Australia and now Canada have seen fit to implement some temporary travel restrictions. The 21 day incubation period for Ebola and the fact that there has been at least one negative test that later resulted in a patient dying are points to consider.
Do you consider equally the fact that active TB is far more infectious than Ebola? Would you have endorsed the idea that the medical personnel at Tampa General Hospital who treated Sarah Williams, a homeless woman testing positive for active TB,(July of 2013) should have been placed in quarantine?
For that matter, would you endorse the idea that any and all health care workers returning from any nation with a high ratio of active TB cases and having treated such patients should be placed in quarantine upon their return?
Our most recent active TB case in Florida concerned a homeless woman picked up by EMTs as she was found unconscious in the streets. At Tampa Bay General where she was transported, they ran a variety of tests to include TB. She tested positive. Before the tests results came back, she left. Disappeared within the general public. No fixed domicile. All homeless shelters were on alert. All soup kitchens on alert. Her description given to all locations where she might show up. The Tampa Bay population was instructed to not communicate with her if they saw her but immediately call 911. Cops were patrolling (to include bicycle cops) every area where she would be susceptible to be found.
Now see...the Sarah Williams case would have been a justified reason for our Tampa Bay population to experience fear. Interestingly, no fear frenzy. No sensationalism. But Ebola...oh yes.
Via its airborne property, such active TB infected person can contaminate an unlimited number of persons by the simple and extremely common vector of speaking or singing within their close proximity.
What are the vectors of contagion/contamination for Ebola , Rose? Does anyone here need to go over them again? Is there any lingering belief here that this strain of Ebola has proven itself to be infectious outside of the actual vector of direct physical contact with infectious bodily fluids/secretions? I hope you understand that emission of those fluids is a necessity for contagion to occur based on direct physical contact. My point being that at the early stage of symptomatic fever, there is NO emission of such fluids and secretions the general public would somehow come in direct physical contact with.The risk of infection is then extremely low when it comes to being infected by someone exhibiting the early symptom based on fever grade.
It is time to debunk once for all any belief that Ebola is so easily transmitted. We have absolute evidence via the 3 relatives who lived in very close quarters with and certainly came in physical contact with Mr Duncan that none of them developed any symptoms and none of them were contaminated despite of it all. They had no PPE. No protection whatsoever. They slept near by,(his girl friend in the same bed) ate at the same table, used the same bathrooms etc....
If even one person has delayed onset of Ebola, the resources needed to monitor all of their potential contacts will very soon prove problematical.
That's true. However and again, the identification of a potential Ebola case on that one person already monitored twice a day relies on fever grade. Again, and applying to the case discussed in the OP which concerns designated health care workers as having returned from all 3 affected regions, what leads you to believe that monitoring alone of their vitals does not suffice to detect a potential Ebola case BEFORE such health care worker develops the symptoms of the ACTUAL infectious nature and again emission of bodily fluids/secretions?
I understand the science behind how contagious diseases are transmitted and have spent enough time in hospitals in critical care situations to observe and verify that healthcare professionals make significant errors on a regular basis.
In theory, one would hope otherwise and perhaps the experience of others is different but I could write a short book on the lives lost to human error just from my own observations and that of a small circle of acquaintances.
Lynx made a very pertinent comment addressing the actual mind state of health care professionals who have volunteered their skills, time and energy treating and caring for Ebola patients in all 3 affected regions:
I think laughing dog might allow that the kind of health worker who goes to W Africa to treat Ebola patients is not your "average health worker" that one meets every day. And would he be surprised to learn that such an experience does tend to concentrate ones mind on not only the job in hand but on the consequences on oneself and one's nearest and dearest and on friends and neighbours of any unnecessary risks taken.
I see that it was dismissed. I need to ask why. Are you Rose or Laughing Dog familiar and acquainted with European and US physicians and skilled nursing providers who volunteer their skills, time and energy battling diseases affecting the African continent? Have any of you encountered in person any of them? Did any of you have any observation while in Africa of the type of extremely pressuring environment they work in? Any of you having had any observation in Africa of how they have learned hands on to perform at their best with the minimum resources? I take it none of you were ever in a medical dispensary dedicated to treating lepers in Senegal, manned by French doctors and nuns who were their nurses.
How informed are you about the work conditions of French physicians and nurses assisting Ivorian health care authorities in identifying HIV sero positive natives as they so commonly will be identified when it is too late, meaning as they already have developed AIDS? Too late as their CD 4 count is so depleted that prophylactic treatments are useless.And their immune system will not respond to any pharma based protocols. Do you have any idea how extremely complex and frustrating it is to work in such conditions when attempting to prevent or contain an HIV epidemic?
Rose, if you could write a short book based on your observation of health care workers in ICUs in the US, I could write one about the resilience, the determination against all odds, the extremely focused mind state of those imported physicians and nurses and all of that working in conditions you will not encounter in the US.
