Squeaky wheel Kaci Hickox gets the grease: out of quarantine
Well, that didn’t last long:
The New Jersey Department of Health issued a statement this morning that Hickox has been “symptom free for the last 24 hours,” and that it decided to discharge her after consulting with the Centers for Disease Control and Prevention.
“After consulting with her, she has requested transport to Maine, and that transport will be arranged via a private carrier not via mass transit or commercial aircraft,” the department said.
Senior officials in the Christie administration said she will be driven in a car and escorted by officials from the state and Doctors Without Borders, the agency the Hickox worked for in West Africa.
“Health officials in Maine have been notified of her arrangements and will make a determination under their own laws on her treatment when she arrives,” the New Jersey statement said.
So New Jersey has passed the buck to Maine. I wonder what pressure was brought to bear on Christie? Of one thing I’m pretty sure: this is not a popular decision, if blogs are any indication. I’m not just talking about blogs on the right, either; even the few I’ve looked at on the left seem to have more than half the commenters siding against the nurse and with Christie, at least prior to today’s announcement.
Last night I noticed a rather strange statement from Hickox. If this is a bona fide quote, it’s scary that she’s working as a nurse:
“To quarantine everyone, in case, you know, when you cannot predict who may develop Ebola or not, and to make me stay for 21 days, to not be with my family, to put me through this emotional and physical stress, is completely unacceptable,” Hickox told Crowley. She added, “I feel like my basic human rights have been violated.”
Now, I’m all for treating people decently when they’re in quarantine, especially those who’ve just come back from working in Africa. That takes guts and sacrifice. So give them steak, nice movies on their widescreen TVs, hot fudge sundaes, whatever. If the authorities really did treat her badly, they need to improve things. For example, the article’s got a photo of a port-a-potty they provided her. That seems pretty yucky, but I wonder whether it has something to do with disposing of her wastes as biohazards rather than letting them go into the general sewage system? I’d like to hear their side, but so far I haven’t seen a word from them.
However, more importantly, how could she have missed learning what a quarantine actually is? Once more, with feeing, “To quarantine everyone, in case, you know, when you cannot predict who may develop Ebola or not…”
Does Ms. Hickox believe you must know that a person will definitely develop an illness in order to justify quarantining that person? I’m really, really curious, because of course one purpose of a quarantine is to separate a person who has been exposed to a dangerous illness from contact with the public until the time is up when they might get that illness. Preventive quarantines must cast a wide net compared to those who will actually come down with the disease. Of course, the term “quarantine” is sometimes used to refer to a person who is already ill, but that’s erroneous. The correct term for that is “isolation.”
My best guess is that Ms. Hickox, who is young, actually has no idea what quarantine is, it’s been so long since these things have been instituted, and she is actually confusing it with isolation, with which she would be familiar. Ah, but she’s the medical expert, and we’re not, right? The term “quarantine,” by the way, is from the Italian, and originated with the forty-day quarantine period instituted for plague.
I’ve noticed that, since Cuomo and Christie made their quarantine announcement, those who disagree and feel that quarantine is not necessary fall back on the old “we are the public health authorities, and we know that no one can catch ebola from someone who doesn’t have symptoms” routine. I’d love to see some scientific backup for an absolute statement like that, because forgive me if I don’t trust the CDC anymore on this sort of thing.
Seems to me that it can’t be a binary, either/or situation, but a continuum. Early on, the chance of contagion is likely to be very low but not zero, and then it increases exponentially. Since somehow the disease managed to get out of control in Africa despite the efforts of medical pepole, I really don’t think we know enough about this particular strain to make statements like the pronouncements I’ve been hearing. The risk with someone in Hickox’s situation may not be high, person by person, but the dangerous possibilities are, and it would be better to err on the side of caution in order to protect this country from what could turn into a conflagration. Make quarantine more pleasant, and most reasonable people (not Ms. Hickox) will consider it part of the deal they take on when they go to Africa to fight it and then return home.
I’ve also gotten sick and tired of people saying we can’t do this here and we can’t do that here because we must eradicate ebola in Africa. This is not an either/or proposition. We need to fight it in Africa and prevent its spread here—what is so hard to understand about that? Oh, I think most people do understand it, but the authorities put it out anyway because they think it sounds good, even though it doesn’t.
One thing I keep wondering is how this epidemic get so of hand in Africa, when previous ones had not? I’ve read that it might be because it spread to cities this time instead of remaining in more isolated rural villages. But why has it spread to cities? Was it just a matter of time? It’s also the first ebola epidemic in Liberia, Sierra Leone, and Guinea; previous outbreaks were mainly in the Republic of the Congo, Sudan, and Zaire, a very different part of Africa. That seems significant, but of what I don’t know.
Here’s a National Geographic piece I found that I thought might answer some of my questions but really doesn’t, although it’s interesting in other ways:
The virus probably will not go airborne, but it could conceivably increase its Darwinian fitness in other ways, becoming more subtle and elusive.
The genetic study by Gire and his colleagues (five of whom were dead of Ebola by the time their study appeared) found 341 mutations as of late August, some of which are significant enough to change the bug’s functional identity. The higher the case count in West Africa goes, the more chances for further mutations, and therefore the greater possibility that the virus might adapt somehow to become more transmissible-perhaps by becoming less pathogenic, sickening or killing its victims more slowly and thereby leaving them more time to infect others.
