Problems With The Response To Ebola, And A Little Perspective

We've become aware of failures in how we've handled the Ebola situation. The response is to figure out what went wrong and do our best to fix it, not to panic.

Ebola Virus And Caduceus

In the wake of yesterday’s announcement that a second Dallas health care worker who treated Thomas Eric Duncan before he died from the Ebola virus had become infected themselves, questions have started being raised about the way that both Texas Presbyterian Hospital handled and the manner in which the Centers for Disease Control has responded to all of this in the two weeks or so since we learned that Duncan had Ebola and had been admitted to the hospital. On the hospital side, for example, there are serious questions raised about how Duncan was handled, including a report late yesterday that health workers were not wearing HazMat suits of any kind for at least the first two days they treated him. On the C.D.C. side, we learned late yesterday that Amber Joy Vinson, the second nurse who was infected, had flown from Cleveland from Dallas and back in the days before being diagnosed with Ebola.. Moreover, she had apparently contacted the C.D.C before her flight on October 13th and, upon advising them that she had a fever of 99.5 was told to go ahead and fly home because her temperature was before the “trigger” level of 100.4 degrees. As a result of that decision, she flew on a Frontier Airlines flight from Cleveland to Dallas along with roughly 140 other people and that plane apparently flew five more flights before being taken out of service to be thoroughly cleaned and decontaminated. The announcement that Vinson had not only flown, but had flown after discussing whether she should with a contact at the C.D.C. came only hours after agency head Dr. Thomas Frieden said that she should not have traveled by commercial airliner at all and that the agency would take steps to make sure this wouldn’t happen in the future. While there seems to be little risk that anyone on the flight with Vinson, or anyone who used the plane after her, was actually exposed to the virus, the C.D.C. has apparently made contact with all the passengers on Vinson’s flight and the incident has raised questions about just how well the protocols that were supposed to be in place prior to this happening are working.

For his part, President Obama took the rather public step of canceling plans for campaign and fundraising trips to the Northeast to stay in Washington and meet with advisers on the issue, after which he spoke briefly to the press:

President Obama addressed the media late Wednesday after having convened a meeting with Cabinet agencies coordinating the government’s Ebola response.

“I want people to understand that the dangers of you contracting Ebola, the dangers of a serious outbreak in this country are extraordinary low, but we are taking this very seriously at the highest levels of government,” Obama said while flanked by Defense Secretary Chuck Hagel and U.N. Ambassador Susan Rice.

Obama had postponed a campaign trip to the northeast in order to meet with the officials Wednesday afternoon.

The president sought to quell nationwide fears about the deadly outbreak, and noted that the CDC would be sending rapid response teams to any site within the U.S. where an Ebola diagnosis was made.

“I want to use myself as an example, just so people have a since of the science here: I shook hands with, hugged and kissed, not just the doctors, but a couple of the nurses at Emory (hospital in Atlanta) because of the valiant work they did,” said Obama. “And I felt perfectly safe in doing so.”

At first glance, these words don’t strike me as something that are going to reassure people who might be worried about some of the rather obvious slip-ups that we’ve seen from both Texas Presbyterian and the C.D.C. over the past two and a half weeks, especially not the health workers that treated Mr. Duncan and are now being monitored for signs of the disease that has already infected two of their co-workers. It’s also not likely to claim concerns that events like allowing Ms. Vinson to get on that airplane in Cleveland are likely to raise in the general public, an event that has already caused people in Texas and Ohio to react in concern by closing schools, staying home, and putting a flight crew on paid leave. Additionally, as The Washington Post notes, the news about Vinson traveling from Dallas to Cleveland and back after having been exposed to someone with Ebola and later being diagnosed with the disease seems likely to raise concerns among members of the general public about a problem that, until now was confined to one hospital in Dallas.

Now, in all likelihood, none of the people that shared an airplane with Vinson, and none of the people that they had contact with before this story broke, are likely to develop Ebola. One clue in that regard is the fact that, so far, the only two people to come down with the disease were people who treated Duncan in the hospital during the worst of his illness, and that’s two out of roughly eighty the remainder of whom are still being monitored for signs of the illness. None of the people that were in contact with Duncan prior to his admission to the hospital, including members of his family who spent days alone with him in a Dallas area apartment, have shown signs of developing the disease. Many of the people in that group are nearing the end of their 21 day incubation period too, which means that it is highly unlikely that they will develop the disease at all unless signs show up at some point in the very near future. Given this, the odds that Vinson spread anything to the people she shared a plane with would seem to be quite low if not zero.

Notwithstanding all of that, there is definitely reason to be concerned with the failures that we’ve seen both at the level of Texas Presbyterian Hospital and at the C.D.C. in the response to Duncan’s diagnosis, treatment, and death and the diagnosis of the two nurses who treated him. The allegations that the initial treatment of Duncan occurred without health care workers being adequately protected, which would seem to be in direct violation of the protocols the C.D.C. had issued even before this started, is astounding and is likely to be the subject of regulatory investigations and, potentially, litigation in the future. Even leaving the issue of the protocols to the side for the moment, the hospital had a duty to take reasonable care not only in its treatment of Duncan, but also in the steps it took to protect the health care workers treating him and any other patients in the hospital at the time, many of whom could have been especially susceptible to infection under the right circumstances. Additionally, there are reasons to be concerned about the C.D.C.’s actions in response to all of this. Some public health experts, for example, have alleged that the C.D.C. protocols and the training and information and training provided to hospitals are inadequate and that those set forth by the World Health Organization are more appropriate. Additionally, Texas Presbyterian has claimed up until now that it was in consultation with the C.D.C. at all steps during its treatment of Duncan, so that raises the question of whether or not someone at the agency was aware of the shortfalls and said or did nothing. Finally, of course, the fact that someone affiliated with the agency told Vinson that it was okay for her to fly home even tough she was developing a fever, rather than say reporting to one of the hospitals in Cleveland such as the Cleveland Clinic, is extremely troubling and something that ought not to happen again. In that situation, Vinson did the responsible thing by calling the agency and asking for advice so, presumably, if they had told her not to fly she would have followed their instructions. Even if nothing develops from this mistake, it shouldn’t be allowed to happen again.

