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baldeagle wrote:I don't believe for one second that medical personnel, seeing symptoms of Ebola, would dismiss a patient simply because he was black and poor. The hospitals are filled with black and poor patients. The idea that he would have been dismissed because of his skin color or lack of money is insulting in the extreme.

And this debacle, as you call it, has so far resulted in one infected person dying and no secondary infections. Not a very impressive debacle.

Baldeagle, I don't think the dismissal is racially based, if for no other reason that people of color are also well represented in the healthcare industry. I think it is has more to do with a certain general fecklessness among some folks. A lot of people working the healthcare system aren't working there because they feel a calling to be in healthcare. They are there because it's a job, and healthcare represents a certain amount of job security in times of uncertain employment. Among those people, a lot are just serving time, going through the motions. It's no different than working for Walmart or Target.

When I worked in healthcare, people generally fell into one of two groups, regardless of their job title. The way to tell them apart was to ask a simple question: "Here, can you please give me a hand with this?" Those who said "that's not my job" (a surprisingly large number) made up one group. The others who said "Sure, let me give you a hand" made up the other group. In that regard, they are no different than people outside of healthcare. (Don't get me wrong, some of the finest people I've ever known were those I worked with for 6 years at a large hospital; but there were some real lemons in there too.) As in any organization made up of a mixture of the feckless and the responsible, most of the work gets done by the responsible, who carry the dead weight of the feckless. They don't see more patients than the feckless, they just get more done with the ones they do see. The ones seen by the feckless simply do not receive the same attention to detail, and consequently, they do not receive the same standard of care.

So when you arrive at an ER with a 103º fever and a blossoming case of Ebola.....which until you start bleeding through your eyes and rectum, looks a lot like flu..... it's a 50/50 proposition whether you'll be triaged by someone who is genuinely interested in helping, or just another time-server. It is terrible and wrong that Mr. Duncan was sent away after his first visit, but as dragonfighter pointed out, it isn't terribly surprising, particularly to someone who has worked in healthcare long enough to be disillusioned a bit by the experience.

Keith B wrote:News jsut now reporting that Ebola patient Eric Thomas Duncan has died.

http://www.nbcdfw.com/news/local/Dallas ... 25691.html" onclick="window.open(this.href);return false;

That's too bad. I was really hoping he'd make it. His survival would have helped to calm fears..... plus, I wish death....especially THAT kind of horrible death...on nobody.

RoyGBiv wrote:http://www.foxnews.com/health/2014/10/0 ... latestnews

At a Dallas apartment where Duncan stayed after arriving Sept. 20, family members were legally quarantined Thursday after refusing to comply with Dallas health officials requests that they stay home.

If you were exposed, could you ever conceive of NOT following a request to stay home to ensure public safety?

Of course not. I would stay home, absolutely without question. I'm not suggesting that people shouldn't. All I'm really saying is that we (the editorial "we") need to keep a level head here about how we A) stop the spread of a disease, and B) do so without a panic-induced trampling on someone's civil rights. I'm not even saying that we shouldn't take possibly infected people into temporary custody. I'm ONLY saying that if we are going to do that, we need to exercise a lot of wisdom and discernment. I don't know exactly where the line should be drawn. I really don't. But what I do know is that I am very uncomfortable with plans that involve indiscriminately rounding people up and detaining them.......even for public health reasons.....without there being some kind of protections and guarantees for their rights in place. Nobody should be locked up against their will without there being a government provided public-health ombudsman of sorts in their corner, making sure that they are treated like sovereign citizens with rights who, if they are to be locked up without having committed a crime, should have someone "official" in their corner to mitigate as much as possible the temporary loss of their rights. Those rights for asymptomatic people should include being separately detained from those who are symptomatic, so that if they are NOT sick, detention won't MAKE them sick. After all, this was a primary means of transmission in Africa......healthy people being confined with sick family members and having to look after them.

Here is a for-instance: Let's say just for argument's sake that ONE of your family members has developed nausea and vomiting. That is a symptom of Ebola Zaire. It is also a symptom of the Flu, of food-poisoning, and of alcohol toxicity.....and maybe a half-dozen other equally common things....

1. Do you order the entire family to be incarcerated in the home for 21 days and see what develops?
2. Do you immediately blood-test all (X number) of you, and still incarcerate the whole family?
3. What if the nausea/vomiting turns out to be Flu? Do you release the whole family, or only those who are not sick?
4. What if the entire family comes down with the Flu because they were forced into close proximity and not allowed to leave the home? Who pays for the lost wages because of the state-enforced quarantine?
5. What if the sick person actually has Ebola Zaire, and the remaining family are hyper-exposed to it by being quarantined along with the sick person? What if the quarantine makes them ALL sick?

