Ebola outbreak in Dallas Texas.

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**Chongara**

Dreadclaw69 wrote:

Still waiting on a source for this

Your demand for sources on basic human behavior is somewhere between laughable and worrying, but wholly entertaining in either case.

**Jihadin**

As it happens, the Supreme Court’s discussions of the permissibility of quarantines has been mostly in the preemption contexts, going back to the landmark dormant commerce clause case, Gibbons v. Ogden in 1824. (A quarantine is by definition a prophylactic measure that applies to those who are not necessarily sick of infected.) The Court has ruled strongly against any kind of implied preemption for quarantines. Rather, it has said that unless the federal government adopts quarantine laws or regulations inconsistent with those of the states, “the laws of the state on the subject are [presumptively] valid.”

http://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/10/28/ebola-quarantines-and-state-powers/

One can always add but never take away. All that Coumo and Christy did was add on top of Federal Law. All nine states are within their legal right to act as they see fit on handling the situation until the Federal Government actually comes up with a SOP/Regulation on handling something

**Ouze**

ScootyPuffJunior wrote:
It's also a borderline breech of rights too..

Yeah, what's going to happen when a health worker is in Liberia, comes back asymptomatic, get put in quarantine anyway, and then they file a writ of habeas corpus? I think it's an open question when no state of emergency has been declared (I know one has in a few jurisdictions).

Automatically Appended Next Post:
Aw I got ninja'd.

**d-usa**

http://www.cbc.ca/m/news/health/ebola-volunteer-work-not-for-everybody-canadian-doctor-says-1.279562

The average deployment length by MSF volunteers for treating Ebola is 5 weeks, adding 3 weeks to that will add a significant burden to volunteers. They will require an employee that is willing to let an employee miss an additional 21 days of work, they will require to find help to take care of their homes/animals/families, and they will have the added psychological stress of being away from friends and family.

It doesn't take a leap in logic to figure out that this has a real potential at affecting volunteer rates.

**Ouze**

Oops, please disregard, I forgot Alpharius said to knock it off for a second.

**Frazzled**

Alpharius wrote:
People's fee fees?

I'm not sure what you're trying to say there, but it did make me laugh!

Waiter there's fee fee in my soup!

Automatically Appended Next Post:

Ouze wrote:
ScootyPuffJunior wrote:
It's also a borderline breech of rights too..

Yeah, what's going to happen when a health worker is in Liberia, comes back asymptomatic, get put in quarantine anyway, and then they file a writ of habeas corpus? I think it's an open question when no state of emergency has been declared (I know one has in a few jurisdictions).

Automatically Appended Next Post:
Aw I got ninja'd.

Nothing will happen. Quarantines are settled law.

**Ouze**

Frazzled wrote:
Quarantines are settled law.

I say this with absolutely no sarcasm - what is the citation for that? Did it apply to someone not actually sick?

**Jihadin**

d-usa wrote:
http://www.cbc.ca/m/news/health/ebola-volunteer-work-not-for-everybody-canadian-doctor-says-1.279562

The average deployment length by MSF volunteers for treating Ebola is 5 weeks, adding 3 weeks to that will add a significant burden to volunteers. They will require an employee that is willing to let an employee miss an additional 21 days of work, they will require to find help to take care of their homes/animals/families, and they will have the added psychological stress of being away from friends and family.

It doesn't take a leap in logic to figure out that this has a real potential at affecting volunteer rates.

One volunteers knowing the risk regardless. They're going in eye's wide open knowing what they're dealing with and what might happen if they have signs of a possible Ebola infection upon arrival back in the US. Those volunteering now already know what states have strict guide lines on possible Ebola infection. Means they will not fly back into the US involving those states.

**Ouze**

I found the case for my earlier question.

**Dreadclaw69**

d-usa wrote:
I can't source common sense for you.

For someone demanding studies earlier I'll let you work out the irony there. Common sense dictates that if you care about your fellow people, and are devoted to stopping the spread of Ebola, then you should not adverse to common sense precautions that prevent the virus from leaving the hot zone. YMMV.

d-usa wrote:
I didn't I next politics into the discussion between us. This has nothing to do with your political leanings or my political leanings. I'm saying that I think that politicians are looking at politics instead of science when making some of those decisions.

If you think that politics has no influence on their decisions then more power to you.

Yes you did. I most certainly did not talk about political considerations. You explicitly brought up the Mid-Terms and "political pandering".