Not being a public health expert or a physician, I am not going to express an opinion as to what the appropriate protocols should be. However, it seems clear that there have been some failures. Those failures could be due to inadequate protocols, protocols that are not being followed, or a combination of both. Even if the current Ebola outbreak in the United States never gets beyond Dallas and ends up being limited to Duncan, Nina Pham, and Amber Joy Vinson, though, it would seem prudent for all of those questions to be asked answered so that health workers are as prepared as possible for the eventuality of another Ebola case walking into their emergency room or physicians office. Given the size of our health care system, that’s not going to be an easy task, of course, and the fact that the initial symptoms of Ebola are largely identical to the symptoms of the flu is going to is going to complicate the situation. However, it’s something that is going to have to be done, not the least to make sure that public confidence in the health care system is maintained even while cable news and the Internet continue to hype a story that, for all the news reports, isn’t nearly the public health threat that they seem to be trying to lead people to believe. To the extent that the C.D.C. and the Obama Administration have failed to date, communicating that sense of confidence and readiness has been their primary failure and, while polling still seems to indicate that Americans aren’t very concerned about Ebola, public attitudes could change very quickly if this becomes about more than one hospital in Dallas.

There’s reason to be concerned here, and the failures that we’ve seen suggest that there are gaps in the response to Ebola that need to be addressed before they really become an issue. At the same time, though, there is not reason to panic, but that kind of rational view of the situation is likely to change if people start thinking that this is something that could actually impact them directly.

FILED UNDER: *FEATURED, Barack Obama, Health, Politicians, US Politics, ,
Doug Mataconis
About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010. Before joining OTB, he wrote at Below The BeltwayThe Liberty Papers, and United Liberty Follow Doug on Twitter | Facebook

Comments

  1. Slugger says:

    I wonder why all the secondary cases that we have seen so far have been in healthcare workers and none in Mr. Duncan’s family and circle of friends. I don’t have any hypothesis for this; just seems strange.
    Also, why is having your neck uncovered dangerous. Does the virus penetrate through intact skin?
    Lastly, would it be useful to get advice from Doctors without Borders? I know that they are French and therefore yucky, but they have been working in West Africa and have lots of experience.

  2. C. Clavin says:

    I think we should bomb Dallas. I mean…the threat, while minuscule, is still greater than ISIS.

  3. Modulo Myself says:

    @Slugger:

    Because the virus is very present in the bodily fluids of those who are in its advanced stages, and not present at all in those who are not showing symptoms.

    Seriously, this fact is everywhere.

  4. C. Clavin says:

    @Slugger:

    I wonder why all the secondary cases that we have seen so far have been in healthcare workers and none in Mr. Duncan’s family and circle of friends.

    Because his family and friends and even the folks who shared an airplane with him weren’t swimming in his vomit and excrement. They didn’t get sick exactly as predicted.
    The health care workers got sick because they did not follow protocols…which ultimately comes back on the hospital.
    What we should really be talking about is Texas Health Care, which ranks at the bottom of 50 states. Coincidence?
    http://www.kaiserhealthnews.org/Daily-Reports/2012/July/06/states-roundup.aspx

  5. stonetools says:

    Conservatives the day before the latest Ebola outbreak : “We don’t need Big Gumint. Big Gumint can’t help us. The CDC and the NIH aren’t even legitimate government agencies, and we can cut their budgets with impunity. Besides, they spend government money funding scientific studies for things we don’t like.”

    Conservatives today: “BIG GUMINT, SAVE US. Quarantine West Africa! Order anyone in contact with any ebola patient to stay home! Command hospitals to comply with CDC protocols.What about constutional authority to do any of this? Fugg that question! CAN’T YOU SEE THIS IS A NATIONAL EMERGENCY? PLUS, I BLAME OBAMA THAT THIS OUTBREAK HAPPENED, JUST BECAUSE!

  6. superdestroyer says:

    @C. Clavin:

    I hope you recognized that the reported you linked to just shows that it is easier to have a good healthcare system in the whitest states in the U.S. and very hard in the states that are not very white. Unless the reports broke out health results by race and ethnicity, they are meaningless just like state wide test scores are worthless unless broken out by race and ethnicity.

  7. Neil Hudelson says:

    Superdestroyer thinks brown people are dirty.

    Shocker.

  8. C. Clavin says:

    @superdestroyer:

    it is easier to have a good healthcare system in the whitest states in the U.S. and very hard in the states that are not very white.

    At least you aren’t a racist.

  9. C. Clavin says:

    It’s being reported that a patient in New Haven, CT (the actual home of Texan wannabe George Bush) has Ebola-like symptoms.
    http://www.courant.com/community/new-haven/hc-yale-new-haven-hospital-1017-20141016-story.html
    Yale New-Haven is one of the best hospitals in the country…and CT is ranked 7th in the country…I’m betting the outcome is different than at Dallas Presbyterian.
    But Rick Perry has consistently defended his States right to shitty health care. So good on him.

