Data is from an Associated Press story posted on Huffington Post:
We need a little balance to the terrifying fantasies of an out-of-control Ebola outbreak in this country. Certainly, when health care workers in a modern American hospital get infected taking care of a patient, and when the CDC itself screws up in advising one of those nurses that she could take a commercial flight, even though she had an elevated temperature, it's time to get worried.
But it's also time to learn from those mistakes -- which I believe everyone is doing.
We should not look just at our supposedly sophisticated medical facilities; we should also learn from what they are doing in Africa. Yes, 4,500 people have died in West Africa since it began seven months ago -- but what is remarkable is that they have kept the disease contained in five West African countries, and two of those appear to have "snuffed out the disease" within their borders. The AP article calls this a "modest success in an otherwise bleak situation."
Senegal had one case, but kept it from spreading, and has had no other cases. May I say that that is better than we did with the one case in Texas. Nigeria had 20 cases (8 deaths), which stemmed from one traveler from Liberia to Lagos, Niberia. Nearly 900 people were potentially exposed, and it could have been a disaster for Lagos' 21 million inhabitants. Instead, with aggressive tracking and public health controls, there have been no new cases since August 31. The World Health Organization called it "a piece of world-class epidemiological detective work."
Liberia, Sierra Leone, and Guinea are the hard hit countries, accounting for all but those 21 cases, with the disease threatening to overwhelm it's health care systems. But even they are not seeing as widespread an epidemic as we might expect -- not yet, anyway.
The learning curve has to be fast, but this can be contained. Tight border control, screening of airplane passengers, and meticulous tracking and isolation of those exposed can make a difference.
The Texas hospital experience has shown how there is simply no room for error in the isolation techniques required in working with these patients. Apparently a major problem is how to dispose of all the waste. Everything -- from bed linens, to body waste, to iv needles -- must be incinerated or autoclaved. And most important of all is the training of hospital staff in how to manage all this. The training has to be serious and extensive, with the rigorous protocols followed to the letter. That was the weak link in the Texas hospital; the nursing staff weren't even required to go to the 'information session' that the hospital offered. There was not a serious training program.
We know how to do this, but that information has to be disseminated and rigidly adhered to.
As President Obama explained, at this point banning air travel from West Africa would be counter-productive. We can screen -- or quarantine, if necessary -- those coming in from there. But if we put in a ban, people will just fly to another country, and then fly here without disclosing where they originated. Then we lose the opportunity to inspect and track those who might be infected. That's how it gets out of hand. Senegal and Nigeria have proved that it can be contained. Can we follow the example of poor African nations?
We should not panic, and our politicians should take a solemn vow not to politicize this issue. Listen to the experts, as President Obama is doing and letting his policy be informed by facts and experienced advice.
Ralph
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Is anyone surprised that Republican politicians are exploiting this? Rick Perry and several politicians calling for an air ban -- despite experts saying it is counterproductive.
ReplyDeleteBut the worst of all is presidential hopeful Rand Paul -- himself a doctor who should know better. Instead he is trading on his medical background to proclaim that the Obama administration is flat out wrong to say this is not highly contagious. He's increasing the fear factor, saying things like it only takes a small "innocula" on the skin.
Rand Paul has his own problems with credentials as an opthalmologist, as Rachel Maddow reveals lsst night.
He claims to be board certified in opthalmology; but he is not certified by the American Board of Ophthalmology, the certifying body.
Instead, he and his wife created something called the National Opthalmology Board -- and then he turns around and certified himself.
He created this Board with 200 other ophthalmologist to protest some policy about grandfathering members by the real board. And it only existed from 1997 to 2000 and operated only in Kentucky.
Former Vermont Governor Howard Dean, himself a doctor, clarified the question about how contagious Ebola virus is.
ReplyDeleteIt is not highly contagious, as in airborn, to individuals that have casual contact. But the bodily fluids of an infected person are highly contagious. So it's not a danger to people you encounter in public; but it is dangerous to caretakers.
So obviously both are right, but Paul isn't making that distinction; instead he's pandering to Obama-haters and to people's fears for political purposes.
Shame on this opportunist.