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How Nigeria Stopped Ebola
HughPickens.com writes Pamela Engel writes that Americans need only look to Nigeria to calm their fears about an Ebola outbreak in the US. Nigeria is much closer to the West Africa outbreak than the US is, yet even after Ebola entered the country in the most terrifying way possible — via a visibly sick passenger on a commercial flight — officials successfully shut down the disease and prevented widespread transmission. If there are still no new cases on October 20, the World Health Organization will officially declare the country "Ebola-free." Here's how Nigeria did it.
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. "That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close," says Dr. Tom Inglesby. "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
The first person to bring Ebola to Nigeria was Patrick Sawyer, who left a hospital in Liberia against the wishes of the medical staff and flew to Nigeria. Once Sawyer arrived, it became obvious that he was ill when he passed out in the Lagos airport, and he was taken to a hospital in the densely packed city of 20 million. Once the country's first Ebola case was confirmed, Port Health Services in Nigeria started a process called contact tracing to limit the spread of the disease and created an emergency operations center to coordinate and oversee the national response. Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected. As soon as people developed symptoms suggestive of Ebola, they were isolated in Ebola treatment facilities. Without waiting to see whether a "suspected" case tested positive, Nigeria's contact tracing team tracked down everyone who had had contact with that patient since the onset of symptoms making a staggering 18,500 face-to-face visits.
The US has many of these same procedures in place for containing Ebola, making the risk of an outbreak here very low. Contact tracing is exactly what is happening in Dallas right now; if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested. "That experience shows us that even in the case in Nigeria, when we found out later in the timeline that this patient had Ebola, that Nigeria was able to identify contacts, institute strict infection control procedures and basically bring their outbreak to a close," says Dr. Tom Inglesby. "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
Once you have a couple dozen actual cases on your hands, this method is quickly overwhelmed. All it takes is for a few infected people to slip through and infect several people before they can be found and isolated. Nigeria did the right thing and was lucky.
It only takes one stupid uncooperative idiot ( maybe from a certain news station) to spread the disease.
And I wouldn't compare USA (or for that matter EU ) citizens to Nigerian citizens, Nigeria is known for it scare tactics, I don't see our governments try the same tactics without getting trouble back.
Let alone that no lower class person will stay home from their job for 3 weeks without pay, they will lose their job and get evicted.
Or is the government finally going to pay for those kind of expenses?
So, USA is following safety standards equivalent to those in Nigeria?
American exceptionalism at its finest. We know everything, the rest of world doesn't know jack shit.
Keep having that attitude and Ebola from an insignificant problem in the US will become a great problem.
I believe we have passed the point of containment. Now it's about damaged mitigation.
Some procedures were not followed, some countries turned a blind eye because it's not their problem...they think now it can be fixed, cause now they care.
The sad reality is that this now has the potential to be the biological weapon of mass destruction that no terror group actually possessed...
I believe this will be firmly under control soon, at the same time I believe that if someone decides to spread Ebola as an act of terror we're looking at an epidemic.
Let's hope I'm overly concerns and very wrong.
Ebola is not a smart virus, killing its host so soon. It can be handled quite easily -- just isolate the people and you have your results within a month. ... I don't get the comparison the CDC drew. HIV can spread easier and stays in the body for such a long time, giving the virus many years to contaminate more hosts before becoming problematic. It's a bigger problem by magnitudes.
HIV on the other hand
Maybe it was sponsored by the oil companies with huge interests in Nigeria... just a thought.
You cannot predict what happens in face of a real treat from the - lucky - turnout of just one single case. That is statistically meaningless. The next time the same process may as well fail at one point...
Yes, but Nigeria went "Isolate THEN test", the US is doing "Test (and by the time they test possible other people may be infected) then isolate" i.e. Nigeria took this seriously, the US isn't.
They just told us, and didn't even ask for a wire transfer? ;-D (I just got a mail saying that I've been identified by the US ambassador to Nigeria as one of the victims of the evil Nigerian scammers and that he and the president of Nigeria agreed to pay me a $5M compensation for my recent trouble in exchange for my cooperation. Hah, Goodluck with that, Jonathan!)
Ezekiel 23:20
I think it's the other way around. Or at least I doubt that the CDC learned these techniques from Nigerians.
Ezekiel 23:20
Nigeria does it better.
"If any question why we died, Tell them because our fathers lied."
No, the US is hoping that it will be able to handle the situation as well as Nigeria did.
So far it isn't.
Watch this Heartland Institute video
No, it learned them from the Ugandans.
Watch this Heartland Institute video
Like the Terminator, it will be back!
This is SUPER INFECTIOUS.
Like CANCER you are never free of it!
Dallas is our Raccoon City!
Yeah, good luck with that. The last thing I saw on TV was people from her plane made hops to at least four states.
The President should have just ordered people with passports and travel stamps from these countries to not be allowed to enter the US.
(Score:-1)
For the mod who has no humor, parent was pure comedy!
It's one thing to have the official protocols in place. However the biggest problem is with cultural attitudes. If you have a huge portion of the population who are highly superstitious, and suspicious of the government, scientists, and modern medicine, as well as a lack of basic social safety nets, then you have a recipe for disaster. So what may have worked well in Nigeria is not guaranteed to be so effective in USA.