  10. Scott says:

    I think this whole episode will be over in the next week or so and the professionals will sit down and review lesson learned, protocols, and make recommendations going forward. Although the public has been on high alert the last few days, they too will forget.

    And we’ll remember other active public health issues that are actually more hazardous and deadly to the public like not getting vaccinations, enterovirus-68, MRSA, West Nile, whooping cough, TB, and some of the other golden oldies that threaten to come back

  11. anjin-san says:

    Perhaps this is a teachable moment, and we might, just might, realize as a society that universal health care is a public good that benefits everyone.

  12. Hal_10000 says:

    @Modulo Myself:

    But .. Duncan was running a high fever, sweating profusely and had diarrhea and vomiting by the time he was admitted. The difference is likely one of degree. Patients are infectious once they become symptomatic and get worse as it goes on. While I’m not surprised the nurses got sick given the lack of protection, I am surprised that no one in his immediate family, who were dealing with him when he was symptomatic, got infected. We have been very lucky so far.

    @stonetools:

    Keep whacking at that straw man. CDC and NIH budget cuts started long before Republicans took over government and Obama’s FY 2015 budget decreased funding for them. And you do see a difference between responding to disease outbreaks and, say, hassling everyone about what they’re eating?

  13. humanoid.panda says:

    @superdestroyer: Unless nothing changes, California will have about 5-10% of its population, more likely less, without easy access to healthcare in 2-3 years. Texas will have about 25%. Which of them will have easier time to control epidemics?
    Vermont is about as White as West Virginia. Which of them has better access to their health system?

  14. humanoid.panda says:

    @Hal_10000:

    Keep whacking at that straw man. CDC and NIH budget cuts started long before Republicans took over government and Obama’s FY 2015 budget decreased funding for them. And you do see a difference between responding to disease outbreaks and, say, hassling everyone about what they’re eating?

    Both are matter of public health, but one is chronic, and the other one acute?

  15. JKB says:

    @stonetools:

    Actually, the CDC was a good concept when it stuck with infectious disease. A central clearinghouse/research center was the way to collect and disseminate information when communications were slow and disjointed. Unfortunately, the CDC didn’t stay on mission and, in fact, it is quite obvious that they’ve become mission incompetent.

    Now, with the federal government’s failures, the local public health officials are dumping the losers and stepping up. They’ve instituted a public health order than no Ebola health carer may fly during their quarantine period. This is as it should be. The CDC is suppose to be a resource, but the public health protection belongs on the local level. State if the locals refuse.

    The real problem here is the giving into the power grab by the ineffective central government that has crept into our society.

    But if we Americans were to set about giving to the state governments things to do that had better be done by counties and towns, and giving the federal government things to do that had better be done by the states, it would not take many generations to dull the keen edge of our political capacity. We should lose it as inevitably as the most consummate of pianists will lose his facility if he stops practicing. It is therefore a fact of cardinal importance that in the United States the local governments of township, county, and city are left to administer themselves instead of being administered by a great bureau with its head at the state capital.

  16. JKB says:

    @Slugger:

    We could just follow the guidelines for Ebola control in an African setting which involve much more use of protective gear and proper PPE procedures than the CDC recommends for US healthcare workers.

    Doctors without Borders would be a good resource. Sixteen of their doctors have become infected and 9 of those have died of the disease. They would not hedge their advice on foolish propaganda goals.

  17. Jenos Idanian #13 says:

    @stonetools: Conservatives the day before the latest Ebola outbreak : “We don’t need Big Gumint. Big Gumint can’t help us. The CDC and the NIH aren’t even legitimate government agencies, and we can cut their budgets with impunity. Besides, they spend government money funding scientific studies for things we don’t like.”

    Christ, you’re pathetic.

    I probably read a LOT more conservatives than you do, and prior to this they were mainly saying things like “the CDC shouldn’t be wasting its time and money on handguns and why lesbians get fat, and should focus on actual diseases.” Feel free to show links to conservatives saying what you say.

    And for bonus points, since you used quote marks, find one that actually used those words.

    And let’s flip it around and repeat a challenge I made yesterday: just what do you consider NOT the purview of the federal government, and the responsibility of the state and local governments?

    Finally, the defense of the CDC sounds JUST LIKE things said about FEMA after Katrina — it’s the job of the local and state officials to handle the initial problems, while the feds are mainly for informational and coordination roles. But that didn’t keep the liberals from going after FEMA tooth and nail while giving New Orleans Mayor (and now convicted felon Ray Nagin and then governor Kathleen Blanco a pass for their complete failures.

    But back on topic: you know what would help restore confidence in the CDC? If they could go a day or two without yet another feck-up. Just a few baby steps would be a good start.

  18. Jenos Idanian #13 says:

    @JKB: Doctors without Borders would be a good resource. Sixteen of their doctors have become infected and 9 of those have died of the disease. They would not hedge their advice on foolish propaganda goals.

    Toss in Firestone and the Christian missionaries as potential resources. They’ve also done some damned impressive work on this. Hell, I’d put Firestone ahead of the CDC.

  19. JKB says:

    @Hal_10000:

    Some truth in funding:

    Attached [at the link above] is a CRS analysis of the actual NIH budget for the last several years in inflation adjusted (real) dollars. It’s worth noting that after the Republican takeover in ’94, the NIH budget rose until the Dems took over Congress in 2006. The Pelosi/Reid Congress was the first to flatline the NIH budget in nominal dollars. If they’re not careful, someone might notice, take the Dems at their word that the decreasing NIH budget is the reason we don’t have Ebola drugs yet, and blame the Democrats.