What all of that does is that it builds their character to how Lynx described it.
The World Health Organization is not pleased by the developments in Canada and Australia:
Australia’s similar move was slammed Thursday by Dr. Margaret Chan, director general of the World Health Organization, who said closing borders will not stop spread of the Ebola virus.
Except, of course, that it
has. One reason that the outbreak has been limited to those three countries (at least so far) is because neighboring African nations halted travel with them. Nigeria put a travel ban in place, and then quarantined the one case of Ebola that broke out, stopping its spread. Even internally within those nations, one strategy to contain the outbreak has been to limit travel. It’s a common-sense temporary consideration, especially when dealing with a disease that has a three-week incubation period and no way to detect an infection until it presents significant symptoms.
http://hotair.com/archives/2014/11/01/canada-enacts-travel-ban-from-ebola-impacted-countries/
The end result of a travel ban will be :
- Impairing/undermining the logistics necessary for all medical humanitarian groups to insure adequate voluntarism to support and assist containment of Ebola in all 3 affected regions, Sierra Leone, Guinea and Liberia. There has been a definite consensus among experts that the effective way to prevent Ebola from expanding is to pursue to control it in all 3 regions. In order for First World Nations to assist in that task and meet that goal, their flow of human resources(meaning their health care workers) must remain constant and able to deploy back and forth.
-Further, the expectation is now placed on those medical humanitarian organizations to send their medical personnel for much longer extended periods of time rather than 4 to 6 weeks to then be relieved by new teams. And more importantly "fresh" teams far less susceptible to burn out.
As to this :
Except, of course, that it has. One reason that the outbreak has been limited to those three countries (at least so far) is because neighboring African nations halted travel with them. Nigeria put a travel ban in place, and then quarantined the one case of Ebola that broke out, stopping its spread.
There were 20 cases in Nigeria, 8 of them fatal. The reason why Nigeria was able to contain it was because they immediately identified their patient zero, a Liberian citizen (Mr Sawyer) who traveled from Morovia to Lagos. They undertook an extensive contact tracing while also relying on the "circles" method. Senegal had 2 cases, 2 immediately identified patients.
It is to be noted that neither Nigeria nor Senegal were involved at any time in providing medical assistance/ support to their neighboring nations. While it is absolutely necessary and VITAL that First World Nations via organizations like MSF NOT be impaired in their efforts to deploy back and forth their health care workers to Guinea, Sierra Leone and Liberia. Let alone all the material and supplies they will need to use.
I hope it is widely recognized that none of those 3 nations have locally provided medical supplies and enough local health care workers to undertake and complete a reduction to the point of elimination of Ebola cases. In fact and as I detailed in the first Ebola thread which ran in this Forum, the main contributing factor to this Ebola outbreak having reached epidemic proportion in the nation of Liberia was due to socio economic conditions reflecting a very disorganized and limited in human resources health care system.
It appears that First World Nations endorsing a travel ban have opted for a counter productive measure which in no way will stop the spread of Ebola in all 3 nations. It will in fact aggravate it.
Then, of course, such measure is unrealistic considering that flights from all 3 nations do not automatically fly directly to Canada or Australia. So, how will they enforce their travel restrictions? Flights incoming from Europe which are connections to Australia and Canada, transporting passengers connecting from a great variety of other ports of origin? Are they going to scrutinize passenger lists and prevent passengers transiting in Paris from Liberia, Guinea and Sierra Leone, from catching a connection to Canada or Australia? Which process of identification will they follow? Now let's extend that to every European international airport susceptible to have flights incoming from all 3 regions with passengers catching a connecting flight to Canada or Australia. Which airlines are to refuse passengers originating from all 3 regions? Should Royal Air Maroc cancel its flights from Casablanca to Monrovia?
Am I the only one here envisioning a chaotic outcome affecting the very complex web of international flights travel?
Even internally within those nations, one strategy to contain the outbreak has been to limit travel.
US health care workers returning from all 3 regions to the US already face restrictions when it comes to their geographical movements(can be found on the CDC website). Meaning no use of public transportation such as planes, buses, trains. Are they now to be prevented from driving their POV?
It’s a common-sense temporary consideration, especially when dealing with a disease that has a three-week incubation period and no way to detect an infection until it presents significant symptoms.
Significant symptoms? Did not US nurse #1 and then US nurse # 2 , both having been infected while assigned to Mr Duncan, test positive when they did NOT have "significant symptoms" rather a persistent fever grade of 100.4 or above? "significant symptoms" would be induced by an increasing viral load causing the onset of gastro intestinal symptoms very clearly detailed as emesis and diarrhea via clinically supported data covering the progression of Ebola induced symptoms from the very early stage of fever to a succession of increasing in severity symptoms to the culminating point of internal and external hemorrhaging.
