Wednesday, October 15, 2014

Ebolabonanza: latest updates


The latest faits-divers regarding Western fecklessness in confronting the epidemic (main essay here:  Ebola tourism).

[Update 9 October 2014] 


(1)  The Obama administration’s timid response to the latest events -- a response evidently reluctant, and under public pressure -- to the extent of taking the temperature of passengers from ebola-ravaged lands, only at five airports and only after it’s too late -- namely, after they have arrived here, from whence no-one will have the guts to send them back -- is, as the CDC itself admits, mostly just for show:  to show, not that they actually care, but they can at least pretend to care.   The French socialist government has just announced that they are unwilling to go even that far.   The leader of the Front national, Marine Le Pen, has called for suspending flights from the infected countries;  unfortunately, the general election isn’t till 2017 -- plenty of time for the socialos to do irreversible damage in the meantime.



[Update 15 October 2014]
National Nurses United, a labor organization, issued a statement it said came from nurses at the hospital who reported feeling “unsupported, unprepared, lied to and deserted to handle their own situation.”
The statement said that the guidelines for handling Duncan were constantly shifting, and that for the first two days of Duncan’s isolation, the protective equipment given to nurses did not cover their necks.


The official Texas biohazard suit
Just add duct tape and you’re done!


(2)  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.

(3)  I just watched a video from Sierra Leone, which attempted to show the professional level of measures being taken by the government there.  The camera crew followed a nice young man -- a volunteer, bless him, in a very dangerous job -- driving to a crowded quarter of Freetown  to retrieve an ebola-infected corpse.  (Remember that the corpse is at least as dangerous as the live carrier.)   The crowd was hostile, especially the relatives of the deceased;  a single soldier stood guard but did nothing; ultimately the young volunteer had to retreat, leaving the corpse to rot and infect others.

We then proceeded to a similar mission, this time at a military hospital, so that there was no problem with an unruly mob.  We watching the volunteer and several of his comrades,  patiently and dutifully suiting up, till they looked like astronauts.  Only … one detail:  In a suit like that, the astronaut would be dead.  For the suit left a gaping hole at the throat.  (Sort of like the Maginot Line, which was sound in construction but omitted to cover Belgium;  epic fail.)   The team proceeded anyway, having patched the gap with … Scotch tape!

Uh-oh ... check your zipper ..



(4)  Those who attempt to calm (or paper-over) public fears, speak blithely of “decontamination” of infected premises, as though that at least were a magic bullet.  But the NBC cameraman who came down with ebola despite not having had direct contact with patients, believes that he caught it in the very act of decontamination -- splashback from spraying a car.

This morning, airline workers at LaGuardia went on strike over being sent in to clean out blood and vomit from airplanes, with minimal protective gear.

(5)  Republicans naturally have been seizing on this, perceiving an issue.   Indeed there is an issue, though they approach it in their by now familiar way, making up lies about ebola-ISIL brigades already at the border with Mexico.   It’s a good thing they are fuming, since the CDC/DHS are both still stonewalling;  but as a party they offer nothing, since, scientifically, they are the party of aggressive incompetence:  witness the many, many missteps in Texas.


However, some friends of mine are committing the fallacy of discounting the dangers of America’s current lax approach, simply because the Tea Party types are attempting to adopt the issue of their own;  as though it were all no more than a Faux News smokescreen.   A good corrective to this is to sample the public response in Europe, where Obama is not an issue.  The point of the examples below  is not to justify the public response, but (a) to help Americans be aware of how this is playing out in Europe, and (b) to counter the suggestion that the whole issue is just an invention of the Teabaggers.


First, Spain.  
* Remarkably, the tone of public opinion has been unexpectedly hostile, both to the now gravely ill nurse’s aide, and to the decision to repatriate the infected Spanish missionary-priest.   The inhospitable attitude towards the priest, their own compatriot, contrasts with the relative mildness of the Liberian who managed to infiltrate the US under false pretenses.   Also, the nurse’s-aide may not be the brightest bulb (aides often aren’t;  she is not an R.N.), and may have infected herself by (as she says) touching her face with her glove while "doffing" (disrobing):  but please!  The particular situation she faced was unprecedented,  and perfection  in such cases  is impossible.  And now a Spanish doctor has likewise quarantined himself:  he says that the sleeves on his moon-suit were too short.  (Having seen that Freetown video, I can well believe it.)
* As for Spanish commentary on sites reporting the Melilla story (which, admit it, you never heard of until just now), it is unprintable:  harder than the hardest of hard lines you are likely to hear in the United States.

Next, France. 
* This morning, some parents are boycotting the local school owing to the return of a pupil from ebola-wracked Guinea.
* The teflon/happytalk French health minister today dismissed the need for further protective measures, with the curious reasoning that “there are no cases of ebola in France”. (Que l’on sache, one wishes to add.)  As though on cue, no sooner had she issued this unsettling reassurance, then a possible case was announced:

9 October 2014 Un bâtiment de la DDASS [direction départementale des Affaires sanitaires et sociales] de Cergy-Pontoise, en banlieue parisienne, a été bouclé ce soir après le malaise dans ces locaux d'une personne qui pourrait être d'origine guinéenne et présentant des symptômes grippaux semblables à ceux du virus Ebola, a-t-on appris de sources concordantes.

Un lecteur ironise:

Ce n'est pas possible. Mme Touraine nous a garantie qu'il y avait aucun danger. Nous aurait on menti ?

