Thursday, October 2, 2014

Ebola tourism

Medical tourism -- motivated often by economics, sometimes by quality of care -- has been one of the top health-stories of the past decade.   This morning I was going to post a note about an impending variant on this, called “Ebola tourism”, since the early news reports from Dallas were dominated by smileyface happytalk from the likes of the CDC;  however, by now people have wised up, and that is no longer necessary.   Still, for a glimpse of the dynamics of media-vs-the-people, check out the following remarkably clueless WaPo article, by Abby Phillip:

then read the readers’ tart and observant comments.

Just a word, then, on the media aspects.

(1)  I subscribed to WaPo ever since moving to the area, then watched it deteriorate from year to year, and finally let the subscription lapse.  But occasionally I consult their website, for the readers’ comments.  These seem to be only lightly censored.  Often they are nothing but content-free Obama-bashing, but sometimes, as in articles relating to federal employment, the commentors are very well informed;  and in the present case, although almost none of the readers had any special expertise, still  they easily overleaped the very low bar offered by the article.

(2) As regards the information released by the government, there were curious parallels between the Dallas Ebola case and that of the White House intruder.  Both cases featured lies and/or stonewalling, of a sort that could not possibly hold good for more than a day or two.    In Dallas, the number of persons who might have been put at risk by Patient Zero  was initially reported  at around a half dozen; then eighteen; then eighty (numbers easy to confuse, to be sure);  and, as of current writing, around a hundred (unless someone innocently confused “100” with such other zero-rich numbers as “1000” or “10000”).  Additionally, the Texan spokesman at first refused to reveal the nationality of Patient Zero (thus telling us all we need to know), or to reveal his itinerary (the airlines later came clean).

One mealy-mouthed CDC spokesperson (reminiscent of the White-House assaults whitewashers) stated:

"The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring, as Ebola is only contagious if the person is experiencing active symptoms."

And how, pray, do they know that? -- that he did not sweat (body fluid), nor throw up or have diarrhea in the john (either on one of the planes, or at one of the airports)?  They don’t;  and worse, given their proven predilection for cover-up, it is by no means a given that, if they had contrary information in their possession, they would share it.

Coming soon to a hospital near U !

(3)  Since the beginning of this slowly swelling crisis, the bien-pensant media coverage has worn two faces.

(a) As regards the threat to Africa:  This is the most deadly event since Noah’s Flood!  Man every resource -- send doctors, send nurses, send troops, spare no expense! This should be the #1 priority of the West!
(b) As regards the threat to the West:  Nothing to worry about;  way overblown; nothing to see here, move along.

As one reader commented, re an article revealing that now an NBC cameraman has been infected:

Was the journalist working as a cameraman handling bodily fluids of Ebola patients? I don't know about you folks but I am beginning to doubt that Ebola is as difficult to contract as we've been told. There are just too many bodies piling up for transmission to be as difficult as they want us to believe.

(4)  Saudi Arabia banned people in affected African countries  from attending the current hajj.  Several African counties likewise imposed travel bans against their west African sisters.  The USA has not had the courage to do so -- its will perhaps sapped by decades of spineless refusal to seal our borders against illegal immigrants.   (And don’t just blame Obama -- Dubya was even worse.)
If the Dallas outbreak were to spin out of control, then  just as with the case of the White House intruder (and sniper, and elevator-rider), it may wind up having a salutory effect, as the public finally says, Enough!

(5)  The US itself is actually not especially vulnerable to travelers bringing in Ebola:  there are no direct flights from Liberia;  the journey of the traveler to Dallas had several legs, and he could have been stopped at any one.

The flight information for the Ebola patient diagnosed in Texas will not be released by health officials because "It's just not necessary," a spokesperson at the U.S. Centers for Disease Control and Prevention told ABC News.
Flights from the airport in the Liberian capital of Monrovia fly to only six destinations -- four in West and Central Africa, one flight to Morocco and one flight to Brussels, Belgium. There are no direct flights into the Dallas-Fort Worth International Airport from any of those six destinations, meaning that man had to make at least one more change

As it happens, his first stop was Brussels.   Had he been stopped there, he would have become Belgium’s problem:  and even less than the US does the EU have the guts to send home those who slip across their borders from abroad.  (There would even be a certain poetic justice to that, since “Brussels” is synonymous with European Union bien-pensance.)