That’s why, the Gire group wrote, we need to stop this thing everywhere as soon as possible.
Note that word “everywhere.”
Our health care authorities are guilty of a combination of stupidity and hubris. They indicate that they believe they know everything there is to know about the science of the way this disease is transmitted, and are arrogant about it. But they don’t even know what they don’t know (such as, for example, that a temperature as high as 101.5 should not be the threshold for an ebola diagnosis, as we’ve learned to our sorrow recently). And yet they—with the full cooperation and urging of the Obama administration and many on the left—continue to say, “Trust us; we know best.” Meanwhile, they’ve acted in ways that make it clear there’s no reason to trust them at all.
Look at this woman’s language closely. It’s all about emotion and connectedness and her feelings of deprivation.
1. The mendacity and duplicity of the Obama Administration has never been or more display here save the Obamacare lies.
2. Mickey Kaus says put up returning healthcare workers in a luxury resort for 21 days. Gates Foundation should pay.
3. What ever happened to prudence? As in it would be prudent to err on the side of caution?
This article from the New Yorker, which I think some of the commenters here have previously mentioned, is the most informative piece I’ve seen on what’s known about the Ebola virus, this outbreak, and genetic research:
http://www.newyorker.com/magazine/2014/10/27/ebola-wars
I can’t speak to whether it’s accurate, not having any expertise in this area, but it seems well-researched and it answered a number of my questions.
it’s scary that she’s working as a nurse:
I wonder how many nurses you know from all your statements because in my experience nurses tend to know a lot about a few specific things, but lord is there a lot they don’t know. I know nurses who work in specific fields and they know nothing about the other fields, and nurses who think they know everything about every field because they are a nurse.
Not that I hate nurses or anything, I’ve just worked with too many of them. And have many as family members. Heavens.
But yes, if she isn’t showing symptoms yet, those tests they are doing to say she doesn’t have ebola are pretty useless.
I saw a news segment (FNC – Greta) where she interviewed Dr. Brantly. He thinks he got the virus while he was working in the ER section of the hospital and not when he was fully suited up and treating patients in the isolation wards.
http://video.foxnews.com/v/3855872075001/heroic-ebola-survivor-reveals-how-he-contracted-disease/?playlist_id=86925
Lea:
The concept of quarantine is not a specific field. It is an extremely general medical concept that even laypeople are familiar with. A nurse—any nurse—should know what a quarantine is, and what it’s for. That’s not esoteric or specialized information. If a nurse doesn’t know that, his/her education his been sorely lacking.
liz:
I’ve read many stories about Brantly. Most say he hasn’t a clue how he contracted it. I think he’s trying to figure it out ex-post-facto, and that’s one of many theories of his.
People coming in for diagnosis don’t necessarily encounter doctors in hazmat suits, of course. And that would be true (and already has been true) in this country as well. So the risk is always present any time a doctor encounters a patient, and in countries where the disease is common, the situation will occur over and over that medical people will encounter ebola patients when the medical people (unknowingly) are not wearing full protection. But Amber Vinson was supposedly always wearing full protection with Duncan—so there is also something wrong with the protection.
I highly recommend checking out the comments at HuffPo on this topic. The far left are truly nothing short of religious: perceived authorities have spoken – how dare you question?
These people have basically substituted one set of religious figures and tenets for another. Instead of priests or preachers or ministers or religious scholars, they assume all utterances from a Scientist or any group associated with Science is final, unquestionable truth – when that is the opposite of what science actually is.
Sometimes, observation causes one to question something previously believed. In this case the large number of fatalities among medical personnel tells me that this is an illness that can be highly contagious and does not require the sort of intimate exchange of fluids that most of the commenters at HuffPo belligerently assume … and call others names for, if they don’t agree.
There is a lot we don’t know and the attitude that we know everything so shut up and don’t ask or question the mighty Scientific Authorities might still get a lot of people hurt.
“Our health care authorities are guilty of a combination of stupidity and hubris. They indicate that they believe they know everything there is to know about the science of the way this disease is transmitted, and are arrogant about it. But they don’t even know what they don’t know (such as, for example, that a temperature as high as 101.5 should not be the threshold for an ebola diagnosis, as we’ve learned to our sorrow recently). And yet they–with the full cooperation and urging of the Obama administration and many on the left–continue to say, “Trust us; we know best.” Meanwhile, they’ve acted in ways that make it clear there’s no reason to trust them at all.”
Hubris and arrogance that leads to the deaths of innocents must result in proportional consequence. The administration and the health ‘authorities’ are charged with the responsibility to protect the public. The health authorities are supporting the administration, maintaining a united front and are therefore equally responsible and now equally culpable in the event of an epidemic.
Their arrogant rejection of common sense precautions is placing the American public at risk. They know it, we know it and they know, that we know it. Thus, if an epidemic does occur, justice would demand that those responsible must be held to account. But if justice is now impossible, then the rule of men has fully replaced the rule of law and retaliatory consequence becomes the only just means left to us.
On so many fronts, the left is forcing that day of reckoning upon us.
I’d love to see some scientific backup for an absolute statement like that
According to This Week in Virology, this was determined from epidemiological review of cases, so take that fwiw.
Cornhead:
Prudence was killed by political correctness and liberalism.