Another comments, more ominously:

      Le camp des Saints version 2014.

(For an explanation of the reference, click here / ici.)


[Update, 13 Oct 2014]  Mounting pushback:

Doctors and nurses pray before entering the Ebola ward at JFK Hospital in Monrovia, Liberia. After a doctor at the hospital contracted the virus, some employees quit and the facility stopped accepting patients.
http://www.washingtonpost.com/world/africa/liberia-already-had-only-a-few-dozen-of-its-own-doctors-then-came-ebola/2014/10/11/dcf87c5c-50ac-11e4-aa5e-7153e466a02d_story.html

The French ministre de la santé, Marisol Touraine, has been as bad as the CDC director Thomas Frieden, showing the same opacity and blithe dismissal.  Most recently, under pressure, she has said she is “considering” clamping down on direct flights from Conakry.  Well, not actually clamping down -- not actually banning the flights;  but anyhow taking the passengers’ temperature after they arrive in France and it’s too late.
The workers aren’t buying it.

Le syndicat national des professionnels infirmiers dénonce lundi l’«omerta» des pouvoirs publics sur Ebola.
http://www.lesechos.fr/economie-france/social/0203853766757-france-un-syndicat-dinfirmiers-denonce-lomerta-sur-ebola-1053003.php

Frieden’s recent foot-in-the-mouth statements were particularly egregious.   Naturally, health-care workers are “bristling” that he (seemingly) blamed the nurse -- e.g.

This healthcare worker risked their life and according to the hospital they worked for she was wearing the required PPE. Why would any healthcare worker want to care for these or any other infectious patient when the CDC will blame the healthcare worker for their contraction of the disease. Why take care of these patients and potentially die? Would you want your legacy to your children to be “breach of protocol”


Actually, his verbiage was so vague that it was unclear whom or what he was blaming;  but really it was worse than that.   If breach there was, by all means lay it out, so that the same mistake won’t be repeated.   But he did not follow through with any details at all;  and apparently, he was talking out of his fundament:  they still don’t know what went wrong.   (As another reader commented, “A breach in protocol … or a protocol that’s broken?”)  Thus, quite apart from any, let us say, lack of bedside manner, the CDC chief’s approach is intellectually quite worrisome as well.



Pushback from a physician:

Officials had previously never made it clear that the 48 people being evaluated did not include those treating him after his admission to the hospital.
Dr. Joseph McCormick, regional dean of the University of Texas School of Public Health in Brownsville, said he was shocked that none of those monitored by officials were hospital workers caring for Mr. Duncan after he was put in isolation. Dr. McCormick worked for the C.D.C. in 1976, when he helped investigate the first epidemic of Ebola in central Africa.
“You know that once this guy is really ill and he’s hospitalized, there’s going to be a lot of contact, manipulation of blood specimens, cleaning up if he’s vomiting or if he’s got diarrhea,” Dr. McCormick said. “You certainly can’t assume that because he’s hospitalized and in this unit that everything is fine and everything that goes on will be without any risk. I mean that’s just ludicrous to think that.”
http://www.nytimes.com/2014/10/14/us/dallas-nurse-ebola-patient.html



Acronym note:
Although usually referred to as “CDC”, the full and official name of the agency is “CDCP”:  Center for Disease Control  and … Propagation?

(or is it "Conservation and Propagation" ?)



[Update 31 October 2014]  A reader’s comment, more cogent than the original article:

Suzanne
Brooklyn, NY
At the risk of sounding like I am from the Dark Ages or being identified with a denier of climate change, I would like to point out 3 contradictions in all of this. I am sure there are more.

It seems like the same people who think that politicians shouldn't be making medical decisions are fine with a judge making medical decisions, as long as the decision falls to their side. Shouldn't their position STILL be that the decision should be in the hands of the doctors, not judges??

I also still do not see why it should matter whether a human being is a "hero" or not in making the judgment whether that human should be quarantined (I'm not sure what the "science" says on this, but I would bet that viruses are not too concerned with distinguishing their altruistic hosts from non-altruistic ones). I have heard Obama and other health experts making this argument, saying "we shouldn't punish our heroes," when the moral qualities of the person really should have nothing to do with that decision.

Finally, would the outcome have been different if instead of riding her bike in remote Maine, the nurse was taking the subway or working closely with children or people with impaired immunity? Shouldn't the law take all situations into account (the law needs to suit the general situation and not be tailored to each individual situation). Looking back, how should the New York doctor have behaved?

http://www.nytimes.com/2014/11/01/us/ebola-maine-nurse-kaci-hickox.html?&target=comments&hp&action=click&pgtype=Homepage&modref=HPCommentsRefer&module=second-column-region&region=top-news&WT.nav=top-news#commentsContainer

And:   Liberal Canada just relocated its mislaid man-card, and is issuing no more visas to travelers from the infected countries.



[Update 20 April 2015]
Signs Ebola Spreads in Sex Prompt a C.D.C. Warning
They were acting on evidence suggesting that a Liberian man who recovered from Ebola might have transmitted the virus to his female partner many months later. Ebola genetic material was found in a semen sample the man provided 175 days after he developed symptoms, 74 days longer than ever before found in a survivor.
http://www.nytimes.com/2015/04/20/world/africa/signs-ebola-spreads-in-sex-prompt-a-cdc-warning.html

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