    More here:

    Dr. Rogers (the “doctor” is for a Ph.D.) adds this comment to his previous message:

    The destruction of biomedical research at the hands of Democrats is a story that needs wider exposure. Not only have they decreased NIH funding by 20% (vs. 80% increase for the preceding Republican congresses—a statistic that always shocks my colleagues), but Obamacare has dramatically decreased the incentive for commercial drug and device development. As a result, large pharmaceutical companies have reduced their research portfolios and biotech startups can’t get funded because investors believe that they won’t be able to charge enough to get a sufficient return on their money.

  20. Tyrell says:

    One problem are the messages being sent out by the CDC. They are sometimes contradictory.

  21. stonetools says:

    @Hal_10000:

    Keep whacking at that straw man. CDC and NIH budget cuts started long before Republicans took over government and Obama’s FY 2015 budget decreased funding for them

    Why don’t you take this up with Drs. Bell and Collins. Anyway, the cuts 2010-2013 are squarely on the Republicans. Now, of course, the Republicans are squealing that those cuts were’nt them. Those pu$$ies won’t own up to their own irresponsibility. Well, screw ’em and their enablers.

    And you do see a difference between responding to disease outbreaks and, say, hassling everyone about what they’re eating?

    And if that’s what CDC was doing, you would have a point. Please link to where CDC or NIH “hassled” anyone about what they ate.

    For the record, obesity and gun violence are perfectly worthwhile public health policy subjects , no matter how much conservatives would like them not to be.

  22. C. Clavin says:

    @Jenos Idanian #13:
    So you typed a lot of words…but utterly failed to respond to the core of the criticism…that the very same people who want to drown the government in a bath tub are now in a panic and crying for the government to save them.
    And oh by the way…guns and obesity are far bigger threats to every single American than Ebola will ever be.
    But feel free to type words that mean nothing. You are good at it.

  23. Jenos Idanian #13 says:

    @stonetools: Why don’t you take this up with Drs. Bell and Collins. Anyway, the cuts 2010-2013 are squarely on the Republicans. Now, of course, the Republicans are squealing that those cuts were’nt them. Those pu$$ies won’t own up to their own irresponsibility. Well, screw ‘em and their enablers.

    You just GOTTA find a way to 1) make this political and 2) blame the GOP, right?

    Here’s an article with a chart on CDC funding from 1970 through 2013. A couple of highlights:

    1) Sharp climbs in 2001-2003 and 2007-2010 — 3.4 to 5.8 billion, then 5.6 to 7.4 billion.

    2) 2013 funding has fallen to roughly 2009 levels — 6.7 billion.

    3) An increase of roughly 2.2 billion in 1994 to 5.6 billion in 2006 — an increase of about 255%.

    I’m working off a mediocre resolution broad graph, so the numbers aren’t precise, but they’re precise enough. Also, it uses constant dollars, not absolute dollars. But it seems adequate to rebut your hysterical blamethrowing.

  24. anjin-san says:

    Perhaps now would be a good time to bury the oft-repeated lie that the CDC wastes resources on gun research that should be going to fight disease.

    The CDC does not do research on gun violence. The budget for it is zero. The time spent on it is zero. They were banned by doing so by Congress in the mid-90s. The CDC does spend about 100K a year tracking the raw number of gun deaths in the US.

    If you repeat a lie a thousand times, it does not become true.

  25. Jenos Idanian #13 says:

    @C. Clavin: Cliffy, if you were the least bit self-aware, you’d go drown yourself in shame. However, that ain’t ever gonna happen.

    FIrst up, you keep confusing conservatives with anarchists. Here’s a hint: the anarchists are usually on your side.

    Next, to repeat a point I’ve made over and over and over again, there are legitimate roles for the federal government. Controlling diseases like this one are one of those responsibilities. On the other hand, you seem to think that the federal government should be in control of everything — until they feck it up, of course, when it’s obviously the fault of the right-wingers SOMEHOW.

    I’ll pose the same question to you I’ve asked before, and haven’t yet to get an answer: is there ANYTHING that you see as not the purview of the federal government, and the responsibility of the state or local government? Just an example or two would be sufficient to show that you are both aware of the 10th Amendment and support it.

    Which, of course, you either aren’t or don’t, but go on.

    Alternately, you can explain how “bomb Texas” is contributing to the discussion here.

  26. Jenos Idanian #13 says:

    @anjin-san: The CDC does not do research on gun violence. The budget for it is zero. The time spent on it is zero. They were banned by doing so by Congress in the mid-90s. The CDC does spend about 100K a year tracking the raw number of gun deaths in the US.

    And what, pray tell, is the disease being addressed here? Lead poisoning?

  27. anjin-san says:

    While we are on the subject of oft-repeated lies, there is the one about CDC going outside it’s mission by studying & tracking things that are not strictly disease related. Three seconds on Google will take you to the CDC’s mission statement, which begins with:

    CDC works 24/7 to protect America from health, safety and security threats

    http://www.cdc.gov/about/organization/mission.htm

  28. C. Clavin says:

    @Jenos Idanian #13:
    Here’s how a$$wipes like you try to operate.

    Next, to repeat a point I’ve made over and over and over again, there are legitimate roles for the federal government. Controlling diseases like this one are one of those responsibilities

    .
    Right…logical…limited…cautious…nothing that can be argued with.