And threats of lawsuits, I suppose. Although I think that’s relatively minor compared with the rest.
Lea:
That can’t be learned from an epidemiological review, unless there was a very small number of cases and they could trace the exact etiology of each. That’s not even remotely the situation here. It may have been the situation for some of the previous, smaller epidemics (I don’t even think that is true for most of them). But it certainly is not true for this iteration of the virus, which clearly has undergone some changes.
“Obama forces Chris Christie into embarrassing U-turn to allow Ebola nurse to leave New Jersey quarantine tent”
“Chris Christie was forced on Monday to allow a nurse being kept in a tent in a hospital parking lot to go home after intense White House pressure to relax a mandatory 21-day quarantine the New Jersey Governor had imposed at a state level.”
Geoffrey Britain:
That’s what I meant when I asked what pressure was brought to bear on Christie. We already knew from yesterday that Obama was pressing him. I’d love to know what the threat was that caused him to cave. I certainly don’t think it was public pressure; I think the public was for Christie’s quarantine.
bring back liability..
ie. if she leaves and anyone gets sick, she has to pay, no matter how long it takes, for their care, and any derivative care.
estimates are about 1500 an hour 24/7
right now, she dont care because if she does leave, and makes anyone sick, she dont have to pay a dime, nor see a jail, or anything. so what does she care, in true liberal fashion?
real easy, get her to sign a contract that makes her 100% responsible… let her know that she would then be liable for 36,000 per day of care/quarantine of anyone else. up to 1.1 million for one months care.
then lets see if she complains about sitting it out to avoid any such liability
That can’t be learned from an epidemiological review, unless there was a very small number of cases and they could trace the exact etiology of each.
My understanding is that this is from research on previous outbreaks, so probably there was a small enough number of cases that they could in fact trace them when the outbreak was over. How that applies to this outbreak, and any mutations, I don’t know although the fact that duncan’s family didn’t get sick from early contact makes me think it’s probably pretty close to the truth.
But I agree with you on this that it makes more sense to think of it as a continuum of risk, rather than a firm line. Maybe it you had a big enough exposure, to blood say?, to an unsymptomatic patient you could still get it but it isn’t likely otherwise.
But if that doctor in NY went from no fever to 103 in less than a day, where is that line really between symptomatic and not symptomatic? A bit too thin…
What may not be airborne in the heat of Africa may in fact become airborne in the colder and drier climate of the U.S. according to a military study. http://www.infowars.com/u-s-army-ebola-goes-airborne-once-temperature-drops/
Lea:
That’s my point: small “n,” and not about this particular strain of ebola, which could easily be more contagious (and in fact appears to be more contagious). Also, it must be a continuum in terms of contagion. Contagiousness seems to increase exponentially as symptoms worsen. But the risk when someone merely has a fever would not be likely to be zero.
Like is often said, if you have to ask the price, you can’t afford it. With only a few cases treated in this country, so far, the cost must be huge given all the precautions, special transportation, and contact tracing. I’d like to see a number and how it will be paid.
Allowing people from the hot areas to come to the U.S. and then mix among the population is political correctness run amok. Some people feel they have to prove they are not racist.
I would like to know if the nurse really was being kept in a tent in a parking lot, as the article linked above asserts. I have also seen reports that the tent was inside a building. If she really was in a tent in a parking lot, that seems ridiculous and indefensible. A tent inside a building — maybe not so much.
But the risk when someone merely has a fever would not be likely to be zero.
It does seem to be pretty low though, which is heartening, since we are going to have people bowling, flying and riding the subway and cruise ships apparently.
I would like to know if the nurse really was being kept in a tent in a parking lot, as the article linked above asserts
When they said that I though maybe it was a decon tent or something? We have those for emergencies here. What’s the weather like in NJ anyway? It’s probably still pretty nice so that’s not exactly the worst thing in the world. It does seem to have been poorly thought out, though.
Lea: from what I understand, the doctor in NY did NOT have a temp of 103 when he called authorities. It was 100.3. The initial reports were incorrect and were the result of what was called a transcription error by some public health or hospital official who informed the media.
I was going to add this to my previous comment on the confusion regarding the tent, but will add it to this one instead as it’s also apropos: we need to be SO careful with the “facts” reported in the news media on all of these things. Especially in the early stages of any event, they are likely to be inaccurate at best, and it’s best to approach everything with a highly-raised skeptical eyebrow. Years ago, I went through a brief period of local semi-demi celebrity after publishing a couple of books, and got written about a number of times in various newspapers. Every single article got many of the basic facts wrong, no matter how carefully I had tried to communicate them in interviews, and often even after I’d supplied written fact sheets. The only times that accurate articles appeared were the rare occasions when the journalists let me see them before they were published so that I could fact-check them. The same thing happened when Mr Whatsit’s business got written about — even in trade publications that should have been on top of the details — and when our kids got written about for various school events and accomplishments. If they spell your name right, you’re doing better than average! This experience was part of the process of my eventual conversion from liberalism to conservatism (as it really brought home that you CANNOT trust what the media tells you) and I try now to bear it in mind, especially in the context of emotional highly-charged events like the Ebola situation or the school shooting we were discussing the other day.
I don’t know about New Jersey, but it’s been pretty doggoned raw, damp and chilly for the past few days in upstate NY, a few hours’ drive from New Jersey. I wouldn’t enjoy a stay in a tent!