**Frazzled**

Ouze wrote:
Frazzled wrote:
Quarantines are settled law.

I say this with absolutely no sarcasm - what is the citation for that? Did it apply to someone not actually sick?

I'm from the government, and I am here to help:
http://www.cdc.gov/quarantine/specificlawsregulations.html

**Ouze**

Well, that certainly answers that. Thanks.

**Dreadclaw69**

d-usa wrote:
But hey, let's listen to idiot politicians instead of the medical community.

In case you forgot the CDC cleared a nurse who developed a fever after the Dallas case to fly on a commercial airline, and who admitted mistakes in how Duncan's treatment was handled. And that a leading expert in treating the disease died from it. But keep reminding us that they are the experts, and that politicians voicing their constituents' concerns are "idiots".

**d-usa**

Dreadclaw69 wrote:
d-usa wrote:
I can't source common sense for you.

For someone demanding studies earlier I'll let you work out the irony there. Common sense dictates that if you care about your fellow people, and are devoted to stopping the spread of Ebola, then you should not adverse to common sense precautions that prevent the virus from leaving the hot zone. YMMV.

Highlighted the important portion for you.

Storing people in quarantine for a disease that cannot be transmitted while asymptomatic, is easy to monitor for symptoms, and is hard for the general public to catch even after you become symptomatic (as evidenced by a current transmission rate of zero) is not common sense.

d-usa wrote:
I didn't I next politics into the discussion between us. This has nothing to do with your political leanings or my political leanings. I'm saying that I think that politicians are looking at politics instead of science when making some of those decisions.

If you think that politics has no influence on their decisions then more power to you.

Yes you did. I most certainly did not talk about political considerations. You explicitly brought up the Mid-Terms and "political pandering".

Are you a politician? Are you running for office in the mid-terms? Are you a decision maker with regards to public policy who is appointed in a partisan matter?

No? Then nothing I said has anything political to do with your argument.

You know, it is entirely possible for me to think that somebody makes a political decision without painting everybody else that disagrees with me as partisan political hacks.

**Frazzled**

Military is quarantining returning troopers for 21 days from the region, in Italy evidently. now thats a quarantine baby!

**d-usa**

Dreadclaw69 wrote:
d-usa wrote:
But hey, let's listen to idiot politicians instead of the medical community.

In case you forgot the CDC cleared a nurse who developed a fever after the Dallas case to fly on a commercial airline,

Please tell me, how many new cases of Ebola were caused by a non-symptomatic nurse flying on a commercial airline?

and who admitted mistakes in how Duncan's treatment was handled.

The Hospital did not follow CDC guidelines when they send him home the first time, and it didn't result in any new cases.

It is unknown if the guidelines, which were since revised, resulted in two people getting the disease.

And that a leading expert in treating the disease died from it.

Wow, it's almost like situations are different when you talk about a person actively treating people that are very sick versus a situation in which asymptomatic patients are being monitored.

But keep reminding us that they are the experts, and that politicians voicing their constituents' concerns are "idiots".

When a politician keeps on referring to a healthy person as "obviously ill" and telling the press "that he hopes she recovers quickly" then I will consider him an idiot.

**Dreadclaw69**

d-usa wrote:
Dreadclaw69 wrote:
d-usa wrote:
I can't source common sense for you.

For someone demanding studies earlier I'll let you work out the irony there. Common sense dictates that if you care about your fellow people, and are devoted to stopping the spread of Ebola, then you should not adverse to common sense precautions that prevent the virus from leaving the hot zone. YMMV.

Highlighted the important portion for you.

Storing people in quarantine for a disease that cannot be transmitted while asymptomatic, is easy to monitor for symptoms, and is hard for the general public to catch even after you become symptomatic (as evidenced by a current transmission rate of zero) is not common sense.

And people can become symptomatic at pretty inconvenient times. Looking at the doctor in New York (coffee house visits, subway trips, jogging, bowling alley) and the nurse allowed to fly commercially with a fever (and thus potentially infect others through droplet infection) there is more luck than skill that the transfer rate is so low.

d-usa wrote:
Are you a politician? Are you running for office in the mid-terms? Are you a decision maker with regards to public policy who is appointed in a partisan matter?

No? Then nothing I said has anything political to do with your argument.

