Two Ebola patients flying to Atlanta? Is this a good idea or reckless?

In My Humble Opinion
41

IF a flight crew refused to work the flight, would they get fired and would refusing the flight be a legitimate firing offence or would the person have the ability to take htem to court for being fired?

It is probably being pitched right now. God help us.

And the people at Los Alamos were ‘smart people’ and someone thought it was a great idea to taunt h\a\p\p\y\ \f\u
\ \b\a\l\l the Demon Core by positioning a screwdriver between the 2 halves of the plutonium ‘ball’ that ultimately was to go in the ‘bomb’ used in the Crossroads nuke bomb test while raising and lowering the halves in a ‘hands on criticality test’. Death by irradiation is particularly nasty.
And the below:

And my dad died of an antibiotic resistant bug he picked up in hospital, your point being?..

While I do realize that the humanitarian thing to do is bring them home so their families can watch them bleed out through their skin and every available orifice through the isolation room windows … while more or less the only treatment is pallative. I am still not happy at importing something other than a sealed vial of material to be tested. People and equipment screw up. Unfortunately this is not a movie, and real people can get ill and die.
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42

The death rate with medical treatment in a third-world country is less than 60%. Given first-world treatment, hopefully these two have a better than even chance of living. Apparently the “bleeding from all orifices” is rare. The hemorrhagic bleeding usually takes place in the GI tract.

One thing I didn’t know is that male survivors can transmit it in their semen two months after recovery. I’d guess that would make other bodily fluids suspect for that length of time, too.

StG

43

How interested are you knowing that in 1996, unknown to anyone, 2 primates at a private quaratine facility had an Ebola type virus. Consequently this lead to a potential exposure to 48 other primates and 8 facility employees.

Ebola-Reston Virus Infection Among Quarantined Nonhuman Primates -- Texas, 1996](http://www.pinterest.com/pin/create/extension/)

44

This is how I feel. I’m sympathetic to the patients, and their families, but heck no these people should not be allowed back into the US. If they survive, and if at some point in the future it can be demonstrated that they pose no danger to the public, then they should be able to come back.

45

Maybe, but consider that TB is contagious and deadly and many immigrants/refugees are carriers and are given entry to the US.

Now that may speak to a need in quarantining all immigrants for X days but it does show that deadly contagious diseases already circulate without any kind of protective measures this case is afforded.

46

I understand the need to study this disease and get first hand experience with Ebola patients. I just wish a lab and treatment facility had been built well away from population centers. The facility could deal with and quarantine patients with multiple epidemic diseases.

47

Don’t worry, the CDC never fucks up.

48

First off, WTF kind of leading poll question is that? Sounds like you did a cut and paste straight off a FoxNews or National Enquirer feed. Anytime I see “America’s Heartland” used it is almost always either patronizing, or part of a statement designed to frighten.

Secondly, my ex-wife is a microbiologist in the lab at Emory. She has had numerous exotic, lethal, and contagious specimens come across her lab bench. You know what’s different about this one? Fucking media coverage.

As for transport, helicopters routinely land on the helipad on the roof of the hospital. Jesus flipping Christ people.

49

Eh… “The Hot Zone” is a scarier read about basically the same thing.

50

This is pretty much where I come down as well. I think the odds that anyone will be lax enough to let it escape at all will be vanishingly small and I think the likelihood of an actual outbreak would be a vanishingly smaller subset of that.

51

These people are US citizens. By what right can we tell them they can’t come home. Are we dumping them on Liberia? Maybe we can send Liberia all our HIV/AIDs patients, all our TB cases, and all our unvaccinated children?

StG

52

This is much harder and less effective than you imagine it to be. The advantage of putting these containment units in a major hospital is that virtually all supplies are quickly accessible. Barring a major supply issue, this unit will not run out of lab supplies, protective equipment, or medicines. This is not the case for an off-shore containment unit. Plus, 99.9% of the time this unit is not in use. Do you staff the off-shore site for all of that time, twiddling their thumbs for all of that time? Alternatively, shutting it down in between uses will result in delays getting it ramped up for use and those delays can be deadly in these situations.

I work at Emory and I’m not hearing anyone worried about it here. Our colleagues, the hospital, and the University are well versed in how to handle these situations and very competent. If we aren’t worried, you definitely shouldn’t be.

53

doesn’t sound like it’s happening right away; the only update I found today was this

from the charity Dr. Brantly works for

*Dr. Kent Brantly and Nancy Writebol remain in serious condition in Liberia as medical evacuation efforts are underway to bring the two Americans stricken with the Ebola virus out of the country for treatment.