“But Amber Vinson was supposedly always wearing full protection with Duncan–so there is also something wrong with the protection.”
Or with the procedures for removing the protection, which have been revisited and tightened up since she got ill. People seem to think that a likely danger point is in the process of taking off contaminated garments, which is apparently quite difficult to do without self-contamination.
It’s interesting that we’re supposed to defer to medical authorities (as opposed to governors who are looking out for all their citizens’ public health & safety), yet it seems to be the medical personnel who have such difficulty with self-monitored quarantine. Only Nina Pham seems to have taken it seriously.
My depression-era parents were just telling me about how there were in-home quarantines when they were young, and the family would remain in the home and neighbors would drop off meals on their doorstep. Why is the concept of a quarantine being debated, especially when we’ve seen Ebola spread (both here and more so in Africa) and exposed people here in the US have shown how useless self-monitoring can be.
Oh, Mrs. Whatsit. Stop being so sensible.
Rush has some interesting, logical, points…
Paraphrasing:
So you travel to west Africa to end ebola… at terrific personal risk… and then object to a quarantine-vacation when you return… so that you can spread ebola inside the USA?
http://www.rushlimbaugh.com/daily/2014/10/27/obama_crushes_state_ebola_quarantines
%%%
Barry applied brutal financial pressure: both NY and NJ are STILL receiving (Federal) hurricane (Sandy) relief — which can be shut off at a stroke of Soetoro’s pen. IIRC, it’s the President’s decision as to when enough ($) is enough.
http://en.wikipedia.org/wiki/Effects_of_Hurricane_Sandy_in_New_Jersey
As you might suspect, New Jersey is STILL recovering from Hurricane Sandy.
Because of the hurricane’s footprint, shoreline zoning has changed all over. Settlements/ claims/ loans are STILL stacked up across the ‘system.’
For Christie, Barry has him over a barrel. A snap cut-off of Federal monies would instantly crater the local construction trades. Right now, they are still doing a land-office business. It’s one of the factors holding up Christie’s popularity across New Jersey. The funding flows outward from the construction zone to reach far distant Jersey businesses — and their employees.
As for Atlantic City:
http://articles.philly.com/2014-09-01/news/53417215_1_atlantic-city-revel-trump-plaza
Yes, it’s a disaster. Previously, Atlantic City had been a money spinner for the state budget.
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Folks, this is what Chicago on the Potomac looks and feels like.
%%%
Am I the only one to question why that Dallas broadsheet published that whiny screed from that obtuse nurse?
According to the Dallas Morning News, which published her article impugning her quarantine, the nurse was “until recently” a CDC employee in the Epidemic Intelligence Service, a two-year epidemiology fellowship.
http://www.dallasnews.com/news/metro/20141025-nurse-former-uta-student-is-quarantined-in-new-jersey-despite-testing-negative-for-ebola.ece
I googled her, and it looks like she is also an M.P.H.
So she ought to be familiar with preventive quarantine.
I’m surprised the paper let her leave that experience out of her article – it’s like having a lawyer comment on a case without disclosing she used to represent a party.
Mrs Whatsit:
Yes, something wrong with the protection itself or of course with the procedures around it. Something wrong with it in general.
But what I’m tyring to say is that something unrelated to an error or carelessness of the nurse herself may be the problem. Not that error isn’t possible, but there are so many of these incidents that I think the protection itself, or the recommended procedures around it, are inadequate.
The nurse’s boyfriend’s Facebook postings maybe shed some light on her thinking:
This is an attack on science, on medicine, on the value we place on health care workers! This is as mind boggling as the debate we have in this country over climate change.
–and–
Ok, I’m going to throw this out here one more time because I know that I must have some friends who know some important people in power who aren’t completely fixated on political grandstanding and causing mass hysteria. If any of you do and care as much as I do about civil liberties, about speaking truth to power, and about making America a place of tolerance and hope, not fear and repression, help me liberate Kaci Hickox from Chris Christie’s private prison.
About what kind of pressure was being put on Christie — perhaps it was simply because Cuomo changed the quarantine policy for New York and that left Christie being a bad guy all on his own.
https://www.youtube.com/watch?v=4AZidJ36nA0
https://www.youtube.com/watch?v=FMELNLTh-b0
VICE [ The Canadian Web narrowcaster ] obliquely lets slip what’s different.
The Congo is non-Muslim. It’s also dotted with clans that don’t cross connect (contagion-wise) all that much.
West Africa’s ebola problem actually sprouted FIRST, and most intensely, among its Muslim population.
In VICE’s footage — they dance around the obvious — one mosque has been so devastated that it’s shut down. [VICE tosses off why a mosque has been so recently been ‘re-purposed.’
The monologist does related that this particular mosque is at — essentially — ground zero for this ebola epidemic.
If so, then this epidemic is repeating historical patterns: viral hotspots. Spanish flu, the pandemic, also danced from hotspot to hotspot.
This trait is EXACTLY why quarantine is so spectacularly effective.
{
In modern MSM medical jargon, hotspots are “ebola out-break CLUSTERS.” Well, that’s putting it softly, isn’t it?
The hotspot phenomenon is the direct result of reflexive quarantines. No-one nearby will visit. The virus does its ‘thing’ and then, having run out of hosts, is obliterated by natural causes.