So, now suppose that Belgium gets its man-card, and bans flights from the affected countries of West Africa.  Well, all the infected person has to do is to fly to one of the other five African destinations.   So suppose Belgium were to ban all flights from Africa.   At that point, America could largely rest easy, protected as it is by a whole ocean;  but Europe would still be in peril.  After all, many thousands of Africans enter Europe illegally every year.  Indeed, in response to pressure from the politically-correct, Italy effectively set up a trans-Mediterranean maritime “taxi service”, paid for by the smiling Italian taxpayers.   All you have to do is to make it into something that floats, then send out a distress signal (with no cumbersome temperature-checks on the Maghreb side);  the misnamed Italian “Guardia”  Costiera will rush to pick you up;  in-cruise peanuts served free of charge.  (That doesn’t mean they’ll take care of you once you hit Italy;  but they will helpfully point out the quickest route to France, and perhaps even give you a free ticket.  Once there, French taxpayers joyfully welcome the new arrivals, in anticipation of shuffling them on further to Angleterre.  But the Brits, burned by the bombings, haven’t been so welcoming of late;  and so the human cargo in Calais, sits and stews.)
Note:  That self-inflicted ferry-service is ironically named Mare Nostrum;  a more accurate title would be Mare Vestrum.   You can read about it here:

So, if Ebola Tourism does become the next big thing, Europe will likely be ravaged long before we are.

[Update 6 Oct 2014]  France is beginning to realize its unusually high vulnerability:

Since, however, the current Socialist government has shown no inclination to defend the nation against various foreign plagues, it will probably do nothing now.

[Update 7 October 2014]  And now this, from Le Figaro:

l'Hexagone est le deuxième pays le plus à risque d'avoir un cas importé de la maladie, derrière le Ghana.


[Update 9 October 2014]   Likewise vulnerable is Spain, via their enclave of Melilla in Morocco.   For reasons of political correctness, Spain has refrained from erecting an adequate barrier, so that the one they have is often scaled or knocked down.  Just yesterday, over three hundred sub-Saharans assaulted the enclave at several points simultaneously (apparently coordinated by traffickers) -- some over the wall, some coming into the port on a float.   All this in the hope (which in the past has repeatedly been fulfilled) of being sent on their merry way to Spain, courtesy of the taxpayer, legality be damned, and with all the diseases they might be carrying.  Melilla itself lacks appropriate specialized hospital facilities, and has requested them, in the face of the continued refusal on the part of the Spanish government  to defend the enclave, or to allow it to defend itself.  (Indeed, just a few days ago, yet another bisounours European commission delivered a tut-tut report against the Melillian (and Moroccan) authorities  for insufficient TLC towards the invaders.

(6)  There has been some speculation that al-Qaeda or (more likely) ISIL, might dispatch ebola-infected operatives to the West.  Indeed, given their predilection for suicide ops, an istishhâdi might even deliberately court infection -- just as some have strapped on the belt, or allowed themselves to be shtupped up the keister with explosives.   Further, AQ has for years been interested in, and sometimes actively working on, poisons and pathogens -- particularly ricin, which is, however not contagious.  For certain, the current band of decapitators would have no moral qualms about such an attack.

ISIL favors maximal effect from minimalist means -- like that Tweet from Syria that set all Australia on its ear.   They could even implement such an attack (since they have a hankering for the picturesque) as a kind of “I Love You” Bug v. 2.0 : simply go around hugging and kissing every American you meet, posing for selfies.  (Les Roms in Paris have a similar scam: sidling up to tourists with a sob story about how oppressed they are, while a confederate steals your cellphone, wallet, and passport.)   Or they could imitate the mindless followers of that Indian guru in Oregon, who went around spraying pathogens on salad-bars:

If so, that would not be the first time an alien cult had launched a bioattack in CONUS.

