OT: Ebola - Should I be worried?

[Wilkinson4]

I know there are a lot of doctors on the forum and I was hoping some can post some thoughts on airborne transmission. I travel for work, so I think about it.

I am not sure we are getting the whole story from the CDC or our Government officials. There have been studies that suggested it could be spread by aerosol transmission in low temp/low humidity environments. Kinda like Colorado.

Also, now it is being reported that sneezing and/or coughing can spread it and it could be transmitted off droplets left on a door handle for up to an hour.

I am not sure what is really true…

If it wasn't for the high mortality rate it wouldn't be so scary. I know +30K die of flu each year and Ebola has a very low reproductivity rate in high temp/high humidity environments. But, we are entering flu season… It presents as flu at least initially and the study on cold low humidity environments is concerning.

Should I worry? I wash my hands, try not to touch things when I travel, try to get outta the habit of touching my hands to my face, etc…But, stuck on a plane that is never cleaned freaks me out a bit.

mIKE

ps. Apparently you should ride a bike if you have been in contact with people infected with Ebola.

http://www.boston.com/health/2014/10/30/showdown-imminent-over-nurse-quarantine-maine/MhbKBGsZ3NnBZ903syb5dK/story.html

Seems a bit irresponsible to me after being in a hot zone...

[akelman]

No, you shouldn't be worried. If you absolutely must worry about something, because you've got spare time on your hands or spare bandwidth or whatever, worry about things that have a much greater chance of killing you: the flu (as you note), falling off your bike, a car crash, or a lightning strike.

[93legendti]

If you come in contact with a soldier who was in the hot zone you should be worried. If you come in contact with a nurse who was in the hot zone? No. Makes sense....Astronauts were quarantined without any worries of offending heroes...

Ebola has come to America for the first time in our history...

If a healthy adult comes in contact with flu, not fatal. If a healthy adult comes in contact with Ebola? Decide what comfortable for you...

[R3awak3n]

you have a bigger chance of getting run over by a car while cycling than contracting ebola.

[thwart]

If a healthy adult comes in contact with flu, not fatal.

Right.

Adam, stick to what you know.

[Mr. Pink]

you have a bigger chance of getting run over by a car while cycling than contracting ebola.

Or having a stroke, or getting shot by a gun, or having a heart attack, or getting cancer.

Pretty crazy how Gov. Christie, a walking talking poster child for what is ailing and killing millions and millions in this country (obesity and anger filled stress) is setting policy for a disease that hasn't killed one person on American soil. But, that's the world we live in.

[FlashUNC]

Unless you're handling or come into contact with the vomit, diarrhea or other bodily fluids of a symptomatic ebola patient, I wouldn't worry too much.

The enterovirus that's spreading across the country among kids, this latest flare up of measles and other diseases due to anti-vaxxing and the flu are all far bigger worries.

[Dead Man]

Or having a stroke, or getting shot by a gun, or having a heart attack, or getting cancer.

Pretty crazy how Gov. Christie, a walking talking poster child for what is ailing and killing millions and millions in this country (obesity and anger filled stress) is setting policy for a disease that hasn't killed one person on American soil. But, that's the world we live in.

Mr. Duncan was on American soil

[eddief]

a conversation about a virus. Anxious to see where it goes.

[93legendti]

Right.

Adam, stick to what you know.

Tell me more. Exactly how many healthy adults die from the flu in the USA every year?

"CDC does not know exactly how many people die from seasonal flu each year... Third, many seasonal flu-related deaths occur ...because seasonal influenza can aggravate an existing chronic illness (such as congestive heart failure or chronic obstructive pulmonary disease). Also, most people who die from seasonal flu-related complications are not tested for flu, or they seek medical care later in their illness when seasonal influenza can no longer be detected from respiratory samples. Sensitive influenza tests are only likely to detect influenza if performed within a week after onset of illness. In addition, some commonly used tests to diagnose influenza in clinical settings are not highly sensitive and can provide false negative results (i.e. they misdiagnose flu illness as not being flu.) For these reasons, many flu-related deaths may not be recorded on death certificates. These are some of the reasons that CDC and other public health agencies in the United States and other countries use statistical models to estimate the annual number of seasonal flu-related deaths..."

[tumbler]

The only cases of transmission in the US have been healthcare workers directly involved in treating someone with full blown Ebola. This involves a level of bodily fluid exposure (blood, vomit, diarrhea, etc) that you are extremely unlikely to encounter outside of a hospital, or more specifically, a room in a hospital that happens to have an Ebola patient in it. It's helpful to keep in mind that none of the family members of Mr. Duncan contracted the virus, despite living with him even when he was quite ill.

[Dead Man]

a conversation about a virus. Anxious to see where it goes.

I was actually quite pleased that this forum had remained ebola-free. Of all the forums I participate on, The Paceline had remained the last one uninfected with EFD (Ebola Fear Disease).

[zap]

If you come in contact with a soldier who was in the hot zone you should be worried. If you come in contact with a nurse who was in the hot zone? No. Makes sense....

No kidding, talk about a confused policy…………..

[shovelhd]

I would worry more about how the CDC and the US government are handling issues like this than Ebola itself.

[buck-50]

I'd be willing to bet that Ebola would not be such a giant media panic right now if there wasn't an election in 5 days.

Also willing to bet that the panic quietly dies off November 5th.

The big question you have to ask yourself in these things is "Who wants me to be upset about this?"

The CDC and every healthcare professional I know say "this is not something you need to worry about."

Everyone I've seen who wants there to be panic about this seems to have an agenda that they've tacked onto every scare that's happened in the last couple years, from Hurricane Sandy to immigration.

Just saying, now is the time to listen to the cold, dispassionate voice of the CDC and not a bunch of hotheads.

[Mr. Pink]

Mr. Duncan was on American soil

Contracted elsewhere. And everyone who has had close contact with him are now cleared and safe.

[cderalow]

If you come in contact with a soldier who was in the hot zone you should be worried. If you come in contact with a nurse who was in the hot zone? No. Makes sense....Astronauts were quarantined without any worries of offending heroes...

Ebola has come to America for the first time in our history...

If a healthy adult comes in contact with flu, not fatal. If a healthy adult comes in contact with Ebola? Decide what comfortable for you...

Ebola was actually in the US in the 1990's. There was an outbreak in a scientific facility in Reston, VA in monkeys that the strain is actually named after.

Also, the CDC and USAMRIID have been studying it for decades.

It's been a known item since the 70's.

What we don't have is large scale outbreaks because we're a society with high regard for hygiene and safety with a huge medical care industry.

It's generally a 3rd world/underdeveloped country problem.

[93legendti]

Sorry, talking about humans...

Listen to the CDC


Dr. Frieden:

'"I think there are two different parts of that equation,” he continued. “The first is, if you’re a member of the traveling public and are healthy, should you be worried that you might have gotten it by sitting next to someone? And the answer is no.”

“Second, if you are sick and you may have Ebola, should you get on a bus? And the answer to that is also no. You might become ill, you might have a problem that exposes someone around you,” he said.'

http://www.mrctv.org/videos/frieden-second-health-care-worker-ebola-should-not-have-been-allowed-travel-plane

[thwart]

I was actually quite pleased that this forum had remained ebola-free. Of all the forums I participate on, The Paceline had remained the last one uninfected with EFD (Ebola Fear Disease).

+100.

This'll be locked by the end of the day, I suspect.

[zmudshark]

I haven't been out of the house in 21 days. Let me know when the seas of vomit and diarrhea have subsided..:rolleyes:

Oh, and IBTL.

[Saint Vitus]

a conversation about a virus. Anxious to see where it goes.

It will go viral of course...

[CunegoFan]

The country is much safer now that a political flunky with no medical knowledge has been appointed the eboloa czar, although I am not quite sure why we need a czar for something that has infected less people than the number of fingers on one of my hands and the CDC has experts for this sort of thing.

[Black Dog]

Risk contracting of Ebola = 0%

Risk of contracting Fearbola = 99%

[atrexler]

I would not worry if I were in your position.

Viral load correlates strongly with symptoms-- meaning that only very sick people are actively shedding alot of virus. This isn't something you're going to get even sitting next to someone who might be incubating the virus but isn't symptomatic yet.

Most of the sick in West Africa aren't getting sick because they're simply interacting with common objects in the environment. Local customs and a near complete lack of healthcare infrastructure are contributing greatly to the current epidemic. Most of the individuals getting ill are family members and healthcare workers actively caring for people who are dying of this disease. These victims are shedding a ton of virus. In some parts of these countries, funeral customs include washing the dead, and then the family washing themselves in the same water. It's easy to see how this is contributing to the spread of the disease. Even in countries where this epidemic is frankly out of control, its my understanding that most transmission is not happening outside of these circumstances.

I've just briefly looked into the airborne transmission you mentioned. To me, I would say the information suggests that in special, unique environments and circumstances it could be possible to spread the disease in this way. Again, heavy viral shedding correlating with very strong symptoms (vomiting, diarrhea, generally brutal flu symptoms, perhaps even bleeding) would probably be necessary. Like, if someone dying from Ebola and actively bleeding through the eyes and has just vomited up their stomach contents sneezes in your face, could you get sick? Yeah probably. What are the odds that situation is going to happen? Alot of these studies, which look to be very few in number, working on aerosolized Ebola were probably done by taking purified, highly concentrated virus, putting in a atomizer like what Windex comes in, and spraying it right in a monkey's face. That kind of situation doesn't really exist in the real world. Thousands of people have Ebola and are actively dying in West Africa right now. If it were airborne, we'd be looking at 10X that number, or even more. Its a chilling thought.

Certainly its possible that virus could survive on a door handle for up to an hour; I'm not familiar with our understanding of Ebola virus survival outside the body. Consider now that the number of individuals traveling from West Africa with even a chance of exposure is probably what, in the dozens? Couple that with the odds you are going to inhabit the same plane as a our potential Ebola vector. And the odds you'll board said plane within an hour of them touching a surface inside it? You're much more likely to get in a car accident on the way to the airport than even seeing someone with Ebola.

Finally, if you don't think you can trust the CDC or the US government, look to the WHO, UN, MSF, or EU.

[nooneline]

If you're worried that the CDC isn't telling you the whole story, or if you think that they're not doing their job, read this article:

http://www.nytimes.com/2014/10/26/us/new-york-ebola-response-polar-opposite-of-dallas.html

1. There's a lot of criticism about what happened in the hospital in Texas.
2. What the CDC does is something else: logistics and infrastructure. Basically, bootstrap epidemiology: tracing contacts, providing technical assistance (but not doing ebola treatment), conducting entry screening, setting recommendations, etc. Learn more (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/what-cdc-is-doing.html).
3. Everywhere has learned from Texas's mistake. It's why, after the Duncan case, every other hospital in the country rushed to have a story about how they had a patient with ebola-like symptoms that they were monitoring.

I work in this field. CDC has been doing a good job. Most hospitals have done a good job. Politicians have done a pretty bad job.

[Joachim]

.

[oldpotatoe]

If you're worried that the CDC isn't telling you the whole story, or if you think that they're not doing their job, read this article:

http://www.nytimes.com/2014/10/26/us/new-york-ebola-response-polar-opposite-of-dallas.html

1. There's a lot of criticism about what happened in the hospital in Texas.
2. What the CDC does is something else: logistics and infrastructure. Basically, bootstrap epidemiology: tracing contacts, providing technical assistance (but not doing ebola treatment), conducting entry screening, setting recommendations, etc. Learn more (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/what-cdc-is-doing.html).
3. Everywhere has learned from Texas's mistake. It's why, after the Duncan case, every other hospital in the country rushed to have a story about how they had a patient with ebola-like symptoms that they were monitoring.

I work in this field. CDC has been doing a good job. Most hospitals have done a good job. Politicians have done a pretty bad job.

I thought so, it's Gov. Perry's fault.

[atrexler]

I work in this field. CDC has been doing a good job. Most hospitals have done a good job. Politicians have done a pretty bad job.

Word.

[laupsi]

Also, now it is being reported that sneezing and/or coughing can spread it and it could be transmitted off droplets left on a door handle for up to an hour.


ebola = virus = cannot survive w/out living host!

[christian]

Come on, seriously?

[alessandro]

I work in this field. CDC has been doing a good job. Most hospitals have done a good job. Politicians have done a pretty bad job.

Word.

Rep. Darrell Issa in particular. :mad:

[crankles]

http://www.newyorker.com/humor/borowitz-report/fear-ebola-outbreak-make-nation-turn-science

http://www.newyorker.com/humor/borowitz-report/study-fear-ebola-highest-among-people-pay-attention-math-science-classes

[Ti Designs]

Come on, seriously?

Yeh, the CDC can't halt the spread of stupidity.