Super wicked viruses don’t do well outside the body. If they should do so, then they’d eventually propagate through any given host population until it was exterminated — or immune.
Sky Says:
October 27th, 2014 at 4:01 pm
This nurse worked for the Obamas CDC. They do not want people quarantined. Hence…Miss Hickox sues NJ. Of course, you won’t hear about that on MSM.
Mrs Whatsit,
That New Yorker article you linked to is excellent, both for giving historical context for this outbreak, but also for showing the thinkng of medical workers and researchers who deal with ebola. One point that should be highlighted is researchers’ concerns about mutations and what airborne really means.
Two other points shoud be made about the US role in understanding the disease: A WSJ article the other day mentioned the huge increase in government spending post 9/11 to deal with potential epidemics caused by terrorism. Ebola research alone increased from about 840 thou to 42 million dollars. And of course, more was spent on things like anthrax. My second point is the rapidity of sequencing the ebola strains and analyzing the full library of them. This is partly due to the remarkable technological advances stimulated by the human genome project. I can remember that some in Germany were not happy about the project because it would take money away from individual projects. James Watson said at the time that the technology would come if the need was there. About 30 years ago my husband spent a lot of his PhD time sequencing a tiny part of E coli that he was studying. Today, he sends away a bug and has it sequenced with in few days. They have even added a new term to studies: in vivo, in vitro, and now in silico. This means that you can search a huge range of organisms to look for similar genes on computers. If you dig a new bug from a volcano or find one deep in the sea, you can sequence it and compare it to existing bugs.
neo…
Lest we forget: it’s IMPOSSIBLE to wear hazmat suits in the prescribed manner in west African weather.
EVERYONE would keel over with heat stroke.
The cavalier attitude of the nurse is her reflection of operational procedures in Africa.
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Lest the commentariat forget: hazmat suits were developed for the military… and NBC warfare.
And by that I mean the actual gear that everyone is using. For the longest time, the DoD was the only serious customer/ market for such protection. Hence, they’re disposable, priced right, and simple to suit up.
From the outset, the DoD/ US Army wanted suits that could be put on in a HURRY. This requirement comes at a cost. Taking them OFF is quite a project.
The drill was that one could put a hazmat/ chemical warfare suit on anywhere — but taking it off had to be done under controlled circumstances — with (trained) specialists — in a controlled setting. For the US Army this actual procedure was classified — video not for general release.
But the gist was obvious: troopers were to come to a tricked out tent with wash down gear and various counter-agent chemicals. (A wide selection known to neutralize this or that nerve agent. For obvious reasons, the US Army didn’t want the enemy to have a crystal clear picture, lest they come up with an evil brew that was practically impossible to rinse off.)
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Which brings us back to the medical professionals: from what footage I’ve seen, they’re washing down their hazmat suits as if they’ve got mud on them — with power washers/ high pressure hoses. (ie full garden hose pressure, at least)
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So, between the impossibility of properly wearing a hazmat suit in that climate — and the wash down procedure — it’s no mystery as to why the players are getting infected — and have a bizarre ideas about ebola transmission.
Both nurse and lover are flaming ESFJ personalities.
http://www.personalitypage.com/ESFJ.html
http://www.truity.com/personality-type/esfj
This ^^^^ is worthy of inspection, for it’s the profile of most nurses. It also goes far in explaining why both she and he are illogical.
Rush is a classic ESTJ:
http://www.16personalities.com/estj-personality
Barry Soetoro is multi-variate, but if anything:
ISTJ
http://www.16personalities.com/istj-personality
Just keep in mind that Barry’s goals are inverted from normalcy, from America, hence: ebola for America!
About that “tent” — here’s what the hospital said:
About that port-a-potty: One of the things Emory University discovered in treating their first two patients was that
@blert: I have thought it odd that the media keeps mentioning funeral practices that involving washing the body as a major Ebola vector, without mentioning that washing a body is mandated in the Koran. It’s almost as if nobody wants to say “Islam is a major reason Ebola is spreading.”
Whether Ebola mutates to go airborne or not, the fact that the disease incapacitates and results in an isolation patient will drive two disastrous genetic changes.
1. Longer viral survival times outside the infected person. This means table tops, door knobs and the life. Dreadful for public health.
2. Infectiousness occurring earlier in the course of the disease, perhaps well before symptoms show.
I’m not sure what we can do about the first other than to keep infection rate down enough for the mutating gene pool to remain small.
The second we can make a great impact on by practicing quarantine and limiting the number of others who get exposed in the early stages rather than waiting for symptoms to develop to act.
I suspect that these so-called experts are simply bureaucrats doing as the Obama administration dictates. What sounds like stupidity is just compliance.
But I can’t make sense of the administration’s policy. Obama desperately needs to be seen as a strong leader and this would be an almost risk-free way to give that appearance. Yet he doesn’t act even with elections looming next week.
Is he that much a wimp? Maybe. On the other hand he may still be trying to be the UnBush. Bush would have gone for a quarantine, therefore he will not.
–Michael W. Perry, author of My Nights with Leukemia
Democrats don’t believe in evolution.
I mean, if you’re talking about Ebola.
Democrats are so ignorant they don’t even know what evolution, religion, or scientific freedom is. Let alone which side is right.