These are all hypotheticals, but my point is that indiscriminate quarantine may not be the optimum answer, and it certainly is not the optimum answer from a civil rights perspective. So, if we are going to violate the civil rights of someone—who has committed no crime—for the good of society, we have to exercise a LOT of discernment in doing so.

I admit that I do not know where to draw the line. I also adamantly state that I would willingly enter home-quarantine because that is the smart thing to do. However, the world is full of a lot of really stupid people, and a lot of them will refuse to stay home.......perhaps because they know that a family member has been exposed, and they don't want to be confined alongside someone who may have a deadly disease. To what extent are you willing to go to round up people and confine them against their will?

Maybe some people have to be forcibly detained. But all people? And, who decides? And who made them God?

I don't have all the answers. The last time we faced a similar epidemiological crisis was the great Flu pandemic of 1918, which killed between 3%-5% of the world's population, including 500,000-600,000 in the U.S. alone: http://en.wikipedia.org/wiki/1918_flu_p ... _the_globe. To put things in perspective, the wiki article says:

This [Flu] pandemic has been described as "the greatest medical holocaust in history" and may have killed more people than the Black Death. It is said that this flu killed more people in 24 weeks than AIDS has killed in 24 years, more in a year than the Black Death killed in a century.

So far, we have exactly one confirmed actual patient in Dallas, and one symptomatic possible under observation in DC (LINKEY). We have as many as 100 people under observation for symptom development. I am NOT saying we don't need to be concerned. I AM saying we need to be wise about it, because precedence is precedence, and once established is very difficult to rescind.



BTW, here is the more or less official libertarian response for Texas, and it is surprisingly moderate: http://www.newsweek.com/libertarians-ebola-texas-274822

.....edited to fix above link......

VMI77 wrote:

The Annoyed Man wrote: But, I ALSO think that panic doesn't serve ANYBODY's interests, and that is what I was trying to get across.

Anybody's? By that I take it you mean the interests of the American people, as it clearly does serve the interests of the ruling oligarchs.

Ok, you got me there. But generally yes, panic will have a negative impact on eradicating the illness, because as potentially infected people flee the zone of initial occurrence, they will spread the disease to uninfected areas. Soon, the dead will be walking....

...I need more .22 LR....

RoyGBiv wrote:

The Annoyed Man wrote:http://www.cnn.com/2014/10/02/health/eb ... index.html
U.S. Ebola case: Searching for contacts
By Gary Tuchman, Jacque Wilson and Holly Yan, CNN
updated 10:53 AM EDT, Thu October 2, 2014

Dallas (CNN) -- Health officials are reaching out to as many as 100 people who may have had contact with the first Ebola patient diagnosed in the U.S., a spokeswoman with the Texas Department of State Health Services said Thursday.

These are people who are still being questioned because they may have crossed paths with the patient either at the hospital, at his apartment complex or in the community.

"Out of an abundance of caution, we're starting with this very wide net, including people who have had even brief encounters with the patient or the patient's home," spokeswoman Carrie Williams said. "The number will drop as we focus in on those whose contact may represent a potential risk of infection."

My guess is that health authorities will have in the end nipped this thing in the bud, containing it to just patient 1. But, that isn't going to avert a sort of general panic for a while. Much common sense is called for.

The people he interacted with from the day he first went to the hospital (maybe a day or two before that) to the day he was finally put in isolation... they were exposed and at risk. IMO, those people should all (everyone we can find) be placed in hospital isolation for 21 days. NOT "stay at home" isolation and have them running out for groceries or having the neighbors visit with them.

You have a point.....but it is entirely possible to get a little overblown in this. Back when AIDS was first being openly acknowledged by the medical community, I worked as a phlebotomist at a hospital during which time we received our first AIDS diagnosis for a patient - a bisexual Haitian male. He was in total isolation in our ICU. I happened to walk by his room on my way to draw blood from another ICU patient. One of the other phlebotomists was standing outside the room, and she couldn't make herself go in there. She was scared to death that she would catch it. I told her that if she simply followed the protocols we were already supposed to be following (we were already exercising hepatitis precautions long before AIDS became a known issue), that she would be fine. She thought she could get it by airborne means. I had to remind her that HE was the one without an immune system, and that just by entering the room, she was a far bigger threat to him than he was to her. She wouldn't do it.