[Louis]

1) So far, when diagnosed early enough in the US, the mortality rate is 0.0

2) IMO Duncan died for two reasons: 1) The US was not prepared (we have now gone up the learning curve very, very quickly), and 2) He was an idiot. If the first time he went to Presby he had told them "I have Ebola [surely he knew] If you do not know what that means, Google the word or call the CDC" he would probably be alive today. The Texas nurses might have still been infected, because clearly those folks had no clue what they were doing. Now they do, so if Duncan #2 walks in the door they will handle it properly.

[JAGI410]

More Americans have been married to Kim Kardashian than have died from Ebola.

It's a media cash cow! There's nothing to fear at all unless you're going to Africa.

[christian]

Yeh, the CDC can't halt the spread of stupidity."Aaaaaah, it's an epidemic!"

[alessandro]

...married to Kim Kardashian


That's truly terrifying.

There's nothing to fear at all unless you're going to Africa.

Africa's a big place. Specifically, three countries: Guinea, Liberia, and Sierra Leone.
http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html

[Saint Vitus]

http://breakingnews.suntimes.com/chicago/nurse-kaci-hickox-defies-ebola-quarantine-in-maine/

[Louis]

Bikes are now part of the Ebola story:

Kaci Hickox (ME nurse) defied the "quarantine" she was supposedly under by going for a bike ride with her boyfriend.

Edit: I see StV beat me to it.

[laupsi]

Come on, seriously?

okay, okay, what I meant was that chances are very, very slim someone is going to contract a virus from a dry, metal door knob. it simply ain't a fertile environment and a virus needs its host to replicate. there call me dumb but not stupid :)

[bcroslin]

I'd be willing to bet that Ebola would not be such a giant media panic right now if there wasn't an election in 5 days.

Also willing to bet that the panic quietly dies off November 5th.


This.

[alessandro]

There have been studies that suggested it could be spread by aerosol transmission in low temp/low humidity environments.

Mike, what studies? I couldn't find any on PubMed. Unless you are referring to the highly controlled experiments done under laboratory conditions that atrexler detailed nicely in post #24 (http://forums.thepaceline.net/showpost.php?p=1648126&postcount=24).

There's a reason ebola so far has not been transmitted through the air in the wild, because as laupsi pointed out, viruses--or at least ebola--don't do well without a host. From the Richard Preston article in the New Yorker, "The Ebola Wars (http://www.newyorker.com/magazine/2014/10/27/ebola-wars):"

The question often asked is whether Ebola could evolve to spread through the air in dried particles, entering the body along a pathway into the lungs. Eric Lander, the head of the Broad Institute, thinks that this is the wrong question to ask. Lander is tall, with a square face and a mustache, and he speaks rapidly and with conviction. “That’s like asking the question ‘Can zebras become airborne,’ ” he said. In order to become fully airborne, Ebola virus particles would need to be able to survive in a dehydrated state on tiny dust motes that remain suspended in the air and then be able to penetrate cells in the lining of the lungs. Lander thinks that Ebola is very unlikely to develop these abilities. “That would be like saying that a virus that has evolved to have a certain life style, spreading through direct contact, can evolve all of a sudden to have a totally different life style, spreading in dried form through the air. A better question would be ‘Can zebras learn to run faster?’ ”

[FlashUNC]

Some interesting reading from an epidemiologist on The Hot Zone and its rather dangerous ebola myths that it has created...

http://io9.com/how-the-hot-zone-created-the-worst-myths-about-ebola-1649384576

[christian]

I was ok with the virus thing, but honestly not sure how I feel about the flying zebras. They're pretty nasty animals even when earthbound. :eek:

[alessandro]

I was ok with the virus thing, but honestly not sure how I feel about the flying zebras. They're pretty nasty animals even when earthbound. :eek:

Thanks! Just the inspiration I needed for tomorrow. Now, gotta get to work on my outfit. Beware the airborne particles:
http://cycleofbusiness.com/wp-content/uploads/2011/04/GWcipopod.jpg

Dang. Now I see that BBD beat me to it: :(
http://forums.thepaceline.net/showpost.php?p=934397&postcount=32

[cderalow]

Some interesting reading from an epidemiologist on The Hot Zone and its rather dangerous ebola myths that it has created...

http://io9.com/how-the-hot-zone-created-the-worst-myths-about-ebola-1649384576



The Demon in the Freezer by Preston is a much better and much more grounded in actual fact read (in fact, I believe something like 90-95% of it is actual fact that's been verified by multiple sources)

[Wilkinson4]

Mike, what studies? I couldn't find any on PubMed. Unless you are referring to the highly controlled experiments done under laboratory conditions that atrexler detailed nicely in post #24 (http://forums.thepaceline.net/showpost.php?p=1648126&postcount=24).

There's a reason ebola so far has not been transmitted through the air in the wild, because as laupsi pointed out, viruses--or at least ebola--don't do well without a host. From the Richard Preston article in the New Yorker, "The Ebola Wars (http://www.newyorker.com/magazine/2014/10/27/ebola-wars):"

That's the one.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1997182/

Point taken since it was a highly concentrated direct dose...

I've crashed 3x in the last year. My chances are good I'll crash again before I catch ebola. But, I have had a lot of travel this year and being around people sneezing, in dirty airports, etc… Just overwhelmed with the rhetoric…

mIKE

[joosttx]

My fear is if gets into Mexico City. Now that would be a $hit storm.

[Wilkinson4]

Some interesting reading from an epidemiologist on The Hot Zone and its rather dangerous ebola myths that it has created...

http://io9.com/how-the-hot-zone-created-the-worst-myths-about-ebola-1649384576

Thanks for that, seems level headed and striped of any political agenda.

mIKE

[93legendti]

Good to know the decision to treat military members the harshest is a political decision...


"WASHINGTON — Gen. Martin E. Dempsey, the chairman of the Joint Chiefs of Staff, recommended to Defense Secretary Chuck Hagel on Tuesday that all members of the armed services working in Ebola-stricken West African countries undergo mandatory 21-day quarantines upon their return to the United States...

On Tuesday, White House officials tried to explain why the military guidelines outlined by General Odierno are different from those for civilian health workers. Soldiers in West Africa, who are not directly providing health care to patients in those countries, have far less contact with Ebola patients than do civilian nurses and doctors in those countries who will not face quarantines under the C.D.C. guidelines."
http://www.nytimes.com/2014/10/29/us/politics/obama-defends-cdcs-ebola-rules-as-sensible-based-in-science.html

[harryblack]

Bikes are now part of the Ebola story:

Kaci Hickox (ME nurse) defied the "quarantine" she was supposedly under by going for a bike ride with her boyfriend.

Edit: I see StV beat me to it.

Kaci Hickox = American hero. Regardless of one's "political beliefs," the morons she's up against should frighten everyone more than any damn ebola.

I personally could do without the boyfriend's 'fat bike' but hey, that's my problem, and seriously, much respect to him for standing up with her.

I'm quesy about linking to this largely loathsome site but since they have the most pictures... caveat lector--

http://www.dailymail.co.uk/news/article-2814208/Quarantined-Ebola-nurse-defies-orders-stay-home-goes-bike-ride-boyfriend.html

[ajz07]

A few things...

1. I actually think the CDC has done a poor job with regards to ebola, and usually I love the CDC. The problem is that they initially had recommendations for a simpler type of precaution (called contact) and then have been ramping up. In my mind they should have started with more stringent precautions and then ramped down. There has been a lot of debate among the epidemiologists and infection control directors within SHEA (society for healthcare epidemiology of america) about this, and given the lack of consensus I do not understand how they started low and ramped up.

2. Ebola is incredibly infections, but no known studies have shown it to be airborn. There is HUGE difference between true airborne and droplet transmission (i.e. from coughing/ respiratory secretions), and it is theoretically possible for ebola to be spread by droplets, which is likely the reason for the ramping up of the CDC precautions. To give you an idea of infectious load (and this is from the nytimes)...1/5 teaspoon of blood from a symptomatic ebola patient can have 10 billion viral particles while the same amount from an untreated HIV pt has up to 50,000 to 100,000...and five million to 20 million in someone with untreated hepatitis C. We are talking huge orders of magnitude more viral particals/ viral load.

3. The mortality rates we have for ebola are for 3rd world countries. We do not have mortality rates for 1st world countries. So far it seems that in our limited experience we are doing much better with it than places that do not have the resources to treat it properly. It should also be factored in that the previous outbreaks of ebola in Africa generally were rural outbreaks where isolation/ quarantining were much more possible. In the current outbreak, because it happened in a much more urban center in a 3rd world setting, those types of precautions and treatment have been virtually impossible.

4. All of the above being true, the fear of it is way overblown. There are many many more things out there that are more likely to kill you than ebola. You are exceedingly unlikely to get even close to being exposed to it, and it is unlikely that it will run rampant through the country. That being said the CDC underestimated it initially and had to play catch up. The healthcare workers infected in TX were likely infected because they followed the initial CDC recommendations and not the updated ones that are now out. As a result they had parts of their bodies exposed (i.e. neck area) and other such areas which may have been exposed to fluids which would not be exposed as of now. Of course that actually is if they don and doff the person protective equipment properly, and that is not nearly as easy as it sounds.

my 2 cents

[gdw]

"Kaci Hickox (ME nurse) defied the "quarantine".

Much ado about nothing. If you've ever been to Ft Kent you'll realize that she is quarantined.:banana:

As to the fatbike, it's perfect for an area where winters are long and brutal. In 2006-7 they had almost 200 inches of snowfall.

[JAGI410]

Oh no! Ebola nurse rides a Surly! I ride a Surly! Do I have Ebola now?

[cfox]

I don't see why a 21 day quarantine for returning health workers is so controversial. It seems perfectly practical to me. Is it really a deterrent to someone willing to go work in an ebola hot zone?? That Doc from NYC passed all the health screenings when he returned but still ended up with ebola.

Kaci Wilcox is among many brave people who selflessly went to help others in desperate need. For that, she deserves much praise. But to call her an "American Hero" because she lawyered up in order to take on "the man" is beyond absurd.

[Louis]

Oh no! Ebola nurse rides a Surly! I ride a Surly! Do I have Ebola now?

Better quarantine you from the forum... :eek::eek::eek:

[93legendti]

http://www.nj.com/politics/index.ssf/2014/10/christies_quarantine_policy_attacked_by_aclu_cdc_a nd_even_the_un_is_embraced_by_2011_nobel_prize_win .html#incart_river

'Christie's controversial Ebola quarantine now embraced by Nobel Prize-winning doctor

...Dr. Beutler, an American medical doctor and researcher, won the Nobel Prize for Medicine and Physiology in 2011 for his work researching the cellular subsystem of the body’s overall immune system — the part of it that defends the body from infection by other organisms, like Ebola.

He is currently the Director of the Center for the Genetics of Host Defense at the University of Texas Southwestern Medical Center in Dallas — the first U.S. city to treat an Ebola patient and also the first to watch one die from the virus. In an exclusive interview with NJ Advance Media, Beutler reviewed Christie’s new policy of mandatory quarantine for all health care workers exposed to Ebola, and declared: “I favor it.”
Unfortunately, while the doctor’s support might provide much-needed credibility for Christie as he threatens to quarantine ever more healthcare workers returning from the Ebola fight in West Africa, it also comes with some chilling words.

“I favor it, because it’s not entirely clear that they can’t transmit the disease,” Beutler said, referring to asymptomatic healthcare workers like Kaci Hickox, a Doctors Without Borders nurse returning from treating Ebola patients in Sierra Leone who was quarantined in New Jersey for 65 hours before being transported to her home state of Maine on Monday afternoon.

“It may not be absolutely true that those without symptoms can’t transmit the disease, because we don’t have the numbers to back that up,” said Beutler, “It could be people develop significant viremia [where viruses enter the bloodstream and gain access to the rest of the body], and become able to transmit the disease before they have a fever, even. People may have said that without symptoms you can’t transmit Ebola. I’m not sure about that being 100 percent true. There’s a lot of variation with viruses.”

In fact, in a study published online in late September by the New England Journal of Medicine and backed by the World Health Organization, 3,343 confirmed and 667 probable cases of Ebola were analyzed, and nearly 13 percent of the time, those infected with Ebola exhibited no fever at all...'

[Louis]

It's amazing how quickly Adam has become an Ebola expert.

Maybe he should be nominated for Surgeon General.

[nooneline]

I thought so, it's Gov. Perry's fault.

I'm actually thinking about Cuomo and Christie, here, enacting mandatory quarantine orders that are based on people's fear rather than science - and doing so without consulting health officials. And then Cuomo starts hedging about it, and Christie gets all blustery about it. Primo idiocy.

I don't see why a 21 day quarantine for returning health workers is so controversial.

Because it's not based on science, and may cause more harm than good.

Is it really a deterrent to someone willing to go work in an ebola hot zone??