They made a big bonfire and threw everyone who had fever-like symptoms in it. Problem solved!
How does this work for people without health insurance? If they want people to pay thousands of dollars to go into an isolation, I wouldn't be surprised if a lot of people don't heed the warnings when they get the early symptoms.
The U.S. is on the cusp of taking monetary advice from Zimbabwe.
What I can't figure out is whether you are saying we are too liberal or too conservative?
With the true meaning of the words the two aren't mutually exclusive. It's only when you think of them as synonymous with your stereotypes of the two major parties that it becomes that way.
The Texas Health Presbyterian Hospital seems to have been overwhelmed with one case. That one case did not "slip through". he was turned away and sent home. Training was non-existent, proper supplies were not available. It's a fiasco.
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
I think anyone, and I mean anyone in direct contact with an Ebola patient should be quarantined for 21 days. No Exceptions. As far as international travel, if you want to come here you go to a facility and be quarantined for 21 days, then you can fly.
Countries do some things well, and other things badly. Apparently Nigeria has done a good job at stopping Ebola. We should respect that, and learn lessons from them on how to stop it here in the US.
Typical of American politicians and fear mongering to bring in the sheep, so sick of this shit.
Let alone that no lower class person will stay home from their job for 3 weeks without pay, they will lose their job and get evicted.
Well that ain't so. Relatives of one of the US infected were quarantined in their house for 21 days with mashalls posted outside to stop them leaving. No idea who pays their expenses, but it is happening.
Obama's response to Ebola is driven by politics and media not science or health. Doing this here would of course be condemned as being racist, homophobic, Islamophobic, immigrantophobic, and anyway, we're way passed the point where it's even practical to conduct face to face visits. So much time has gone by that we're in the millions of visits needed. No I'm afraid the best approach is Obama's approach which is to do nothing and blame it on someone else until it burns itself out.
This is the USA we are talking about?
There will be ebola patients dumped on the sidewalk for lack of insurance. Not the one or two at the start, I am talking about when there are hundreds a week. Obama care haters, eat it up, time, to pay the ferryman!
Oh, wait ...
Sent from my ASR33 using ASCII
This disease can spread from surface contact with contaminated fluids (which Ebola victims tend to leak profusely). Indoors, even dried fluids can remain infectious for hours. All it takes is to touch the fluids and then touch your eyes or mouth (which you do all the time) Something like the NYC subway provides very good conditions for spread, once the first sick people take a few trips
Contact tracing is not...web scale. They need to use MongoDB.
Eventually the political reality of the steady drip of new cases will force Obama and his activists to implement a travel ban. It is almost certain that there will be more cases related to Thomas Duncan. The CDC has performed abysmally. As a Republican, I find this all to be a most welcome October Surprise.
Hmm, interesting theory, that.
Both Nigeria and the USA began their ebola problems with one (1) Liberian man entering their country with ebola.
Nigeria ended up with ~20 ebola cases, of which 9 died.
So far, the USA has had ~3 cases, of which one has died.
Now, the USA isn't done yet. Probably. Maybe. We'll see.
But so far, our situation is essentially identical with Nigeria's, and our outcome is the same as or better than their outcome. Note the "so far" - it's important.
"I do not agree with what you say, but I will defend to the death your right to say it"
Because muh freedurp
Seems they are more efficient than USian white trash....
From the NYT today:
http://www.nytimes.com/2014/10...
Federal health officials effectively acknowledged the problems with their procedures for protecting health care workers by abruptly changing them. At 8 p.m. Tuesday, the Centers for Disease Control and Prevention issued stricter guidelines for American hospitals with Ebola patients.
They are now closer to the procedures of Doctors Without Borders, which has decades of experience in fighting Ebola in Africa. In issuing the new guidelines, the C.D.C. acknowledged that its experts had learned by working alongside that medical charity.
But...
The Doctors Without Borders guidelines are even stricter than the new C.D.C. directives
So, USA is following safety standards equivalent to those in Nigeria?
Ever been to Africa? I have. They know a hell of a lot more about infectious disease than we do. They deal with it every day.
When a patient goes to a healthcare facility presenting symptoms, the attitude is "It's not Ebola until it is proven that it is, and so it would be inappropriate to scare people by taking precautions."
In Nigeria, "it's Ebola until we prove it isn't."
Until the US takes the same tack, more and more people will get it until it is unstoppable.
Once you have a couple dozen actual cases on your hands, this method is quickly overwhelmed. All it takes is for a few infected people to slip through and infect several people before they can be found and isolated. Nigeria did the right thing and was lucky.
So you watched "The Stand" last night I take it? In real life it doesn't work that way. They are still using this method even in the hot spots where the potential contacts include just about the entire population. It lets them narrow down who to test and who to quarantine.
The cdc was supposed to be on top of this. They were not. They didn't even clean the apartment for a week. Now they are going to send a team right away, next time............ We spend billions to run the center for disease control, and for what? so some political appointee can endanger the entire country. wow.
So glad we were able to stop the spread of ebola here.
