ScootyPuffJunior wrote:
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

 Jihadin wrote:

Highlighted the bold being

Someone needs to go through the 7 steps of problem solving then to identify where it went wrong for Doctor Spencer.

 ScootyPuffJunior wrote:

 Jihadin wrote:

Highlighted the bold being

Someone needs to go through the 7 steps of problem solving then to identify where it went wrong for Doctor Spencer.

Treating multiple violently ill and dying people in a hospital on the other side of the world.

I think it goes without saying (mainly because it's been said here dozens of times at this point) that medical professionals are going to be among the most vulnerable to this disease and any disease because of the nature of their work. This is a given and it's a risk they face every day.

 Jihadin wrote:

 ScootyPuffJunior wrote:

 Jihadin wrote:

Highlighted the bold being

Someone needs to go through the 7 steps of problem solving then to identify where it went wrong for Doctor Spencer.

Treating multiple violently ill and dying people in a hospital on the other side of the world.

I think it goes without saying (mainly because it's been said here dozens of times at this point) that medical professionals are going to be among the most vulnerable to this disease and any disease because of the nature of their work. This is a given and it's a risk they face every day.

Not good enough. One needs to find where it wrong in the procedure for Dr. Spencer to come up positive.
Did he break the procedure
or
was there a break in the procedure itself (as in whoever helping him de-gown either contaminated him or improper gowning happen before he went in to treat patients)

Right now it seems Dr. Spencer is at fault.

 ScootyPuffJunior wrote:

 Jihadin wrote:

 ScootyPuffJunior wrote:

 Jihadin wrote:

Highlighted the bold being

Someone needs to go through the 7 steps of problem solving then to identify where it went wrong for Doctor Spencer.

Treating multiple violently ill and dying people in a hospital on the other side of the world.

I think it goes without saying (mainly because it's been said here dozens of times at this point) that medical professionals are going to be among the most vulnerable to this disease and any disease because of the nature of their work. This is a given and it's a risk they face every day.

Not good enough. One needs to find where it wrong in the procedure for Dr. Spencer to come up positive.
Did he break the procedure
or
was there a break in the procedure itself (as in whoever helping him de-gown either contaminated him or improper gowning happen before he went in to treat patients)

Right now it seems Dr. Spencer is at fault.

Actually, that is good enough.

He isn't the first doctor from MSF to contract EVD and he won't be the last. I think you guys are failing to realize the difference between treating EVD in Africa under the conditions they are and treating it in America.

 d-usa wrote:
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.

 d-usa wrote:
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:
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:
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:
He's an idiot because he made it extra clear that he doesn't know what he is talking about.

Other people are idiots because they implement non-needed restrictions that will cause less people to travel and will result in less people getting treatment which will not do anything to help the spread of disease in Africa. And until we stop the spread in Africa nothing we are doing here will actually make a difference, especially not stupid decisions like these.

 Frazzled wrote:
There are reports that the administration is considering importing Ebola non-US Ebola patients. Thats 8 stages of crazy.

Automatically Appended Next Post:

Frazzled wrote:
There are reports that the administration is considering importing Ebola non-US Ebola patients. Thats 8 stages of crazy.

The basics of containing any disease is that you quarantine and isolate the patients. That means they stay in situ, and you move materials and manpower to them to help stop the spread of the disease. This is the opposite of that concept.

The Washington Post wrote:
Obama assails Ebola quarantines, saying they are based on fear, not facts

President Obama on Tuesday forcefully rejected the idea of a quarantine for medical­ workers returning from Ebola-affected­ countries, arguing that such an approach would undermine the broader effort to eliminate the epidemic .

Politicians in the United States, including the president, have come under increasing pressure to curtail the movements of medical personnel returning from Ebola-affected regions after Craig Spencer — a doctor who had been treating Ebola patients in Guinea — was diagnosed with the virus 10 days after he returned home to New York City.

While the president did not directly criticize New Jersey Gov. Chris Christie (R) and New York Gov. Andrew M. Cuomo (D) for imposing mandatory quarantines on health workers coming back from West Africa, he made clear that he thought those moves were a bad idea and were not based on the best medical information.

“We don’t just react based on our fears. We react based on facts and judgment and making smart decisions,” Obama said, just after placing a call to members of the U.S. Agency for International Development’s Disaster Assistance Response Team (DART), which has been in West Africa since the first week of August.

The notably assertive presidential response came as the country enters the final campaign stretch before next week’s midterm elections. While the president has sometimes refrained from taking on his critics, he took the unusual step of addressing the Ebola issue with reporters just before boarding Air Force One to depart for a campaign event in Wisconsin.