According to people who are willing to go to work in ebola hot zones, yes.

Do you really want politicians making health policy that goes against the recommendations of public health experts... and without consulting those experts?

[ajz07]

Because it's not based on science, and may cause more harm than good.


actually the WHO (world health organization) has agreed that ~95% of cases of ebola have an incubation period of 21 days. Ergo, if you quarantine some for 21 days you are going to catch most of the cases of ebola that would occur (yes there are occasionally longer incubation periods, but it is relatively rare).

As a side note, the epidemiologists/ infection control practitioners I know who have thought of going over, all of them were taking into account a 21 day elective quarantine away from their families on their way back into the country. This was several weeks ago, and they were not willing to take any chances with their loved ones.

[Charles M]

Right now, you should be more worried about being killed by

ants
buffalo
bears
lightening
Sharks
farm equipment
Rain
the flu
Birds
snakes
cows
taxi cabs
grain
electricity
mold
bleach
deer
spiders
rocks
falling trees
cycling
large shelving
grapes (choking)
beef jerky
canned food

and, well eh, anything else that has killed more people in the US in the last 10 years.

[Louis]

http://forums.thepaceline.net/attachment.php?attachmentid=88088&stc=1&d=1322531757

[nooneline]

actually the WHO (world health organization) has agreed that ~95% of cases of ebola have an incubation period of 21 days. Ergo, if you quarantine some for 21 days you are going to catch most of the cases of ebola that would occur (yes there are occasionally longer incubation periods, but it is relatively rare).

As a side note, the epidemiologists/ infection control practitioners I know who have thought of going over, all of them were taking into account a 21 day elective quarantine away from their families on their way back into the country. This was several weeks ago, and they were not willing to take any chances with their loved ones.

We think long and hard before forfeiting people's civil rights due to health concerns.

21 days is the maximum incubation period. 2-10 days is the common range. People develop an obvious fever 2 days before they are contagious. Congagion requires being in close contact with somebody who is dying of the disease.

The CDC, WHO, and MSF don't call for mandatory quarantines. I think they know a bit more about treating and controlling ebola than Chris Christie does.

These policies have been criticized by a jillion people at the top of their fields, including the New England Journal of Medicine (http://www.nejm.org/doi/full/10.1056/NEJMe1413139?query=featured_ebola&%20&), a group of "over 100 AIDS researchers, clinicians, and activists" (http://www.nytimes.com/2014/10/28/upshot/aids-activists-oppose-cuomo-on-ebola-quarantines.html) (including Paul Farmer (http://en.wikipedia.org/wiki/Paul_Farmer), who knows a thing or two about infectious disease).

[cfox]

We think long and hard before forfeiting people's civil rights due to health concerns.

21 days is the maximum incubation period. 2-10 days is the common range. People develop an obvious fever 2 days before they are contagious. Congagion requires being in close contact with somebody who is dying of the disease.

The CDC, WHO, and MSF don't call for mandatory quarantines. I think they know a bit more about treating and controlling ebola than Chris Christie does.

These policies have been criticized by a jillion people at the top of their fields, including the New England Journal of Medicine (http://www.nejm.org/doi/full/10.1056/NEJMe1413139?query=featured_ebola&%20&), a group of "over 100 AIDS researchers, clinicians, and activists" (http://www.nytimes.com/2014/10/28/upshot/aids-activists-oppose-cuomo-on-ebola-quarantines.html) (including Paul Farmer (http://en.wikipedia.org/wiki/Paul_Farmer), who knows a thing or two about infectious disease).

Curious, would you let your 3yr old hug/kiss/hang out with an ebola volunteer family member who just got off the plane from Liberia?

My cousin is a former CDC infectious disease researcher (left to start a family). She is appalled by the handling of all this by her former employer. She can't believe anyone who has spent time in a hot zone would be opposed to a quarantine. The "does more harm than good" argument is not rooted in science, but anecdote, as in, it "might" discourage volunteers.

[ajz07]

I respectfully very much disagree. While I understand your point about civil liberties, and do not think ebola should cause the enforcement of martial law/ fear mongering I will say this...

-AIDS researchers/ activists/ clinicians and Paul Farmer are not experts on ebola. AIDS researchers/ activists/ clinicians in general are not even experts on infection control/ epidemiology, and that is what this ebola stuff really boils down to. One virus is NOT the same as another.

-The last author on the NEJM editorial you cite is an infection control specialist at BWH (brigham and womens hospital). She is one of the people who initially wrote an editorial in JAMA agreeing with the low level recommendations the CDC initially issued, you know the ones that were actually insufficient. Additionally in reading the editorial you would note they are mostly against the quarantines due to the fact that they might potentially spread a lot of fear and reduce the number of health care workers from the US going overseas to help (which is their main aim, getting more workers to stem the problem in West Africa). This is a very controversial point, as in talking with some infectious control practitioners it is unclear whether the current epidemic in west africa will ever go away, or if it will remain and reside in corners smoldering for a long time/ indefinitely with occasional flare ups (i.e. reach a steady state).

-You do not need to be "dying" from ebola, to spread it. Just having symptoms. For 95% of people that is within 21 days. How do you think WHO and MSF treat and prevent ths spread of ebola in rural Africa. It was via quarantines. This is the reason it has not worked in the urban setting this outbreak is currently in.

[nooneline]

I don't have a 3 year old.

I can say that I wouldn't hesitate to hug and kiss somebody who is obviously not sick with ebola.

Science, not fear.

I mean look - yes, there is always a case for an additional precautionary approach. I see all the points. Except it's not necessary. You could also tell people that the only way to prevent STDs for sure is to never ever have sexual contact with anybody else. And you'd be right. But it wouldn't be necessary.

Here's what MSF has to say about their ebola protocols (http://www.doctorswithoutborders.org/article/q-msf%E2%80%99s-ebola-response-and-protocols#5). They have 3,200 staff treating Ebola in West Africa. 700 of those are international staff. 3 of those have contracted Ebola while in W. Africa. Those 3 have transmitted Ebola to 0 people.

[redir]

I have so much to do around the house I would welcome a 21 day quarantine. As long they let me walk 20ft to the shop out back.

[sitzmark]

...
I've crashed 3x in the last year. My chances are good I'll crash again before I catch ebola. But, I have had a lot of travel this year and being around people sneezing, in dirty airports, etc… Just overwhelmed with the rhetoric…
mIKE

A good way to look at it - outside of the affected regions. It's a numbers game and in North America the statistics of crossing paths with an infected person or a person who came in contact with a person who knew a person who sat next to a person who once visited and infected region is minuscule (for now) - even if you travel by air.

I'm a schooled microbiologist (non-practicing) with enough immunology and virology background to understand the basics of viral capsid structures, DNA packing, and mechanics of enveloped viral cell entry. Unlike microorganisms, viruses are not "alive" and cannot "do anything" unless the virus can inject its DNA into a host cell capable of replicating its genetic code.

Most viral capsids ("skin"/shells) are relatively delicate - most disintegrate in warm dry conditions. Others can remain intact, but again do nothing until environmental conditions develop which are less detrimental to their shells and the virus finds compatible host cell binding receptor sites to latch onto. Once bound to the surface of a cell, then the virus' functional mechanics leading to DNA injection are initiated. ...And then the process of replication and over-running host immune systems (or not) takes place.

There's no 100% "safe" way of dealing with infectious agents. There is good asceptic technique and if practiced properly the chances of infection are very very small. Somewhat akin to if you handle a firecracker with the same caution as stick of dynamite, then you have very little to worry about. Anyone with a strong health sciences background should understand the mechanics of contamination and how to avoid it. Actually chefs/food workers handling raw food have the same basic challenges. Tag something with a dye and then see how difficult it is to handle and dispose of the item without finding signs of dye anywhere where you don't want dye to be - either on your person or in the environment. While the CDC can develop standardized protocols - which may evolve as the agent mutates or evidence-based medicine dictates - it is a cop-out for local healthcare experts to claim they don't know how to handle a highly infectious agent. As healthcare workers have proved, it is possible to interact with an infected patient without a full-environmental suit and not become infected.

The statistical numbers for the complex conditions necessary to propagate wide-spread infection are currently too low for the "hysteria" that is taking place in the US. The 21-day monitoring process - without quarantine - is a statistically viable solution until it isn't. Meaning that until a sufficient number of aid workers prove themselves unable to prevent infection and return home to overwhelm the system, the existing protocol has been highly effective (but not absolute). 21-day forced quarantines move the needle another degree toward the pursuit of absolute ... but still not absolute. It would be nice if other contagions that have greater actual public health impact were taken as seriously - far more lives would be saved ... for now.

[CunegoFan]

I don't have a 3 year old.

I can say that I wouldn't hesitate to hug and kiss somebody who is obviously not sick with ebola.


How about a nurse who was measured with a fever and just got back from treating Ebola patients in Africa? Is it unreasonable to believe that such a person should be quarantined where she can be tested for the disease rather than letting her prance off into the general population or is that, as she alleges, the equivalent of being hauled off to Gitmo?

[ajz07]

I read the forum all the time, and rarely post. So am a bit annoyed with myself that I have posted so much today (so many other things I could be doing at work).

Look, to me the problem boils down to fear. How does one stop the largest amount of fear. Will the public at large who has no medical training be consumed by it if they think that they could get ebola on the subway from returning healthcare workers. Will fear be more prevalent if the healthcare workers are quarantined as that may legitimize in lay people's minds the fears they already had.

The STD point is a bit off base. You can control who you have sex with (in general), you cant control who is on the subway/ bus/ airplane with you.

Additionally someone who presents to the ED with a fever and has been to Africa, well now that person wont be touched with a ten foot pole by most ERs (did you know that the patient volume to the hospital in Dallas has dropped significantly and they are losing money hand over fist after having taken care of an ebola pt in a non biocontainment area). Only problem is that they are far more likely to have malaria or any one of many other diseases that are common/ endemic to Africa than they are likely to have ebola. And given the paranoia and fear they are still far more likely to die and be mistreated for their malaria as people are busy worrying about ebola.

So yes, in the end a lot of this is about fear. If this were an easy question it would have any easy solution. Unfortunately it is not, and it is likely one we are going to have to deal with as the crisis in West Africa is likely not going anywhere anytime soon. I cant say I know the best answer, but the answer has to be one that address' the issue of fear as well as the science behind transmission (incubation period, routes of transmission, etc..). It also has to be one that has checks to it, as unfortunately some people believe they are infalliable, and may not report their symptoms thus endangering others.

I leave this for better people than me as I am fataly flawed and know enough to know that much like the college football national chamionship one solution will never appease everybody, and be decried as unfair, flawed and possibly illegal by most.

[nooneline]

How about a nurse who was measured with a fever and just got back from treating Ebola patients in Africa? Is it unreasonable to believe that such a person should be quarantined where she can be tested for the disease rather than letting her prance off into the general population or is that, as she alleges, the equivalent of being hauled off to Gitmo?

I assume you're talking about Kaci Hickox.

She was quarantined before anybody thought she had a fever.
Secondly, she "had a fever" based on a topical reading, which everybody knows is far less reliable than an oral reading. The oral reading showed no fever.
Thirdly, after testing negative for ebola, she is still quarantined.

Had she not been subject to the mandatory quarantine order, she would have been doing exactly what Dr. Craig Spencer was doing - taking temperature twice a day (reliably), and calling and reporting the first sign of a fever. Because of that system, Dr. Spencer was getting treatment, in isolation, before he was contagious.

Will the public at large who has no medical training be consumed by it if they think that they could get ebola on the subway from returning healthcare workers.

This is actually a great point. But then one must acknowledge that certain steps are security theater and not public health.

[earlfoss]

I think that this nurse is an idiot. Ignoring her quarantine and raising hell via the media and legal channels makes her come across as a whiny, selfish person. Aid workers know that there's a quarantine policy in effect before they go over there so this isn't a surprise. It's worrisome that a health care worker would put their loved ones and the public at risk like this. I've worked in flu and ebola research and I knew the policies for possible exposure before I ever picked up a pipet and understood the importance and consequences of of these policies.

[oldpotatoe]

Mike, what studies? I couldn't find any on PubMed. Unless you are referring to the highly controlled experiments done under laboratory conditions that atrexler detailed nicely in post #24 (http://forums.thepaceline.net/showpost.php?p=1648126&postcount=24).

There's a reason ebola so far has not been transmitted through the air in the wild, because as laupsi pointed out, viruses--or at least ebola--don't do well without a host. From the Richard Preston article in the New Yorker, "The Ebola Wars (http://www.newyorker.com/magazine/2014/10/27/ebola-wars):"

C'mon, I saw it on Faux news...

[holliscx]

Hazmat suit :eek:

[dogdriver]

.