--fatboy
No, I did not watch "The Stand" last night. I don't live in your country. In real life the infection rate keeps increasing in the hot spots. You can "narrow down" all you want: There is a point where the infection starts spreading faster than you can find and isolate people, and for a highly infectious disease in a highly mobile society, it's very close to the beginning of the epidemic.
It's crazy to me that those suits the caretakers have to use are so unpractical.
One would think that with modern technology (space suits) we would be able to engineer a practical suite that can hold out ebola.
Thank you, Bradley Manning, Edward Snowden and so many others, for courageously defending humanity, my freedom and more!
They stopped it before whoever the hell is sending those scam e-mails caught it and died. This is certainly not a good thing.
All you need is to have 1 kid in daycare get this and then you have a real problem.
The basic problem with Ebola in the US is that everybody in the US who knows what to do about Ebola is over in Africa right now trying to stop it at the source. The folks still stateside are the B team.
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
RTFA: "They did a good job in and of themselves. They worked closely with the U.S. CDC. If we can succeed in Nigeria I do believe we will stop it here."
No, the US is hoping that it will be able to handle the situation as well as Nigeria did.
So far it isn't.
If we would only learn to allow the free market to decide.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
The problem that the US has is that if you have no health insurance, you can't go to a hospital. So show symptoms of Ebola - oh no I don't have health insurance, I'll just sit home and hope it goes away.....
even after Ebola entered the country in the most terrifying way possible â" via a visibly sick passenger on a commercial flight
The most terrifying way possible? Not even close.
My first script idea is a planeload of weaponized Ebola patients blasted to smithereens over New York City, raining bodily fluids down on the terrified populace. I'm sure a real creative type could come up with something better.
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet. In addition, terrorist issues include biological warfare, a situation where similar isolation and contamination issues exist. Why didn't a hospital in Dallas Texas have materials on hand to provide a proper response - if it didn't have them.
Maybe we should spend a little less time and money militarizing our police forces, and more time and money getting hospitals to say, 2002 readyness?
Also, we really need to look into exactly Why this person was released. A person of African descent shows up with ebola symptoms, and is sent home. Ill enough to be throwing up in the parking lot is pretty ill.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
I'm surprised, thought Nigeria would have just shot them. Problem solved.
Currently the CDC and States Health Control organs are playing Keystone Cops and it's just the start.
Secondly, States Governors are starting a 'Gold Rush' for having their airports quarantined and citizens thrown into concentration camps for killing and burning of their dead bodies even if they do not have Ebola. Just look at what is today in California.
Thirdly, with an estimated 3 million US low-to-middle income democratic citizens sick and dying on November 4 Obama has no choice but to institute Ebola SWAT death squads to kill Whites who are predominately republican in order to try to level the playing field to control the Senate before the election.
I'm pretty sure they're not actually on the team.
There are two types of people in the world: Those who crave closure
They're Nigerians, not Americans.
Watch this Heartland Institute video
If Dallas is like Raccoon City, NUKE IT FROM ORBIT!
You have a +3 Flaimbait. Comon folks lets get this where it deserves to be +5 Flamebait.
Here is the problem with all that.
The process is very simple and works well on paper, but it completely fails if the patient does not know who all he was in contact with. If he went to a store and handed some contaminated money to somebody, who in turn pass it on to somebody else, or if the patient used a public drinking fountain and touched the fountain, or anybody they bumped into and have no way of knowing, or maybe the patient simply forgets some people he or she touched.
In Western countries, people travel and have these kinds of interactions all the time. Millions of people travel between different cities and some times states, constantly interacting touching, handing contaminated money, or a contaminated credit card to somebody else.
Mr. Obama has also been intentionally complacent. The Mexico border has been intentionally left open for at least 15 years. And flights from heavy ebola regions have not been stopped.
on a side note Nigeria also banned flights to/from these hotspots - Arik Air (Nigeria), Gambia Bird and Kenya Airways have suspended services to Liberia and Sierra Leone. source: https://www.internationalsos.com/ebola/index.cfm?content_id=435&language_id=ENG
That is if the nurse(s) knew anything about Liberia. My experience is that people of the United States do not know the difference between Liberia and Belgium.
There's an assumption by many that there is an actual desire to stop this. I'm not so sure. Put the country in crises, destabilize it, and call for martial law 'for the health and safety of the people' and, Bob's your uncle, you're in charge for life! Alinksy thought the same thing.
Exactly. Typical Obama nanny state government thinks it's their business to protect us from ebola.
The hospital also waited until they got a positive Ebola test result back before taking any safety precautions. Staff were exposed for something like two days and administration resisted isolating the patient. The sample was sent through the normal channels for testing which potentially contaminated their tube system. High-risk individuals who treated Duncan were not placed in quarantine and they allowed something like 70 different people to come into contact with him. Then there's the issue of them initially prescribing antibiotics for a viral infection.
Put all that NSA surveillance crap to work for you. For fuck sake, your taxpayers bought the fancy stuff for NSA. NSA needs to learn to use it for something good or fuck off for good!
Yes, you absolutely can get it that way.