In the end, we traded patients, and I drew the guy's blood. Now, I do realize that Ebola Zaire is far more infectious than AIDS, but all the same, by observing some simple precautions, the spread of the disease can easily be overcome. I previously posted that we shouldn't let political correctness get in the way of dealing with this, and that does speak to your point. But, I ALSO think that panic doesn't serve ANYBODY's interests, and that is what I was trying to get across.

http://www.cnn.com/2014/10/02/health/eb ... index.html
U.S. Ebola case: Searching for contacts
By Gary Tuchman, Jacque Wilson and Holly Yan, CNN
updated 10:53 AM EDT, Thu October 2, 2014

Dallas (CNN) -- Health officials are reaching out to as many as 100 people who may have had contact with the first Ebola patient diagnosed in the U.S., a spokeswoman with the Texas Department of State Health Services said Thursday.

These are people who are still being questioned because they may have crossed paths with the patient either at the hospital, at his apartment complex or in the community.

"Out of an abundance of caution, we're starting with this very wide net, including people who have had even brief encounters with the patient or the patient's home," spokeswoman Carrie Williams said. "The number will drop as we focus in on those whose contact may represent a potential risk of infection."

My guess is that health authorities will have in the end nipped this thing in the bud, containing it to just patient 1. But, that isn't going to avert a sort of general panic for a while. Much common sense is called for.

mamabearCali wrote:So WHY didn't he say that when he went to the hospital! Good heavens! First of all with Ebola the sooner you catch it the better off you are as a patient. Second how many lives has he put at risk and for what...denial....great.....

I think it had less to do with denial than it did fear of authorities....although why, we can only speculate. He's an immigrant, so maybe....

There is also a "close associate" of patient 1 who is under close observation with possible symptoms:
Officials: Second person being monitored for Ebola
Marjorie Owens, WFAA-TV, Dallas-Fort Worth 2:37 p.m. EDT October 1, 2014

DALLAS — Health officials are closely monitoring a possible second Ebola patient who had close contact with the first person to be diagnosed in the U.S., the director of Dallas County's health department said Wednesday.

All who have been in close contact with the man officially diagnosed are being monitored as a precaution, Zachary Thompson, director of Dallas County Health and Human Services, said in a morning interview with WFAA-TV, Dallas-Fort Worth.

"Let me be real frank to the Dallas County residents: The fact that we have one confirmed case, there may be another case that is a close associate with this particular patient," he said. "So this is real. There should be a concern, but it's contained to the specific family members and close friends at this moment."

[sidebar]Is it me, or does Zachary Thomas sound a lot like Tracy Morgan's character in "30 Rock"?[/sidebar]

Initially, my reaction to my wife's exclamation this morning of "Oh Great! Why does it have to happen HERE? Why couldn't it have happened in Chicago or somewhere else?" was to say that we should be grateful that if it had to come to the US, that it would come here where it would get handled by one of the best medical systems in the country without it getting too politicized. If the Chicago Machine gets its hands on this "crisis", they will not let it go to waste.....to use Rahm Emanuel's phrase. HERE, at least the disease will get dealt with first, without trying to turn it into another opportunity to grow the federal government.

And drudge has this gem:
http://www.nytimes.com/2014/10/02/us/af ... .html?_r=0
In Dallas Ebola Case, Officials Monitoring Children Exposed to Patient

The patient was identified by Liberian health officials and The Associated Press as Thomas Eric Duncan, a Liberian national. Mr. Duncan came to the United States on Sept. 20 aboard a commercial airliner and officials said that he had shown no symptoms of the disease while on the flight and that he had posed no threat to other passengers.

———SNIP———

Mr. Duncan may have become infected after his landlord’s daughter fell gravely ill. On Sept 15, Mr. Duncan helped his landlord and his landlord’s son carry the stricken woman to the hospital, his neighbors and the woman’s parents said. She died the next day.

Soon, the landlord’s son also became ill, and he died on Wednesday in an ambulance on the way to the hospital. Two other residents in the neighborhood who may have had contact with the woman have also died. Their bodies were collected on Wednesday as well.

Health officials in Dallas said Wednesday that they believed Mr. Duncan came in contact with at least 12 to 18 people when he was experiencing symptoms.

So far then, it's not just

• Patient 1
• and a possible patient 2,
• plus 5 possibly exposed children
• and 1 possibly exposed ambulance driver.

That's 8 people, but there may be actually 12 to 18.

Lovely.