Calling the DART team “the strategic and operational backbone of America’s response” in the region, Obama said the effort was starting to have an impact, especially in Liberia.

“So we don’t want to discourage our health-care workers from going to the front lines and dealing with this in an effective way,” he said. “The point is this disease can be contained. It will be defeated.”

On Wednesday, Obama will convene a meeting at the White House with doctors and public health workers who have either returned from treating Ebola patients in Africa or are on their way there. The president said he convened the session not only to thank them “but to make sure that we’re getting input from them, based on the science, based on the facts, based on experience, about how the battle to deal with Ebola is going and how our policies can support the incredible heroism that they are showing.” Obama will be introduced by Kent Brantly, the missionary doctor for the group Samaritan’s Purse who became infected with Ebola in Liberia this summer but recovered after he received an experimental drug and was evacuated to Atlanta for treatment.

Obama’s comments came as the second Dallas nurse infected with Ebola has been cured and appeared at a triumphant news conference Tuesday to mark her release from Emory University Hospital in Atlanta.

“I’m so grateful to be well. First and foremost, I want to thank God,” said Amber Joy Vinson, 29, who was infected with the virus at a Dallas hospital while caring for Thomas Eric Duncan, the Liberian man who died of Ebola on Oct. 8.

Vinson added, “While this is a day for celebration and gratitude, I ask that we not lose focus on the thousands of families that continue to labor under the burden of this disease in West Africa.”

The recovery of Vinson leaves Spencer as the only person in the United States known to have an active case of Ebola. He remains isolated in what New York’s Bellevue Hospital Center said Tuesday was serious but stable condition.

A 5-year-old boy who had been admitted with a fever has been cleared of Ebola; his symptoms were caused by a respiratory infection, the New York hospital said.

The president, who spoke to Vinson by phone Thursday, said her recovery speaks to the success the U.S. medical system has had in containing the virus’s spread. “Of the seven Americans treated for Ebola, all have survived,” he said.

The numbers are catastrophically worse in West Africa, where, according to the latest numbers from the World Health Organization, there have been more than 10,000 cases dating to the beginning of the outbreak at the end of last year, and nearly 5,000 deaths.

There are, however, scattered signs of progress. In Liberia, according to the WHO, the number of new cases has dropped in recent weeks.

“I don’t think we’ve turned the corner, but it’s better than exponential growth of new cases,” Rajiv Shah, the administrator of the U.S. Agency for International Development, told The Washington Post after a recent trip to the region. But, he added, “In Sierra Leone we are not yet seeing the kind of trend shift that we’re seeing in Liberia. There’s an urgent need to scale up the effort in Sierra Leone.”

Helen Epstein, a writer specializing in public health who has been in Liberia recently, published an online article Monday in the New York Review of Books saying the decline in new cases there is dramatic, and suggesting that “many Liberians, who at first denied the epidemic was real, have come to their senses and changed their behavior by avoiding direct physical contact with sick or dead people.”

But there is still great uncertainty about the possible reach of the virus into remote areas and rain forests where disease surveillance has been limited. The official WHO statistics show minimal progress, and disease modelers continue to be concerned.

“Hard to know what’s really going on,” said Joshua Michaud, associate director for Global Health Policy at the Kaiser Family Foundation. “Maybe it’s only people looking for good news in an ongoing crisis, maybe reporting is worse than ever and we just don’t have good understanding, maybe people are staying away from the treatment units and cases aren’t being counted, or maybe community behaviors actually have changed in the face of the mounting toll to the point where transmission has been reduced.”

The virus has a history of subsiding, then flaring up again. For example, in Kenema and Kailahun districts in Sierra Leone, new cases dropped to zero for several weeks, but then more recently the districts had 23 and 10 cases, respectively, in a single week, the WHO reported.

Samantha Power, the U.S. ambassador to the United Nations, is touring the region and on Tuesday tweeted a positive bulletin:

“Just left Sierra Leone: good news in fight vs leading cause of Ebola infection: safe burials in Freetown have gone from 30% to nearly 100%.”

The head of the World Bank, Jim Yong Kim, said Tuesday that an additional 5,000 health-care workers are needed immediately to treat Ebola victims in the three countries most afflicted: Liberia, Sierra Leone and Guinea.

Speaking in Ethi­o­pia, where he was joined by U.N. Secretary-General­ Ban Ki-moon and African Union Chairwoman Nkosazana Dlamini-Zuma, Kim pleaded with African leaders not to close their borders at a time when the stricken countries need a massive influx of health-care workers.