From the CDC:
"blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
objects (like needles and syringes) that have been contaminated with the virus
infected animals
Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus"
The problem in Africa is any fold. People lying and saying the people their to help are causing it. People spreading rumors that the people their to help are harvesting organs, The tradition of kissing the dead, the habit of not going to the doctor. Africans being target by peddlers of SCAMSs(Supplement, Complementary, Alternative Medicines). All of that is possible with exceedingly high levels of illiteracy, and a high belief in woo.
The Kruger Dunning explains most post on
flamebait? That was funny and texas is so full of hot air, they ask to get knocked down a peg. Stupid thing that though, texans actually believe everything in texas is Bigger, better, stronger, faster. This moderation shows it.
Look, the disease is hard to get. We've had 1 case, that has infected 2 other people at one Dallas hospital that apparently was not prepared for it. The 2 Americans that went to the Atlanta hospital were treated and survived without infecting anyone. There is no "outbreak." An outbreak is something with geometric progressions in the number of infected. This is not threat to us unless we become monumentally stupid. All its good for is to give the talk channels like Fox something to yammer about, over and over, all day, trying to make everyone afraid so they can boost ratings. Relax. This is going nowhere.
The performance so far does not inspire confidence. Mistake after mistake and being reactive instead of proactive.
So far neither the CDC (nor WHO) has explained exactly how more cases of Ebola in more locations leads to eventual control. Texas is an informative example of what to expect when Ebola shows up in a new location that has no experience with such an unusual and deadly disease.
[And the flu trolls have to stop. Flu is already endemic. Meanwhile Ebola must be prevented from becoming endemic. There is a very rational reason to be agitated by the apparent lack of competent response. Ebola has never before been contained after an outbreak this large. This outbreak is already twenty times larger than the largest successfully contained outbreak.]
... or any other outbreak, for that matter.
especially with all that money the Nigerian Prince has been trying to send me... It's about time he put it to good use!
Question Reality, Find Your Own Truth...
"if any one of Thomas Eric Duncan's contacts shows symptoms, that person will be immediately isolated and tested."
Well, after a quick plane flight to Dallas anyway...
(the nurse had a fever before she flew).
"There is more worth loving than we have strength to love." - Brian Jay Stanley
Maybe you are a retard. Just a thought.
That is if the nurse(s) knew anything about Liberia. My experience is that people of the United States do not know the difference between Liberia and Belgium.
That's silly. Liberia is where they get books, and Belgium is the place to go for waffles.
But seriously, even Fox news watchers seem to know it's in that country where "Those colored people live" and that it's Obama's fault.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
Yeah. By making sure the 150 flying people over from West Africa every day still can hop on a plane and get here. Because our economy would be devistated if those 150 could not get here.
Got ebola? Don't want to be cared for by pariahs in grass huts? Hop a flight to the USA and get a half million dollars worth of care for free.
Mod down people who tell people how to mod in their sigs
DEAR SIR OR MADAM:
I am an Ebola prince. I have a sum of FIVE BILLION YOUR CELLS (5,000,000.00 cells) in a bank account in Dallas, Texas. I need your help to repatriate it. If you could just lend me access to ONE CELL (1.00 cell) it would facilitate the transfer of control.
Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
Individuals should have the freedom to decide which viruses meat their needs and to choose the type of hemorrhagic fever is best for them.
Won't work a country full of assholes who's entire existence revolves around not being told what to do.
That one case did not "slip through". he was turned away and sent home.
But he was carrying a handgun. What more protection could anyone need?
If you like your Ebola, you can keep your Ebola.
Mod down people who tell people how to mod in their sigs
This only works if there is cooperation from those spreading the disease. Maybe I have an overly devious mind but one of my first thoughts was when is some ISIS nut-job going to get themselves purposefully infected and start planting bodily fluids on every subway handrail, mall restroom door handle, drinking fountain leaver, escalator hand-rail, ketchup-dispenser, and whatever else they can think of, before they get too sick to move, and then finish it off by collapsing in the middle of some very public place, causing panic. Don't tell me there aren't at least a few sick bastards out there thinking along these lines. All it would take is one or two of these cases and the shear panic it would induce would shut this country down for a long time.
"terrorism" and "pedophilia" are the root passwords to the Constitution
Maybe stop being too political and trying to figure out if someone is too liberal or too conservative and focus on the fucking problem.
True but that doesn't mean that the U.S. will necessarily do a good job of following those same protocols. Following those protocals that should already be in place could give us the same results as Nigeria. That would be excellent. Hopefully more can be done in the African countries affected that will start slowing down infection.
Frankly, the main difference is probably that Nigeria took it seriously because they thought there was a massive risk that this was going to turn into an unmitigated disaster for the country. They were thoroughly terrified that any slip at any point would result in anything from a massive death toll to the end of the country.
In most western countries the message is 'yeah, don't worry, we can deal with it'. That attitude will permeate not only the public but the organizations whose job it is to deal with the problem. And the result of that is what we see in Dallas. Organisations that do not take it seriously, potential infected people getting told 'yeah, go sit on a plane, your symptoms probably aren't that serious anyway, a couple of hundred more to trace and spread over the continent isn't an issue if it does turn out to be serious', etc.