[Ti Designs]

i have so much to do around the house i would welcome a 21 day quarantine. As long they let me walk 20ft to the shop out back.

+1

[oldpotatoe]

http://www.nj.com/politics/index.ssf/2014/10/christies_quarantine_policy_attacked_by_aclu_cdc_a nd_even_the_un_is_embraced_by_2011_nobel_prize_win .html#incart_river

'Christie's controversial Ebola quarantine now embraced by Nobel Prize-winning doctor

...Dr. Beutler, an American medical doctor and researcher, won the Nobel Prize for Medicine and Physiology in 2011 for his work researching the cellular subsystem of the body’s overall immune system — the part of it that defends the body from infection by other organisms, like Ebola.

He is currently the Director of the Center for the Genetics of Host Defense at the University of Texas Southwestern Medical Center in Dallas — the first U.S. city to treat an Ebola patient and also the first to watch one die from the virus. In an exclusive interview with NJ Advance Media, Beutler reviewed Christie’s new policy of mandatory quarantine for all health care workers exposed to Ebola, and declared: “I favor it.”
Unfortunately, while the doctor’s support might provide much-needed credibility for Christie as he threatens to quarantine ever more healthcare workers returning from the Ebola fight in West Africa, it also comes with some chilling words.

“I favor it, because it’s not entirely clear that they can’t transmit the disease,” Beutler said, referring to asymptomatic healthcare workers like Kaci Hickox, a Doctors Without Borders nurse returning from treating Ebola patients in Sierra Leone who was quarantined in New Jersey for 65 hours before being transported to her home state of Maine on Monday afternoon.

“It may not be absolutely true that those without symptoms can’t transmit the disease, because we don’t have the numbers to back that up,” said Beutler, “It could be people develop significant viremia [where viruses enter the bloodstream and gain access to the rest of the body], and become able to transmit the disease before they have a fever, even. People may have said that without symptoms you can’t transmit Ebola. I’m not sure about that being 100 percent true. There’s a lot of variation with viruses.”

In fact, in a study published online in late September by the New England Journal of Medicine and backed by the World Health Organization, 3,343 confirmed and 667 probable cases of Ebola were analyzed, and nearly 13 percent of the time, those infected with Ebola exhibited no fever at all...'

pass-rick, put your glasses back on!!

[oldpotatoe]

actually the WHO (world health organization) has agreed that ~95% of cases of ebola have an incubation period of 21 days. Ergo, if you quarantine some for 21 days you are going to catch most of the cases of ebola that would occur (yes there are occasionally longer incubation periods, but it is relatively rare).

As a side note, the epidemiologists/ infection control practitioners I know who have thought of going over, all of them were taking into account a 21 day elective quarantine away from their families on their way back into the country. This was several weeks ago, and they were not willing to take any chances with their loved ones.

AND if the military get a 21 day quarantine, most see it as a 21 day vacation..no drills, no inspections, no PT, decent food, video games..

[93legendti]

I think that this nurse is an idiot. Ignoring her quarantine and raising hell via the media and legal channels makes her come across as a whiny, selfish person. Aid workers know that there's a quarantine policy in effect before they go over there so this isn't a surprise. It's worrisome that a health care worker would put their loved ones and the public at risk like this. I've worked in flu and ebola research and I knew the policies for possible exposure before I ever picked up a pipet and understood the importance and consequences of of these policies.

She claims to be a member of Drs Without Borders...
I wonder why she doesn't reveal that she works for the CDC...
http://www.cdc.gov/mmwr/cme/coursedetail/mm6328_cd.pdf

I wonder how many dr and nurses from Drs Without Borders have been infected so far...

[Louis]

She claims to be a member of Drs Without Borders...
I wonder why she doesn't reveal that she works for the CDC...

Time for a HUAC investigation.

[gdw]

"AND if the military get a 21 day quarantine, most see it as a 21 day vacation..no drills, no inspections, no PT, decent food, video games.."

Not in the Army. Lockdowns suck especially after you've been deployed to east bum****.

[gasman]

She claims to be a member of Drs Without Borders...
I wonder why she doesn't reveal that she works for the CDC...
http://www.cdc.gov/mmwr/cme/coursedetail/mm6328_cd.pdf

I wonder how many dr and nurses from Drs Without Borders have been infected so far...

Uhh the link shows only that she was one author in a study published in 2011 with CDC support not that she works for the CDC. If she lives in Maine I'd be surprised she works with the CDC. Their staff is all in major metro areas.

MSF ( Doctors without Borders) has some 3,300 providers working with Ebola patients- 23 providers have been infected working in country and 8 have recovered fully.

Nobody on this board is an Ebola expert and you can't become one searching the internet.

I've been on several mission trips, the last to Haiti and if I had to undergo a 21 day quarantine that wasn't backed by science I'd be pissed if I was hauled off. The nurse is not being smart about keeping a low profile. There's just too much hysteria.

[nooneline]

She claims to be a member of Drs Without Borders...
I wonder why she doesn't reveal that she works for the CDC...
http://www.cdc.gov/mmwr/cme/coursedetail/mm6328_cd.pdf

I wonder how many dr and nurses from Drs Without Borders have been infected so far...

lol. that right there is the silliest kind of internet-era conspiracy theory nonsense.

i did about three minutes of googling, and i can take apart your comment and its assumptions piece by piece. but i'll let you do the googling. if you can avoid the tinfoil hat websites you'll find that there are simple answers.

[Louis]

if you can avoid the tinfoil hat websites you'll find that there are simple answers.

Where's the fun in that? It's better if you can blame Obama.

[nooneline]

blaming Obama is only slightly harder than seeing that her linkedin profile includes mention of a CDC epidemiology fellowship, she was stationed in Nevada, and published a report on pedestrian deaths in the Morbidity and Mortality Weekly Report.

...

I recognize that I'm thread····ting all over this but it's because this is my field. I do this work because I believe that we as a society can be healthier by being healthier. And I know that so many of my colleagues are smart, dedicated people.

Some of them risk their lives to do the work that they do.

And then politicians step in and start doing things that are against science. And people made soft-brained by cable news start making absurd claims about conspiracy theories. And it's all so ridiculous.

http://www.skepticalraptor.com/blog/wp-content/uploads/2014/05/tyson-science-true.jpg

[1centaur]

I am clearly missing something: why should anyone ever have a 21 day quarantine for Ebola under the nurse's theory of "if I don't feel it there is no problem?" Was it not the CDC that recommended 21 day quarantines for some people who contacted the original Dallas Ebola patient? Surely that was a practical joke designed to fool the NY and NJ governors. If we go with the nurse's theory, we hope that anyone who has been in contact with Ebola patients goes to the hospital if she starts feeling sick and that's all we need. Universal self diagnosis and responsible choices. That works for everything else in society, why not Ebola? Public policy choices are so simple, really.

[gasman]

blaming Obama is only slightly harder than seeing that her linkedin profile includes mention of a CDC epidemiology fellowship, she was stationed in Nevada, and published a report on pedestrian deaths in the Morbidity and Mortality Weekly Report.

...

I recognize that I'm thread····ting all over this but it's because this is my field. I do this work because I believe that we as a society can be healthier by being healthier. And I know that so many of my colleagues are smart, dedicated people.

Some of them risk their lives to do the work that they do.

And then politicians step in and start doing things that are against science. And people made soft-brained by cable news start making absurd claims about conspiracy theories. And it's all so ridiculous.

http://www.skepticalraptor.com/blog/wp-content/uploads/2014/05/tyson-science-true.jpg



+100

Well said

[nooneline]

I am clearly missing something: why should anyone ever have a 21 day quarantine for Ebola under the nurse's theory of "if I don't feel it there is no problem?" Was it not the CDC that recommended 21 day quarantines for some people who contacted the original Dallas Ebola patient? Surely that was a practical joke designed to fool the NY and NJ governors. If we go with the nurse's theory, we hope that anyone who has been in contact with Ebola patients goes to the hospital if she starts feeling sick and that's all we need. Universal self diagnosis and responsible choices. That works for everything else in society, why not Ebola? Public policy choices are so simple, really.

You are missing something.

It's not the nurse's theory of "if I don't feel it there is no problem."

It's the policy of well-respected organizations who have been doing this stuff regularly to have people monitor themselves daily and if they have a fever, which means that in 2 days they will be contagious, that they THEN get themselves in isolation treatment.

It's been working. MSF has had 700 international volunteers working with Ebola patients. 3 have contracted ebola. 0 have infected others.

You're talking about healthcare professionals, here. Not the general public.

"Better safe than sorry" is only applicable when you're talking about actual, not perceived, safety measures.

And with that, I'm done. I've taken up too much space in this thread. Anybody on here interested in talking about ebola is welcome to PM me.

[SamIAm]

And then politicians step in and start doing things that are against science.



Our understanding of nature continues to evolve. Science is not static. You don't know what you don't know.

[Louis]

It's been working. MSF has had 700 international volunteers working with Ebola patients. 3 have contracted ebola. 0 have infected others.

If Presby Dallas had followed MSF's protocols you can be sure that we would not be having this conversation.

Whether or not that's the fault of the CDC is an interesting question that I'm not qualified to answer.

[gasman]

Our understanding of nature continues to evolve. Science is not static. You don't know what you don't know.

Ebola was discovered in 1976. I suspect there is solid science about its natural history and epidemiology.

[1centaur]

Though again, where did the original 21 day quarantines come from, and why? Under what circumstances do doctors think 21 day quarantines are warranted?

[gasman]

Though again, where did the original 21 day quarantines come from, and why? Under what circumstances do doctors think 21 day quarantines are warranted?

The maximum time found between exposure and symptom onset. Usual is something like 6-10 days.

[1centaur]

I recognize that, but it does not answer my question. That whole 21 day concept emerged immediately after the Dallas case, pre-NJ/NY. If it had not, those governors would not have picked that period. Was the original 21 day concept generated by politicians, or doctors?

[gasman]

I recognize that, but it does not answer my question. That whole 21 day concept emerged immediately after the Dallas case, pre-NJ/NY. If it had not, those governors would not have picked that period. Was the original 21 day concept generated by politicians, or doctors?


Epidemiologists/ doctors I presume

[SlackMan]

http://www.skepticalraptor.com/blog/wp-content/uploads/2014/05/tyson-science-true.jpg

...Except when it's not. How many "scientific facts" over the last couple of centuries have been proven wrong by later science? Hint: The number is not close to zero.

And how many people assert something is settled science when either they or the scientists or both do not have full information to make the judgment? Hint: The number is large.

[gasman]

...Except when it's not. How many "scientific facts" over the last couple of centuries have been proven wrong by later science? Hint: The number is not close to zero.

And how many people assert something is settled science when either they or the scientists or both do not have full information to make the judgment? Hint: The number is large.


I'm not sure what scientific facts you are talking about being disproven. Scientific theories yes. Scientific speculation yes.Scientific thoughts yes.
Not facts.

[Louis]

...Except when it's not. How many "scientific facts" over the last couple of centuries have been proven wrong by later science?

Perhaps, but this is a red herring. What would you like medical public policy decisions to be based on, our currently available data or something else?

I, personally, don't vote for the intuition of our politicians.

[Louis]

I'm not sure what scientific facts you are talking about being disproven. Scientific theories yes. Scientific speculation yes.Scientific thoughts yes.
Not facts.

He put "facts" in quotes, so I figured he was referring to what was considered settled science, which can change over time. The old "facts vs theories vs Thomas Kuhn" story is a long discussion.

[FlashUNC]

When Nigeria, far closer to the countries affected in West Africa than the United States, can eliminate the disease in one of the most populous cities in the world with 21 million people in a busy port megalopolis, I'm fairly confident the U.S. can handle this.

http://www.forbes.com/sites/davidkroll/2014/09/23/nigeria-free-of-ebola-as-final-surveillance-contacts-are-released/

[1centaur]

Epidemiologists/ doctors I presume

As do I. So when should those who have been exposed to Ebola patients have 21 day quarantines, in the view of Paceline members?

[SlackMan]

He put "facts" in quotes, so I figured he was referring to what was considered settled science, which can change over time. The old "facts vs theories vs Thomas Kuhn" story is a long discussion.

Bingo! Thanks.

I don't want politicians deciding policy by intuition either, but attempting to shut down reasonable debate with a claim that "sciences says XYZ" can also be harmful. Reasonable people can disagree on the appropriate safeguards that should put in place regarding Ebola. There are those who use the science "bat" to beat down any who disagree with them either because they put blind faith in CURRENT science or because they are afraid to engage in a real debate.

[cfox]

As do I. So when should those who have been exposed to Ebola patients have 21 day quarantines, in the view of Paceline members?

The protocol is for exposed health workers to self monitor. If they get a fever, they call it in. It's then determined whether a quarantine is necessary.

