Thursday, October 02, 2014

Ebola News. 80 people had contact.

It was just announced that officials say 80 people came in contact with the Ebola patient.

That's more than quadruple the number first stated.

It always goes this way.  First the lie to calm fears, then a slow dribble of truth to prepare the public for the worst.  If your spider sense isn't tingling then you need to work on your survival skills.

23 comments :

  1. You don't want to startle the frog until it's too late for him to hop out of the pot.

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  2. Yep, time to start buying those things which have value that could increase in a SHTF situation.

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  3. I think the numbers will go up a lot further over time, if you consider that its communicability is based on body fluid exposure... It makes every unsanitary toilet and bathroom he used between Monrovia and Dallas, a potential problem... Patient X probably had two layovers, and three aircraft he could've potentially contaminated... This is even more problematic, if you consider how maintenance people often cut corners...

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    1. How many airlines are likely to strip the seats he sat in/near, and burn them? If you're lucky, they MIGHT squirt them with some Febreeze or something. But CDC guidelines say burn all contaminated clothes/bedding/etc.

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    2. None... This is why the contamination issue will likely get a lot worse... All it takes is for an infected person, such as Patient X to use the facilities on any of the planes and places he shared with other passengers and travelers, over the course of his trip, to create a giant window of opportunity for something to spread. If you consider the European to US leg of his trip was probably 9-13 hours, with the facilities likely cleaned once or twice over 24 hours (and probably superficially, I might add...), the possibilities of spreading something are pretty big... The cleanup procedures for Ebola are pretty stringent. I can't think of too many airlines (or airports) that go through cleanliness measures that even come close to matching the CDC requirement for cleaning after Ebola....

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  4. The virus undergoes some kind of mutation and then turns the dead into flash eating undead. Oh my..

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    1. In that case, it's easy. Just shot them in the head and burn the bodies after.

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  5. Ebola isn't spread by simple contact. Could it be a problem? Sure. But it doesn't spread just by being in proximity or even simple hand-to-hand contact. It requires contact with bodily fluids or organs. So there is some risk, but you have a greater likelihood of catching TB or some such disease. CDC and WHO have basic info available on their websites.

    WHO summarizes: Transmission

    It is thought that fruit bats of the Pteropodidae family are natural Ebola virus hosts. Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.

    Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials (e.g. bedding, clothing) contaminated with these fluids.

    Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.

    Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola.

    People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.

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    1. It spreads by simple breathing and coughing within 3-4 feet of an infected person. The CDC itself said so in the first fact sheets they distributed when the infected doctors were being flown in from Atlanta. That's not *technically* airborne transmission, but you do need to read the fine print.

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    2. Thanks for that absolutely BS synopsis, Mordechai.
      Unfortunately, let's look at the CDC info sheet:

      "Close contact

      Close contact is defined as
      a.being within approximately 3 feet (1 meter) of an EVD patient or within the patient’s room or care area for a prolonged period of time (e.g., health care personnel, household members) while not wearing recommended personal protective equipment (i.e., standard, droplet, and contact precautions; see Infection Prevention and Control Recommendations); or
      b.having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment.

      Brief interactions, such as walking by a person or moving through a hospital, do not constitute close contact."

      http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html

      So everything you just posted is pure hooey.
      You weren't just wrong, you were as wrong as it's possible to be.
      But thanks for playing.

      And BTW, do you notice any logic fail when you note that it isn't spread by hand to hand contact, and then observe that it's transmissible from infected bedding?
      Didja figure people in Africa have been licking that stuff, or what?

      Sit down, and bone up.
      What you think you know that's totally wrong could kill you.
      What you think you know that's wrong and you post on the internet could kill others.
      Ebola is doing that just fine without any help from you.

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    3. Well, Aesop, I care for and do air transport of critical care patients for a living. My life, and my patients' and colleagues' lives depend on my getting it right. And I am married to a physician who specialized in toxicology and pathology. We know something about CDC guidelines, and how to professionally read and apply them. My impression is you don't have that education or expertise.

      So, l stand by what I said. You'll note that the CDC document you reference was written for healthcare workers. Says so right at the top. Patient care workers are at much higher risk for any disease transmitted by bodily fluids, including but not only Ebola. That is because we have prolonged and repeated exposures to the patients, and are likely to be exposed to fluids when caught unawares, such as a vomiting patient and the like.

