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Never mind Ebola, the passengers on the plane also did not have MERS
By adamg on Mon, 10/13/2014 - 8:48pm
The Boston Public Health Commission reports the patients taken off Emirates Flight 237 from Dubai at Logan Airport today "do not meet the criteria for any infections of public health concern," including Ebola, Middle East Respiratory Syndrome or meningococcal infection.
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Comments
The Future
So is this what we have to look forward to now? If people have the sniffles on a flight everyone gets to be inconvenienced by the hazmat suit gang?
My hope is that this is all just a big overreaction to Dallas and the media will find a new ball of yarn to play with because traveling is difficult enough without an emergency a minute at Logan.
They really need to implement a system of testing and checks and balances so this kind of crap doesn't happen every day. Ebola symptoms and the common cold seem to be quite different yet look what happened yesterday.
I'm starting to think that maybe stopping flights from West Africa at least until they know what they're doing over here might not be such a bad idea, Obviously systems aren't in place here at every airport.
There's a lot of doomsday types thinking Dallas was just the beginning.
What do you think?
http://cappyinboston.blogspot.com/
Stopping flights from
Stopping flights from entering or leaving West Africa is not the answer. Never has been, never will be.
The only way to stop this is to treat it at the source. There's no way to treat it there if mission flights can't get in and out. Stopping flights "until they know what they're doing over there" will only delay and compound the problem.
Dealing with public hysteria is a nuisance, yes, and it makes me feel all weird about humanity but actually having Ebola? I'd rather deal with the fear mongering and hope that rational, compassionate heads prevail.
Actually, it is the answer.
We can fly over all the stuff they might need. We have 3000 troops on the ground over there. If the potential carriers aren't let on planes, maybe the public here might feel a bit better about it. Oh, before someone gets all "I'm smarter than the public" remember, perception means a lot.
Oh, and the possibility exists that the "not contagious/contagious" line might be a bit more blurry than is believed.
Please show your work
Do you have some examples and references that demonstrate that this will be effective? References from the epidemiological literature demonstrating efficacy?
Consider this: one of the reasons this spread so much this time is ISOLATION. The other is LACK OF EXPERTISE.
Consider this as well: people will travel out of the area to board planes to where they want to go.
Consider this as well:
They still need passports. Passports are issued by the citizen's country. They can swim to New Zealand and they will still have a Liberian passport.
Consider this: one of the reasons this spread so much this time is ISOLATION. The other is LACK OF EXPERTISE.
Um, isolation doesn't help? Maybe that's why they are put into isolation when they present at a hospital? (The second time, when they stopped lying about it.) Lack of expertise? Maybe the CDC (No salt for you!) might argue about that.
Again
Where are you getting the idea that any of this will work?
Isolation by country-wide quarantine? That means lack of supplies, lack of expertise, lack of containment, and broader spread by ground routes.
Also, answer this: why are you so afraid? Ebola is brutal, but it isn't very virulent. Meanwhile, car crashes kill 30,000 people a year, influenza kills 2-14,000, etc.
What are you talking about?
He just said there are 3000 troops on the ground helping.
They aren't isolated at all.
There's a giant coalition over there fighting this disease.
What's the problem with limiting civilian flights here?
Civilian flights not likely the issue
Note that you can't get ebola except through direct contact.
Who, exactly, has direct contact?
The nurse who treated Mr. Duncan.
Anyone who gets bodily fluid into their system from an infected person.
The scary part is how someone who has the disease but hasn't shown symptoms can easily get here.
Yes, Health Care workers
Now, are you saying that anyone who goes over for the CDC or military is marooned there?
Seriously?
So much for limiting civilian flights.
Yup. Isolation...
...in a controlled environment. They either get better or die. Containment in the affected geographical areas, keep the hot zone contained, prevent the spread to the warm or cold zones.
Field hospitals (or regular ones dedicated to Ebola-only patients), what little hired help is willing to hang around, doctors with real protective equipment, maybe some experimental antivirals (hey, what's to lose?), a decent incinerator on premises, any logistical help they need, but keep it from spreading.
Isolation does not mean no supplies, it means anything that is needed goes in, nothing comes out.
"Where are you getting the idea that any of this will work?"
The CDC. It seems to have worked for the Ivory Coast. They cut off all travel from the affected areas in August. Here's a map of the area now:
http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map...
"Also, answer this: why are you so afraid?"
Don't confuse deep respect with actual fear. I have deep respect for one of the most deadly diseases on the planet. For me it's not merely all academic. I have to have faith in an N95 mask, knowing it's probably not good enough.
Actually, I'm more afraid of one of the enterovirus family, being exposed, being rather asymptomatic, then accidentally paralyzing one of my nieces or nephews.
