“The drug is known as ZMapp and is aimed at boosting the immune system’s efforts to fight off Ebola and is made from antibodies produced by lab animals exposed to parts of the virus. It is made in tobacco plants at Kentucky BioProcessing, a subsidiary of Reynolds American Inc., in Owensboro, Kentucky, said spokesman David Howard. The plant “serves like a photocopier,” and the drug is extracted from the plant, he said.”
I’m surprise we haven’t seen more arguments like this.
Does anyone know if illness something that the government is legally allowed to use as a reason to deny US citizens their right to reentry into their country? It is my understanding that US citizens are legally entitled to reenter the country.
You have a knowledgeable physician with an incurable communicable disease. One of the top medical facilities and staff on the planet is administering a promising drug in a heavily controlled environment. Be grateful.
By statute, yes. But in theory Congress could prohibit you from leaving the country at all. The right to interstate travel is protected by the Constitution; the right to international travel is not.
Pre-9/11 attacks there were two acknowledged Biosafety Level 4 labs in the Unites States. The CDC in Atlanta, Georgia housed one such lab. Fort Detrick in Maryland was the home of the other, the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID). After 9/11, in the name of preparedness, there was a proliferation of BSL4 labs. Thusly there are samples of some really nasty pathogens all over the United States.
In 2004 there was a lab accident at USAMRIID, the Fort Detrick facility. A researcher suffered a needlstick injury while working with a sample of Ebola. She self-reported the incident and voluntarily entered quarantine. If she did not report the injury, its not like alarm bells would have gone off as she left the lab.
BSL4 labs attempt to engineer out, as much as possible, the risk of release or spread of one of these biohazards. But in the end it may come down to a decision by a researcher.
Did that needle go through all three layers of gloves and penetrate my skin? Let’s look. Crap, there are holes in all three layers of the gloves. But I don’t see any skin penetration. I didn’t feel anything. Could I have been exposed? Was I exposed?
The fraternity of virology researchers in such facilities truly understand the risks and, I believe, err on the side of caution. Would the general public?
The risk of a general release from the Emory facility is slim given they are working with known positive patients. The greater risk is like with the man being tested in New York. He came to the hospital after already feeling ill. If it turns out he has Ebola then he was likely infectious prior to arrival at the hospital.
Who was he in contact with prior to submitting himself at the hospital? What sort of contact did he have with friends and loved ones? Was he sweating during the cab/subway ride to the hospital? Did he wipe his sweat on the seat? How can we track his fellow airline passengers? Did any hospital personnel have unsafe contact prior to recognizing that he was a potential Ebola case?
But that’s ok. Media is telling us Ebola isn’t really all that contagious, right? Must take a big dose to cause an infection, right?
A dose of 1 to 10 viral particles administered in aerosolized form is [sufficient to spread Ebola](Clinical recognition and management of patients exposed to biological warfare agents.).
Wait just a minute. Ebola isn’t spread in aerosolized form naturally!?
Airborne transmission has been documented in animals and is suspected in human-to-human transmission, so say the researchers in those BSL4 labs.
At least Ebola virus doesn’t survive outside the body, right?
Unfortunately, Ebola virus can survive several days outside the host, either in liquid or in dried form. And Ebola remains infectious at room temperature for several days. (previous cite)
If that was the case there wouldn’t be 30 million dead from HIV. There is no way you can make the statement that it’s less of a threat by bringing it across the ocean. It’s simply a false statement.
That’s the point. 30 million dead from HIV because precautions weren’t taken even when it was obvious what the chain of transmission was. Needle sticks occur. People ignore warnings and medical attention.
Per Wiki it is not entirely clear how Ebola is spread. 2 people who knew the protocols still contracted the disease. whether they made a mistake isn’t really material. However they got the disease it can occur in the US. Treating the disease on-site removes the possibility of spreading it.
Just noticed, a completely meaningless observation that does nothing other than call attention to random chance… Nancy Writebol.
Well that’s a pretty serious bit of word twisting on your part. The question is whether or not we should bring in known cases. Keeping people out of the country who are known carriers prevents transmission of the disease from those kept out of the country. But you knew that.