      If you briefly shake hands with an HIV or Ebola patient on the street, the odds of you becoming infected are slim to none. IF you have broken skin on your hand, and IF the patient has bodily fluid on their hand, then your risk goes up incrementally.

      So, before you go opining based on professional literature - make sure you understand it. You didn't.
      Before you opine on professional literature - make sure it is the relevant and correct literature. You didn't.
      Before you go discounting the information presented to you, maybe find out if the guy has reason to know what he's talking about. You didn't. (And yes, professionals can be wrong. Just make sure you're equally informed before arguing.)

      There's an ancient parable about a fool who observes how each day people line up at the physician's house for care, and go away improved or healed by the herbs and other medicines he administers and distributes to them. (You can find one version of this in the Kuzari by Yehudah Halevi.) When the physician goes away, the fool thinks to himself, 'I can do that'. So, with minimal knowledge of what he observed (you don't know what you don't know), he opens the doors to the clinic and offers medicines and advice to all comers. The result is he kills and harms a bunch of people in his ignorance.

      Aesop, you certainly aren't the physician in the parable.

      Oh, and try posting with your name so you can be accountable for your opinions. I do. That way, what I post on the internet after due consideration can be questioned by directing the questions or arguments to me. Of course, not every man is willing to stand behind his word; or risk public argument.

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    4. BTW, Aesop - I looked briefly at your blog. I know that we are colleagues. But you engaged there in hyperbole under the guise of informed opinion, and grossly distort the picture and information in the process. That disqualifies your opinion in my view.

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    5. I see.
      So all the ad hominem in the prior post questioning my medical bona fides is "no longer operative"?
      Since it was all you had to attempt to discount the plain English language meaning of the CDC bulletin posted at their site regarding the truth of the matter, which I offered to directly and conclusively refute everything you've asserted, rather than admit that your information and understanding don't conform to the best available public health information, and rather than being accountable for your counter-factual opinions as you claimed, and despite waving your own expert creds, you're now questioning the validity because it offends your delicate sensibilities, being too scary.

      But on the facts and merits, you've got nothing.

      Gotcha. Moving goal posts much?

      Having concluded that the ice cream is, in fact, ice cream, you now instead wish to dispute its flavor because it's not your personal favorite.

      When they seek to appoint someone to decide all matters of taste for everyone else, I'll be sure and forward your C.V. to the nominating committee.

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    6. Not a matter of taste, at all. I indeed question your bona fides. I've known nurses and docs over the years who, despite being degreed and credentialed, were unprofessional and sometimes even incompetent. Not many; but not lacking, either. And nurses are famously undereducated in reading research and clinical literature. I stand by everything I said about your incorrect reading or use of the information. I only added that I say so, your livelihood notwithstanding. As I said, "you grossly distort the picture and the information." And you're still unaccountable for what you write on the internet.

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    7. Your opinion is noted.

      All I've done is provide link after link to site after site, with definitive and authoritative information that contradicts your flawlessly wrong assertions. Most of them from the very CDC you claim to adhere to, yet apparently of whose very Ebola information sheets you remain in near total ignorance.

      All you've got is ad hominem attacks and innuendo, because you can't muster a contradictory fact to save your argument.

      It's a free country, and you have the ability to be a gainsaying jackass, based solely on your inalienable right to your personal opinions.
      But you don't get to make up your own imaginary facts on the same basis, and then yourself as the World's Foremost Authority before whom we mere mortals ought flee when summoning facts fails you.

      Either find a real fact, and then pop off, or mind your own business with regard to what better informed people post, even when it hurts your precious feelings and counterfactual intuition.
      Anything else - which to put it pointedly, is pretty much everything you've posted on the subject - is just you as Obvious Troll Being Obvious.

      I get that you think you're brilliant, and your farts don't smell. Good luck with that when the jury comes back in.
      I'm just a guy stringing documented truths together to see where they point, which is clearly a matter of some vexation to your worldview.
      So please, get a clue, a life, or a new gig. Your current one is merely tedious and obnoxious, and the Internet isn't notably short of people for whom such life skills are their only defining characteristic.

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    8. "All I did was provide facts." If that were the case, we wouldn't have much argument, if any. But you DO NOT stick to providing data. Your interpretation includes rhetoric designed to...well, I'm not sure what the point of your exaggerations and distortions is. But you do employ exaggerations and distortions; and while you are admiring your way with words you are misleading people. I've already pointed out two of the more easily noted distortions. I've made it clear that since you don't take direct, attributable responsibility for your words, that increases the doubts about your information, your motives, and your credibility. Do you write charts without signing them? Better yet, would you talk to patients and staff with the hyperbole that you do on the internet? Employ that hyperbole in your charts? How long would your credibility last?