The Nigerians were SERIOUS about containing the disease. The US Center for Disease Control has not been as serious. They have delayed the response to the possibility of incoming infected air passengers, they have failed to quickly move in with oversight, training, and other response when infections have occurred in the US, and they have provided poor guidance and leadership to people seeking it such as the Ebola-infected nurse flying from Cleveland to Dallas on a commercial flight with CDC approval or the clipboard man 'supervising' the transfer of the Ebola-infected nurse to Emory University. Now we have hundreds of people potentially exposed, two known new infections, and dozens of people in quarantine. All of that would not have happened if the CDC was SERIOUS about containing this virulent disease. They need to approach their job as if a twitchy mental case were walking behind them with a cocked and loaded pistol pointed at the back of their head. That kind of serious. That's what it will take and we will get there eventually, although it might take a few dozen more new US infections.
Uganda be kidding me!
(stolen from Chelsea Handler)
You have the right to remain sentient. If you give up the right to remain sentient, you will be elected to public office
Less than two weeks ago, the government told us that the Ebola virus couldn’t spread here.
Also, the Internal Revenue Service isn’t targeting, the Islamic State is JV, Iraq is secure, the National Security Agency isn’t eavesdropping, Benghazi was about a video, the economy is getting better and you can keep your health plan.
Fucking ape.
One can note that there's great motivation that Nigeria stay running free of disease issues:
Oil...
That's why they we're able to rid Ebola. There was great motivation--if the country fell into a health problem, the oil wouldn't be flowing. Again, if there's a strategic interest, the problem will get solved.
As for the other countries.... you're out of luck unless you have the goods.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet.
It isn't that strange. Because if you did listen to the news or watch television, then no, you didn't know about the 'threat', because what has been repeated time after time is 'there is no threat, relax, we can deal with this, we're prepared'. Nigeria probably had a quite different message running through both media and government knowing that they have one single chance to stop this and that's at the source. Screw up a single thing and the preview of what happens was available next door.
Some like to think our health care standards make a difference, that the West is more civilized and it can't happen here. But the thing is, after a few ICU places and a few quarantine beds, modern medicine is left with aspirin and electrolytes as far as 'treatment' goes which doesn't give us much edge on African medicine. This needs to be taken as seriously in the developed world as it does in Nigeria, and we need to get useful treatments available _now_.
Mmmmm "meat their needs" yummy Ebola meat.... Wait, wut?
In most western countries the message is 'yeah, don't worry, we can deal with it'.
That's not the message I've heard. The message(s) I've heard range from "This is a huge threat and requires meticulous attention to good isolation procedures, but we have people specially trained for exactly this situation" (from professionals) to "Close the borders and shut down the schools because we're all going to die" (from the media).
Nigeria shut it down. There was a story on NPR last week about an (oil) company town in west Africa that shut it down. Anyone involved, or potentially involved, in Ebola response ought to read what they did, compare it to general practice in Libera and to their own practices or policies. They should be confident in their methods, and ready to improvise. Panic never helps.
The Texas case just exposes (again) the fallacy that the US has the best healthcare in the world.
This hospital made too many amateur mistakes to count:
- Sent the guy home with antibiotics when he presented with a fever after travel to Ebola infected area.
- Did not institute full isolation protocol until three days after he was admitted (thus exposing nurses and other patients to the disease).
- Did not follow CDC protocol even after confirmed Ebola.
I don't read your sig. Why are you reading mine?
Once you have a couple dozen actual cases on your hands, this method is quickly overwhelmed.
Lol, if it ever became a matter of national security, they could just ask the NSA to do contact tracing...
But I'm sure the US could easily mobilize a lot of people to do contact tracing.
Nigeria did the right thing and was lucky.
Give me a break, they weren't just lucky, they made 18k face-to-face visits... Let's give them credit for working hard :)
"...that person will be immediately isolated..."
Unless of course, they need some soup.
http://www.dailymail.co.uk/new...
http://www.nydailynews.com/new...
http://www.georgianewsday.com/...
If the US has an Ebola epedemic, it'll probably be because of people fighting for their "civil rights."
Not saying I'm against civil rights, I personally hate the Patriot Act and what the NSA has become, but sometimes you just have to live by the golden rule. In this case, that means turn yourself in for testing and possible isolation if you think you might have Ebola.
If they really wanted to cause havoc they'd get a bag full of contaminated vomit or something and have a completely healthy person start smearing bits of it all over the place. That healthy person would probably be completely healthy for a week or two before they even start to become symptomatic themselves, and then they'd have a few more days to spread it further before they succomb. They don't have to personally be the source of the virus they're spreading, which greatly increases the length of time they have to spread it before they die.
Nigeria was more than lucky; they were prepared. Texas Health Presbyterian was not.
This is the strange thing. It isn't like no one knew of the ebola threat, unless you didn't watch television, listen to the news, or use the internet. In addition, terrorist issues include biological warfare, a situation where similar isolation and contamination issues exist. Why didn't a hospital in Dallas Texas have materials on hand to provide a proper response - if it didn't have them.