We are relying on returning health workers to properly self monitor. Your faith in that is up to you. Me? I think a lot of hysteria could have been avoided by having a mandatory quarantine in place. Maybe it's overkill, but it just seems reasonable to me.

[93legendti]

blaming Obama is only slightly harder than seeing that her linkedin profile includes mention of a CDC epidemiology fellowship, she was stationed in Nevada, and published a report on pedestrian deaths in the Morbidity and Mortality Weekly Report.

...

I recognize that I'm thread····ting all over this but it's because this is my field. I do this work because I believe that we as a society can be healthier by being healthier. And I know that so many of my colleagues are smart, dedicated people.

Some of them risk their lives to do the work that they do.

And then politicians step in and start doing things that are against science. And people made soft-brained by cable news start making absurd claims about conspiracy theories. And it's all so ridiculous.

http://www.skepticalraptor.com/blog/wp-content/uploads/2014/05/tyson-science-true.jpg
She has since deleted it...

Kaci Hickox | LinkedIn
[link to www.linkedin.com (secure)]
Las Vegas, Nevada - Epidemic Intelligence Service Fellow at Centers for Disease Control and Prevention
View Kaci Hickox's professional profile on LinkedIn. LinkedIn is ... Epidemic Intelligence Service Fellow at Centers for Disease Control and Prevention. Location ...

P.98. 5th row. 2nd from the left.

http://www.cdc.gov/eis/downloads/2014-EIS-Conference.pdf

[93legendti]

Uhh the link shows only that she was one author in a study published in 2011 with CDC support not that she works for the CDC. If she lives in Maine I'd be surprised she works with the CDC. Their staff is all in major metro areas.

MSF ( Doctors without Borders) has some 3,300 providers working with Ebola patients- 23 providers have been infected working in country and 8 have recovered fully.

Nobody on this board is an Ebola expert and you can't become one searching the internet.

I've been on several mission trips, the last to Haiti and if I had to undergo a 21 day quarantine that wasn't backed by science I'd be pissed if I was hauled off. The nurse is not being smart about keeping a low profile. There's just too much hysteria.
Did you miss this?

"Kaci L. Hickox, MSN, MPH, EIS officer, CDC; Southern Nevada Health District"

[93legendti]

Or this?

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6328a1.htm?s_cid=mm6328a1_w

"Pedestrian Traffic Deaths Among Residents, Visitors, and Homeless Persons — Clark County, Nevada, 2008–2011
Weekly
July 18, 2014 / 63(28);597-602

Kaci L. Hickox, MSN, MPH1,2, Nancy Williams, MD2, Laurie F. Beck, MPH3, Tom Coleman, MD2, John Fudenberg4, Byron Robinson, PhD5, John Middaugh, MD2 (Author affiliations at end of text)...

1EIS officer, CDC; 2Southern Nevada Health District; 3Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC; 4Clark County, Nevada Office of the Coroner/Medical Examiner; 5Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, CDC (Corresponding author: Kaci L. Hickox, khickox@cdc.gov, 702-759-1287)"

She is an eis officer with the CDC and has a cdc.gov email address.

[Seramount]

already got a hazmat suit for my Halloween costume...

thanks, Ebola.

[BMS]

There's nothing to worry about. This is just another "crisis" that certain people in our country are not allowing to "go to waste."

[93legendti]

If there is nothing to worry about, then why are the returning military personnel being quarantined?

[Louis]

You have to wonder what would be happening if lots of people in the US (say, more than one or two) were dying from this.

The whole country would have to shut down. Vigilante neighborhood watch groups would roam the streets, shooting anyone they didn't recognize. We'd be back to the stone age in a week.

Anyone ever see the movie "The Road?"

http://www.thesundaytimes.co.uk/sto/multimedia/dynamic/00207/the-road_207457k.jpg

[gasman]

Interesting that she does seems to be a eis officer for the CDC. She received 2 years of special epidemiology training. She certainly knows more than me about epidemiology and about Ebola. I guess I would trust her ability to self monitor and get herself to isolation at the first sign of illness. Similar to what the the NY physician did.

Do we trust everyone to do the right thing ? I don't know but if the Dallas nurses had been provided with the proper protective gear and training we likely wouldn't be so worried.

I've watched the official videos from U of Nebraska for protective gear and it's very extensive. Not what the original nurses were provided.

As far as the military applying the 21 day isolation when the soldiers have had no exposure makes no sense to me.

[Louis]

As far as the military applying the 21 day isolation when the soldiers have had no exposure makes no sense to me.

One way it makes sense is if you think of it in terms of the group we're talking about. It's a heck of a lot easier to order soldiers around and put them in quarantine than it is a private citizen. One of a soldier's jobs is to do as s/he's told. He or she is much less likely to hire ACLU lawyers and claim that civil rights are being trampled.

[CNY rider]

Do we trust everyone to do the right thing ? I don't know but if the Dallas nurses had been provided with the proper protective gear and training we likely wouldn't be so worried.

I've watched the official videos from U of Nebraska for protective gear and it's very extensive. Not what the original nurses were provided.



I have not read the whole thread but this is the crux of it right here.
I work in a teaching hospital. The nurse who runs infection control is a dear friend and colleague whom I have known and respected for 20 years. There are few people on this planet that I trust more than her.
So what's the problem? The problem is I still have her email from August telling us that we would be ready to care for an Ebola patient if we needed to using the standard contact precautions. As in flimsy gown with loose ties, gloves, disposable surgical mask.
As in completely inadequate protection that could have gotten us killed.
Where did those recommendations come from? My nurse colleague surely didn't make them up.
She got them from CDC and NY state health authorities.
The lack of concern that CDC showed for us front line health care workers is astonishing and disgraceful and a whole bunch of other things.
As a result I have zero confidence in them, nor do I believe anything they have to say.
Sad state of affairs.

[El Chaba]

I have not read the whole thread but this is the crux of it right here.
I work in a teaching hospital. The nurse who runs infection control is a dear friend and colleague whom I have known and respected for 20 years. There are few people on this planet that I trust more than her.
So what's the problem? The problem is I still have her email from August telling us that we would be ready to care for an Ebola patient if we needed to using the standard contact precautions. As in flimsy gown with loose ties, gloves, disposable surgical mask.
As in completely inadequate protection that could have gotten us killed.
Where did those recommendations come from? My nurse colleague surely didn't make them up.
She got them from CDC and NY state health authorities.
The lack of concern that CDC showed for us front line health care workers is astonishing and disgraceful and a whole bunch of other things.
As a result I have zero confidence in them, nor do I believe anything they have to say.
Sad state of affairs.

Indeed. I would only add that this would be step # 2 (adequate measures of protection for healthcare workers). Step # 1 would be the basic rule of epidemiology-Isolate the disease at its source whenever possible.

[cfox]

One way it makes sense is if you think of it in terms of the group we're talking about. It's a heck of a lot easier to order soldiers around and put them in quarantine than it is a private citizen. One of a soldier's jobs is to do as s/he's told. He or she is much less likely to hire ACLU lawyers and claim that civil rights are being trampled.

While what you write is true, it is hardly a robust reason for the differentiation. "Yeah, we should probably quarantine everyone for 21 days, but let's just do it to the group that won't sue us".

[93legendti]

Good to know the decision to treat military members the harshest is a political decision...


"WASHINGTON — Gen. Martin E. Dempsey, the chairman of the Joint Chiefs of Staff, recommended to Defense Secretary Chuck Hagel on Tuesday that all members of the armed services working in Ebola-stricken West African countries undergo mandatory 21-day quarantines upon their return to the United States...

On Tuesday, White House officials tried to explain why the military guidelines outlined by General Odierno are different from those for civilian health workers. Soldiers in West Africa, who are not directly providing health care to patients in those countries, have far less contact with Ebola patients than do civilian nurses and doctors in those countries who will not face quarantines under the C.D.C. guidelines."
http://www.nytimes.com/2014/10/29/us/politics/obama-defends-cdcs-ebola-rules-as-sensible-based-in-science.html

Right, it makes no sense. If the military is quarantined, the health care workers in contact surely must be quarantined. If they aren't, quarantining the military is merely punitive. Quarantining someone merely because you can, without a public health justification? Please.

Where's the outrage for our heroes?

[93legendti]

Interesting that she does seems to be a eis officer for the CDC. She received 2 years of special epidemiology training. She certainly knows more than me about epidemiology and about Ebola. I guess I would trust her ability to self monitor and get herself to isolation at the first sign of illness. Similar to what the the NY physician did.

Do we trust everyone to do the right thing ? I don't know but if the Dallas nurses had been provided with the proper protective gear and training we likely wouldn't be so worried.

I've watched the official videos from U of Nebraska for protective gear and it's very extensive. Not what the original nurses were provided.

As far as the military applying the 21 day isolation when the soldiers have had no exposure makes no sense to me.

So why did she lie about her CDC status? Why not trumpet it?

"I am CDC, I know what I am doing."

Makes no sense.

[fuzzalow]

I do not agree with the responses that strain and stretch for the mock outrage at the policy of 21-day quarantine for our military. It seems to me like there is nothing underlying that but discontent and anger that permeates all your live long days.

It is the military. It is not ordained as a organization that as perquisite makes sense. Phrases like "hurry up and wait", "FUBAR", "SNAFU", Joseph Heller's 'Catch-22' are all derived from or satire the military experience. As correctly mentioned earlier, these brave men & women follow orders. Above all else, that is what they do. Sure, it may seem nuts but we as civilians live in our sometimes perverse reality just the same.

As far as the OP, we are a first world nation so even if the WHO ranks our health care infrastructure behind most of the Eurozone, Ebola is not going to get out of hand in our wealthy republic.

[holliscx]

@Wilkinson4's cubicle at work

[mike p]

I have no dog in the fight one way or the other, but for those that say " should we base these decisions on politics or science?" I say science has become so politicized is there any difference?

Mike

[sitzmark]

I have not read the whole thread but this is the crux of it right here.
I work in a teaching hospital. The nurse who runs infection control is a dear friend and colleague whom I have known and respected for 20 years. There are few people on this planet that I trust more than her.
So what's the problem? The problem is I still have her email from August telling us that we would be ready to care for an Ebola patient if we needed to using the standard contact precautions. As in flimsy gown with loose ties, gloves, disposable surgical mask.
As in completely inadequate protection that could have gotten us killed.
Where did those recommendations come from? My nurse colleague surely didn't make them up.
She got them from CDC and NY state health authorities.
The lack of concern that CDC showed for us front line health care workers is astonishing and disgraceful and a whole bunch of other things.
As a result I have zero confidence in them, nor do I believe anything they have to say.
Sad state of affairs.

The nurse running infection control was not promoting the CDC guidelines if she did not include goggles (or face shield) in the list of personal protection equipment/ supplies (PPE). The primary changes to the previous protocol have been the addition of (1) a full head hood, (2) no exposed skin, and (3) observing personnel to make sure healthcare workers follow proper procedures when adorning, but most especially removing, PPE after coming in contact with infected patients and/or contaminated body fluids. Most beneficial consequence of changes - repeated practice by healthcare workers to add and remove PPE properly.

For healthcare workers with strong PPE skills, the chances for infection were limited with the prior recommendations. Adding full coverage head protection will not provide a guarantee against transmission, but does remove additional risk due to errors in technique (like adjusting goggles after contacting contaminated matter) or situational hazards (like flying patient spit or vomit directly or indirectly contacting a mucous membrane). Not all of the immediate attending healthcare workers in TX contracted the disease, so the prior protocol was effective .. just not 100%.

The PPE practices used to interact with an Ebola patient shouldn't be significantly different than interacting with patient's who have other highly contagious diseases - at least from the perspective of preventing transmission of infecting agents from one person to another. The goal should be no transmission of any infecting agent, but with Ebola the stakes are higher due to the lack of vaccines and confident treatment. Basically we can become complacent in PP technique without serious consequences for many highly infectious agents, but that is not currently the case with Ebola. So HC workers need to double down on their PP skills with practice, practice, practice, and be observed by others to make sure what is practiced is what gets done in battle.

[GregL]

The goal should be no transmission of any infecting agent, but with Ebola the stakes are higher due to the lack of vaccines and confident treatment. Basically we can become complacent in PP technique without serious consequences for many highly infectious agents, but that is not currently the case with Ebola. So HC workers need to double down on their PP skills with practice, practice, practice, and be observed by others to make sure what is practiced is what gets done in battle.
This is exactly what I have been hearing from my 86 year-old mother, who became a nurse in 1950. She told me that early in her career, when diseases such as polio did not yet have vaccines, proper PP technique was essential. As part of her training in the 1940's, she spent three months working in an infectious disease ward in a NYC hospital. Mom is appalled by the lack of training and professionalism she has seen thus far in the US as we deal with our first ebola cases. Those who forget the past...