I really don’t agree that volunteers should get steak or special treatment in quarantine. Treated well is a no brainer, but these people don’t have the right to expose the rest of us to ebola because they have volunteered themselves. It’s getting tiresome to hear these allegedly altruistic individuals expecting taxpayers to foot the bill for their extraordinary medical care and to allow them to travel freely and potentially expose others. To me, these people are behaving selfishly, and don’t deserve the adoration they are getting. sorry, that’s how i feel about it.
southpaw:
Well, I certainly don’t think anyone could describe my attitude towards Ms. Hickox as adoration 🙂 . I said from the start that she struck me as petulant and arrogant, and I see no reason to change my mind (except I’d add “truculent”).
I do think good food, etc., would be appropriate for all these people. The government wouldn’t necessarily foot the bill for that; it could be private donations or provided by the organizations that recruit them. Not steak every day, either. Just enough perks and pleasantries to sweeten the deal. After all, we certainly want people to be wiling to go over there and help. It’s not just altruistic, either, it’s in everyone’s best interests to damp down the epidemic there if possible.
” up to 1.1 million for one months care. ”
Art, what, exactly, will you do when she signs, leaves, then says “F*ck you, won’t pay.” We don’t have debtors prison.
I have noticed that the returning SIM/Samaritan’s Purse missionaries have been very careful about quarantine on return from the hot zone. The non-religious medical volunteers (who do good work) have not been as careful. It’s probably true that the virus is not transmitted until the patient is rather ill. Otherwise why weren’t Duncan’s apartment mates infected? But with a virus this horrible a better safe than sorry approach is the way to go. Returning medical people should check their temperatures, have a plan on whom to call if their temperature rises, and stay out of public for the good of their communities until the quarantine time expires.
There is no good reason to be permitting non-medical related travelers into the country at this point. Visas should be suspended until the epidemic is burned out.
With all that being said, New Jersey was apparently not prepared for an actual quarantine patient. If they’re going to do this, they need to rent a block of hotel rooms with TVs and WIFI and put people there with their luggage for the duration or until, like this woman, an alternate quarantine site, like home, is approved. A tent and porta potty, no shower, for a detainee who is not ill? I flew into Cairo at the height of the swine flu hysteria, terrified that if I looked feverish I could end up locked up in an Egyptian hospital ward, which doesn’t sound like it would have been as bad as a tent and paper scrubs to wear.
Good grief. I just read at The Hill that the CDC thinks quarantines should apply only to people who know they were directly exposed without protective gear. This, they say, is Science. How they explain Brantly, Writebol, Spencer, and Mukpo is beyond me, but then I’m not a Scientist.
neo – We don’t disagree on getting decent treatment. In terms of taxpayer expense, I’m a little bothered by the cost of food and lodging, althought it’s in our interest to tamp down the epidemic as you put it, it’s the cost of these people NOT being quarantined that should be considered. These people’s civil rights don’t include tax payer cleanup of their living quarters and the entire path they covered while they were infected and running loose. It’s really the height of arrogance to think we owe them freedom to travel here without restrictions after exposing themselves to a deadly disease. It ought to be part of their understanding when they sign up for this that they are foregoing the right to endanger anyone at home, but I’m only hearing in the media that we’re all meant to admire their selflessness, while people like this nurse are anything but.
If I volunteered for this, I would fully expect to be cleared of the disease before touring NY and going to a Jets game. It’s just basic consideration for others we’re talking about, but it seems completely absent from the discussion -It seems to be an unspoken theme that because they’re helping the sick, we’re all supposed to sacrifice something too. I don’t agree -they get to make that decision for a whole country without its consent.
“But why has it spread to cities? Was it just a matter of time?”
Yes. As I’ve said before, I used to live in the area of northern Liberia across the border from where the outbreak began in southern Guinea. As soon as I read of the outbreak, back in March before it had even been confirmed as Ebola, I said to myself basically, “If they don’t nip this thing in the bud there is no doubt it’s going to be in Liberia.” There’s just a lot of road traffic in that area. Families and the tribes they belong to straddle both sides of the border. The border is a political border but not a cultural border.
And the corollary to that is that once something is in Voinjama, the capital of Liberia’s northernmost county, then it’s a one day trip from the capital. You leave in the morning and by late afternoon/early evening you’re in the heart of Monrovia. It’s only 250 miles. In our world that would be a four hour trip but over there more like 10.
And the thing about Liberia and a lot of countries like it is that the capital is the hub for everything. If you leave Voinjama, the next most likely place you’re going to go in the country is all the way to the capital. You likely have friends and family there, which you don’t necessarily have in other parts of the country because other tribes predominate in those places that you’re not as directly related to. Monrovia is a microcosm of the country, with all tribes and areas represented. When you go there, you tend go to the part of town people from your area are concentrated in. (Like all the retirees living near my aunt in Florida who came from the same part of Michigan she did.) So really, Ebola is just two (maybe three) hops from a village in southern Guinea to the capital of Liberia. The outcome wasn’t hard to see if you’ve spent time in that area.
Sorry about the error with italics.
Perhaps the difference in this outbreak is the difference between a virus appearing in eastern Montana vs it appearing in the NY, NJ, Connecticut tri-state area. There are a lot more borders easily accessible to migrate across. And each border represents the spokes on a wheel.