    On the other hand, you seem to think that the federal government should be in control of everything — until they feck it up, of course, when it’s obviously the fault of the right-wingers SOMEHOW.

    Illogical…limitless…total delusion…a straw-man argument…based on pure nonsense.
    Call up to your mommy and ask her for some jello…and have her hide your meds in it…the way you like.

  29. Jenos Idanian #13 says:

    @anjin-san: If you have to keep misstating the other side’s argument, it’s a pretty good indicator that you’re lying.

    The point isn’t that the CDC shouldn’t be studying such things. It’s that they should worry about the big issues — their main job — first, and THEN — if they have time and resources left over — work on these side projects.

    That they are failing over and over again on this issue is pretty much proof that they were misallocating their resources.

  30. Jenos Idanian #13 says:

    @C. Clavin: Here’s how a$$wipes like you try to operate.

    Cliffy, you’ve proven over and over again that you 1) have no clue how to have civil discussions here, 2) have no respect for the rules our hosts have established, and 3) have no fear in ever having those rules imposed against you. So I don’t see any reason whatsoever to attempt to engage you in discussions.

  31. anjin-san says:

    @Jenos Idanian #13:

    it’s a pretty good indicator that you’re lying.

    What lie have I told? Please be specific.

  32. CB says:

    This is embarrassing, because the usual suspects just insist on carrying out their own personal vendettas in every @#$%&!@ thread. Could you guys stop sniping at each other like children?

    Also, Ebola is bad but everyone needs to take a deep breath.

  33. Jenos Idanian #13 says:

    @CB: Also, Ebola is bad but everyone needs to take a deep breath.

    Just don’t do it around any Ebola patients.

    Sorry, couldn’t resist.

    (Inhale… exhale…)

    Good comment. I’m gonna step away for a few hours. I occasionally do have a life…

  34. C. Clavin says:

    @Jenos Idanian #13:
    So you got nothing…you could have just said that.

  35. anjin-san says:

    @CB:

    I’m aware that not everyone on OTB is happy about my back & forth with Jenos. I’ve made a point of keeping my comments on this thread on topic and non-personal, and that will continue to be my policy henceforth.

  36. David M says:

    I am not surprised that the party of cutting all government spending is trying to make sure everyone knows this wasn’t the spending they wanted to cut. I hope no one is gullible enough to believe this nonsense and let the GOP off the hook.

    If the GOP always want to cut government spending, then they own the consequences of all cuts to government spending.

  37. stonetools says:

    @Jenos Idanian #13:

    The point isn’t that the CDC shouldn’t be studying such things. It’s that they should worry about the big issues — their main job — first, and THEN — if they have time and resources left over — work on these side projects.

    Er, why not? Because it doesn’t fit in with your right wing view of what CDC should be doing? If it’s within their authority, why not? For the record , a hell of a lot more people will die from obesity and gun violence in America this year than from ebola.
    Let’s be blunt. The mission and role of either the NIH and CDC is no way limited to infectious diseases. Both are organizations with broad public health and public policy missions. Tens of thousand people die each year from the causes that you term “side projects”.Until a couple of weeks ago, no American died from ebola. So no, your idea of what should be the NIH and CDC ‘s main concerns is warped by your right wing ideology
    As to CDC’s efforts so far, there is room for improvement, but actually, hardly anyone has died from ebola as yet and disease has thus far been contained. There is no need at all to panic. And panic is what congressional Republicans are doing by calling for the CDC director to resign (They are of course also doing this out of political expediency- to draw attention from their role in CDC budget cuts).

  38. wr says:

    @anjin-san: I’ve given up responding to Jenos. I’m sure it was annoying everyone else, and it was useless, since he’s nothing but a troll who gets pleasure from annoying people. You can never win with him, you can only encourage him to keep pushing.

    And I have to say that my life is nothing but improved since he no longer takes up a second of it. I know at first it takes some will control not to respond to infuriating, deliberate stupidity, but it gets easy pretty fast…

    And if you feel like engaging, there are plenty of people here to disgree with. The difference is that many of them are actually interested in what they’re talking about, not just in being irritating.

  39. C. Clavin says:

    @Jenos Idanian #13:

    1) Sharp climbs in 2001-2003 and 2007-2010 — 3.4 to 5.8 billion, then 5.6 to 7.4 billion.

    Those were couter-terrorism moneys…and not general CDC moneys.
    But don’t let the facts get in the way of your ideology.

  40. Matt says:

    @Slugger: There’s nothing weird about it. People infected with Ebola aren’t really contagious till they show a fever and it’s the bodily fluids that are contagious. At home Duncan was probably pooping in a toilet and he wasn’t puking or bleeding like mad. In the hospital he was probably wearing a catheter and a diaper.Changing those are a massive risk for being exposed. Also late stage ebola causes a lot of horrible bodily fluids to be produced.

    So logically there’s nothing to wonder…

  41. Matt says:

    @Jenos Idanian #13:

    That they are failing over and over again on this issue is pretty much proof that they were misallocating their resources.

    What are some of the failures you speak of?

  42. anjin-san says:

    @C. Clavin:

    Those were couter-terrorism moneys

    A lot of money was pumped into the CDC in the wake of 9.11 to deal with bio-terror threats. Did that help, hinder, or have no effect on situation such as the one we face today?

