Anyone else worried about Ebola?

[Dave Anderson NH]

A serious note folks. The CDC is primarily a research agency and a resource agency serving the government, doctors and other health professionals, and hospitals. It does not have statutory authority to issue orders, only recommendations. It doesn't have the kinds of authority needed to give orders like the FCC, FAA, ICC, CPSC, etc, etc. While almost everyone in the medical field takes their pronouncements and recommendations seriously, they are only that, recommendations. I felt it necessary to repeat this to make it clear. It seems that some posters in this thread have overly high expectations of what the CDC is capable of, and allowed to do.

[David Weaver]

Bringing that entire ship back to the port to dump off someone with no symptoms 19 days after a possible exposure is way over the top. Isolating them may not be, though, that's just good policy.

I'd imagine the cruise company probably feels the need to "do as much as they can" so they don't become the target of conspiracy theorists and ad campaigns or internet spook stories.

What stick out in my mind is 3000 troops in liberia, wherever they are, in much worse conditions than we have here. Are they going to isolate them for 21 days when they come back? Are they coming back on commercial flights or troop carriers? that just doesn't make sense to me if they just come back and are monitored voluntarily, because it's not like there's a lack of proof that people in the hot zones are actually getting ebola because of known exposures.

I noticed on another forum late last night, Nina Pham was being shown in a hospital room in a video, and the nurse shown on camera had a full suit with a respirator. The response by everyone was "look, the nurse has a respirator, it's airborne, we're all gonna die!!". Protocol is to have fully sealed suits for people working with patients who have known ebola with symptoms. Not a single person reasoned that you might actually need to have an air supply in a sealed suit or you will run out of air inside of it and not be a very good nurse.

Nor did anyone suggest that there are hundreds of people who have been in proximity of people who are symptomatic, but nobody so far has gotten ebola without direct contact. I just don't understand why people fail at general reasoning, is it like a horror movie where everyone just wants to scare themselves? Because there are horror movies (in 3d even) if that's what someone wants.

[Phil Thien]

Earlier I said that my fear was something like this would get on a cruise ship. "Whoop- there it is..." http://www.washingtonpost.com/news/m...try-in-belize/

Our hospitals in the Caribbean are not even remotely ready to handle a large outbreak. Although I am sure this person will end up not having ebola, the story shows that one person can get on a cruise ship with this disease and boom- every island on the cruise gets exposed.

You know, in the yet-to-come final analysis, the CDC's biggest failure will be a failure to recognize that the game against of Ebola is won or lost early-on.

NEVER BEFORE has the old adage that an ounce of prevention is worth a pound of cure, been more true!

But the CDC's response has been absolutely mind-boggling. A combination I'd say of incompetence with some arrogance tossed in.

[Phil Thien]

A serious note folks. The CDC is primarily a research agency and a resource agency serving the government, doctors and other health professionals, and hospitals. It does not have statutory authority to issue orders, only recommendations. It doesn't have the kinds of authority needed to give orders like the FCC, FAA, ICC, CPSC, etc, etc. While almost everyone in the medical field takes their pronouncements and recommendations seriously, they are only that, recommendations. I felt it necessary to repeat this to make it clear. It seems that some posters in this thread have overly high expectations of what the CDC is capable of, and allowed to do.

Read this:
http://www.cdc.gov/phlp/docs/ph-emergencies.pdf

At the request of the CDC, the Department of Homeland Security and/or Health and Human Services would simply declare a public health emergency, and then defer to experts at the CDC to call the shots.

The idea that the CDC is powerless in these situations is far from reality. With a phone call or two their power is nearly without limit.

[Dave Anderson NH]

Phil, I said statutory authority. Again, they can make the recommendation, but they can neither make the decision nor enforce it. The declaration of a pubic health emergency would be made possibly by the agencies you mention, but the final decision to declare it, would because of its seriousness and political ramifications, almost certainly fall to the president. As for CDC incompetence, since Ebola has in the past been "only" a disease on another continent, it was undoubtedly a pretty low priority compared to AIDS and both common and uncommon diseases endemic to this continent. They have limited dollars and both real need and political pressure almost certainly weigh heavily in their budget allocation decisions. It's real easy to scream incompetence with 20/20 hindsight. Where were the folks pushing at the CDC months ago when the disease was only a west African problem? Where was the pressure to research and find cures for probably a dozen other diseases which normally occur only in other parts of the world?

[roger wiegand]

AIDS pales in comparison to TB, malaria, flu, and dysentery as worldwide infectious disease killers. Get your facts right please.

[Dave Anderson NH]

Roger, I was not commenting on the seriousness of AIDS compared to other diseases other than the patently obvious fact that there is a lot of political clout behind the expenditures and efforts to find a cure. Because of that clout huge sums are spent on research. With limits imposed by Congress on funding any agency, many of the choices are made in every government agency based on publicity and the placating the appropriate representative or senator. Like it or not, that's reality and unfortunately real needs often are of secondary consideration.

[David Weaver]

That didn't sound right (that malaria, dysentery and TB cause more deaths per year than HIV/AIDS), so I looked it up:

2012 Deaths:
Malaria: 627,000
AIDS: 1.5 million
TB: 1.3 million
Diarrheal Diseases: 1.5 million

http://www.who.int/mediacentre/factsheets/fs310/en/

I can't say much about the flu, I'm sure there are statistics on it, but it's a major killer of the young and old, but not as much in otherwise healthy individuals like HIV/AIDS.

