ebola quarantine--governmental overreach?

nafod · Post by **nafod** » Tue Oct 28, 2014 5:39 pm

Dunn wrote:
nafod wrote:
Turdacious wrote:
Pinky wrote:
Turdacious wrote:
Pinky wrote: It makes no sense to talk about quarantine without also talking about how much more we should pay people to first risk their lives and then face a three-week quarantine. (OMG, what if three weeks isn't enough? Better make it 6!)
Fuck those assholes for trying to help! I want action, I want it now, and I don't want rational thought or morality to get in the way.
OK.
So that's what the view from the ivory tower looks like.
Uhhh, google on 'coeds' and hit the image button
Gods bless you.

WOULD! Even if covered with Ebola vomit.

Turdacious · Post by **Turdacious** » Tue Oct 28, 2014 8:39 pm

nafod wrote:
johno wrote:
nafod wrote:
johno wrote:Any of you know-it-all, nothing to-see-here experts want to explain how the two US nurses contracted Ebola?
Since the disease is so difficult to get and the nurses had the resources of modern US medicine at their disposal, and knew they were treating Ebola patients?
They fucked up and let fluids get on them.
You say this based on evidence? Or blind faith?
I say this based on this is how you catch Ebola. From the fluids. There's a lot of empirical data from the field after dealing with this in Africa for years that says you get it from when folks start vomiting and gushing out other orifices.

The smart thing to do is to set up testing of people for the virus that you would consider quarantining. We have tests that can pick up Ebola before the patient has symptoms (I'm pretty sure). The test will pick it up long before they are contagious. Probably a little pricey.

If they had it, wouldn't we heard about it? Why didn't they use it in Texas or NJ? Or are they keeping this test away from nurses and governors who refuse to use science and logic?

nafod · Post by **nafod** » Tue Oct 28, 2014 8:52 pm

Turdacious wrote:
nafod wrote:
johno wrote:
nafod wrote:
johno wrote:Any of you know-it-all, nothing to-see-here experts want to explain how the two US nurses contracted Ebola?
Since the disease is so difficult to get and the nurses had the resources of modern US medicine at their disposal, and knew they were treating Ebola patients?
They fucked up and let fluids get on them.
You say this based on evidence? Or blind faith?
I say this based on this is how you catch Ebola. From the fluids. There's a lot of empirical data from the field after dealing with this in Africa for years that says you get it from when folks start vomiting and gushing out other orifices.

The smart thing to do is to set up testing of people for the virus that you would consider quarantining. We have tests that can pick up Ebola before the patient has symptoms (I'm pretty sure). The test will pick it up long before they are contagious. Probably a little pricey.
If they had it, wouldn't we heard about it? Why didn't they use it in Texas or NJ? Or are they keeping it away from nurses and governors who refuse to use science and logic?

Because you don't read the NY Times.

There is a fourth strategy, although it will need to be evaluated and deployed carefully. Since the 1990s, novel methods have allowed doctors to detect viruses in the pre-symptomatic phase of an infection, often with remarkable sensitivity and precision. One of these involves the polymerase chain reaction, or P.C.R., a chemical reaction that amplifies pieces of a virus’s genes floating in blood by more than a millionfold, which is what makes early, pre-symptomatic infections identifiable. The technique is not particularly cumbersome: As an oncologist working with blood cancers, I have been using variants of it to detect subclinical infections in patients for nearly a decade.

A 2000 study in The Lancet illustrates the power of this approach. Twenty-four “asymptomatic” individuals exposed to Ebola were tested using P.C.R. Eleven of the exposed patients eventually developed the infection. Seven of the 11 tested positive for the P.C.R. assay; none of the other 13 did. In 2004, virologists at the Centers for Disease Control and Prevention further refined this method to increase its sensitivity. The test now requires only a teaspoon of blood. The sample is transported, on ice, to a centralized lab. Results are back in a few hours.

http://www.nytimes.com/2014/10/13/opini ... .html?_r=0

tough old man · Post by **tough old man** » Wed Oct 29, 2014 12:56 am

I say we just let it run unchecked. No way will it be anywhere close to the flu for deaths.

