Can you really trust the “experts” when the head of the CDC says you can’t catch Ebola on the bus, but you might still transmit the disease to someone on the bus? I think a 10th-grader can figure the logical fallacy in that one.
It should come as no surprise that Dr. Tom Frieden, the CDC director and author of that absurd bus pronouncement, was the guy pushing Mayor Bloomberg’s anti-large soft drink agenda. I suspect he still believes that large cola drinks are more hazardous to my children than people with Ebola walking the streets of America.
I’ve been tweeting about Ebola using the intro, “Let’s be clear.” So let’s be clear here. There are several notions that need to be seen with real-world spectacles, not the rose-colored glasses of Dr. Frieden.
There are multiple modes of disease transmission, and the community response must take these into account. Ebola is not airborne. If it were to become airborne, that would be disastrous, but such transformation has never been seen, so let’s worry about the here and now. An airborne disease can infect you by flowing through ventilation ducts from one part of a hospital to another. For example, in the last known case of smallpox in Europe – and smallpox is truly airborne – the exhalations of a victim flowed out the window into the German winter air, up the wall of another wing of the hospital and infected and killed several student nurses.
Ebola is also not truly “bloodborne” in the sense of HIV. You truly cannot get HIV on the bus or from any casual contact. To acquire HIV, you have to be injected with a patient’s infectious blood or at least have it come into contact. You can get it from sexual exposure to semen, but even sex doesn’t always transmit it.
Ebola is a “droplet disease.” The Ebola virus is present in all body fluids from tears to semen to vomit to sweat. If you are infected and sick and you sneeze or cough or vomit, you spread live infectious virus. Sweat on the sheets, and for a time the sheets are infectious. One of the unknowns is how long this strain of Ebola lives on “fomites” – inanimate objects that transmit disease from person to person.
And there are differences in “infectivity” of diseases. For example, salmonella and Shigella bacteria produce dysentery (bloody diarrhea) when ingested. But the difference is, it takes 100,000 germs of salmonella to get sick, but only one Shigella germ. Unfortunately, Ebola is like Shigella – it only takes apparently a very small amount of virus to make a person deathly ill. Doctors overseas have died merely from touching the skin of an infected patient.
Let’s also be clear about protective gear. In a level-four containment biological research facility, like Fort Dietrich, which deals with Ebola, the researchers wear special biohazard suits and go through a decontamination chamber before removing the suits. In this manner, they ensure that all the bad germs are eliminated/killed from the suit’s surface so they don’t contaminate themselves during removal.
The hospital workers (at least initially) were wearing what we call standard hospital “protective isolation gowns.” These are paper gowns, latex gloves, non-occlusive surgical masks with a splash shield in front of the eyes and paper booties. There is no decontamination unit in these hospitals, and these suits cannot undergo wash-down prior to removal. There is a technique for removing standard hospital garb without contaminating yourself, but it would take a second person, and it is not easy. I’m a surgeon, and I can’t consistently do it without occasionally having some skin contact to the gown or outside of the gloves.
There are only four hospitals in America with true biohazard units for this kind of highly infectious deadly disease. All other hospitals have no true isolation units, no decontamination facilities and no experience dealing with this level of problem. Most doctors and nurses have never seen Ebola or any disease like it and are totally unprepared to do the needful. Everyone throws around the word “protocol” as if having a piece of paper with standardized responses supplied by the CDC will somehow magically convert St. Elsewhere into a contagious disease facility. Although protocols make some sense, they do not substitute for experience, honest situational appreciation and leadership – none of which are in evidence right now.
Finally (and this is the most important point about which we must be clear), what is the key component to contagion control? It is keeping people from moving about and spreading the disease.
When faced with a disease that has no treatment, is highly infectious and deadly, the first thing to do is to contain it in the “hot zone.” Even in First-World medical systems, we cannot control such a disease as Ebola without preventing transmission. And the only way to prevent transmission is stopping people to people spreading the disease. Ironically, our government/ pharmaceutical company partners (using our easily co-opted medical profession) demand we vaccinate our babies against influenza to prevent transmission. They want to force nurses and hospital staff to get vaccinated against their will – although there is no evidence flu vaccine to nurses actually decreases rates of influenza among hospital patients nor sick days of hospital personnel. But they refuse to do the tried and true action that would stop the spread of Ebola –limit transportation.
It is notable that those African countries abutting Liberia and Sierra Leone have closed their borders. The small Caribbean Island of St. Lucia has closed its borders to travelers originating in endemic Ebola areas. They are smarter about this than the administration of the supposedly most powerful nation on earth. And it’s not just our government. A liberal student organization in Texas is now circulating a petition for “Ebola equality” to allow Ebola victims to freely travel in the U.S., to receive free medical care and free housing. We’ll see how many of them actually volunteer to house Ebola patients.
It is not kind to allow travel on some vague notion of non-discrimination, then let the disease kill countless innocent victims, when we could stop the disease here and in Liberia using the tried-and-true principle of contagion control.
First, stop all flights out of Liberia and the other two countries affected at present. Secondly, stop inter-town/ intercity transit. And in those towns with Ebola raging, stop house-to-house transit (i.e. quarantine people in place). The international community can help with drop-shipping food and real biohazard gear and supplying expertise. Once properly equipped, the Liberians need to “own” the problem by burying the dead, and supplying house-to-house medical care and food distribution. It may or may not be possible to evacuate sick people into a central Ebola facility.
It is absolutely the case that we cannot make Liberia a First-World medical nation in the time required to stop this outbreak. As witnessed, we can’t even save everyone in America. But by stopping transmission in Africa, those who live, live; and those who die, die. Ultimately, the disease “burns out” in a month or two.
In America, everyone who is in any way in contact with an Ebola victim and all the spaces associated with an Ebola victim are locked down. No more waiting two-and-a-half weeks to close an ER that accepted an Ebola patient, as in the case of Mr. Duncan. We are still holding our collective breath to see how many more people pop up sick on that one. It is a fiscal nightmare for a hospital to close its emergency facilities and block off rooms, but how much more disastrous to transmit disease to innocent bystanders because you were worried more about your bottom line? And how much more costly would those lawsuits be?
The CDC is filled with knowledgeable researchers and clinicians. It is their leadership that has become politicized beyond any real usefulness. It does appear the guys with the ideas are squeaking, because the CDC is no longer insisting that every American hospital can handle these high-level pathogens. They now have an emergency response team with the correct equipment (one presumes) and with the experience to deal with Ebola. These will be dispatched to any area where a patient is diagnosed. And red tape at all levels must be discarded when it’s ridiculous.
The hospital in Dallas was equipped with a machine that could have made a rapid diagnosis of patient Duncan, but in classic bureaucratic fashion, the kit needed to test for Ebola was not “FDA approved” and, therefore, unavailable to them. (It is being used in Liberia by our military.) Perhaps the FDA can be seen as the obstructive sphincter it is and bypassed – at least for this outbreak and hopefully forever.
This is not a so-called “false flag.” This is a real medical and social emergency. Before it gets really out of hand infecting towns and cities all over America – before, in the name of “fairness,” we let our children become infected – let’s take Ebola seriously, but not leaders who distort the truth for their own self-serving agendas.