Category Archives: Ebola

“An Abundance Of Caution” When Dealing With Ebola

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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.

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Restricting Entry Into The US And Quarantining People Exposed To Ebola To Control Its Spread

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The actions being taken by the incompetent Obama administration to control the spread of Ebola in our homeland are insanely inadequate. The first person who was an Ebola carrier to come into the US without a medical escort should not have been permitted entry. He had been in contact with a person dying of Ebola in a West African country only a few days before he boarded a plane and began his journey here. He lied about his Ebola exposure and like other infected persons who are not yet contagious or showing other symptoms, had no temperature. That enabled him to gain entry into the US. Within a week he become contagious and put at least 50 other people including family, neighbors, first responders and hospital personnel at risk of exposure. The number of people potentially exposed was increased because of a failure due to human error to properly diagnose the Ebola carrier on his first visit to highly classified hospital in Dallas.

His entry should have been denied. The questionnaire he filled out was meaningless. We cannot trust a person who has been exposed to Ebola to tell the truth. This person had to know he was exposed to Ebola and might soon become ill and face death. We know that the Ebola incubation period is 21 days. Taking the temperature of a person before they board an airplane or prior to their entry into the US is worthwhile, but it does nothing to detect a person who has in fact contacted and is incubating Ebola and is bringing it into the US. As the word spreads that the best way to survive Ebola is to get to a hospital in the US, the more likely it is that people who have been exposed to Ebola will lie when filling out a questionnaire to get into the US. The greater the number of cases in West Africa, the greater the risk of plane passengers bringing it into the US becomes.

As we get into the flu season, it will become more difficult to make and early diagnosis of Ebola. We are taking a risk that, like in parts of West Africa, our capacity to contain Ebola may be strained or exceeded. Hundreds, thousands, hundreds of thousands or millions of Americans may die as a result.

What should we do to reduce the risk of an Ebola plague in the US?

NO PERSON SHOULD BE PERMITTED TO ENTER THE US (EXCEPT UNDER APPROVED MEDICAL SUPERVISION) WHO HAS BEEN IN A COUNTRY, OR A SPECIFIED AREA WITHIN A COUNTRY, WITHIN THE PREVIOUS 21 DAYS THAT HAS BEEN IDENTIFIED BY THE US DEPARTMENT OF HEALTH AS SUBJECT TO AN EBOLA EPIDEMIC AS DEFINED. ALL SUCH PERSONS ARRIVING AT US CUSTOMS SHOULD EITHER BE RETURNED TO THE COUNTRY OF ORIGIN, BE PLACED IN QUARANTINE OR, IF THEY HAVE A HIGH TEMPERATURE, THEY SHOULD BE HOSPITALIZED TO DETERMINE IF THEY HAVE BEEN EXPOSED TO EBOLA.

IN ADDITION, IF SUCH A PERSON IS TESTED AND FOUND TO HAVE A HIGH TEMPERATURE OR SHOWS OTHER EBOLA SYMPTOMS UPON ARRIVAL IN THE US, THEN ALL PASSENGERS ARRIVING ON THE PLANE WITH SUCH A PERSON SHOULD ALSO BE PLACED IN QUARANTINE UNTIL IT IS DETERMINED IF SUCH PERSON IS INFECTED WITH EBOLA. IF SUCH PASSENGER IS CONFIRMED TO HAVE EBOLA, ALL SUCH OTHER PASSENGERS SHOULD BE KEPT IN ISOLATED QUARANTINE.

SIMILARLY, IF A PERSON IS IDENTIFIED AS BEING INFECTED WITH EBOLA ANYWHERE WITHIN THE US, THEN ALL PERSONS WHO ARE IDENTIFIED AS AT RISK OF BEING INFECTED WITH EBOLA BECAUSE OF CONTACT WITH SUCH PERSON OR THEIR BODILY FLUIDS, AFTER, OR, AS A PRECAUTION, FOR A DAY OR TWO PRIOR, TO THEIR BEING DIAGNOSED AS CONTAGIOUS WITH EBOLA, SHALL BE PLACED IN ISOLATED QUARANTINE.

ALL SUCH PERSONS PLACED IN QUARANTINE SHOULD BE KEPT IN ISOLATION FOR 21 DAYS AT A SPECIAL RESIDENCE BUILT AT OR NEAR OUR IMPORTANT AIRPORTS AND SERVICED BY SPECIALLY TRAINED PERSONNEL.

IF ANY OF SUCH PERSONS HELD IN QUARANTINE DEVELOP A HIGH FEVER OR SHOW OTHER SYMPTOMS OF EBOLA, THEY SHOULD BE TRANSFERRED TO A HOSPITAL FOR TESTING AND TREATMENT.

BECAUSE OF THE HIGH RISK TO HEALTHCARE PROVIDERS WE MUST DEVELOP IMPROVED PROCEDURES TO AVOID BREACHES OF PROTOCALL (INCLUDING BY CAMERA OBSERVATION) AND TAKE STEPS TO INCREASE SUPPLIES OF PROTECTIVE CLOTHING AND IMPROVE WASTE DISPOSAL AND CLEAN-UP PROCEDURES AT ALL HOSPITALS AND CLINICS.

THE NAMES AND METHOD TO CONTACT ALL PLANE PASSENGERS AND EMPLOYEES WHO HAVE SHARED A FLIGHT WITH A PASSENGER DETECTED TO HAVE EBOLA-LIKE SYMPTOMS, BUT WHO HAS NOT WITHIN THE PREVIOUS 21 DAYS VISITED AN AREA SUBJECT TO KNOWN EBOLA CONTAGION, SHOULD BE RECORDED FOR LATER USE IF NECESSARY.

The argument that prohibiting the entry of persons to keep Ebola from entering our country will likely cause great financial hardship in the countries currently effected and increase the risk that Ebola will spread worldwide is ridiculous. We are sending in military personnel to construct housing for potential Ebola patients and are supplying financial assistance, trained medical personnel, food, medicines and medical products to help countries attempt to deal with the Ebola epidemic. We can  attempt to stop the spread of Ebola within such countries by increasing financial and medical and humanitarian assistance to help offset losses to their economies, but the risk is too high of an Ebola epidemic within the US if we do not prohibit such entry. There are estimates that one million will die in Africa from Ebola within six months. We may not be able to prevent that, but that is an even greater reason to prevent people exposed to Ebola from entering the US.

There is a strong likelihood that Ebola will soon spread to South and Central America. It is therefore imperative that we seal our southern border now. We should have sealed it long ago. We know that many of the children and families that illegally entered the US with President Obama’s encouragement, and surrendered to border agents, had a variety of detected illnesses, but were nevertheless recklessly transported for political reasons throughout the US without being quarantined for at least a 30 day period. They were permitted to enter our schools without appropriate vaccinations. We do not yet know the source of enterovirus 68D which has hospitalized large numbers of our children at least two of whom have died. It seems highly likely that the illegal immigrants, who have different immunities to local viruses than US residents, were the source of enterovirus 68D. We cannot afford the risk that Ebola may be spread in the US as a result of illegal immigration. The press must speak out and Congress must act quickly because we cannot trust the Obama administration to acknowledge its prior errors and quickly close our borders on its own.

The failure to prevent entry of persons infected by, but not yet displaying Ebola symptoms, will very likely, in a short time, disrupt US air travel and cause panic in many American communities and damage our economy as Ebola cases are diagnosed. We must act now to prevent it.