithet, which seems to have been added for rhyming purposes in one of the songs.) Great fun, all about a self-regenerating pudding with a bad temper and unsocial habits.