- Greg

[gasman]

I guess I'm lucky , at my hospital they have full hazemet suits, respirators, hoods etc and have already been training proper donning and doffing. Selfishly I have to admit that I rarely have to be in the ICU.
Our infectious disease people seem to be well prepared but likely only because of the Dallas experience.

[redir]

If there is nothing to worry about, then why are the returning military personnel being quarantined?

If there was nothing to worry about then why were Japanese Americans imprisoned in WWII?

It's called irrational fear which occurs through ignorance. We fear what we don't understand especially when it's exploited by those intrusted (politicians) to lead.

That's not to say that there should be no need for preparation. After all that IS the reason why it is spreading around West Africa.

[Lewis Moon]

This is exactly what I have been hearing from my 86 year-old mother, who became a nurse in 1950. She told me that early in her career, when diseases such as polio did not yet have vaccines, proper PP technique was essential. As part of her training in the 1940's, she spent three months working in an infectious disease ward in a NYC hospital. Mom is appalled by the lack of training and professionalism she has seen thus far in the US as we deal with our first ebola cases. Those who forget the past...

- Greg

I don't think they're forgetting the past, I just think the accountants (the real arbiters of healthcare) decided it cost too much to train a prioi.

[Climb01742]

As I watch how certain media outlets, for surely they are not 'news' organizations, and certain politicians, for they surely are not leaders, exploit the Ebola situation for their small tawdry fear-mongering purposes, I'm yearning for someone today to ask this question of them.

https://www.youtube.com/watch?v=fqQD4dzVkwk&app=desktop

[93legendti]

If there was nothing to worry about then why were Japanese Americans imprisoned in WWII?

It's called irrational fear which occurs through ignorance. We fear what we don't understand especially when it's exploited by those intrusted (politicians) to lead.

That's not to say that there should be no need for preparation. After all that IS the reason why it is spreading around West Africa.

You can do better than that. Why not evoke Salem Witch Trials?

Irrational Fear is why soldiers NOT in contact are under mandatory quarantined. That's what the head of the military decided. Ok, apparently he is irrational and ignorant. The commander in chief could over rule that. Pen and a phone. He hasn't.

Ok, so once again I ask, why aren't the health care workers who ARE in contact under mandatory quarantine? Irrational assurance?

You got the irrational part right.

[Mr. Pink]

As I watch how certain media outlets, for surely they are not 'news' organizations

This was a big surprise about a week ago, considering it's source: http://www.youtube.com/watch?v=Z2KBfynW09I

[gdw]

"As I watch how certain media outlets, for surely they are not 'news' organizations, and certain politicians, for they surely are not leaders, exploit the Ebola situation for their small tawdry fear-mongering purposes, I'm yearning for someone today to ask this question of them. "


True. Unfortunately "lack of leadership" has given the media and "certain politicians" an opportunity to exploit the situation.

[Wilkinson4]

I have no dog in the fight one way or the other, but for those that say " should we base these decisions on politics or science?" I say science has become so politicized is there any difference?

Mike

And that's it… Instant access to information has made us more un-informed because all of this data, regardless of how it is distributed is slanted it seems.

As a layperson, I have to run thru several filters and my own sieve to come to a conclusion. And even then I am not sure 1/2 the time!

On a side note… I am amazed at the breadth of knowledge and opinion on our little site. No flaming, civil discussion, and thoughtful opinion. Good stuff.

mIKE

[Lewis Moon]

Let's substitute the phrase "gun control" for "ebola quarantine" and see how the tables change. 86 people die EVERY DAY in the US from gun violence.

Don't get me started about influenza deaths and the number of people who go to work sick.

If you're going to "protect the American Public" be consistent.

[Spdntrxi]

Let's substitute the phrase "gun control" for "ebola quarantine" and see how the tables change. 86 people die EVERY DAY in the US from gun violence.



Don't get me started about influenza deaths and the number of people who go to work sick.



If you're going to "protect the American Public" be consistent.


How many guns .. Or how many bullets made per year.. Death rate?

How many millions get the flu? Death rate?

Ebola .. Yes rare but kills upwards of 70%

Your comparison is not comparable

[Louis]

How many guns .. Or how many bullets made per year.. Death rate?

How many millions get the flu? Death rate?

Ebola .. Yes rare but kills upwards of 70%

Your comparison is not comparable

The bottom line is how many die due to a specific cause.

Furthermore, I can guarantee you that in the US the death rate from Ebola will not be 70%.

[Lewis Moon]

How many guns .. Or how many bullets made per year.. Death rate?

How many millions get the flu? Death rate?

Ebola .. Yes rare but kills upwards of 70%

Your comparison is not comparable

It's 50%. Get your facts straight.

On the otherhand, influenza is MUCH more easily transmitted, (airborne).

[daker13]

Some interesting reading from an epidemiologist on The Hot Zone and its rather dangerous ebola myths that it has created...

http://io9.com/how-the-hot-zone-created-the-worst-myths-about-ebola-1649384576

Thanks for this--I vividly remember Preston's New Yorker articles on ebola from the 90s (The Hot Zone was based on them). It's good to see many of these vivid details (liquifying innards, airborne ebola) from the articles have been debunked.

By the way, one of the Paceliners who seemed to have expertise in infectious diseases wrote a post saying that viruses don't like "warm, dry air"--if that's true, why do people get the flu in winter? Just curious.

It's interesting to see how many Paceliners support the nurse in Maine. Personally, I don't see the 21 day quarantine as a major civil rights issue. I value her service and courage, MSF is one of the non-profits I regularly donate to, but I believe health care workers should be willing to quarantine themselves if so directed. The situation in Texas didn't inspire much confidence.

[Louis]

The situation in Texas didn't inspire much confidence.

The folks in Texas were clueless and paid the price. The good thing about really scary stuff is that people are motivated to improve very quickly. I'd say chances are most hospitals in the US would today respond much better than they did in Dallas.

Edit: If MSF can do this safely in some of the poorest countries of the world, then we have a decent shot at figuring it out in the US.

[Likes2ridefar]

The folks in Texas were clueless and paid the price. The good thing about really scary stuff is that people are motivated to improve very quickly. I'd say chances are most hospitals in the US would today respond much better than they did in Dallas.

Edit: If MSF can do this safely in some of the poorest countries of the world, then we have a decent shot at figuring it out in the US.

I'd say chances are they wouldn't...but I work in one (mt sinai NYC) and hate it so perhaps that is why.

[drewski]

1) So far, when diagnosed early enough in the US, the mortality rate is 0.0

2) IMO Duncan died for two reasons: 1) The US was not prepared (we have now gone up the learning curve very, very quickly), and 2) He was an idiot. If the first time he went to Presby he had told them "I have Ebola [surely he knew] If you do not know what that means, Google the word or call the CDC" he would probably be alive today. The Texas nurses might have still been infected, because clearly those folks had no clue what they were doing. Now they do, so if Duncan #2 walks in the door they will handle it properly.

According to the 60 minutes interview they did with Presby he mentioned nothing about the fact that his pregnant neighbor who passed due to Ebola. He was with her before travelling to Texas. I thought this what was reported. Let me know if my facts are not right.

If he did not disclose this prior exposure to ebola, it seems like he partly culpable in his own demise.. I feel very bad for everyone who is involved in this. The story was very sad and tragic. Respects to Mr. Duncan. It sounds like he was really trying to put himself out there to save some one. The neighbor and Mr Duncan were turned away from the hospital.

[redir]

You can do better than that. Why not evoke Salem Witch Trials?

Irrational Fear is why soldiers NOT in contact are under mandatory quarantined. That's what the head of the military decided. Ok, apparently he is irrational and ignorant. The commander in chief could over rule that. Pen and a phone. He hasn't.

Ok, so once again I ask, why aren't the health care workers who ARE in contact under mandatory quarantine? Irrational assurance?

You got the irrational part right.

I think it's because as someone mentioned earlier it's easier to bully around the military personnel. It's also shear politics. With the upcoming elections you can now have a lot of finger pointing and blaming for this and that and mean while the real issues that actually do affect the citizens as a whole are swept under the rug while we all argue about something that is nil and meaningless.

The OP was concerned about it as he travels a lot. He doesn't need to be concerned. Period. Unless he is traveling to an infected village in West Africa.

Meh like I said earlier I could use a 21 day staycation.

[FlashUNC]

According to the 60 minutes interview they did with Presby he mentioned nothing about the fact that his pregnant neighbor who passed due to Ebola. He was with her before travelling to Texas. I thought this what was reported. Let me know if my facts are not right.

If he did not disclose this prior exposure to ebola, it seems like he partly culpable in his own demise.. I feel very bad for everyone who is involved in this. The story was very sad and tragic. Respects to Mr. Duncan. It sounds like he was really trying to put himself out there to save some one. The neighbor and Mr Duncan were turned away from the hospital.

He carried a pregnant neighbor who had ebola hours before she died, when her viral load was, I'm sure, off the charts. He lied about exposure to the ebola patient when he was departing Liberia on their exit questionnaire, and didn't show symptoms until he was already in the United States. None of the family he stayed with contracted the disease.

[goonster]

If the military is quarantined, the health care workers in contact surely must be quarantined.

If you extend the "what the military does makes sense for the rest of us' rationale to its logical conclusion, we'll all be painting a lot of rocks.

[goonster]

I can highly recommend the PBS Frontline episode on Ebola (http://video.pbs.org/video/2365321775/) in Sierra Leone.

You will see an MSF field hospital in action, and get a good sense of what its like to be up close with the disease. For example, talk of transmission via sneezing and coughing seems silly when you see that people sick with Ebola don't do that. Ungowned staff interact with patients across a 6' separation zone, etc.

[crankles]

When my girls asked me about ebola, I reminded them to look both ways before crossing the street.

[Louis]

If you extend the "what the military does makes sense for the rest of us' rationale to its logical conclusion, we'll all be painting a lot of rocks.

Adam's on a mission, don't try to dissuade him.

[Louis]

Maybe we should go this route:

[93legendti]

If you extend the "what the military does makes sense for the rest of us' rationale to its logical conclusion, we'll all be painting a lot of rocks.

You missed the point. The people who should be quarantined, if at all, are the health care workers in contact. Not the military who aren't.

The point isn't, "because you're quarantining the military, quarantine everyone".

[Louis]

You missed the point. The people who should be quarantined, if at all, are the health care workers in contact.

If this were the rule, I wonder how quickly we would run out of hospital staff if we had more than a handful of Ebola patients?

It's completely unnecessary and completely impractical.

How quickly some are willing to give up the civil rights of others, when they themselves refuse to compromise one millimeter on different issues that kill orders of magnitude more people.

[Richard]

Right on, Louis!

[1centaur]

If this were the rule, I wonder how quickly we would run out of hospital staff if we had more than a handful of Ebola patients?

It's completely unnecessary and completely impractical.


I think that depends on the definition of quarantine. Staying at home for 21 days taking your temperature is not going to sideline the medical industry, at least until we have a big problem. I am still where I started: either everyone in contact with Ebola patients stays out of circulation until they are clear or nobody does. It would be dumb to say that medical workers who were in contact with Ebola patients should be free to roam around at their discretion but everyday folks should be quarantined. If the "science" is so perfect, nobody should do house duty, because they don't have symptoms so they are dangerous to nobody. If "I tested negative" is the key, then we'd be talking testing and not 21 days. But health care workers do not get special dispensation because they are as selfish, lazy, and sloppy as everybody else at least to some significant percentage.

Then again I heard a doctor on the radio today who said some % of Ebola patients got it without obvious body fluid contact, and sneezing droplets are not the same as airborne (people are confused); droplets could carry the virus, he said. Science. So settled. Politicians. Such idiots.

[goonster]

sneezing droplets are not the same as airborne
Show me a sneezing Ebola patient.

[Louis]

Staying at home for 21 days taking your temperature is not going to sideline the medical industry

I haven't run the numbers, but I think it would shut things down pretty quickly. It isn't as if we have a massive surplus of doctors and nurses waiting to be called in from the bullpen.

Furthermore, the ratio of care staff / patient for Ebola is very high. (I read the number a while back, but have forgotten. It isn't just a few.)

[Louis]

Show me a sneezing Ebola patient.

Correct. Happily, unlike the flu, they don't sneeze or cough much.

[sjbraun]

At Emory, one of the four places equipped and trained to care for these patients, they staff 10 to 1, per shift. So, 20 staff a day.

An outbreak in the US would find our healthcare system lacking, quickly.

Right now, the hospital I work for is scrambling to purchase the required personal protective equipment, as is every other hospital in the US. What we're learning is that basic supplies are unavailable.