  43. Grewgills says:

    @Jenos Idanian #13:
    Sigh, I explained to you already ( Grewgills ) what the role of the state government and the CDC were. I challenged you to acknowledge your misunderstanding on those roles later in that conversation, yet here you are making that same argument. The supposed failures you have most focused on, failure to quarantine Duncan’s family and others in Texas, are not failures of the CDC. They are failures of the Texas department of health and governor Perry if they are indeed failures. Why do you continue to focus all of your ire at the CDC? You focus virtually all of your response to the federal government, while telling anyone that points to the state’s larger responsibility in this case that they are playing politics. Pot, meet kettle.

  44. JKB says:

    Reports of a school in California evacuated because a kid on the nurse’s flight has thrown up. Alarm! Alarm!

    Would all those with high risk of Ebola exposure, please take the White House tour. Obama wants to show everyone how innocuous the virus is.

  45. CB says:

    @Jenos Idanian #13:

    Just don’t do it around any Ebola patients.

    There’s a special place in Hell for people like you.

    (Just kidding. I think.)

    @anjin-san:

    Wasn’t necessarily directed at you, and I understand the impulse (someone on the Internet is WRONG!!), and I don’t wanna sound like a blog nanny. It’s just getting tiresome, and it’s degrading a once exceptional commenting experience.

  46. anjin-san says:

    The “fat lesbians” thing keeps popping up. I understand that comments about fat lesbians are titillating to Erick Erickson and his readers, but I don’t understand how anyone can not see that obesity is absolutely an epidemic/public health crisis in this country, and that it will affect us all as resources are increasingly diverted into treating it’s fallout.

  47. Moosebreath says:

    And then there are people who seem determined to create panic over this:

    “Sen. Ron Johnson (R-WI) said during a Wednesday interview with NewsmaxTV that he’s concerned the Islamic State may use Ebola as a weapon against the U.S.

    The interviewer referenced comments made by a professor of national security affairs who last week said he feared that ISIS fighters could use Ebola as a weapon if they infected themselves and traveled to the U.S.”

  48. anjin-san says:

    @CB:

    it’s degrading a once exceptional commenting experience.

    No argument there. I will just say that I think the epidemic of low-quality comments can be traced back to a single source, let’s call him blog guy zero, and leave it at that 🙂

  49. C. Clavin says:

    @anjin-san:
    I tried to find the article that info is from but I’m striking out.
    The jist was that the big influx of $ was intended for counter-terrorism, but was more than they could actually spend, so with the help of creative accounting was spread around to help lessen the effects of years of under-funding.
    I think the effect, in regards to today’s imaginary crisis, is minimal.

  50. anjin-san says:

    @C. Clavin:

    The subject of panic spending in response to 9.11 is a fascinating one. The overall damage the attacks did in the long run goes beyond the actual loss of life and property that day by orders of magnitude.

  51. grumpy realist says:

    @Jenos Idanian #13: Um, we have a hell of a lot of obese people in the US, have you noticed?

    Fact is, as a typical American, you’re far more likely to die of complications from Type II diabetes than of Ebola.

    Heck, you’re probably far more likely to die in a car accident squished by some dumb texting/cellphone-using idiot than of Ebola.

  52. C. Clavin says:

    @grumpy realist:

    Fact is, as a typical American, you’re far more likely to die of complications from Type II diabetes than of Ebola.

    Or a gunshot wound.

  53. C. Clavin says:

    @anjin-san:
    Yup….exactly what OBL wanted us to do.

  54. anjin-san says:

    @Moosebreath:

    “Sen. Ron Johnson (R-WI) said during a Wednesday interview with NewsmaxTV that he’s concerned the Islamic State may use Ebola as a weapon against the U.S.

    The right seems to search endlessly for imaginary confluences such as this. Glenn Beck’s rantings about “socialist jihad” were absolute classics of the genre.

  55. JKB says:

    @C. Clavin:

    Neither of those are a disease.

    Now the real problem here, with the CDC and the poor local public health agency response is that in the absence of real disease to fight, the social scientists took over the agencies. They are ill prepared to conduct the core mission. We saw it with the invasion of Iraq. A lot of generals and colonels had to be replaced as they, while experts in bureaucratic wars proved ineffective in actual battle against a main-mission enemy.

    Once the infectious disease people take positions of command at the agencies, this all settle out. But right now, we have cola warriors trying to fight a skilled microbe threat.

  56. C. Clavin says:

    @JKB:

    Neither of those are a disease.

    CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.

    Emphasis mine.
    They may not be diseases strictly speaking…but they are greater health, safety, and security threats than Ebola will ever be.

  57. Grewgills says:

    @Grewgills:
    @Jenos Idanian #13:
    Crap my link didn’t work. Hopefully this one does and this one.
    If you are/were really upset about the failure to quarantine Duncan’s family you have been directing your outrage at the wrong target. I trust that now that you know the party responsible for that decision you will direct your ire appropriately.

  58. bill says:

    @C. Clavin: you don’t like democrats i guess? the city of dallas votes democrat, you must not like blacks and latinos.

    but seriously, the “open borders” policy of the obama administration is to blame for the disease ridden peoples streaming across the border-legally and illegally. this is his deal, he needs to own it. and the cdc is having trouble keeping up with the talking points too, embarrassing for all. now that it’s spreading they just can’t seem to keep their game plan straight- maybe they forgot that all of their policies require “humans” to enforce, and they’ll always find a way to screw something up.

  59. beth says:

    @bill: Ebola didn’t come in via any open borders. As a matter of fact, there’s no diseases that can be proven to have entered the country that way. Try again.