When someone age 90 dies of pneumonia, heart attack, stroke, etc, we used to say "they died of old age".

[Phil Thien]

Phil, I said statutory authority. Again, they can make the recommendation, but they can neither make the decision nor enforce it. The declaration of a pubic health emergency would be made possibly by the agencies you mention, but the final decision to declare it, would because of its seriousness and political ramifications, almost certainly fall to the president. As for CDC incompetence, since Ebola has in the past been "only" a disease on another continent, it was undoubtedly a pretty low priority compared to AIDS and both common and uncommon diseases endemic to this continent. They have limited dollars and both real need and political pressure almost certainly weigh heavily in their budget allocation decisions. It's real easy to scream incompetence with 20/20 hindsight. Where were the folks pushing at the CDC months ago when the disease was only a west African problem? Where was the pressure to research and find cures for probably a dozen other diseases which normally occur only in other parts of the world?

The decision to declare a public health emergency falls to the secretary of the Department of Health and Human Services, of which the CDC is an agency.

I believe other declarations by the Department of Homeland Security can be automatic triggers of public health emergency declarations.

The final decision to declare DOES NOT fall to the president, though, it falls to his cabinet secretary. The president could ask the secretary not to declare. But that means the president and his party accept all the fallout if things go south (so not a terribly likely scenario). And in reality, the president cannot PREVENT a declaration, only ask.

But none of that is material, because they COULD declare, they never NEED to declare. Nobody is ever going to question the authority of the CDC because ultimately the CDC can get whatever authority it needs.

To your point about recent history, none of it matters, we cannot change a thing. All we can do is deal with the problem immediately in front of us. Keeping Ebola as contained as possible is our only solution. Anything to the contrary works absolutely against us and will allow the disease to spread, making the only solution (containment) that much more difficult.

[Frank Drew]

I turned on the radio in my car while driving from job to job a couple days ago and it was a guy that was a CEO of a major drug company. He was fairly upset at all the misinformation going on. He said this is NOT Ebola. He said the actual strain of Ebola is the nastiest thing on the face of earth and has a 100% fatality rate. He said it turns your whole body to liquid, bones and all, in 48 hours.

Scott,

In a word, no. Ebola is one of the hemorrhagic diseases, meaning it can cause bleeding from clotting disorders and other pathologies, but the whole body doesn't melt as in that fellow's description. (All the bleeding and vomiting and diarrhea, though, might make it seem like the poor patients are melting!)

I work directly in front line patient care and I'm not panicked about Ebola but I'm definitely concerned because if this currently very minor outbreak does in fact develop some traction here, our hospitals might quickly become overwhelmed; a disease of this nature is extremely difficult to deal with, even more so than something like a major influenza epidemic. It's highly labor and resource intensive, commodities already in short supply in our health care system. Just handling and disposing of all the medical waste is something we're not ready for.

Today at work we practiced putting on, and, more importantly, taking off the multiple layers of protective garb necessary each and every time you enter an Ebola patient's room. Hugely time consuming, and with obviously very severe potential consequences if you make a even a minor error somewhere along the line.

(I hope nobody's thinking, "Yeah, but that's what you get paid for.")

[Phil Thien]

(I hope nobody's thinking, "Yeah, but that's what you get paid for.")

Actually I was putting myself in your shoes, imagining the dread of having to "suit up." And thinking how much worse a situation we as a nation would be in if it comes to that.

[Harold Burrell]

I came across this that I thought might be of interest here...

http://www.youtube.com/watch?v=1qj4X0MsQjM

[Frank Drew]

Phil,

On the slim chance that this does blow up, it's going to be a mess (literally and figuratively) and, frankly, will test the commitment to health care of many health care workers, particularly those with kids, etc. Just getting cleaning crews willing to do their part of the work will be a major challenge, IMO.

I can just barely imagine the difficulty of fighting this disease in the heat and primitive conditions of W. Africa; it's no surprise that the infection rates among health care aides over there are so high.

Harold, I'll probably have to wait until I go to work to use the fast connection speeds to watch the whole video, but from what little I've seen Shepard Smith is telling his viewers that the vast, vast majority of them don't have to worry about catching Ebola, and that some of the overwrought media attention is simply fear-mongering. I agree. My main concern at the moment is how well the medical system will deal with this if the numbers increase; even if we get thousands of cases, by far most Americans won't be exposed, but they might not have access to their local hospitals, or even their doctor's office, for the duration of the outbreak depending on where patients turn up.

[Phil Thien]

Frank, the other day a local talk show host asked for healthcare workers to call in and voice their feelings on possibly having to treat Ebola patients. I'd say the majority of them were committed to helping, but not a single one of them didn't voice some concern not so much about their own safety, but the safety of their families.

And there were a few callers that simply said at this point, knowing what they know at this point in time, that they would resign before treating Ebola patients.

[Keith Hankins]

Well, as someone who is married to someone in the medical field and a son who works with biologic agents in the military, you should be scared to death. This is real and the horse is out. We should be banning travel from africa, but they wont, so nothing can be done. It will hit home when we have a major outbreak and other countries ban us from traveling to their country like mexico did with the cruz ship. I wish our prez was as worried about our citizens as he was with the rest of the world. The only thing you should beleive is that the Gov't is trying to calm the populace and they are lying through their teeth.