(7)  Just as defending against a missile once it has been launched, is much dicier than taking it out while it is still on the ground,  so too, we need to consider protecting ourselves via action closer to the source -- before the effects have radiated beyond reach.

The international transportation system has also proved to have porous screening procedures. In an indication that current safety procedures are relying heavily on the honesty of travelers and the diligence of airport workers, the chairman of the Liberian national airport authority… said Thursday that Mr. Duncan had been deceptive about his exposure to the virus when he flew out of Roberts International Airport in Monrovia on Sept. 19.

Well, perhaps the Roberts International Airport  needs to become a bit less international for a while.

Several commentors have sighed online  that there is nothing the US can do about the Monrovia airport.   On the contrary, we could shut it down in a heartbeat, if the Liberian government refuses to do so.   In fact, we already have boots on the ground who could do it, with more on the way:

The United States has made the largest contribution and is sending 3,000 troops to Liberia to assist with healthcare logistics. It is the biggest military operation for America in Africa since withdrawing forces from Somalia in 1993.
I’m not saying we necessarily should do that;  merely, that this whimpering that “there’s nothing that can be done” is pitiful.

(8)  Just happened upon this comment from an alert reader:

What is more scary, Ebola or the cdc. As we have seen so many times lately they are just another incompetent govt body now or soon will be. Are they not the same ones that allowed the prez. to ride a elevator with a three time convicted gun holding criminal.

That is true;  the President was visiting CDC in Atlanta when that contractor was allowed into the elevator.

So, the Secret-Service Scandals story and the Dallas Ebola Scandal  intersect at an additional node.

[Update 4 October 2014]  Political correctness can kill:

Federal officials flatly rejected the idea of expanding the screening of passengers arriving from West Africa, and said they would not support calls for a ban on travel to the United States from countries being ravaged by the disease.

[Update 5 October 2014]  After previous assurances that the Dallas health authorities had quarantined everyone who’d been in close contact with Patient Zero after he became fully symptomatic,  this just in:

Authorities in Dallas are looking for a man who had contact with Thomas Eric Duncan, the Liberian man diagnosed with Ebola in a Dallas hospital.

"We have our Dallas County Sheriff's Department and Dallas Police Department teams on the ground," Dallas County Judge Clay Jenkins said in a statement. "We are working to locate the individual and get him to a comfortable, compassionate place where we can monitor him and care for his every need for the full incubation period."

The Dallas Morning News reports the man, who may be homeless, was in the ambulance that took Duncan to the hospital.

The only reason I cite that, is because it is so exactly like the sort of plot twist that the TV show “24” used to pull repeatedly out of a hat, so that the plot could go chugging forward for a full 24 episodes (as it did, back in the Golden Age) even after some situation had seemingly been resolved.  It always seemed contrived; sometimes such incidents do happen.
(You can almost film the sequel in your own head:  Cut to a dazed-looking hobo, shuffling along skid row.   A sidewalk-sitter invites him to share some Ripple.  As he puts the bottle to his lips, we notice that sweat is breaking out on this forehead, some of it dripping on to the bottle, which he hands back to his host, who takes a long swig…)

Cinematic footnote:  A similar fantasy has already been very well filmed.   The movie is called “12 Monkeys”.

L'Armée des douze singes 

Update 6 October 2014]  Slowly, slowly, they are coming around.

[Update 7 October 2014]  The qualms that some leading scientists have about po-faced CDC happytalk  is finally being allowed to make it into the mainstream media.  An abundance of testimony here:

[Update 8 October 2014] Draw your own conclusions:

(1) In Madrid, una auxiliar de enfermería (“nurse’s aide”, which the American press continues to misreport as a “nurse”) contracted ebola from a dying patient, though she had only been in his room twice -- the second time, after his death.   The details of how she got it (apparently touching her face with a glove) don’t matter in this connection;  what matters is that she was a health professional, with many years experience in the field, and working at a premier Spanish hospital, with intense media attention on the case.   In short, conditions where you would be on your best behavior.

(2)  The U.S. is sending thousands of soldiers into harm’s way in West Africa.  With few exceptions, these guys are not health workers by training, let alone with years of experience in the field.

Your assignment:  Consider the implications of these two facts.


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