      And that's all you did here, too. Rather than defend/justify your overblown rhetoric (hazmat suits in triage? Really?), you make it personal. I suspect you know that your writing is misleading and unprofessional, but just want to go on with entertaining yourself. And I will take direct responsibility for saying so.

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    9. 1) You don't get to make up fake quotes, especially with what I actually wrote just two inches away.
      The rhetorical term for this is "strawman fallacy"; the common term for it is lying. If you were really concerned with credibility, you'd demonstrate some.
      2) You also don't get to lie by implying I said that I only provide data. I know this may come as a shock to you, but some people can take data, and analyze it, and synthesize it, thus reaching new conclusions, and bringing up new questions. Educated people commonly refer to this activity as thinking. Being evidently wholly unfamiliar with that concept, I don't know what you call it, but despite its strangeness to you, I practice it on my blog pages regularly. Again, sorry if that hurts your feelings, but the world is a cruel and unfair place.
      3) You have pointed out zero distortions. What happened was, you got caught bullshitting beyond your range of intelligence:
      "Ebola isn't spread by simple contact. Could it be a problem? Sure. But it doesn't spread just by being in proximity or even simple hand-to-hand contact."
      and I quoted you chapter and verse from the exact CDC info sheet that directly contradicted you, and spotlighted that you were wholly illiterate on even the most basic information about Ebola.
      You then launched into an extended rant of ad hominem attacks based on your utter unfamiliarity with what I do or know, apparently out of embarrassment at having been caught with your head shoved in a tight dark place.
      You then tried to pretend that whole thing didn't happen when you realized your kneejerk assumption of your own professional superiority was insupportable, and instead decided to make this a disagreement based on your infallible intuition and personal taste.
      And now, having been caught at that, you've evidently decided that maybe the midpoint ad hominem attack was a better way to go, and have returned there.
      Factually and on the merits, you've still got nothing, and you bring all of it to each new post.
      (cont.)

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    10. So having written a full book of personal attacks, while wholly ignoring your own failure to know or articulate basic facts about Ebola, the entire topic under discussion, you maybe want to lay off trying to accuse other people of "making it personal". You're projecting.

      And as noted elsewhere, the CDC specifically recommended implementing the donning of PPE by first-line hospital responders on page 4 of the checklist that was sent to every hospital in the country two weeks before Duncan arrived here:
      http://s3.documentcloud.org/documents/1301646/hospital-checklist-ebola-preparedness-2014-sep.pdf
      So once again, you're a little behind on your reading.

      If I'd assed up such clinically germane information on such a hot topic, I'd be more reticent than proud of noting such functional ignorance under my own name for the entire Internet to see.
      Most people who'd so stepped all over their johnson with golf cleats would just stop, not do jumping jacks.

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    11. Aesop, you really love to hear your own voice (or see it in writing) don't you? Fortunately for me, the entire world can read this exchange, can read what's published on your blog, and can judge for themselves. You really are pretty verbose, I'll grant you that. And good at personal insults, though not enough for me to have ever said I'm insulted. I'm not. I have rarely seen someone write so much, so bombastically (on your blog, too), and say so little of valid information.

      But let's take up at least a few of your points, shall we?

      1. On your point #1, I have no idea what your talking about. I pointed out that on your blog, you suggested that triage should have had hazmat suits, and that it was incorrect. You came back with some backpedaling about not meaning the simple meaning of the term. I pointed out that you distorted the CDC recommendations, and even added an item of your own. As you pointed out, it's right/write there for all to see just inches away.

      2. As for your point #2, just a few inches above here you wrote: "All I've done is provide link after link to site after site, with definitive and authoritative information..." I would say I paraphrased that pretty well. And I already pointed out a few specific examples of how you either distorted or misrepresented the CDC info. Anyone who wishes to do so, can go back here and see that.

      The CDC did not say that Ebola is spread by simple contact. They recommend contact precautions for those who would be in close contact with patients. Educated professionals know that those guidelines are designed with a margin of safety to prevent unnecessary risks. But the actual transmission of the disease is still not through simple contact. It requires bodily fluids entering the receiving body through some route: ingestion, injection, broken skin, etc. Nowhere does CDC or anyone else say that simple contact is a route for transmission. They DO say that contact precautions should nonetheless be employed.