You know, it is entirely possible for me to think that somebody makes a political decision without painting everybody else that disagrees with me as partisan political hacks.

Whether or not I am a politician is immaterial and wholly irrelevant. I asked about the use of a quarantine as a precaution for further transmission and you took a political angle saying that the idea was "political pandering", so yes you injected politics into the discussion as an attempted rebuttal to my question.

**d-usa**

Dreadclaw69 wrote:
d-usa wrote:
Dreadclaw69 wrote:
d-usa wrote:
I can't source common sense for you.

For someone demanding studies earlier I'll let you work out the irony there. Common sense dictates that if you care about your fellow people, and are devoted to stopping the spread of Ebola, then you should not adverse to common sense precautions that prevent the virus from leaving the hot zone. YMMV.

Highlighted the important portion for you.

Storing people in quarantine for a disease that cannot be transmitted while asymptomatic, is easy to monitor for symptoms, and is hard for the general public to catch even after you become symptomatic (as evidenced by a current transmission rate of zero) is not common sense.

And people can become symptomatic at pretty inconvenient times. Looking at the doctor in New York (coffee house visits, subway trips, jogging, bowling alley)

He was not symptomatic during any of these.

and the nurse allowed to fly commercially with a fever (and thus potentially infect others through droplet infection) there is more luck than skill that the transfer rate is so low.

Low grade fever, so very questionable. Also not showing any symptoms that would result in shedding of viruses.

Viruses leaving your body is one of those pesky requirements for them to be able to enter another body.

And fever doesn't cause droplets, it's one of those pesky science facts.

d-usa wrote:
Are you a politician? Are you running for office in the mid-terms? Are you a decision maker with regards to public policy who is appointed in a partisan matter?

No? Then nothing I said has anything political to do with your argument.

You know, it is entirely possible for me to think that somebody makes a political decision without painting everybody else that disagrees with me as partisan political hacks.

Whether or not I am a politician is immaterial and wholly irrelevant. I asked about the use of a quarantine as a precaution for further transmission and you took a political angle saying that the idea was "political pandering", so yes you injected politics into the discussion as an attempted rebuttal to my question.

I think that the people that made the decision made it for political purposes. The science doesn't back it up, and there are less restrictive alternatives that are effective.

You can talk about stuff like that, it's okay, it doesn't make the science any less valid or the effective alternatives any less effective.

**whembly**

Again... let's have a process in place to have a luxurious quarantine location.

That'll solve it.

Go spend 5 weeks helping your fellow man, then come back and have a 3-weeks Spring Break.

**d-usa**

whembly wrote:
Again... let's have a process in place to have a luxurious quarantine location.

That'll solve it.

Go spend 5 weeks helping your fellow man, then come back and have a 3-weeks Spring Break.

Yeah, because my job is totally going to always be willing to give me an 8 weeks sabbatical instead of a 5 week sabbatical, and the additional 3 weeks of paid leave I need to cover my time on "vacation" is going to appear out of nowhere.

And are we going to quarantine the staff working there? And then the staff working at the maybe just a little less nice resort where they will be quarantined? Where will the infinity-loop end?

Which again is in addition to the fact that it is not required in the first place.

**Dreadclaw69**

d-usa wrote:
Please tell me, how many new cases of Ebola were caused by a non-symptomatic nurse flying on a commercial airline?

Non-symptomatic? She had a fever, as one of the symptoms of Ebola does this not make her symptomatic?
Are you saying that CDC was right to permit her to fly with a fever after treating an Ebola patient?

d-usa wrote:
The Hospital did not follow CDC guidelines when they send him home the first time, and it didn't result in any new cases.

It is unknown if the guidelines, which were since revised, resulted in two people getting the disease.

http://www.cbsnews.com/news/ebola-virus-response-in-dallas-had-mistakes-cdc-admits/

But now, the Centers for Disease Control and Prevention (CDC) is admitting that mistakes were made, reports CBS News correspondent Mark Strassmann.

The CDC has gotten a lot of criticism, especially from nurses in Dallas who said they had neither the proper training nor equipment to treat Ebola patients.

Even the agency has criticized its own initial response and is now taking steps to correct its mistakes.

When Thomas Eric Duncan was diagnosed with Ebola on September 30, CDC Director Dr. Thomas Frieden was confident about containing the Ebola threat.

"Virtually any hospital in this country that can do isolation, can do isolation for Ebola," he said. "We have no doubt that we will stop it in its tracks in Texas."