In the case of the Ebola outbreak, the northern spoke goes directly to Conakry, the capital of Guinea. The southwest spoke goes straight to Freetown, the capital of Sierra Leone, and the southeast spoke goes to the heart of Monrovia, the capital of Liberia – for the reasons I mentioned in my earlier comment. It’s just unfortunate that the hub happened to be located in the place that it was. It guaranteed a huge problem if the outbreak wasn’t squashed immediately. And it wasn’t.
The governors should give people like Hickox a choice: Either go into quarantine or pay for your treatment and for the cost of monitoring everyone you expose. And, oh yes, if you get sick at home, you will lose all your possessions.
Here’s what I don’t get. I’m a doctor or a nurse who’s just seen up close the hideous suffering of people with ebola, and yet I’m not terribly concerned that I could just possibly come down with it myself and then spread it to others. So I go bowling, take the subway, or get really miffed when I’m stopped from taking a plane up to Maine and put in isolation until I’m given the all-clear.
The cdc and the so called experts do not have a firm understanding of how this current ebola pandemic spreads and are stubbornly insisting their procedures are adequate to protect caregivers and prevent the spread of ebola outside Africa. They have lost all credibility. Its so obvious a mandatory quarantine is necessary and it should be made as comfortable as possible. But this whining holier than thou goody two shoes is despicable. She’s willing to infect her family, other caregivers, and the general public simply because she is so special.
Meant to add — Is it some kind of denial mechanism that comes into play? You know, thinking deep down that they’re not truly vulnerable, which helps them work in dangerous situations.
Ann:
I think a person must feel somewhat invulnerable to do this sort of work.
But I think there’s quite a bit more going on with Ms. Hickox, including a political agenda.
If you could stand another link to an “interesting article”:
http://www.theatlantic.com/national/archive/2014/10/21-days/381901/?single_page=true
Dr. Steven Hatfill has experience with Ebola, and DOES recommend quarantine. Interesting tidbits: “… 12.5 percent of patients don’t run a fever”; and (indicating there are other ‘viral footprints’ we find in reservoir species) ” … there are worse things out there. Again, we’re finding viral sequences, and we don’t know what these are from. There are other things out there.”
Then, asked by the interviewer “How do we get the government to invest?” {in research} Hatfill replies, “We spent 120 billion on this, on emerging disease and bioterrorism, what have we got to show for it? Machines that the FDA hasn’t licensed for rapid diagnosis.”
Lots more; good article. Food for thought.
Neo-neocon, I always enjoy reading your blog. Great, always great.
Two things:
1) the young are always bullet proof – even if they know better.
2) truculent – I thought Strawberries were “truculent”?
I couldn’t help my self.
Ann – as obnoxious as Ann Coulter seemed in her criticism of the doctor who contracted Ebola, there was a element of truth in her characterization of the people who volunteer for this duty. At some level there’s a self gratification and fulfillment they get from doing this sort of thing — yes, it’s for a good cause,but it’s gratifying for them nonetheless, and in some cases, they’re annoyed when everyone else isn’t rushing to pat them on the back for their efforts. I think what they’re doing is great, but they owe all of us the same consideration and respect. It’s their choice to put themselves in danger, but some seem to feel that this behavior as noble as it may be, doesn’t entitle them to risk anyone else’s life. Ms Hickcox and the doctor who went bowling see themselves as entitled to do whatever they want and the rest of us have no right to judge.. They simply reject that we’re in danger compared to their potential their sacrifice.
And while I am sure that there’s a certain bit of invulnerability that Ms Hickox and similar people feel, I am not so sure they’d all feel this way if it was clear they would not be admitted back to this country if they contracted the disease. As evidence of this, one only needs to witness the indignation they feel at being asked to remain in quarantine, and inconvenienced for a few weeks. They risked death, how dare we not recognize this supreme sacrifice and ask them to stay in a hospital for 3 weeks ?
Maybe it’s political too, but I’m leaning on a touch of hero syndrome for Ms HIckcox too.
southpaw:
Hickox and Dr. Spencer are very very different. What you impute to Hickox cannot be imputed to Spencer.
We might wish he’d stayed home, but he actually followed the CDC guidelines to a T. He was allowed to go out as much as he wanted, as long as he took his temperature. When his temp rose he self-quarantined and called the CDC, and then he was hospitalized without making a single self-aggrandizing or hostile statement. I would not tar him with the same brush.
What’s more, for months probably hundreds of US health care workers have been going to the ebola countries, treating patients, and coming back, and following those same exact CDC guidelines without incident. The only thing different about Dr. Spencer is that he contracted ebola there and was incubating while traveling, so that he came down with it here without knowing he’d contracted it.
How can anyone coming from ebolalandia not consider they are unknowingly infected??? It defies my limited imagination. Of ccourse you may be infected despite your body temp or other symptoms. Do we wait for high temps, projectile vomiting or uncomfortable dihirea before they are quarantined? In a sane society, with sane leaders the answer is of course not.
Neo: “Hickox and Dr. Spencer are very very different.”
Thank you, Neo, I too needed to be reminded of that.
On another note; there are various news outlets reporting that the Army is now suggesting that it will institute a mandatory quarantine for returning soldiers from the “hot zone.”
If true I do find that interesting that the Army is sort of at odds with the White House. Will Obama make them change too?