Materials and preparation cost money. Hospitals that don't have them make more money than hospitals that don't, unless they actually have an Ebola outbreak. Hospitals figure they never will, so they don't prepare.
That is what happens when you don't mandate preparation by regulation and audit compliance, and combine that with a competitive market-based healthcare system. Nobody has incentive to prepare for anything unlikely to occur. If anything does go wrong they just throw their hands in the air and say that nobody could have seen this coming and beg for help from the (CDC/Federal Reserve/FEMA/whatever).
In typical hollywood fashion, the CDC seems to be more concerned with creating an image of no panic when they don't have a clue. Everything they have done so far has been reactionary. You don't have a plan if all you do is react to events. No fly list should have been in place. Isolate then test should have been in place. Seems a lot of things aren't there but they keep telling the public how great their plan is.
did you forget to take your meds?
Health officials used a variety of resources, including phone records and flight manifests, to track down nearly 900 people who might have been exposed to the virus via Sawyer or the people he infected.
I thought collecting metadata was wrong and EEEEVIL!
If the hospital had admitted every uninsured foreigner who showed up with a fever, and then broke out the best protective equipment and procedures, well, then, that would be bad for the shareholders.
These are my friends, See how they glisten. See this one shine, how he smiles in the light.
What did you expect them to do? Treat a guy without insurance?!
The U.S is getting fubar:d by the CDC and IDSA like they always have.
You think Nigerian doctors don't know how to deal with infectious diseases?
Most top ID doctors in Africa will run circles around ID doctors in US/Europe.
They deal with this all the time. Their problem is resources, NOT competence.
Venture capitalist medicinal companies holding out on drugs until someone someone comes along who can pay for them.
Great idea, until they screw the world over.
Selling the misery of an entire planet over something as dirty as money.
they prefer it that way.
Sleep your way to a whiter smile...date a dentist!
It does have the best healthcare in the world - for the one-percent. For the ninety-nine percent, not so much.
They have it in place, but they haven't been using it properly until Patient #3 FLEW on a Frontier flight, pretty much exposing everyone on it. Up until this point, they've been doing half-assed things like no protocol for two days at Presby Dallas, P2/P3 level contagion type protective gear instead of the P4 called for BY Ebola, power washing all the vomit, etc. Duncan had puked in front of the apartments (A few aerosol drops of a fairly low viral load (50 pfus) inhaled will ensure you get it...), and the like.
Until they start doing like Nigeria and taking it for-serious (and they're NOT yet...they're still half-assing it right now...) it's going to get a lot worse before it's over here in the US.
The Texas case just exposes (again) the fallacy that the US has the best healthcare in the world.
The best healthcare in the world does not mean a perfect system in every way. How dare these people not instantly recognize Ebola and treat it properly. I mean hadn't they seen an enormous amount of 0 Ebola cases in Texas prior to this? They should have extremely rigorous procedures for dealing with Ebola isolation considering they'd done it 0 times in the past.
Most hospital healthcare workers are just trying to help the people that come in to their building however they can. They are not reading all the CDC bulletins and following the latest outbreak of a rare disease in Africa. That's for hospital administrators to keep up on, not nurses and staff.
I suppose you'd rather all hospitals in the US lock down every patient that comes in with a fever or vomits. Better safe than sorry, right? I mean, who cares if the odds of Ebola coming to Podunk, USA is nil. This is EBOLA!!!!! We should panic and tear our hair out! I mean this disease has killed more people in 40 years than the Flu will kill in 2014 alone!
Also, we really need to look into exactly Why this person was released. A person of African descent shows up with ebola symptoms, and is sent home. Ill enough to be throwing up in the parking lot is pretty ill.
Totally agree. This nigger should have been sold as someones slave, right?
Then there's the issue of them initially prescribing antibiotics for a viral infection.
Dude, they obviously didn't know he had Ebola. How were they to know that he had a viral rather than bacterial infection when they didn't know exactly what he had?
The Texas case just exposes (again) the fallacy that the US has the best healthcare in the world.
This made me burst out with laughter. In what fairyland do you live if you think that anywhere in the world people think the US has the best healthcare in the world? I can promise you that nobody outside the US would even rate it mediocre. You have good universities, you have good research labs, but your healthcare is worse than in most developing countries.
Also, we really need to look into exactly Why this person was released. A person of African descent shows up with ebola symptoms, and is sent home. Ill enough to be throwing up in the parking lot is pretty ill.
Totally agree. This nigger should have been sold as someones slave, right?
NO you silly shit. If ebola broke out in any place, people who very likely came form that place should be considered carefully. If it was Sweden, we might look at people who came over from there too.
Trying to save people's lives becomes profiling now? That's simply nucking futs. If you see a black guy running away from a bunch of white guys in white bedsheets, is it profiling him to stop and say "Those people might want to hurt you, hop in and I'll get you away from here."
I don't know if that dude form Liberia would still be alive now or not, but he was certainly condemned to death by what they did with him.
The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
That is if the nurse(s) knew anything about Liberia. My experience is that people of the United States do not know the difference between Liberia and Belgium.