" Ebola is brutal, but it isn't very virulent. Meanwhile, car crashes kill 30,000 people a year, influenza kills 2-14,000, etc.
up"
Ah, you changed your post. Well, I usually get to the car accident after the fact...
Anyway, got to go outside and play.
What is "Most Deadly?"
I think we're all playing fast and loose with what it means for a disease to be "deadly."
If a disease were to have a 100% mortality rate, but if it were rare, and somewhat hard to transmit, then I wouldn't call it "deadly."
On the other hand, if a disease were to have a 10% mortality rate, and were fairly common and fairly easy to transmit, then I would call it "deadly."
HN51 flu had a mortality rate estimated at between 35 and 50 percent. That's right, up to half the people who got the disease, died from it. I'd call that a "deadly" disease.
Ebola is a nasty disease to be sure. It's mortality rate is decidedly lower than 100%. It's a rare disease (more Americans have been dumped by Taylor Swift than have died of Ebola). And it's not super easy to catch.
Well...
"If a disease were to have a 100% mortality rate, but if it were rare, and somewhat hard to transmit, then I wouldn't call it "deadly." "
Like rabies?
" It's a rare disease (more Americans have been dumped by Taylor Swift than have died of Ebola)."
So far.
Of what relevance is the passport?
Consider a New Zealand citizen, holder of a New Zealand passport, who has recently been in contact with a close relative recently returned from Liberia.
Now consider a Liberian citizen, holder of a Liberian passport, who has been living in New Zealand for the past 3 years.
What does either passport tell you about Ebola risk?
What does either passport tell you about Ebola risk?
"Consider a New Zealand citizen, holder of a New Zealand passport, who has recently been in contact with a close relative recently returned from Liberia. "
Please tell the truth, right? We can assume, like all civilized people that will happen. Oh, I guess you didn't swim from Liberia recently.
"Now consider a Liberian citizen, holder of a Liberian passport, who has been living in New Zealand for the past 3 years. "
Little risk. Been in New Zealand for three years. Ask about Liberian contacts. Please tell the truth, right? We can assume, like all civilized people that will happen.
How broadly would you ban travel?
Would you also restrict travel from countries where there is influenza or measles?
If not, why not?
Is there
an Influenza and Measles epidemic killing thousands of people?
I must have missed that on CNN.
Um
Measles kills ~200,000 people every year and influenza in this country kills anywhere between 10,000 and 60,000 people per year, never mind the worldwide deaths from flu.
Don't forget
Cars kill 30,000 a year.
Maybe we should ban importing cars.
That's Why
We have measles vaccinations, flu shots, seat belts, and traffic control systems. Are these or analogous preventative methods available for ebola?
(Not saying we need to ban flights or anything, but saying X kills more than Y is insufficient reason not to try reducing the Y mortality rate.)
As a matter of fact, yes
Depending upon the year, influenza kills between 3,000 and 49,000 Americans per year, and hundreds of thousands worldwide. http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm
Measles kills 220,000 people per year worldwide http://www.who.int/mediacentre/factsheets/fs286/en/
If you want facts about epidemics, try the medical journals and not CNN.
If you don't have the facts, then how about refraining from insisting on policy changes?
What facts are needed? By
What facts are needed? By pointing out other diseases that kill you aren't quoting any Ebola pertinent facts either. You're just pontificating to show us how smart you are.
Very impressive. The fact is it's irrelevant. The issue is whether or not another Mr. Duncan can walk through an airport carrying Ebola and infect other people. The answer is undoubtedly yes.
So out of an abundance of caution there should be flights from western Africa limited to maybe airports that are actually prepared or canceled altogether until our Gov. gets systems in place to deal with this properly.
When you turn around and say something stupid like, "OK then let's strand all our own people over there!" That isn't furthering your point at all.
You are saying that changing how things are done here is a waste of time. We should not limit flights or do anything differently because Aids, Influenza, lots of other diseases....
Sorry. I disagree.
Why facts are needed
Explain how your scheme wouldn't simply make things worse?
You can't do that without factual evidence.
That's one reason facts are needed.
Again, this isn't Homeland Security - this is a disease outbreak. Ebola couldn't give a shit about "epidemic theater".
My Scheme?
Your choice of words are very revealing about you as a person.
BUT anyway. It's already worse in Western Africa. It isn't really here yet so keeping it away from here would make it better.
Worse would be other infected people who like Duncan aren't showing any symptoms arrive here in the US and begin infecting people with their bodily fluids.
Saying it can't happen is making things worse.
Why are you making a special case for Ebola?
You still haven't explained your position.