Yes, and the main point of the thread was whether it was reckless or not to bring these two known patients here. Considering they already do research with the disease here, I see them as part of ongoing research, and they and everyone around them would be looked at closely and monitored.
The HIV epidemic is not a valid comparison. With HIV, especially early in the epidemic, infected individuals could be spreading the disease for years before they had any symptoms or even knew they were infected. That’s years of travel, medical care, blood donations, new sexual partners. All with no clue that they may be infectious.
Ebola, on the other hand, is not infectious until the infected individual is symptomatic. At that point, the person either seeks medical care or self-quarantines (happening in Africa due to fear of the healthcare system). At that point, it’s pretty obvious that the person is infectious. The rate of transmission in Africa is largely due to lack of appropriate protective equipment for healthcare workers, the use of family to care for patients in the hospital (with no protective equipment), patients being cared for at home to avoid hospitals, and families performing their own burial practices including washing the body. None of these issues will apply to Brantly or Writebol.
Yes, accidents could happen, but there is a huge team caring for two patients. No one is ever alone. If an accident occurs, it will be reported and the affected individuals will be quarantined. They are hyper aware of the potential for error and taking every possible precaution.
It sure isn’t word twisting: you appear to be backpedalling on your statements which speak for themselves. Which is an improvement from digging in and refusing to acknowledge any errors you have made elsewhere, I grant you that.
this is just a circling argument. Per the wiki article the method of transmission is not fully known. The people in question used the standard protocols and still got infected. Flights to the region are being cancelled because of the threat. The disease is best managed by bringing treatment to the infected which is what was done.
The most effective effort to stem the tide of global contamination is to localize the treatment and contain it at the source.
There is no ambiguity with what I said. They can’t contaminate anyone in the United States if they aren’t transported here.
Yes, they can. Because isolation and surveillance systems in West Africa are inadequate, there is a possibility they can spread it to someone who travels to the US and spreads it to the general population (where it is unlikely to get far, but that is another story.)
Right now, there is basically zero risk of them spreading it to the general population.
Both are pretty small risks, but bringing them here reduced risk AND doesn’t leave our heroes to die alone far from home.
They weren’t brought to the US because it in some way lowered the overall risk of transmission. Removing two people from an outbreak of over 1000 won’t change the risk of spread. They were brought to the US because we don’t leave Americans in trouble overseas if we can help it. We don’t leave soldiers in the field or reporters in North Korean jails. These people risked their lives to help others much less fortunate than us. If we can help them, we should. Their safety and prognosis is better in the States. In addition, the safety of the physicians caring for them is greater in the US compared to sending the same docs to Liberia. Does bringing them here present a risk of local transmission that otherwise didn’t exist? Sure. But what we are saying is that the risk is very small, much smaller than the transmission risks we know for this disease in an African setting. It is certainly not great enough that we abandon our citizens to die.
What we should be concerned about is someone arriving by plane without knowing they are infected. That person presents a reasonable risk of transmission to others in the US. Still less than in Africa, but greater than Brantly and Writebol. Now that confirmed cases are in Lagos, it’s only a matter of time before one lands in the US.
Such a wonderfully unprofound statement: I’ll also never lose a boxing match against Mike Tyson if I never step in the ring.
The fact is that there is consensus in the medical community that bringing two patients to one of the world’s most advanced medical research facilities isn’t going to cause an outbreak here. But you read something on wikipedia and jump to the conclusion that the world’s best physicians and medical researchers don’t know what they are talking about.
By the way, have you noticed that the first patient arrived in the US by airplane on Saturday, and the second patient arrived on Tuesday? In your view, why did it take four days to transport the second patient? I recall you saying several times that it only takes 20 minutes to get a plane ready to take off.
As noted, HIV is contagious in asymptomatic carriers - ebola is not.
Also, do you seriously expect to compare doped-up drug addicts screwing up sterile protocols with needles and injections with trained, sober medical personnel?
HIV spread a lot due asymptomatic carriers and the fact that the average schmoe can not be relied upon to maintain sterility when self-injecting. There is also the dual problem of a lot of men not liking condoms, not knowing how to use condoms for maximum effectiveness, and condoms breaking.