  60. wr says:

    @anjin-san: “The subject of panic spending in response to 9.11 is a fascinating one. The overall damage the attacks did in the long run goes beyond the actual loss of life and property that day by orders of magnitude.”

    Which, astonishingly enough, is exactly what the terrorists who committed it hoped for.

    I don’t know if the American media or the Republican Party is Al Qaeda’s biggest ally in this country.

    And they’re at it again with Isis, blowing it up into a global crisis that puts our very existence at risk, simply because they murdered a tenth the number of people some angry teenager can take out at a movie theater with an AK.

  61. wr says:

    @Moosebreath: “Sen. Ron Johnson (R-WI) said during a Wednesday interview with NewsmaxTV that he’s concerned the Islamic State may use Ebola as a weapon against the U.S.”

    That would be particularly bad right now, seeing as how we’ve barely finished fighting that plague of leprosy the GOP said all those Central American kids were bringing over the border.

  62. wr says:

    @bill: “but seriously, the “open borders” policy of the obama administration is to blame for the disease ridden peoples streaming across the border-legally and illegally. this is his deal, he needs to own it.”

    You mean the open border between us and Belgium? Because that’s where the only “disease ridden” person flew in from.

  63. JKB says:

    @C. Clavin:

    CDC works 24/7 to protect America from health, safety and security threats, both foreign and in the U.S. Whether diseases start at home or abroad, are chronic or acute, curable or preventable, human error or deliberate attack, CDC fights disease and supports communities and citizens to do the same.

    Highlights mine.

    Funny how disease is so prominent in their mission statement but not in their actual recent work.

  64. stonetools says:

    @JKB:

    Neither of those are a disease.

    According to the Oxford Dictionary, a definition of disease:

    1.
    a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury:

    “bacterial meningitis is a rare disease”

    synonyms: illness · sickness · ill health · infection · ailment · malady ·

    More

    2.
    a particular quality, habit, or disposition regarded as adversely affecting a person or group of people:

    Under 1, obesity is most definitely a disease, especially since it can lead to type 2 diabetes.
    The whole gun worship syndrome seems to fit definition 2 rather well, leading to 30,000 unnecessary deaths per year.Put another way , every year, the United States suffers half a Vietnam War worth of deaths because of the plague of gun violence.

    So, wrong again, Bob.

  65. Guarneri says:

    @anjin-san:

    Or, on the other hand, that government is incapable of getting past it’s bureaucratic ways, not that the VA didn’t also run like clockwork mind you.

    You’re doin’ a heck of a job, Fried-y.

  66. Jenos Idanian #13 says:

    Here’s what appears to be the first “fat lesbians” article I can find — it’s part of a list of projects that were funded despite the “draconian” Republican spending cuts (which didn’t really happen).

    Yes, there seem to be people who are promoting panic at this outbreak. But I repeat: the single biggest panic promoter is the CDC with every new screw-up.

    However, it looks like Mr. Clipboard on the Tarmac wasn’t a matter of negligence, but of policy. I dunno if it was such a good idea or not (he looks more like Mr. Canary In A Coal Mine to me), but at least it wasn’t a mistake.

    And I’m still wondering why the complete flip-flop on state/local vs. fed responsibility when comparing this to Katrina.

  67. anjin-san says:

    @Guarneri:

    I don’t really think that the federal government should be the one providing the health care services. The problems with the VA are very real, and instructive.

    What they should be doing is acting as a single payer so that we can eliminate the parasitic health insurance carriers that suck money out of the system and have a negative impact on care in the process.

    On another topic, have you done anything about power conditioning?

  68. CB says:

    @Jenos Idanian #13:

    As far as Katrina comparisons, the issue, for me, was always the politicization that left FEMA completely unprepared for any kind of federal response. There’s a lot to pore over with regard to Brown’s incompetence. There was no excuse for such a poorly orchestrated effort to something with which we should have been well accquainted (general hurricane relief). I have no love for Nagin, but the effort should have begun with the feds, and there’s little evidence that they took it seriously until images from the Superdome started being broadcast.

    Conversely, I just see the Ebola crisis as a fundamentally messy situation that would wreck havoc on even the best prepared governments. Look at every other Western nation dealing with a case. They’ve all been handled in basically the same way, with the same kind of breakdowns. Don’t take this as me painting the CDC in glory, I just don’t see the two situations as very comparable.

  69. Grewgills says:

    @Jenos Idanian #13:
    If you follow the link on the ”fat lesbian” study you can click through and see that it is a study on the effects of sexual orientation on obesity and it cost a bit over $670,000 out of a budget of over $5,000,000,000 (that would be less than 0.013% of the budget). This infatuation on the right with minuscule line items in budgets somehow proving rampant waste and constituting proof of horribly misplaced priorities is truly mind boggling. The idea that this study on obesity in a minority community somehow derailed ebola research is beyond stupid.

  70. Hal_10000 says:

    The idea that this study on obesity in a minority community somehow derailed ebola research is beyond stupid.

    And yet the idea that flat spending at the NIH did so is considered respectable. Never mind that vaccine research is difficult (we’ve been working on a malaria vaccine for decades) and sometimes produces vaccines of dubious utility. Never mind that the NIH has a $30 billion budget.

    I don’t like the process of picking out weird-sounding studies for criticism. Often these “stupid studies” aren’t so stupid (e.g., the infamous shrimp treadmill) or are a smart part of a large grant (e.g., the infamous shrimp treadmill). But I think the overall point — that NIH has $30 billion to spend, is valid.