The nurse knew, it was one of the questions she asked the patient so they were checking, but the information that the patient had been to Liberia did not make it to the doctor. Why that is, either that info didn't make it to the record, or if the doctor didn't read the record, I have not seen. However, they probably certainly know about such issues as the ER of a major city hospital probably has a lot of cases of foreign nationals and immigrants coming in. We are still dealing with stuff like TB and other non-standard medical issues on a daily basis in the one I work for.
President Obama has been meeting secretly with Joint Chiefs, DoD top brass and military scientists. Strategic thermonuclear Air Force strikes have been authorized to incinerate Dallas-Fort Worth TX and Cleveland OH.
On Monday night at 09:00 pm ET, The President will make a like address to the nation as the incineration campaigns begin to explain the necessity of the cleansing.
You mean +5 Informative, right?
What prick modded this Insightful? You guys are some cold bastards.
They did treat the guy - a non US Citizen - without insurance - they even gave him a $1,000 + CT Scan because he complained of a headache.
Who could possibly think that the US has the best healthcare system in the world? That person must be running a fever.
Your post is a fantasy, Stripe7 - the reality in the US is that hospitals and doctors all follow strict procedures laid out by their medical malpractice insurers to minimize their lawsuits (unbounded $$$ in jury awards) and the medicaid/medicare payout standards which standardize the high costs of treatment. If you are not a citizen of the US and not covered by Medicare / insurance you can quickly be bankrupted by the very much non-free market price set system that is guided between the Trial Lawyers of America (who hold Obama's leash) and the Medicare/ Medicaid system that establishes payout norms. When Duncan went into the hospital the first time, not only did he get antibiotics, but he also got a CT scan for his -headache- - a $1,000+ billable procedure that is mandated due to the threat of Lawsuit in the Rare Event of Brain Bleeding. These very much non free market, completely political forces, have killed 95% of all common sense and market forces in our medical system, yet you pawns of the former Socialist states continue to call American medicine 'Free Market'. Pathetic.
Oh crud komrades, I just saw one of those teabaggers holding up a sign -- it said 'We demand the right to Life, Liberty, and the Pursuit of Happiness' -- they must be on to us, we should take active measures... Contact our friends in the Cheka
Sent the guy home with antibiotics when he presented with a fever after travel to Ebola infected area.
THAT mistake I can understand. They've seen SO many cases of Ebola after all. But permitting scores of people to be in the room with the guy *after* they decided to test for Ebola was a preventable error. And failing to tell the folks involved in his treatment to stay away from public transportation for a safety period following their contact with a confirmed Ebola patient was total amateur hour. Seriously, WTF do we have a no-fly list for anyway?
Moderating "-1, Disagree" is simple censorship. Have the guts to post your opinion.
let's hold of on those flights?
Hold all flights from brussels and casablanca?
Watch this Heartland Institute video
They didn't want to spend money that they wouldn't get to recoup
. . . we need more stubborn, ignorant people in this world.
Nigeria is successful because the government there made people aware (and very afraid) of the Ebola disease. They quickly provided posters and pamphlets all around the major cities on how to prevent contracting the disease. People entering any shops in Lagos had their temperatures checked, there were hand sanitizers everywhere, etc ...
Contrary to this approach, very early on in the Thomas Duncan fiasco, US officials convinced Americans that compared to "rural West Africa" (this is exactly how one top Dallas healthcare official so condescendingly put it), the United States was in far better shape to handle this crisis. So even till now there are none of the basic precautions (temperature screenings at airports, basic hygiene measures) being taken in the index city - Dallas - and many other American cities.
I pity the fools that walk into Texas Health Presbyterian.
Bu.. Bu.. But .. what about the hospital shareholders.and reduced third quarter profits? Can't have all that wastefully expensive training and preparation costs! We've only *just* discovered it's cheaper to shoot patients than give them antibiotics, although our legal dep't advised against it ;-( Now we've got these terribly expensive safety procedures because of ebola! Can't we just send them to, say, Canada and.. kind of.. "hush it up"? I just bought a nice 400 acre Golf course & racing horse stable on Florida and don't want to suddenly have to "economize"..
> It isn't that strange. Because if you did listen to the news or watch television, then no, you didn't know about the 'threat', because what has been repeated time after time is 'there is no threat, relax, we can deal with this, we're prepared'.
No, it is strange. The "there is no threat, relax" message is not actually said in those words, (but close enough), is addressed to the non-medical public, and the motive to reduce panic in the populace is a correct one. The "we're prepared" part means that "we" medical staff, supposedly INCLUDING nurses in Texas, have an ounce of intelligence and training, and are in fact prepared. If the first nurse in Texas had bothered to be aware, training or not, of the outbreak in Africa, and made sure the Doctor was informed of the patient self-reporting that he had been to Liberia, none of this would have happened on US soil. What kind of idiot doesn't realize that it's CRITICAL to pass on this information repeatedly until it is acknowledged? I could see that, with no nurse training whatsoever.
Now we are one or two steps perilously closer to that critical mass where you can't track down everyone that all the people had contact with, as mentioned by in earlier comment.