[Kirk007]

Have you seen where this nurse lives? She's already self quarantined! And now on a lighter, more saner note:

http://reason.com/blog/2014/10/27/watch-and-cringe-us-vs-uk-media-on-ebola

[Kirk007]

Judge sides with nurse: http://www.reuters.com/article/2014/11/01/us-health-ebola-usa-idUSKBN0II1SP20141101

[harryblack]

Yeah, this American ebola pandemic is MORTIFYING... death toll reminds me of Antietam or Gettysburg, minus the stacks of amputated limbs outside the field hospitals... not to mention those who'd expire from diarrhea or infections in days, weeks, months to follow. Remember President McKinley?

Q: How many Americans will die directly or nearly so from alcohol consumption tonight?

Not I'm suggesting a return to Prohibition but the scarifying some people here and especially elsewhere are propagating is inane & embarrassing.

If Kaci didn't have a stand up fat bike boyfriend, I'd send her flowers!

Actually, this reminds me a bit of the "West Nile Virus" b.s. of a few years back where in NYC, bc a few very vulnerable people got it (they-- like us all-- would have died of SOMETHING anyway), loathsome Giuliani ordered widespread and ill-supervised insecticide spraying... I remember a woman walking on I think 11th Ave in Hell's Kitchen got BLASTED because idiots in spray truck forgot to turn it off. (Hell's Kitchen, like all Manhattan below 60th Street, is very densely wooded, lots of ponds, etc.)

[CNY rider]

I haven't run the numbers, but I think it would shut things down pretty quickly. It isn't as if we have a massive surplus of doctors and nurses waiting to be called in from the bullpen.

Furthermore, the ratio of care staff / patient for Ebola is very high. (I read the number a while back, but have forgotten. It isn't just a few.)

Correct.
I work in a smaller sized hospital.
Staffing of both hospital physicians and nurses is very tight.
It would be impossible for us to ramp up staffing to care for infectious patients if at the same time we had a number of staff on home quarantine.
A few mistakes causing exposures which led to quarantine could paralyze us.

[1centaur]

Sigh.

Is it just vaguely possible that a patient in the early viral loading period, getting a fever, sneezes on someone, before they let the man seize their freedom in the face of science? No, no, of course not, because we can count on everybody relinquishing their freedom at the first possible moment of perfect self diagnosis.

Did I put in a qualifier about 21 days out of work not being too much to bear unless it gets too far? Too subtle?

The goal of these quarantines is to snuff it out early, before people who value their freedom to roam above all else create a tipping point.

And BTW, we have all heard assertions of how Ebola is not going to spread much in the US because we have our act together. If that is so, then we won't have a lot of quarantines. Cognitive dissonance much? All this 0.0 stuff and suddenly we have thousands of critical care workers at home? And STILL I don't hear anybody here saying NOBODY should stay home for 21 days. Why not?

That Maine judge just made the point that quarantine makes sense by inventing a poor man's Solomonic quarantine in plain sight imaginary world that if extended to 100 different people would quickly prove problematical. Stay 3 feet away from somebody? Why, when you are not contagious until stuff is oozing out of you? 3 feet away from people in NYC is a little harder than in BF Maine.

Everybody exposed or nobody without self reported symptoms, pick one. Given the comments here, the choice would seem to be obvious.

[cfox]

Yeah, this American ebola pandemic is MORTIFYING... death toll reminds me of Antietam or Gettysburg, minus the stacks of amputated limbs outside the field hospitals... not to mention those who'd expire from diarrhea or infections in days, weeks, months to follow. Remember President McKinley?

Q: How many Americans will die directly or nearly so from alcohol consumption tonight?

Not I'm suggesting a return to Prohibition but the scarifying some people here and especially elsewhere are propagating is inane & embarrassing.

If Kaci didn't have a stand up fat bike boyfriend, I'd send her flowers!

Actually, this reminds me a bit of the "West Nile Virus" b.s. of a few years back where in NYC, bc a few very vulnerable people got it (they-- like us all-- would have died of SOMETHING anyway), loathsome Giuliani ordered widespread and ill-supervised insecticide spraying... I remember a woman walking on I think 11th Ave in Hell's Kitchen got BLASTED because idiots in spray truck forgot to turn it off. (Hell's Kitchen, like all Manhattan below 60th Street, is very densely wooded, lots of ponds, etc.)

If you are sending flowers, why don't you send some to Dr. Colin Bucks from Stanford? He spent a month treating ebola patients in Liberia and is now home and under a 21 day quarantine. He thinks it is the rational thing to do. But, yes, people doing calm, practical, and rational things don't make the news. It's much more fun to politicize EVERYTHING, hire lawyers, and get angry with mean politicians. He may not appeal to your politically fueled admiration for the "rebel" nurse in Maine, but he's certainly worthy of a bouquet.

Dr. Bucks has stated the main reason he believes in the quarantine is to calm public anxiety, to which I agree 100%. Kaci Wilcox has done the complete opposite; she has done more than anyone to keep ebola and the attendant anxiety in the news.

[Kirk007]

But why do we have the hysteria and runaway fear in the first place?

Perhaps the spastic colons that pass for news anchors and the lack of and disparagement of science education that has lead to a scientifically illiterate general public in many parts/segments of our country has something to do with it.

While I am sure that in some circumstances a quarantine may be warranted, the political grandstanding with Ebola is unbelievable and reminiscent of the Monty Python skit about witches. Have we regressed to the Dark Ages?

[oldpotatoe]

But why do we have the hysteria and runaway fear in the first place?

Perhaps the spastic colons that pass for news anchors and the lack of and disparagement of science education that has lead to a scientifically illiterate general public in many parts/segments of our country has something to do with it.

While I am sure that in some circumstances a quarantine may be warranted, the political grandstanding with Ebola is unbelievable and reminiscent of the Monty Python skit about witches. Have we regressed to the Dark Ages?

In more ways than one...

http://www.youtube.com/watch?v=grbSQ6O6kbs

[rustychisel]

I have no dog in the fight one way or the other, but for those that say " should we base these decisions on politics or science?" I say science has become so politicized is there any difference?

Mike

No. Nearly 100 years ago Clarence Darrow knew that politics could be right or wrong, opinions may vary, but the science remained the same. Science is science, it is theory (not an idea) tested and found. Or found wanting.

Your idea that politics and science mix in such a way has no validity.

[cfox]

No. Nearly 100 years ago Clarence Darrow knew that politics could be right or wrong, opinions may vary, but the science remained the same. Science is science, it is theory (not an idea) tested and found. Or found wanting.

Your idea that politics and science mix in such a way has no validity.

You don't think science is ever invoked to advance political agendas? Because that's what he meant. How many scientific studies are funded by groups with an obvious political or economic agenda? Hint: lots.

[sitzmark]

...

Is it just vaguely possible that a patient in the early viral loading period, getting a fever, sneezes on someone, before they let the man seize their freedom in the face of science? Yes. Is it also vaguely possible - even probable - that the viral loading is not systemic at that point so there is no active EBOV in the saliva/snot? Also Yes. Don't think anyone is arguing for continued wandering or against an immediate change in actions/behavior upon early onset of symptoms.

The goal of these quarantines is to snuff it out early, before people who value their freedom to roam above all else create a tipping point. Granted, but if more than voluntary it becomes a public policy/constitutional law argument. Thought the medical/science part was complex...

And BTW, we have all heard assertions of how Ebola is not going to spread much in the US because we have our act together. ... And STILL I don't hear anybody here saying NOBODY should stay home for 21 days. Why not? Semantics. Difference between should and must. Existing medical evidence suggests the outcome between responsible self monitoring and forced 21-day quarantine is the same. At least in the US. West Africa, too, where the bulk of medical evidence exists, but comparisons are complex as the two are literally and figuratively worlds apart.

That Maine judge just made the point that quarantine makes sense by inventing a poor man's Solomonic quarantine in plain sight imaginary world that if extended to 100 different people would quickly prove problematical. Stay 3 feet away from somebody? Why, when you are not contagious until stuff is oozing out of you? What you do when you're caught between public policy and personal liberty in a legal system designed to vigorously protect the liberties of individuals. A protracted legal battle might resolve one way or the other, but you have a nurse riding the streets today. Wadda ya do? Nothing or something.

[Climb01742]

Do others see the extraordinary irony in this situation? The folks most strongly advocating for mandatory government enforced quarantines of private citizens are the same folks who complain at every turn of government 'overreach'. Who see even the smallest step of gun laws such as greater background checks as the greatest threat to individual liberty since fascism? We shouldn't regulate even the smallest thing in business but we should regulate lives without any legal or medical logic? Apparently, philosophical consistency is inconsistent with fear of Ebola.

[93legendti]

So when will they cancel the quarantine for the military?

Sad that people accept unnecessary quarantines for the military who were ordered to the peripheries of the hot zone (merely because they can be "bullied"),

but will not accept quarantines for individuals who voluntarily went into the hot zone and had contact with Ebola...

Do others see the extraordinary irony in this situation? The folks most strongly advocating for mandatory government enforced quarantines of private citizens are the same folks who complain at every turn of government 'overreach'. Who see even the smallest step of gun laws such as greater background checks as the greatest threat to individual liberty since fascism? Apparently, philosophical consistency is inconsistent with fear of Ebola.

The only irony I see is people over reaching to fit their political agenda. I've said either quarantine everyone or quarantine no one and stop singling out and punishing the military. My complaint is govt over reach against the military.

Gun laws involve the 2A, "the law of the land", "settled law". "Shall not be infringed" - seems pretty clear. Not to mention that everywhere there are strict gun laws, they have the most gun violence..Washington, Chicago, Detroit, etc. guess what happened when Chicago's carry law was struck down? Gun violence plummeted. Oops...same reason Detroit's Police Chief advocates legal gun ownership. Gun ownership is up the last 10 years and gun crime down the last 10 years, according to the FBI.

Enough with the false premises. They already have police and FBI background checks for buying guns. Who else do I need to check with?

It's odd that people think limiting LEGAL gun ownership will prevent CRIMINAL use of guns. Sounds like "collective punishment".

Maybe we should talk about abortion?

The free Ebola worker crowd have gone from attacking the character of those who pointed out that Kaci is CDC, to invoking Japanese American WWII internment, referencing Catch 22, to gun laws.

That's a wild ride.

Do you support singling out the military for quarantine?

[SlackMan]

Maybe I am missing the point of many of the posts, but a fundamental difference between Ebola and being killed from alcohol consumption, lightning, car crashes, pianos falling out of windows, etc. is that Ebola has the potential to grow rapidly out of control and kill growing numbers of people, whereas all of other examples listed lack that potential. All or most of the other ways to die that were mentioned are largely independent events. It's not the first or second or third person that dies from Ebola that is the main fear. It's the possibility of it to grow exponentially that is the problem because one infection can lead to N infections which can lead to still greater N infections and so on.

RE quarantining the military, from a national security perspective, it is clear that we would not want large fractions of our military personnel to become very sick and/or die.

RE Ebola not causing sneezing: Well, what if a person with seasonal allergies is infected with Ebola? Ebola doesn't cause the sneeze, but having an Ebola infected person sneeze on other people or objects other people might touch is clearly a potential problem. It's estimated that 50 million Americans suffer from seasonal allergies.

[gdw]

"Do others see the extraordinary irony in this situation? The folks most strongly advocating for mandatory government enforced quarantines of private citizens are the same folks who complain at every turn of government 'overreach'. Who see even the smallest step of gun laws such as greater background checks as the greatest threat to individual liberty since fascism? Apparently, philosophical consistency is inconsistent with fear of Ebola."

Wow, and I thought the governor of NY was an antigun democrat. :banana:

[Kirk007]

Personally I'm not advocating strongly one way or the other for the quarantine as I haven't studied the issue, I think there are rational (this is different from convincing or compelling) reasons for one and against and I think policy makers and those tasked with governing do have some difficult decisions to make without obvious, intuitive answers.

What bugs me is the mass hysteria and hyperbole which I attribute mostly to politicalization of the issue and reasoning devoid of scientific support or logic. I think it is safe to say that no one regardless of political affiliation wants to see an Ebola epidemic in the U.S.

Yet politicians, often Rs and conservatives, but obviously not exclusively) and their political mouthpieces (mostly Fox News and other conservative outlets - Rush Limbaugh - anyone want to claim him?) have turned it into a political issue. It started with folks piling all responsibility for the United States "inadequate response" on Obama, again (indeed I'm sure in our toxic political environment, if a meteor struck the earth Obama would be blamed for not shooting it down with lasers).

And I'm with Climb, there is a weird juxtaposition with those most frequently (or vocally) screaming about quarantine and inadequate government response and their view on most other political issues that touch the spectrum between government action and individual liberty (although perhaps I'm wrong here those who are frequently complaining about our overreaching nanny state are often frequently quite willing to tell others who to sleep with (or not), who to marry (or not), and what to do with their bodies (abortion).