      "A full book of personal attacks"? Anyone who's wasted their time reading this exchange can see that simply isn't true. I'm (not) sorry you get butt-hurt when credibly challenged on your professionalism and credibility. What you haven't done is directly answer any of that challenge.

      In your second-to-last paragraph above you once again distort and mislead in order to deflect attention from your actual previous statements. No one, not me or anyone else, has said that first-line responders, etc. don't need PPE. What I DID say, and continue to say, is that the CDC did not recommend hazmat suits or hoods. They didn't. You did. And their recommendation for N95 type protection was only for aerosol-producing procedures; something not normally done in triage, and maybe in fact done by EMS if suctioning or the like.

      I did check my facts with a few colleagues (critical care RNs, and MD, and an industrial hygienist working in the DFW area). I even asked what they thought of some of your statements. The conclusion is you are maliciously FOS.

      So I stand by what I have actually said to you in plain language, black-and-white for all to see. You are fear mongering through distortion, misrepresentation, and outright lying in some instances. No one can hold you accountable since you hide behind anonymity; but you still should be called out. But I'll stop. I'm tired of your BS and Chicken Little routine. And I strongly suspect that few informed people are going to pay you much mind; so you probably can't do much of the harm I thought you might. This exchange has gone on plenty long enough for readers to be able to judge for themselves.

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    12. 1) I backpedaled nothing. You're wrong, as any number of articles, both public and scholarly, confirm.
      2) Quotation marks don't go around paraphrases, unless you're trying to put words never said into someone else's mouth. That's called lying. You're busted.
      3) "The CDC did not say that Ebola is spread by simple contact." - Mordechai Y. Scher, Supergenius
      http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-emergency-medical-services-systems-911-public-safety-answering-points-management-patients-known-suspected-united-states.html
      •The likelihood of contracting Ebola is extremely low unless a person has direct unprotected contact with the blood or body fluids (like urine, saliva, feces, vomit, sweat, and semen) of a person who is sick with Ebola - CDC
      http://www.cdc.gov/vhf/ebola/transmission/index.html
      Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with
      •blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen
      ) of a person who is sick with Ebola
      . - CDC

      Just stop, Mordechai. Please. You're delusional.
      The CDC, on both the linked pages (which aren't even a fraction of the total), directly contradicts you on precisely the point you opined on.
      You cannot walk being that wrong, and that deliberately stupid, back, nor bluster your way to expertise on this point.
      Reconcile being 100% factually wrong despite the exact contradiction of your very words sitting here in front of your face, before you wave your imaginary friends and comments about professionalism and credibility. You're clueless on the very concept.

      You're bucking for King Of The Assclowns every time you keep trying to reconcile what you think with actual reality on planet earth.
      For God's sake, man, stop before you have a further psychotic break.

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    13. THIS ENDS GENTS.

      i value you both and your opinions/discussion but this has taken a venomous turn that i reserve for my hated enemies.

      i don't think i want you guys to head that way, so stop this.

      every person will have to react to information they receive in the way that they determine is best. history and Darwin's law will decide who is right and who is wrong.

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  6. Wanta hear some real funny sheet?
    The Haj Started today, two million Muslim's under one hot sweaty tent in Mecca.
    They traveled all over the world to get here, even from and through Africa.
    What are the odds against one infected and communicable Ebola patient being there?
    Out of two million what are the numbers of infected and contagious that could be there?
    We have One Ebola infected and sick traveler who met how many people and possibly infected 80 or at least 80?
    If this were Mecca and One Ebola contagious Haji infected 80 others then with their type of health and medical expertise how many would those 80 infect?
    1 = 80 each of the 80 infects another 80 a piece so that's what? 80 x 80?
    That would be 6400?
    Each of them would infect 80 each.
    I know they say it takes 21 days to become infectious so how long does Hajji stay at the Haj and how long does it take some of them to get home and how?
    If the US cannot stop one Ebola infested man from flying into Washington DC, and ending up at Dallas Texas, how can the Saudi's grantee no Ebola Mary isn't already there?
    So far there have been no known cases of Ebola in the Middle east, Russia, China or anywhere else at least nobody is talking if there has been.
    I'm thinking this Haj may just infect the world. The Muslim world for sure.



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