Turdacious · Post by **Turdacious** » Wed Oct 29, 2014 1:08 am

nafod wrote:
Turdacious wrote:
nafod wrote:
johno wrote:
nafod wrote:
johno wrote:Any of you know-it-all, nothing to-see-here experts want to explain how the two US nurses contracted Ebola?
Since the disease is so difficult to get and the nurses had the resources of modern US medicine at their disposal, and knew they were treating Ebola patients?
They fucked up and let fluids get on them.
You say this based on evidence? Or blind faith?
I say this based on this is how you catch Ebola. From the fluids. There's a lot of empirical data from the field after dealing with this in Africa for years that says you get it from when folks start vomiting and gushing out other orifices.

The smart thing to do is to set up testing of people for the virus that you would consider quarantining. We have tests that can pick up Ebola before the patient has symptoms (I'm pretty sure). The test will pick it up long before they are contagious. Probably a little pricey.
If they had it, wouldn't we heard about it? Why didn't they use it in Texas or NJ? Or are they keeping it away from nurses and governors who refuse to use science and logic?
Because you don't read the NY Times.

There is a fourth strategy, although it will need to be evaluated and deployed carefully. Since the 1990s, novel methods have allowed doctors to detect viruses in the pre-symptomatic phase of an infection, often with remarkable sensitivity and precision. One of these involves the polymerase chain reaction, or P.C.R., a chemical reaction that amplifies pieces of a virus’s genes floating in blood by more than a millionfold, which is what makes early, pre-symptomatic infections identifiable. The technique is not particularly cumbersome: As an oncologist working with blood cancers, I have been using variants of it to detect subclinical infections in patients for nearly a decade.

A 2000 study in The Lancet illustrates the power of this approach. Twenty-four “asymptomatic” individuals exposed to Ebola were tested using P.C.R. Eleven of the exposed patients eventually developed the infection. Seven of the 11 tested positive for the P.C.R. assay; none of the other 13 did. In 2004, virologists at the Centers for Disease Control and Prevention further refined this method to increase its sensitivity. The test now requires only a teaspoon of blood. The sample is transported, on ice, to a centralized lab. Results are back in a few hours.
http://www.nytimes.com/2014/10/13/opini ... .html?_r=0

If the NYT gets the study right-- why haven't we heard about it being used? It would seem that science and logic would dictate it. Maybe it's not quite that simple.

The CDC's opinion:

Diagnosing Ebola in an person who has been infected for only a few days is difficult, because the early symptoms, such as fever, are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever.

However, if a person has the early symptoms of Ebola and has had contact with the blood or body fluids of a person sick with Ebola, contact with objects that have been contaminated with the blood or body fluids of a person sick with Ebola, or contact with infected animals, they should be isolated and public health professionals notified.

http://www.cdc.gov/vhf/ebola/diagnosis/

Interesting that Christie and Cuomo seem to have done exactly what the CDC recommended-- isolate until the person is proven Ebola free.

Maybe another reason is because the FDA has been sitting on it's hands.

dead man walking · Post by **dead man walking** » Wed Oct 29, 2014 8:15 pm

would you have unprotected sex with her? or lock her up?

you can't do both.

Maine Gov. Paul LePage (R) is looking for ways to force a nurse released from mandatory Ebola isolation in New Jersey to abide by a similar 21-day quarantine in Maine.

“The Office of the Governor has been working collaboratively with the State health officials . . to seek legal authority to enforce the quarantine,” LePage’s office said in a Wednesday statement.”We hoped that the healthcare worker would voluntarily comply with these protocols, but this individual has stated publicly she will not abide by the protocols.”

The nurse, Kaci Hickox, . . was placed in quarantine in New Jersey after returning from West Africa, despite testing negative for the virus.

By Saturday, she was battling . . . over the conditions and legality of the quarantine, filing a lawsuit . . . .