On Tuesday, the three largest organizations representing U.S. hospitals, nurses and physicians endorsed guidelines issued by the Centers for Disease Control and Prevention that recommend state and local officials closely monitor but not quarantine returning health workers based on their level of exposure to Ebola.

Meanwhile, the Joint Chiefs of Staff made a formal recommendation Tuesday to Defense Secretary Chuck Hagel that he require all U.S. troops returning from West Africa to be subjected to 21 days of quarantine-like conditions. If approved by Hagel, the policy would essentially extend to all branches of the armed forces a decision made Monday by Gen. Ray Odierno, the Army chief of staff, to put several dozen soldiers returning from West Africa in isolation for 21 days at a base in Italy.

Speaking to reporters Tuesday, White House press secretary Josh Earnest said the civilian and military policies differed because there are “a couple of dozen health-care workers a week who are returning to this country from West Africa,” compared with “thousands of military service members who have been or will be deployed to West Africa to carry out the mission that the president ordered.”

“It would be wrong to suggest that it would make the American people safer to apply this military policy in a civilian context,” Earnest said. “The science would not back that up.”

According to Capt. Carter Langston, an Army spokesman in Monrovia, there are now more than 700 U.S. personnel in West Africa.

 Frazzled wrote:
Yet his own military-which he directly controls-has implemented a 21 day quarantine.

 Frazzled wrote:
Yet his own military-which he directly controls-has implemented a 21 day quarantine.

“It would be wrong to suggest that it would make the American people safer to apply this military policy in a civilian context,” Earnest said. “The science would not back that up.”

White House Press Secretary Josh Earnest said Monday that the Defense Department "has not issued a policy related to their workers that have spent time in West Africa."

"I know that there was this decision that was made by one commanding officer in the Department of Defense, but it does not reflect a department-wide policy that I understand is still under development," Earnest said.

 ScootyPuffJunior wrote:

 Frazzled wrote:
Yet his own military-which he directly controls-has implemented a 21 day quarantine.

I'm guessing you missed this part:

“It would be wrong to suggest that it would make the American people safer to apply this military policy in a civilian context,” Earnest said. “The science would not back that up.”

 Frazzled wrote:

 ScootyPuffJunior wrote:

 Frazzled wrote:
Yet his own military-which he directly controls-has implemented a 21 day quarantine.

I'm guessing you missed this part:

“It would be wrong to suggest that it would make the American people safer to apply this military policy in a civilian context,” Earnest said. “The science would not back that up.”

What an asinine statement. I guess the virus is more dangerous if you're wearing camo....

 Dreadclaw69 wrote:

 d-usa wrote:
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.

It was off by less than 1F (99.5 v 100.4) this may have been caused by differences in the instrument used, drinking water with ice before, etc. And this was recorded before the flight. Again we come back to more luck than skill that no one else was infected on that plane.

 d-usa wrote:
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.

Was the CDC right to permit a nurse who was in close contact with an Ebola patient to travel on a commercial flight with a fever that registered 0.9F below the cut off?

 d-usa wrote:
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.

The CDC were wrong. They admitted to it.

 d-usa wrote:
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.

It's a good thing that I was talking about quarantine for those people "elbow deep in the stool, emesis, and blood of people with advanced EVD", and not people in contact with those not displaying symptoms.
I'm starting to think that you may have mis-interpreted what I said when I originally posted "With the incubation period for the disease being up to 21 days why are we not seeing a period of quarantine before medical staff return to their country of origin?"

 d-usa wrote:
He's an idiot because he made it extra clear that he doesn't know what he is talking about.

Other people are idiots because they implement non-needed restrictions that will cause less people to travel and will result in less people getting treatment which will not do anything to help the spread of disease in Africa. And until we stop the spread in Africa nothing we are doing here will actually make a difference, especially not stupid decisions like these.

Common sense tells you that only non-essential travel would be effected, and that medical personnel would still be able to enter the hot zone. I can't source common sense for you.

 Frazzled wrote:

 ScootyPuffJunior wrote:

 Frazzled wrote:
Yet his own military-which he directly controls-has implemented a 21 day quarantine.

I'm guessing you missed this part:

“It would be wrong to suggest that it would make the American people safer to apply this military policy in a civilian context,” Earnest said. “The science would not back that up.”

What an asinine statement. I guess the virus is more dangerous if you're wearing camo....

 Frazzled wrote:
Someone in the DOD? He's in charge!

 Frazzled wrote:
Nonsensical argument. He could overrule it at any time. He didn't. As sending troops there is a major move it surely was discussed. If not, then he's blindingly incompetent.

 Frazzled wrote:
Obama's his boss. He could over-ride if it was an issue.