We don't screen arriving passengers for flu or measles. We don't restrict travel from countries where there is flu or measles. And yet flu and measles are more contagious and more of a public health threat then Ebola.
So, why are you suggesting that Ebola be treated differently than we treat other diseases?
The Ebola mortality rate is
The Ebola mortality rate is 50% http://www.who.int/mediacentre/factsheets/fs103/en/
The Flu's mortality rate .... well read this Mr. Facts -
http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm
Measles? We have this thing called a vaccination. Ebola? Not so much.
http://www.who.int/mediacentre/factsheets/fs286/en/
So that's why I'm thinking we maybe should treat Ebola differently. It's sort of self explanatory but for the sake of debate there it is. So why don't you explain to me why taking the possibility of an Ebola outbreak in the United States seriously has your panties in a bunch Mr. Condescending internet guy?
Mortality Rate is not the important statistic
Incidence is the important statistic.
based...
...on a high mortality rate. Over 50-90% MUST limit the incidence rate. So, must contain the disease spread.
Looking for absolute certainty is a mistake
Without a doubt. No matter what level of travel restrictions you put in place, no matter what level of screening you put in place, I guarantee you that sooner or later, a carrier of whatever disease will slip through your net.
So now, figure this: Let's say the measures you call for would reduce (not eliminate, but reduce) the number of infected carriers entering the country by some number. Call it n.,
Now, what is the cost (fully loaded: not just the cost of implementing the measures you call for, but also lost commerce, lost business, diversion of resources from other tasks)? And what is the cost (medical resources consumed, lives shortened, public fear, etc. of letting n infected carriers into the country?)
Obviously, I'm in favor of any measures that can plausibly be claimed to be cost effective, and opposed to any measures that cannot.
I don't get it
Why does there have to be civilian flights to get medical help and medicine over there.
The military doesn't have planes?
You can't charter a flight?
What am I missing? Why do we have to let civilians who may been infected like Mr. Duncan take vacations here?
Enlighten me.
Want to save lives?
Ban cruise ships. A lot more people have died from norovirus than Ebola, and the r0 for noro is through the roof!
Also, why don't you explain, with appropriate references to the literature on containment of epidemics, how and where this approach has ever worked?
In other words, stop applying the "we just know" approach used by Homeland Security, and start demonstrating the efficacy of the approach using valid public health metrics.
Numbers
Because more people have died from Norovirus and the Flu we shouldn't take steps to ensure that it doesn't come here?
I don't understand your logic. It seems we should do everything possible to make sure we don't have Norovirus type numbers.
Ban all travel, then
And go read up on the flu cycle - new strains ALWAYS come to this country via travel.
SydneyA is an epic example.
So?
What is your point exactly?
We should not limit travel because we have lots of other infectious diseases here and they get here by letting sick people come here therefore we should keep letting sick people come here because there is a long list of diseases we already have to worry about..... what?
I dunno.
Apparently slowing down the spread of disease carriers has no effect on the spread of disease.
I think the real problem is that people lie. Even to the various governments.
How about a rational analysis of risks and benefits?
Surely you don't mean that.
If we were to use our entire nuclear arsenal and flatten every other major city on Earth, and then destroy every airport and ship terminal in the world, and then shoot down every plane and sink every ship approaching our shores, it would undoubtedly reduce the number of Ebola cases arriving in the USA.
But..... most people think that the cost of such a response would vastly exceed the benefits.
So, you probably don't mean that we should "do everything possible," but, instead, you mean that we should "do everything whose benefits exceed the costs."
Now, with that out of the way, we can have a reasonable conversation about costs and benefits.
Yeah...
That's a really good point there nutbag. I was saying to do exactly that.....
Well...
Nuke'em from space, it's the only way to be sure.
Again
That probably wouldn't work. The wildlife reservoirs alone would ensure future outbreaks. Strategic metals are in those areas and few others as well.
Not to mention the increase in mutations ...
{facepalm}
{facepalm}
No, you weren't
Actually, all you need to do is to scroll up and see that you were making an extreme blanket statement and not calling for fact-based policymaking based on rational analysis of costs and benefits.
Keep panicking about Ebola
Meanwhile, Dengue Fever is a major killer and has expanded its range, and is much more of a threat than Ebola will likely ever be (unless Ebola becomes weaker AND more transmissable).
Have you heard of it? http://www.cdc.gov/dengue/
So, are we also going to stop ships and planes from the expanding endemic areas (about 1/3 of the world's population, now)?
Or are we going to recognize that we have a major information base on how epidemics develop, and start listening to the people who are studying them, and start funding what we know works?
NOTE: most of the "doomsday" people are clueless. Epidemics don't work like they think they do.
Spray.