[SlackMan]

Personally I'm not advocating strongly one way or the other for the quarantine as I haven't studied the issue, I think there are rational (this is different from convincing or compelling) reasons for one and against and I think policy makers and those tasked with governing do have some difficult decisions to make without obvious, intuitive answers.

What bugs me is the mass hysteria and hyperbole which I attribute mostly to politicalization of the issue and reasoning devoid of scientific support or logic. I think it is safe to say that no one regardless of political affiliation wants to see an Ebola epidemic in the U.S.

Yet politicians, often Rs and conservatives, but obviously not exclusively) and their political mouthpieces (mostly Fox News and other conservative outlets - Rush Limbaugh - anyone want to claim him?) have turned it into a political issue. It started with folks piling all responsibility for the United States "inadequate response" on Obama, again (indeed I'm sure in our toxic political environment, if a meteor struck the earth Obama would be blamed for not shooting it down with lasers).

And I'm with Climb, there is a weird juxtaposition with those most frequently (or vocally) screaming about quarantine and inadequate government response and their view on most other political issues that touch the spectrum between government action and individual liberty (although perhaps I'm wrong here those who are frequently complaining about our overreaching nanny state are often frequently quite willing to tell others who to sleep with (or not), who to marry (or not), and what to do with their bodies (abortion).

I know we're not supposed to bring up politics, but it seems many are and the thread is running so I'll jump in also.

I can't help but notice the parallels between piling on and blaming Obama about an "inadequate response" to the piling on and blaming Bush for an inadequate reponse to Hurricane Katrina. But of course both sides will claim the other situation was different....that's how politics works.

I also can't help but pointing out that many of those who would scream that government should NOT tell them whom to marry (or not), or whom to sleep with, or what to do with their bodies are more than happy to have government tell me that I have to give up ever-increasing fractions of my income, tell me that I have to give up certain types of firearms, etc. Can't I have a 'right to choose' on these things?

[Kirk007]

.... Can't I have a 'right to choose' on these things?

its messy isn't it? But I think an often fundamental factor to consider is whether the activity has societal impacts well beyond the individual. A person's claimed right to a military grade weapon and armor piercing shells certainly has the possibility of doing greater harm to the general public than an 18th century weapon, no? Unfettered liberty vs reasonable regulation?

As to taxes and being told what to do, well clearly the level of taxation implicates all that the government can or can't do for the collective good. That requires collective input and decision making as the welfare of the commons is at stake.

Of course my statements above can easily be made in support of quarantines. We seem to have lost the ability, as a country, to have hard discussions that don't quickly escalate into shouting matches along "progressive" and "conservative" lines. And what is reasonable to one is fighting words to another it seems.

[sitzmark]

So when will they cancel the quarantine for the military?

Sad that people accept unnecessary quarantines for the military who were ordered to the peripheries of the hot zone (merely because they can be "bullied"), but will not accept quarantines for individuals who voluntarily went into the hot zone and had contact with Ebola...


Great respect for "the military" - especially the individuals who comprise the military. The "they" you speak of is unknown to me. Who actually devised and implemented the policy? Who in the command structure is its champion? Presumably the Commander-in-Chief would have final authority for adopting/not adopting such a policy and seeing to its enforcement. If the quarantine was the recommendation of top military commanders, would the CINC chose to override their judgement? What would be the benefit?

A lot changes with respect to civil/personal liberties once one enlists in the military. "Bullying" may or may not be an applicable term. The military has its own justice system. If one defies a military order of quarantine, it isn't the US courts that will preside over the outcome.

If self-monitoring over a 21-day period is deemed acceptable for the general public, then medically/scientifically it should be reasonable for the military to follow the same guidelines. Strategically the command may decide differently and do what it believes is in the military's best interest. The general public has little influence.

[saab2000]

I am not following all the posts here but what's fundamentally wrong with having people who work exposed to a contagious and very dangerous virus having limited exposure to others during the known maximum 21-day incubation period when they are finished working with these patients?

It seems like a fairly reasonable measure and 21 days is hardly a life sentence in a 'Super Max' prison. Some of the doctors and nurses have quarantined themselves and that seems to make sense.

I'm not going to fall into the politics of it (because not everything needs to devolve into a partisan pissing match!!!) but based on what I have read, until we know more it seems like some level of limited exposure, up to and possibly including, a full 21-day quarantine seems reasonable to me.

And living in rural Maine and going for a bike ride doesn't seem to me to represent a danger to public health. That falls into the category of 'reasonable' activity to me.

Maybe I'm naive and stupid, but something is wrong here with all the hysteria. Common sense solutions for this seem to be obvious to me.

[fuzzalow]

I also can't help but pointing out that many of those who would scream that government should NOT tell them whom to marry (or not), or whom to sleep with, or what to do with their bodies are more than happy to have government tell me that I have to give up ever-increasing fractions of my income, tell me that I have to give up certain types of firearms, etc. Can't I have a 'right to choose' on these things?
Compare and juxtapose what you propose here as equivalences to the freedom of the human condition. There is a marked difference.

And IMO it is astounding that in you espouse them as, in essence, fungible rights in the pursuit of happiness consistent with your world view.

As far as the fuss surrounding handling of the Ebola situation - it was the first outta the gate for all involved. It is inevitable that some mistakes were made, things were learnt and the process was improved as we went along. Not bad considering the grave and unforgiving consequences of making a mistake. All the rest is just noise. All the biggest mouths crying over mistakes, real or perceived or seized upon as hate-agenda fodder did not have the burden of decision making in real-time. It ain't so easy being in the hot seat and there will always be the critics that second guess. So what.

[SlackMan]

Compare and juxtapose what you propose here as equivalences to the freedom of the human condition. There is a marked difference.

And IMO it is astounding that in you espouse them as, in essence, fungible rights in the pursuit of happiness consistent with your world view.

Perhaps I should clarify that my reference to firearms is really about the right to protect myself. Look across the world at various societies where people lack the ability to protect themselves from those who have greater force capability, and you will often see that the only rights they have are the ones that those with greater force choose to grant them. So, yes, in my worldview, the right to protect oneself is pretty much on par with anything else associated with the freedom of the human condition.

[sjbraun]

It was written,

"My complaint is govt over reach against the military."

Um, isn't the military a part of government?

There three arguments in favor of the stronger quarantine for military personnel,

http://time.com/3548677/military-ebola-quarantine/

1) Military personnel do not have the same rights t personal freedom as civilians. (This one is kind of lame, I admit.)

2) The number of military personnell involved, currently 1,000 but soon to grow to 4,000.

3) Military personnel do not have medical training and as a result may be more at risk for making an error that could lead to infection.

Do you really think "the government" has it in for the military?

[Louis]

Do you really think "the government" has it in for the military?

Of course. It's all part of Obama's 20 year plan to weaken the military so ISIS can invade and take over.

[Wesley37]

http://i.imgur.com/LgKGNAf.jpg

[fuzzalow]

Perhaps I should clarify that my reference to firearms is really about the right to protect myself. Look across the world at various societies where people lack the ability to protect themselves from those who have greater force capability, and you will often see that the only rights they have are the ones that those with greater force choose to grant them. So, yes, in my worldview, the right to protect oneself is pretty much on par with anything else associated with the freedom of the human condition.

As was originally written by you was something else entirely as there are certain types of firearms that have no place in civilian use. But realistically, getting a ban on assault weapons would be nearly impossible and it was there where you created a false equivalence to gay marriage. Marriage as a legal entity has all kinds of associated legal rights & obligations. A ban on "certain types of firearms" would likely carry no more teeth than the outlaw of the 30-round magazine. In the real world, marriage as a legal status impacts taxation, right to benefits, estate planning, etc. A ban on 30-round magazines impacts only the necessity to reload.

OK. As you have expanded on what you meant, I agree with your right to protect yourself. In sparsely populated or rural environments, it is only correct that you count only on yourself and I would do the same. The 2nd Amendment is not under threat of repeal anytime in our lifetimes. However it is manipulated as to its interpretation to expand its scope and to create a siege mentality that can useful towards mobilization of certain citizenry.

There was a slight drift here in this exchange but relevant to Ebola current events all the same. There will always be opportunism taken to further agendas by politicizing everything under the sun. It is always that somebody is out to "get you" and some miscarriage of rights and justice is always happening. B!tch, b!tch, b!tch. For me, that just sounds of paranoia and seems a terrible and miserable way to live a life.

[Wilkinson4]

Well, on a good note I am no longer worried about catching Ebola. No longer a shut in I actually got out today for a nice bike ride!

mIKE

[cash05458]

can't believe this thread has not been shut down...but then again, I am a gun toting atheist Leninist liberal from Vermont who believes in huge tax refunds for abortions and the honest beauty of quill stems...:cool:

[pbarry]

Well, on a good note I am no longer worried about catching Ebola. No longer a shut in I actually got out today for a nice bike ride!

mIKE

You started this after all.. :hello:

[pbarry]

can't believe this thread has not been shut down...but then again, I am a gun toting atheist Leninist liberal from Vermont who believes in huge tax refunds for abortions and the honest beauty of quill stems...:cool:

Just for that I'm going to buy that 2lb. saddle you have for sale. :)

[Spdntrxi]

It's 50%. Get your facts straight.



On the otherhand, influenza is MUCH more easily transmitted, (airborne).


Wake up... It's airborne
It's above 50 as well..

[Louis]

http://msccncareernavigation.files.wordpress.com/2011/08/82nd-900x.jpg

[oldpotatoe]

So when will they cancel the quarantine for the military?

Sad that people accept unnecessary quarantines for the military who were ordered to the peripheries of the hot zone (merely because they can be "bullied"),

but will not accept quarantines for individuals who voluntarily went into the hot zone and had contact with Ebola...



The only irony I see is people over reaching to fit their political agenda. I've said either quarantine everyone or quarantine no one and stop singling out and punishing the military. My complaint is govt over reach against the military.

Gun laws involve the 2A, "the law of the land", "settled law". "Shall not be infringed" - seems pretty clear. Not to mention that everywhere there are strict gun laws, they have the most gun violence..Washington, Chicago, Detroit, etc. guess what happened when Chicago's carry law was struck down? Gun violence plummeted. Oops...same reason Detroit's Police Chief advocates legal gun ownership. Gun ownership is up the last 10 years and gun crime down the last 10 years, according to the FBI.

Enough with the false premises. They already have police and FBI background checks for buying guns. Who else do I need to check with?

It's odd that people think limiting LEGAL gun ownership will prevent CRIMINAL use of guns. Sounds like "collective punishment".

Maybe we should talk about abortion?

The free Ebola worker crowd have gone from attacking the character of those who pointed out that Kaci is CDC, to invoking Japanese American WWII internment, referencing Catch 22, to gun laws.

That's a wild ride.

Do you support singling out the military for quarantine?

You are not 'bullied' in the military. Have you been in the military? In the last 2 decades or so? It's not the "draftee, gotta get my numbers, take anybody" military of the VietNam era. 3 weeks 'quarantined', is not 6-7 month deployment. You make it sound like they are locked up in orange jumpsuits and treated like Gitmo prisoners. Anybody who has been in the military recently can do 3 weeks standing on their head. It was almost 2 weeks coming back from the Med on a CV..essentially 'quarantined', nice time to rest.

"Government over reach against the military"...errr, the military IS the government. 'Over reach' is the second invasion of Iraq, which the military still did with aplomb. "I am a simple soldier" 'I do my mission, do or die'.

Mental health agencies, I'd say, who needs to be consulted before a gun is bought.

It is that, election season. We won't see this foolishness until about a year from now..

BTW-Yes I do have 2 legally obtained firearms in my house, even here in the people's republic. Problem is I agree with both sides of the isle on certain things, I wish a centrist leader would emerge..not this cycle tho. There, I've related this to 'bikes'.

[cash05458]

Just for that I'm going to buy that 2lb. saddle you have for sale. :)

LOL!:banana: you are the best P! really made my morning here...LOL!

[bikinchris]

I don't have a problem with the military doing what they want with soldiers. The soldiers are government property and frankly, they are getting paid to do nothing.

[gdw]

"The soldiers are government property and frankly, they are getting paid to do nothing."

Methinks you've never been in the military. Enlisted men are rarely if ever allowed to "do nothing" for very long. :banana:

[bikinchris]

"The soldiers are government property and frankly, they are getting paid to do nothing."

Methinks you've never been in the military. Enlisted men are rarely if ever allowed to "do nothing" for very long. :banana:

Great. Then they are not isolated anymore?

Interesting article I read in USA Today, it seems Fearbola is everywhere:

http://www.usatoday.com/story/news/world/2014/10/30/berlin-immigrants-ebola-racism-africa/18187819/

It also highlights political interests in the anti Ebola efforts.

[Bruce K]

I think the whole Ebola thing has pretty much run out of juice here.

Back to bikes, if you please, guys and gals.

BK