The Obama administration and the CDC keep reassuring us that they are using “an abundance of caution” in dealing with Ebola. Like so many other statements made by President Obama and his administration these words sound good but can’t be trusted.
Treating Ebola with an abundance of caution will vary over time. It currently requires:
1. That we prevent entry into the US of anyone who has been in a West African nation within the past 21 days, (the period during which a person may be incubating the disease even if not yet feeling sick or being contagious. The passports of all persons seeking entry must be checked to determine whether such condition exists. Otherwise they may become contagious after arriving in the US and infect multiple people before we recognize the symptoms. Ebola is so dangerous and difficult to treat that we must use our best efforts to keep it out. The argument that a travel ban will increase the risk of the disease getting out of control in West Africa is specious. We can and should greatly increase our effort to control Ebola at its sources to prevent it from becoming a pandemic that will reach South and Central America and Europe and inevitably to the US. To help them deal with Ebola, we must also give much greater financial assistance to the governments and people in West Africa whose lives and economies are being destroyed by the Ebola epidemic. If we fail to restrict entry many people, who fear that they have been exposed to Ebola, will lie to be able to come to the US for potential treatment. If we do restrict entry, those same people may attempt to come to the US indirectly through countries that do not restrict entry. However, if our border agents are diligent in examining passports of incoming travelers to determine whether they have been within West Africa within the past 21 days, the risk of a person entering the US who is infected with Ebola will be reduced.
2. The hospital employees who treat Ebola patients or are otherwise involved with Ebola should not have any contact with any other patients or perform any other services within the healthcare facility. They should all be monitored from the time of their first potential contact with the Ebola virus until 21 days after their service ends. Ideally all Ebola patients should be transported by specialized teams and treated at designated Ebola facilities by dedicated personnel.
3. Every person who is at risk of having been exposed to Ebola should be monitored and subject to restricted contacts and movement or quarantine as necessary (beginning about 10 days after first exposure and until the end of the 21 day incubation period) to limit the possibility of the spread of Ebola if they become contagious. No-one who is being monitored should be permitted to visit any public places or take any form of public transportation. They should limit their contacts with other people or animals. The apparent failure of the CDC to prevent a person being monitored because of Ebola patient contact from taking a commercial flight was grossly negligent and clearly inconsistent with a claim that it was requiring “an abundance of caution”.
4. Airplane passengers on a plane where Ebola symptoms have been detected should be quarantined until Ebola had been ruled out. If a passenger is confirmed to have Ebola, then all passengers and crew should be kept in quarantine for 21 days at special facilities to be constructed for such purpose. If a passenger is diagnosed with Ebola within a few days after a flight all fellow passengers should be notified and monitored.
5. All safety protocols should be constantly reviewed and healthcare personnel involved with Ebola patients should be properly trained and retrained in safety procedures.
6. Removal of protective clothing and waste disposal by healthcare facility personnel should be supervised using video and two-way communication equipment.
Although we have not used an abundance of caution, there is some apparent good news relating to Ebola and certainly there is no need to panic at the current time. The patients who have survived Ebola may have been helped by an experimental vaccine and have antibodies in their blood which is apparently helping others survive. We are nearing the end of the 21 day incubation period for the 48 people (and possibly more) who had contact with the first Ebola patient and none of them have yet shown symptoms. This is indicative that Ebola is not spread easily despite the failure to properly diagnose the initial Ebola patient’s illness on his first hospital visit. The two nurses treating such patient were apparently infected as a result of outrageous breaches of protocols which will become less likely over time. Our healthcare system has successfully dealt with other infectious viruses in the past.