Pinky · Post by **Pinky** » Wed Oct 29, 2014 8:33 pm

Turdacious wrote:
Pinky wrote:
Turdacious wrote:
Pinky wrote: It makes no sense to talk about quarantine without also talking about how much more we should pay people to first risk their lives and then face a three-week quarantine. (OMG, what if three weeks isn't enough? Better make it 6!)
Fuck those assholes for trying to help! I want action, I want it now, and I don't want rational thought or morality to get in the way.
OK.
So that's what the view from the ivory tower looks like.

That's what the view of people who don't naively assume away the potential danger of deterring healthcare workers from fighting the outbreak looks like.

Turdacious · Post by **Turdacious** » Wed Oct 29, 2014 8:46 pm

Pinky wrote:
That's what the view of people who don't naively assume away the potential danger of deterring healthcare workers from fighting the outbreak looks like.

You want them to naively accept the danger of public panic? The healthcare workers who went saw the danger of public panic in Africa first hand. Blame the doctor who lied about his movements in NYC, he screwed it up for everyone else.

judobrian · Post by **judobrian** » Wed Oct 29, 2014 9:28 pm

The guidance on personal protective equipment has continued to evolve from facemask and gloves up to full gear / no exposed skin. I go in for my refresher course tomorrow. It is very easy to self-contaminate while removing a standard facemask and goggles (demonstrated by UV light testing by EMS here in NC), which is why we've gone to full hood.

The nurses at Presby in Texas were not using Level C gear - no one was at that point.

We are not certain as to what the mortality of Ebola is when treated with first world country medical resources. Simple diarrheal illness is an often fatal disease in Africa, so it stands to reason (but has not been proven) that mortality will be much less in developed countries. That doesn't mean that we can be cavalier.

johno · Post by **johno** » Wed Oct 29, 2014 9:32 pm

From MD on TV: an Ebola patient can generate up to 3 gallons of diarrhea per day.

Spiller · Post by **Spiller** » Wed Oct 29, 2014 10:06 pm

My heart goes out to the people of Ebola.

Turdacious · Post by **Turdacious** » Wed Oct 29, 2014 10:21 pm

Maine officials said they are prepared to get a court order to enforce a mandatory quarantine on Ebola nurse Kaci Hickox, who has vowed to disobey the state's voluntary quarantine rules.

The order would first need to be approved by a judge before it could be enforced.

"When it is made clear by an individual in this risk category that they do not intend to voluntarily stay at home for the remaining 21 days, we will immediately seek a court order to ensure that they do not make contact with the public," Maine Health Commissioner Mary Mayhew said during a news conference this evening.

http://abcnews.go.com/Health/happen-nur ... d=26542668
#WhitePrivilege

tough old man · Post by **tough old man** » Wed Oct 29, 2014 10:41 pm

I watched the interview with that liberal cunt. voluntary quarantine or isolation cell. Her choice.

Protobuilder · Post by **Protobuilder** » Thu Oct 30, 2014 1:53 am

I was in Beijing during SARS and they would send in troops or police to surround an entire apartment building if it was quarantined.

johno · Post by **johno** » Thu Oct 30, 2014 1:54 am

judobrian wrote:The guidance on personal protective equipment has continued to evolve

Brian, I'm curious. How many Ebola patients would it take to overwhelm the average city hospital?
My impression is that it wouldn't take many.

Fat Cat · Post by **Fat Cat** » Thu Oct 30, 2014 2:25 am

johno wrote:
judobrian wrote:The guidance on personal protective equipment has continued to evolve
Brian, I'm curious. How many Ebola patients would it take to overwhelm the average city hospital?
My impression is that it wouldn't take many.

It took precisely TWO ebola patients to overcome the special quarantine section at Emory hospital. Walt and I have a different plan...