If Nigeria can perform this kind of hard-to-believe miracle, why can't they find the kidnapped girls? Oh right. They're being held by men with guns. Totally different scenario and, well, they're just girls.
Makes sence, technically Zimbabwe has a lot more money than U.S.
Well, there are obviously a couple of solutions.
If you're still all-in for the free market, then just mandate that all hospitals conduct training/drills/etc for particular epidemics (including ones like Ebola that end to result in fluids all over the place, and other epidemics that are perhaps a bit more tidy but airborne), Mandate that hospitals also stock a certain list of materials in some ratio to the number of beds they have. Then audit for compliance, and fine anybody who doesn't comply sufficiently that they aren't saving money via non-compliance. Since every hospital is affected, they all have to raise their prices, and nobody who complies gets priced out of the market.
However, I think that problems like Ebola point to the need for true universal coverage. For an epidemic like Ebola the chain is as strong as the weakest link. It doesn't help if half the population has the world's most comprehensive insurance policies if the other half of the population tries to hide their illness because they're uninsured. I can have the world's greatest insurance plan, but if some minimum wage worker who doesn't get sick days and has no insurance has a drop of swat land on my hamburger because they went to work instead of the hospital despite feeling lousy and being friends with a guy who just got back from West Africa, then I'm probably going to die and my insurer can't do anything about it.
Sure, eventually we'll probably have treatments, but right now we don't, and plasma donations from Ebola survivors only work when you have only a few sick people in the entire country to deal with.
The cheapest way to deal with Ebola is to have people who are sick go to the hospital, and they aren't going to do that if they're stuck with a $20k bill even if it turns out they don't have the disease, and they lose a day of work besides. For the want of $25k, we get an extra $1M worth of epidemic spreading.
It boggles my mind that they can charge $1000+ to shove someone in a machine they already have and turn it on.
Do not forget that the EPA shut the incinerators off in these hospitals.
As for the dozen or so high isolation beds in the US that FoX and others wants
all patients to be sent to... Oh wait there are many in isolation and only
13 beds... 1,2,3, many... none can count high enough for sure.
The way to think about these 13 beds is that they are 13 lab rat cages.
Not designed for anything beyond experimental access to astoundingly
ill individuals.
Truth is stranger than fiction, but it is because Fiction is obliged to stick to possibilities; Truth isn't. Mark Twain.
after a few ICU places and a few quarantine beds, modern medicine is left with aspirin and electrolytes as far as 'treatment' goes which doesn't give us much edge on African medicine.
Probably not a good idea to mention aspirin in conjunction with Ebola treatment. Ebola patients suffer from decreased blood clotting and internal and external bleeding. Aspirin, a blood thinner, would exacerbate that situation.
That that is is that that that that is not is not.
I find your negatives very irritating.
I just spent the night last night in the emergency room of the huge VA hospital in West Los Angeles; I was there for an unrelated infection. For the 14 hours or so that I was there, I kept hearing repeated references to Ebola, but it was not about some idiotic hysteria or fear mongering... I kept hearing discussions of who was going to be next to take their special Ebola classes, the scheduling of the classes, discussion of the special isolation suits, etc... it was all very reassuring to see them handling it all so professionally and without any drama or craziness. If all the hospitals are as well - prepared as these people are, there will be no problems.
Actually, it is probably good to wait a week. That minimizes the risk to the cleaning personnel, because there should be no live viruses by that point. Now if they had waited a week to seal it off, that would be another story.
Check out my sci-fi/humor trilogy at PatriotsBooks.
Depends on how serious you are about containing it. If you consider Nigeria's response to be overkill, then you're correct. If you consider it to be a reasonable response, then I think you're drastically underestimating how badly contract tracing scales beyond a tiny number of people.
The Nigerians' response involved 18,500 in-person visits to handle the fanout from a single patient. Based on that standard, if you ended up somehow with ten patients, in the worst case, you may be talking about visiting every man, woman, and child in an average American city. At just a thousand patients, it means an in-person visit to nearly everyone in the state of Texas. If, God forbid, we end up with as many cases in the U.S. as they have had in Africa, in the worst case, a similar response level would require an in-person visit to almost half of the people in the United States! To describe that as infeasible is a gross understatement. Admittedly, people in the U.S. are more likely to be reachable through non-in-person means, and contacts are likely to have some overlap, both of which make it slightly less infeasible, but an 18,500:1 fanout still qualifies as nuts even in the best-case scenario.
Worse, there's no guarantee that the Nigerian approach will be nearly as effective here in the U.S., because conditions are so different. In Nigeria, most people (statistically) do not own cars. Contrast that with Texas, where in some parts, the average person has three of them gathering rust on the front lawn alone. :-D The more mobile the population, the harder it becomes to contain an outbreak through contact tracing.
Check out my sci-fi/humor trilogy at PatriotsBooks.
Like with any "pandemic" fear mongering by CDC and BigPharma, this one too, a LIE, a FRAUD.
Videos online how the whole story was orchestrated in africa, people get paid to act as sick...etc.
In what fairyland do you live if you think that anywhere in the world people think the US has the best healthcare in the world?
That fairyland would be (parts of) the US itself. It was (and is) pretty obvious.