Duncan died October 8 and two of his nurses now have the virus.

More than 100 other people may have been exposed.

"As far as I can tell, there wasn't training there," professor of epidemiology at Columbia University's Mailman School of Public Health Stephen Morse said. "The CDC could have helped with that, but I think they didn't realize how large the gap was."

The agency now admits a mistake. Its rapid-response team should have been mobilized to Dallas right away to help train the staff caring for Duncan, something the agency said it will do from now on.

The CDC wants to better prepare U.S. clinicians to treat Ebola patients while also protecting themselves.

Oh look, the CDC admitted they made mistakes.

d-usa wrote:
Wow, it's almost like situations are different when you talk about a person actively treating people that are very sick versus a situation in which asymptomatic patients are being monitored.

You mean like all those medical workers abroad treating Ebola patients? You know, the ones exposed to the virus. The ones who have multiple instances of contracting it even though they have the right training?

d-usa wrote:
When a politician keeps on referring to a healthy person as "obviously ill" and telling the press "that he hopes she recovers quickly" then I will consider him an idiot.

You hear that noise? That is the sound of the goal posts shifting. You went from "idiot politicians" to "an idiot". So what happens if we extend that logic to the entire CDC and judge them on an isolated example? You know, like not obeying their own guidelines on storing anthrax and smallpox?

**Jihadin**

They can always pick up a "Traveler" to take your place and we both know that

**whembly**

d-usa wrote:
[
Which again is in addition to the fact that it is not required in the first place.

The point isn't the fact that it *may* not be required...

But, how much we're willing to *risk* it. Know what I mean?

**d-usa**

Dreadclaw69 wrote:
d-usa wrote:
Please tell me, how many new cases of Ebola were caused by a non-symptomatic nurse flying on a commercial airline?

Non-symptomatic? She had a fever, as one of the symptoms of Ebola does this not make her symptomatic?

Did she have a fever higher than the cutoff? Nope. So non-symptomatic. Also did not show any symptoms that would shed any actual viruses. A key requirement for being contagious.

Are you saying that CDC was right to permit her to fly with a fever after treating an Ebola patient?

I'm saying that there is no risk of an asymptomatic person flying. The guy with the flu 5 rows behind you is more of a risk to you than the non-symptomatic Ebola patient right next to you.

d-usa wrote:
The Hospital did not follow CDC guidelines when they send him home the first time, and it didn't result in any new cases.

It is unknown if the guidelines, which were since revised, resulted in two people getting the disease.

Oh look, the CDC admitted they made mistakes.

A) They still don't know if the old recommendations were to blame, or if the old recommendations were not followed correctly.
B) Changing recommendations based on current knowledge is one of the primary points of science and evidenced based care. It's also the complete opposite of quarantining people despite less restrictive and effective alternatives being available.

d-usa wrote:
Wow, it's almost like situations are different when you talk about a person actively treating people that are very sick versus a situation in which asymptomatic patients are being monitored.

You mean like all those medical workers abroad treating Ebola patients? You know, the ones exposed to the virus. The ones who have multiple instances of contracting it even though they have the right training?

Yes. It's completely different than all those people who have casual contact with asymptomatic Ebola patients who never get ill. And all those people who have casual contact with Ebola patients in the early stages who don't get ill because it's a very hard disease to catch. Saying "people who are elbow deep in the stool, emesis, and blood of people with advanced EVD get sick, so we should lock up non-symptomatic people for 21 days" doesn't make any sense because they are completely different situations.

Science is such a wonderful thing.

d-usa wrote:
When a politician keeps on referring to a healthy person as "obviously ill" and telling the press "that he hopes she recovers quickly" then I will consider him an idiot.

You hear that noise? That is the sound of the goal posts shifting. You went from "idiot politicians" to "an idiot". So what happens if we extend that logic to the entire CDC and judge them on an isolated example? You know, like not obeying their own guidelines on storing anthrax and smallpox?

**Jihadin**

Wonder if the Ebola Czar is up to date on everything..

**d-usa**

We are also pretending that the only two options are "just let them do whatever they want" and "lock them up for 21 days".

The argument against the quarantines is that there are less restrictive and effective alternatives available, not that you shouldn't do anything.

You can restrict flying. You can require mandatory checkups. You can require twice daily visits to monitor them. It is easy enough to follow asymptomatic patients.