    I also think the desperate attempts to blame this on Republicans is ridiculous. I realize I’m peeing in the wind: the idea that Republicans gut science funding is an article of faith among liberals. But I’ve been in science a long time. I started in the early 90’s, when Clinton and the Democrats cut science funding (including killing the SSC, which basically crippled American particle physics) to balance the budget. For the next decade, under a Republican Congress, science funding boomed. From 1995 to 2003, NIH’s budget nearly tripled. And it wasn’t just anti-terrorism (which would include Ebola research). NSF also saw their budget soar.

    Science funding tapered off around 2004 and was pared back once Democrats took Congress and has been basically flat for the last decade — under Republicans and Democrats. I knew people whose careers ended because they couldn’t get grants at that time. I had a proposal was highly rated but wasn’t funded because NSF was flat out supporting the grants they had. This was back in 2007, when the Democrats controlled Congress.

    The recent cuts to NIH/CDC are the results of the sequester — a bipartisan agreement that neither side made a serious effort to undo. The GOP raised CDC spending 8% this year. Obama’s FY 2015 proposal actually cuts CDC funding. Obama’s budget plan cut NASA astrophysics. The GOP budget restored that spending. You might make the argument that cutting science spending is bipartisan. It’s very hard, based on the budgets of the last 20 years, to make the case that this is *all* on the GOP.

    I now return you to your regularly scheduled epistemic closure.

  71. Hal_10000 says:

    Incidentally, the WaPo gives the claim that Republican budget cuts are to blame four pinnocchios.

  72. bill says:

    @beth: um, duncan flew in from liberia. we can call him “patient 0” if you’d like.

    @wr: if ebola was raging through belgium i think we’d have had a travel ban for them and the neighboring countries.

    obviously our administration isn’t prepared to deal with this, although it was nice to see obama cancel an appearance at a political fundraiser due to this mess- that’s unheard of from him.

  73. anjin-san says:

    Not much discussion so far about the GOP blocking the surgeon general nomination at the behest of the NRA. Those of us who are old enough remember how C. Everett Koop stepped up and provided real direction and leadership on AIDS (when people were in a panic about it) and smoking.

    Republicans, what possible excuse do you have for leaving this key post in the government vacant?

  74. Grewgills says:

    @Jenos Idanian #13:
    This has been answered multiple times. That you choose to ignore the facts presented that hurt your position is no one’s fault but your own.

  75. Grewgills says:

    @Hal_10000:

    And yet the idea that flat spending at the NIH did so is considered respectable. Never mind that vaccine research is difficult (we’ve been working on a malaria vaccine for decades) and sometimes produces vaccines of dubious utility.

    Most of our budget woes are due to hyperpartisanship more than anything. The reflexive NO, kills almost all potential for compromise.
    A relatively quick google search and quick perusal of the NIH website didn’t turn up how much they have been spending on Ebola/Marburg, so I don’t know if that specific budget was cut. What that search unfortunately turned up is the usual blather about several small projects with silly sounding names that can be made fun of and blamed.
    Malaria isn’t really comparable as it isn’t a viral disease and so producing a vaccine is more problematic. That’s not to say producing an ebola vaccine would be quick or easy, but it is in a different ballpark as far as difficulty.
    This scare will probably get some fat wads of cash pushed towards finding a vaccine, which will hopefully make it happen considerably sooner than it otherwise would have.

  76. Jenos Idanian #13 says:

    @anjin-san: Those of us who are old enough remember how C. Everett Koop stepped up and provided real direction and leadership on AIDS (when people were in a panic about it) and smoking.

    I must be a little older than you, because I recall Congressional Democrats fighting like hell to keep Koop from being confirmed as Surgeon General.

  77. Jenos Idanian #13 says:

    @Hal_10000: I don’t like the process of picking out weird-sounding studies for criticism. Often these “stupid studies” aren’t so stupid (e.g., the infamous shrimp treadmill) or are a smart part of a large grant (e.g., the infamous shrimp treadmill). But I think the overall point — that NIH has $30 billion to spend, is valid.

    I prefer the studies of duck penises. Duck genitalia are in an amazingly fast state of evolution; it’s almost an arms race between the males and females. The females keep changing their genitalia to keep the males from impregnating them without their consent. The penises are corkscrew-shaped, and so are the female’s cloacae. However, the males go counterclockwise, the females are clockwise. Only if the female is consenting does she relax enough for him to overcome (if you’ll pardon the expression) the reversed threading.

    This is literally natural selection and evolution happening on a very, very fast scale, and could have some truly useful consequences. And even if it doesn’t, it blows way off my personal scale of “so cool, it must be studied.”

  78. anjin-san says:

    @Jenos Idanian #13:

    I recall Congressional Democrats fighting like hell to keep Koop from being confirmed as Surgeon General.

    Well, they were wrong about him, and they failed. He went on to a very distinguished tenure. And now Republicans are repeating this mistake and damaging the country for strictly partisan reasons.

    BTW, what year is it?

    A. 1982
    B. 2014

  79. al-Ameda says:

    @wr:

    “Sen. Ron Johnson (R-WI) said during a Wednesday interview with NewsmaxTV that he’s concerned the Islamic State may use Ebola as a weapon against the U.S.”

    I’m concerned that people like Ron Johnson (R-WI) are elected to the United States Senate.

  80. Eric Florack says:

    @al-Ameda: and you keep dodging the fact that it is still not up to the task. and I suggest it is intenntionally so.