“We are grateful that Kent Brantly and Nancy Writebol made it through the night,” Samaritan’s Purse President Franklin Graham said. “They remain in serious condition. The medical evacuations could be complete early in the week.”*

by next week it might not be an issue.

ETA - I voted they should be brought to the US, assuming their doctors think they can travel

54

Was your dad in the habit of breaking in to high security isolation units and having close person contact with the patients?

If not, he would be safer surrounded by Ebola victims than regular patients.

The idea that this is a general threat is high ignorance. Ebola is spread by close personal contact. It is not an epidemic threat in areas with modern medical facilities and public health surveillance mechanisms. Ebola is scary, but it’s pretty well understood.

55

This is how every plague horror story begins.

There also seems to be something going on with the disease itself; heretofore, ebola was so lethal that it was nearly self-containing. Now it’s apparently more virulent but just enough less lethal to allow a faster and sustained spread that bypasses experienced control measures.

I vote for “war-criminally reckless” to move the outbreak out of the area, much less to a new continent.

56

We’ll it’s how every summer zombie movie starts I guess. Maybe not the best basis for coming up with a medical protocol though.

57

Uh. The difference is that previous outbreaks were in rural areas. It’s pretty easy for any disease to be self contained when you are in a remote area with low population. People pretty quickly either learn to stop touching the sick people, or they get sick and die. And there aren’t many health workers to infect- either the doctors get infected or they don’t.

This is the first urban outbreak. Urban areas have hospitals with a huge supply of health workers who can get sick. And the families come from disparate communities, so they are less likely to learn from each other.

But, in the US we are less likely to have those problems. We can afford to have healthcare workers work short shifts so they don’t skip safety precautions out of fatigue. We can effectively educate families, and there is zero chance we are going to return the infected body to them for burial. It’s just such a different situation than a place where doctors are working around the clock in bad facilities.

58

and healthcare can take place in air conditioning - so staff aren’t so wiped out by heat that they make a mistake while doffing the protective gear…

59

Okay. Just Being America and A/C make it all no problem. Got it.

Then again, there’s tonight’s headline about how the outbreak is spreading much faster than WHO expected and a general sense that “this time is not like the others.” Urban is one thing. Viral evolution is another. Let’s see what tomorrow’s news brings.

60

Well, yeah. Have you been to a West African hospital? They do not serve meals or provide laundry. This makes them lively, homey places while the patient’s families prepare food over open fires and hang the boiled sheets between the trees. Changing bandages, hygiene, keeping the room clean, etc. is done by families. Latrines will be limited, and most patients will use basins which are emptied and cleaned by hand. All of this provides ample opportunity for infection. This would not happen in the US, where patients would be kept in isolation units, anything they make contact with will be destroyed or professionally disinfected, and families will not be having close personal contact. And in West Africa, the bodies of deceased patients are handed over to the family, which would not happen here.

In the current Ebola facilities, they are hosing down the protective materials to be re-used immediately. Doctors are working long shifts, making them prone to forgetful actions like wiping their brow. In the US, doctors would likely work short shifts, maybe even less than 10 minutes. There would be little of the fatigue and mental/physical strain that is associated with healthcare worker infections. There is still opportunity for needle sticks and other failures that you can’t really do anything about, but right now most healthcare worker infections are fully preventable.

One problem is that early Ebola symptoms are non-specific. In West Africa, this is a problem because people may mistake Ebola for less serious diseases and almost anyone could be potentially exposed. But in the US there are relatively few people who will be possibly exposed-- just travellers, healthcare workers, and maybe some incidental contacts. You can bet each and every one of these will be tracked, and if one of them has a headache they are not going to write it off.

And if they do get a headache, they will be treated as a positive until they are proven otherwise-- which means they will be placed in isolation with full precautions. In West Africa, that is impossible. They cannot do that for everyone who has a headache.

Finally, survivors will be hospitalized until they are no longer infectious. This is not happening right now in West Africa, and there have been lost and escaped patients.

Literally no public health expert in the world thinks this is a threat to the US. These are people who get career advancement, funding and attention when they are working with a major, high-visibility threat. Think about how this story went from a side note to front page news after two Americans were infected. We care about stuff here. If Ebola was a serious problem for the US, these experts would likely become the biggest names in their field and awash with more funding that they could imagine for their dream programs. But, despite having every motivation in the world, they aren’t sounding the alarm. Why do you think that is?