If a mistake is made it is easy enough to rectify that and improve the current process.

Instead we went to this:

Which is just complete overkill and doesn't make any sense.

**Jihadin**

Safe then sorry mode. I like it

**whembly**

d-usa wrote:
We are also pretending that the only two options are "just let them do whatever they want" and "lock them up for 21 days".

The argument against the quarantines is that there are less restrictive and effective alternatives available, not that you shouldn't do anything.

You can restrict flying. You can require mandatory checkups. You can require twice daily visits to monitor them. It is easy enough to follow asymptomatic patients.

If a mistake is made it is easy enough to rectify that and improve the current process.

That's cool...

But, I'd still do that Luxurious Quarantine idea... it isn't exactly that wasteful™ in the whole scheme of things of Gubmint spending.

(ie, offer it, don't make it mandatory)
It'd be interesting to see if they'd take up on that offer...

**Jihadin**

Forgot that one apple that took it upon herself to break quarantine to get take out?

**ScootyPuffJunior**

This was an email I just received from MSF:

MSF wrote:Dear Friends,
Thank you for your support of Doctors Without Borders/Médecins Sans Frontières (MSF), especially during this unprecedented and trying time. We are hearing many kind words of encouragement from our supporters, as well as some questions and concerns. I would like to address these concerns, and also update you on our safety protocols and our current work to contain Ebola in West Africa.
As you likely know, Dr. Craig Spencer, a physician from New York who spent over a month treating patients in our Ebola project in Guekedou, Guinea, was diagnosed with Ebola on Thursday. He is currently receiving care at Bellevue Hospital in New York City. Although MSF is not in charge of his medical treatment, we are monitoring his progress, and hoping for his full recovery.
Prior to developing Ebola, Dr. Spencer used public transportation in New York City and visited several locations. This activity has been treated by some media and viewed by many people as irresponsible. Both MSF and Dr. Spencer have been criticized for putting New Yorkers at risk. For the thirty years we have been managing Ebola outbreaks, we have found our protocols effective at preventing the spread of the disease back to the homelands of our volunteers. In Dr. Spencer’s case, he followed MSF’s strict safety protocols and was placed in isolation before he was contagious. Dr. Spencer is a highly experienced medical professional who knows Ebola well. He would not put others at risk for a disease that he had just watched ravage his patients.
Ebola is frightening, but much more help is needed on the ground to stop this outbreak. Unnecessarily punishing healthy aid workers with mandatory quarantine upon their return home does not serve the public interest, but does make the commitment to go to West Africa more difficult for those who are willing and able to help. Combatting the disease at its source is the only way to curb this outbreak and prevent from spreading worldwide. MSF protocols governing returned health workers are driven by science and based upon the guidelines of international health agencies, notably the World Health Organization (WHO), the National Institutes of Health (NIH), and the US Centers for Disease Control (CDC). Diligent health monitoring of returnees from Ebola-affected countries is preferable to coercive isolation of asymptomatic individuals, as happened recently to one of our returning staff, Kaci Hickox.
The medical facts about how the Ebola virus is transmitted are validated by our own experience in the field and Ebola scientists around the world. Before an infected person is symptomatic, their viral load is too low for them to pass on the disease. Of the more than 700 international staff members who have worked in our Ebola projects during this outbreak, Dr. Spencer is the first, and thus far the only one who has shown symptoms after returning home.
As of October 23, MSF is operating six Ebola case management centers across Guinea, Liberia, and Sierra Leone, and providing some 600 beds in isolation, more than any other organization is today. Since the beginning of the outbreak in March 2014, MSF has admitted more than 4,900 patients to its treatment centers. Around 3,200 were confirmed as having Ebola and 1,140 Ebola patients have survived.
We ask you to stand by us as we call for a rational approach to handling the return home of medical staff from all organizations who volunteer to fight Ebola. Please read our Q&A to answer some of your questions about how we respond to Ebola outbreaks and the current situation in West Africa.
Also, please join us on Thursday, November 13 at 8:00PM EST for a webcast about the Ebola crisis and our response, featuring MSF leadership and field workers recently returned from West Africa. You will have the opportunity to ask your questions directly to our staff and panelists via an interactive chat feature. You can register here: https://ebolacrisiswebcast.eventbrite.com
Thank you again, sincerely, for your support.

Sophie Delaunay, Executive Director, MSF-USA