On the other hand, people with ebola who are contagious are obviously sick, with high fevers and vomiting/diarrhea. It’s a lot harder to miss them, and people are a lot less likely to have sex with them.
By that rationale we should never have any airplane accidents. People make mistakes even when safe procedures are known! People make mistakes! Airplanes break! It’s an outrage and an unreasonable risk!
Pilots who know procedures still have accidents… and your point is…?
Even the best medical people get needlesticks from time to time. It’s an occupational hazard. Working in the real world a hazmat suit can tear if you brush up against something sharp, opening up another opportunity for infection.
Researchers have worked with ebola in US laboratories for a couple decades now. The virus is already here. Yet there has been no outbreak. As others have said, the risk is FAR higher from random traveler arriving from Africa than a known positive patient privately transported under very strict safeguards.
Which is not practical when the infected are located in the part of the world with a crap medical infrastructure.
There is no “tide of global contamination”. That just doesn’t exist at this point. It’s an outbreak. It’s larger than prior outbreaks and there is concern it is in a large urban area now but using “tide of global contamination” is basically lying to your audience.
And the fact is, we can’t “localize treatment and contain it” without knowing about the disease. That requires research. Research is better done in a modern lab setting with reliable power, clean water, and ample supplies rather than a “hospital” that is little better than a bare cinderblock shed.
this right here - good for you, Red Stilletos
as Broomstick points out - you are either not understanding or not caring about reality with saying this - the outbreak is out of control because of conditions in poor countries.
fear mongering doesn’t help anyone. :mad:
And since Mike Tyson lives in Vegas the odds are you will never have to fight anyone, ever. Epidemic averted.
It’s been pointed out above, but bears repeating. Let’s compare working in the field in Africa with Emory:
Field:
- endless sequence of patients
- understaffed (both doctors and technicians)
- >100 degrees F temperatures, sustained, with high humidity
- insufficient supplies and clean water
- makeshift facilities
- conditions that make following procedures 100% nearly impossible
Emory:
- two patients
- far, far more doctors and technicians available than patients
- the world’s best in terms of supplies, facilities, personnel
- staff breathing down everyone’s neck to make sure that procedures are followed 100% and exceeded whenever feasible.
If risk to the Emory staff was the only factor, even infinitesimal risk, you’d be right. As usual with reality, we have to balance risk against other factors, not the least being risk to the patients, and the message it would send to other doctors who might be considering going to Africa to help.
The biggest risk to America is not these two patients. It’s the epidemic in Africa. Let’s fix THAT and not worry about what the CDC has calculated as a relatively insignificant risk in transporting the two patients to Atlanta.
You evidently don’t understand the virtues of a fast incubation period for both of the arguments.
First, a fast incubation period definitely is in sven’s favor for comparing HIV with Ebola. I’ll assume you understand that, and conclude that you’re talking about the original argument, which is bringing the patients to America. A short incubation helps there too, because it means the quarantine period to be sure that nobody has caught the disease is smaller. It’s far faster to figure out whether the disease has spread.
If the incubation period were 10 years, would your position be to require all the doctors to stay away for 10 years?
What you say doesn’t follow. The reason for 30 million HIV deaths is primarily because most cases were caught before anyone even knew the disease existed, because of its very long incubation period.
A long incubation period is hell, from a epidemiological / disease control standpoint. It’s the worst possible case.
You’re correct if your argument is limited to “Ebola is more likely to spread from Emory if they don’t bring patients to Emory.” But, as I said above, the biggest threat is spread from Africa. What’s the best way to reduce that threat? By getting the epidemic under control. What do we need for that? Doctors and technicians willing to go, knowing they’re taking grave risks, but knowing that we in America have their backs, and are willing to take minuscule risks in their support.
Of course it is, as are the ridiculously difficult conditions under which those accidents occurred.
Can, but won’t.
No, it removes the possibility of those two people spreading it, while quite likely hindering the overall effort, by giving potential doctors and technicians a big disincentive to go to Africa.
When assessing risks, don’t be penny-wise and pound foolish.
Failure to bring the two back to the US for care at Emory would be very bad risk assessment, as it would increase the likelihood of a global outbreak for the benefit of eliminating an infinitesimal risk.