Spray for mosquitoes.
http://link.springer.com/article/10.1007%2Fs00018-010-0357-z
See? That's an example of "referencing from the epidemiological literature demonstrating efficacy."
You are not helping.
This is the tenth-or-so time you've engaged Swirly on the Ebola thing on UHub in the last week. In every case, you have come out looking like a fool with no idea what he is talking about, while she sounds (rightfully) like an epidemiologist who is providing the rest of us with much-needed and much-valued expertise on a nascent public health issue. Your continued insistence on moving the goalposts when she makes an analogy or comparison is especially grating. I'm sure you don't care what I have to say, but sometimes I get the feeling like people here treat the silence of other members as tacit endorsement of their own insane opinions and weird hobbyhorses, and I just wanted *someone* to speak up in asking you to please stop engaging in repeated, childish back-and-forth with someone who clearly knows a lot more about the subject than you do.
OK...
I cited mosquito spraying for her dengue fever thing, I cited a CDC map of the area for her 'hey, isolation is bad' thing, I cited 3000 troops and the facts of containment and help. I'm wondering if Cappy is the only one here with any reading comprehension and avoidance of the ad hominem 'Im a card carrying 100% right person so your opinion is meaningless and wrong."
I'm not moving goalposts, I'm just stating what I see the situation as. Telling us the auto fatality rate has little to do with the spread of diseases between continents. As far as my "own insane opinions and weird hobbyhorses" That's your opinion. You're entitled to it.
Perhaps it's all academic to you, but not to me. I have to live it, for real, no computer reset button, no 're-do', no second chances.
Oh, there are some reasonable folks out there that do not consider my opinions and ideas insane.
OK then
By listing all of the other diseases that kill better you really are not explaining why as the media puts it, "an abundance of caution" should not be taken.
It happened once. I don't trust the airports to be able to stop infected people from getting in.
So what is your answer? Don't worry about it?
Don't worry about it
Continue surveillance, alert people who have traveled through endemic areas to be on alert, and stop panicking.
Have we learned absolutely nothing as a society from the AIDS epidemic? Ebola is less transmissible than HIV.
maybe don't worry about it as much?
I'd like to know... what is your fear, really? that YOU are going to contract Ebola? or someone you know? that you'll have to watch them suffer a painful, undignified death like those in West Africa? Chartering flights is cost prohibitive, military flights won't provide for civilians that wish to help too. These people need. our. help and we are in a position to do so. Their lives are no less valuable than our own. An abundance of caution is being taken, but there comes a point where this caution can begin to hurt the people we are trying to help.
Ebola made it to America, yes. and it will most likely get here again but our hospitals are equipped to handle this sort of thing, even if we fumbled the ball a bit. Cases that make it here will be isolated, and their contacts quickly traced. it's not like our hospitals lack things like running water, electricity and beds. it's not as if we are allowing those that may be positive for Ebola to lay side by side on the floor next to confirmed Ebola patients for lack of space. our doctors are not overwhelmed by the constant stream of death and lack of supplies for which they can do nothing about. the situations are completely different. given these disparities in care, deaths from Ebola in America are likely to be relatively few and far between. deaths in West Africa could top hundreds of thousands. there is no comparison, and certainly no reason to fear it happening to you unless you hop a plane to somewhere and go lick an ebola patient, even then you'd be hard pressed to catch it.
compassion, not accusations are what is needed here. comments such as yours make me fear there isn't enough compassion left in this world to fight this.
Don't worry about it.
Because everyone tells the truth.
My answer:
My answer would be to have a common framework for policymaking around communicable diseases, and to impose the screening and/or travel restriction policies that are appropriate for each disease, based upon the facts available.
You, on the other hand, can't or won't answer questions about why you think Ebola ought to be treated differently from the way we handle other diseases.
Ebola and Public Health Resources
Fear of Ebola is already consuming resources that should go to more common and more overall deadly diseases.
This is driving my colleagues in the NYC Department of Health and Mental Hygiene batty. Instead of putting emphasis on and money into prevention of flu and pneumonia, HIV, hepatitis, and vaccine preventable diseases that kill a lot of people every year, they are already seeing the shifting of resources to measures with no validated prevention value or benefit, just to make the irrationally fearful feel better.
The flu clinics and campaigns are going on, but they are being asked to cut back. Why? The money has to come from somewhere.
This is a great potential harm of extreme caution amok or absent factual evidence: more people will die of preventable alternative causes when resources are shifted into epidemic security theater.
OK
That's a good point.
Response of Local and National Media to NO Logan Ebola:
"DAMMIT, DAMMIT, DAMMIT!!!!!!!!!!!"
The ridiculous msm is going to drive the country back into recession if they keep up like this. These people ought to be ashamed of themselves.