Turdacious · Post by **Turdacious** » Thu Oct 30, 2014 2:38 am

Not sure how tag-o-biddies and pasties will solve the problem, but I approve of the solution anyway.

judobrian · Post by **judobrian** » Thu Oct 30, 2014 3:38 am

Johno,
Community hospital will fall apart with one. Prepared academic center - we've had three false alarms - one transfer, one from a community physician's office, one primary EMS call. I will not detail them except to say that each one has provided insight and improvement on a plan that was declared "We are ready" by the executive suite. I actually feel pretty comfortable with our ability in the ER to take care of a not all that sick but has risk factors case, one at a time. More than one in any ER in the country, or one who walks in and a) lies or b) doesn't know that they are at risk? Catastrophe.

However, this is almost but not quite a zero risk. I am still giving 19:1 against that this is overblown on the continental US. Of course, if that 5% comes to pass? It will be worse than we can imagine.

The ER doc in New York. Young, male, still bought into the myth that he is immortal. Sounds like he did the right thing, once he felt sick. WITHIN THE LIMITS OF WHAT we understand about the pathophysiology of ebola, he probably did not expose anyone. I hope. I have been on the NY subways.

The nurse in Maine. Fear is a public health threat as great as any other. It puzzles me that someone so obviously capable of being other-centric as to risk her life in an ebola-ridden country does not grasp the possibility of doing good by sitting at home for a couple more weeks. And proving her point without creating talking points for the media.

Meanwhile, we make ready.

johno · Post by **johno** » Thu Oct 30, 2014 5:10 am

judobrian wrote:More than one in any ER in the country, or one who walks in and a) lies or b) doesn't know that they are at risk? Catastrophe.

However, this is almost but not quite a zero risk. I am still giving 19:1 against that this is overblown on the continental US. Of course, if that 5% comes to pass? It will be worse than we can imagine.

Thanks Brian.

I can't begin to quantify the risk. But the downside is enormous.
To use a Russian Roulette analogy, whether there are 20 or 200 chambers in the revolver, pulling the trigger on the live round is catastrophic; we should use utmost caution.

And, God, please stay my hand from murdering nurse Kaci Hickox.

Turdacious · Post by **Turdacious** » Thu Oct 30, 2014 6:02 pm

In 2010 [Kaci Hickox] was working on a measles outbreak in northern Nigeria when the Doctors Without Borders team conducted a medical investigation. Children were dying in one village, and the team discovered the cause to be acute lead poisoning from poor gold mining practices.

“After that experience and others like it, I realize that we need to find better ways to improve health surveillance and outbreak response in settings with poor resources,” Hickox says. “My training in the EIS with the CDC will allow me to learn the gold standard of this kind of work.”

http://www.uta.edu/utamagazine/archive- ... -graduate/

Apparently the 'gold standard' involves telling state health officials to go fuck themselves.

dead man walking · Post by **dead man walking** » Thu Oct 30, 2014 10:34 pm

where are the defenders of individual liberty when you need them?

that's what kaci wants to know.

Turdacious · Post by **Turdacious** » Fri Oct 31, 2014 12:37 am

dead man walking wrote:How can I maximize my 10 minutes of fame for long term gain?

that's what kaci wants to know.

Fixed that for you.

dead man walking · Post by **dead man walking** » Fri Oct 31, 2014 12:53 am

why are the defenders of the constitution distancing themselves from an unpopular cause?

her being an objectionable human is irrelevant

Turdacious · Post by **Turdacious** » Fri Oct 31, 2014 1:52 am

dead man walking wrote:why are the defenders of the constitution distancing themselves from an unpopular cause?

her being an objectionable human is irrelevant

Because it's perfectly constitutional?

dead man walking · Post by **dead man walking** » Fri Oct 31, 2014 6:15 pm

A Maine judge on Friday ruled in favor of a nurse who defied a quarantine in a tense standoff with state authorities, saying local health officials failed to prove the need for a stricter order enforcing an Ebola quarantine. . . .
Her attorney, Norman Siegel, called the decision a victory. "She won," he said. "She is not quarantined. She can go out in the public. ... (The judge) got the understanding of what liberty is about and how the government can't restrict your liberty unless there is compelling justification."

IGX

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