He needs to get the US Army medical corps to throw away the rule book.
Unlike his generals, his Army doctors may not be worried about promotion/ status within the Army.
They can ALWAYS bail out into a higher paying slot.
As a non-doctor, the US Army medical corps book gives the CinC no clout at all.
This is but a part of how officer-doctors don’t command troops — and troop commanders don’t doctor.
It turns out that Kaci Hickox is also an Epidemic Intelligence Service fellow at the CDC. She has concealed her ties to the CDC, her employer. The CDC, strenuously opposes a travel ban or quarantine for Ebola.
Kaci Hickox previously was convinced her of the importance of quarantines and “health surveillance” it seems.
She is also a Left-wing Democrat and Obama supporter.
http://gotnews.com/ebola-nurse-complaining-quarantine-left-wing-democrat-cdc-employee/
It seems to me that familiarity with the Dark Winter exercise can help us understand what is at stake and how an American Ebola epidemic could play out.
In June 2001, the Center for Strategic and International Studies and the Johns Hopkins Center for Civilian Biodefense Studies among other groups hosted a senior-level war game examining the national security, intergovernmental, and information challenges of a biological attack on the American homeland. The scenario used smallpox as the hypothetical infectious agent but I expect Ebola would produce similar results.
In this scenario, about a week after the Federal government understands it has an smallpox outbreak on its hands (1,000 infections of which 300 are dead) “hospital in most highly affected states face desperate situations. Doctors, nurses are scared and exhausted. Many hospital employes are not showing up for work for fear contagion”. Things quickly get worse and in weeks much of America’s healthcare system has collapsed as the number of infected reaches 3 million with 1 million dead.
Sen. Sam Nunn played the role of POTUS in this exercise. Interestingly I am aware of reports that VP Dick Chenny and National Security Adviser Condi Rice were observers.
Every time I read something like liz’s statement about Brantly I’m getting more convinced that the ebola mutation making this outbreak more severe than others is not air-borne transmission but something that creates asymptomatic carriers (think Typhoid Mary) or a period where the person can transmit the disease but is asymptomatic. Which makes statements about not being able to catch the disease from asymptomatic people more faith-based than scientific.
Science is faith based now.
Here’s what I don’t get. I’m a doctor or a nurse who’s just seen up close the hideous suffering of people with ebola, and yet I’m not terribly concerned that I could just possibly come down with it myself and then spread it to others. So I go bowling, take the subway, or get really miffed when I’m stopped from taking a plane up to Maine and put in isolation until I’m given the all-clear.
That should be relatively easy for you to understand. On a previous topic you supported government coverage or protection of a kind.
That person in the story was merely relying on the gov and his organization to tell him what to do, which will become right. He wasn’t going it alone or making a cowboy act.
Just because some stranger gives him a rule to do X, doesn’t mean he will recognize it as being legitimate until he knows it comes from his Overlords and slave masters.
Leftists like Hickox always talk about the “common good” and “science” but they let the mask slip occasionally and you realize it is all about “me!, me!, me!”.
How much does she really care about her children? She presumably has seen the horrors of children dying from ebola in Africa.
Even if there was only an infintessimal chance of you having ebola and transmitting it to your kids, would you take that chance, or wait a few weeks to make sure there was absolutely no chance of your kids dying a horrible death (and worse, through a virus that you yourself passed to them)?
Neo: “Hickox and Dr. Spencer are very very different.”
No, I don’t think they are. I don’t know Dr. Spencer’s background, but I assume if he was working directly with ebola patients, he knew a lot about the disease and its forms of presentation, which is exponentially more than the average doctor. He might have had a background in epidemiology, or at least learned a lot while on the job. In fact, he probably had a better handle on what the disease was capable of than the CDC officials who instituted the “take your temperature” policy.
The fact that he reportedly did meticulously monitor his temperature makes him more despicable than Hickox in my mind. Someone who thought they were “invulnerable” to the disease wouldn’t have followed the guidelines so closely. His actions make it seem that he knew full well there was a chance he could be infected.
He, more than most, likely knew that body temperature wasn’t reliable early on in infection. He could have done more than what the CDC required (self-quarantine at home for a time) but didn’t, because he wanted to go out THAT NIGHT and party, and if he didn’t end up getting sick, he could always fall back on the “I did everything the CDC told me!” excuse. He not only exposed his fiancee before determining if he was in the clear, but all the people he came in contact with when he went out on the town. Remember, he determined he was symptomatic and quite possibly infected just the next morning after coming back to the US. He couldn’t even wait just ONE NIGHT to possibly avoid exposing hundreds of people to ebola.
With Dr. Spencer, just like Hickox, it was all about “me!, me!, me!”. This attitude makes me suspect Spencer’s motivations behind going to Africa were less about “helping people” and “global goodwill” and more about resume-building, moral preening in liberal circles, and photos to be taken with cute African children to hang on his office wall.
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I don’t mean to be totally cynical of Doctors Without Borders. I think there are a lot of doctors in that program who are doing it more for the moral preening they’ll be able to perform for the rest of their lives after they return, with the actual helping of sick people as an aside.
However, there are clearly doctors who participate in the program because they are good people and want to do good for the world. Unfortunately, these are usually the doctors who don’t live to return.
Australia is going much farther re a quarantine — they’re requiring “a mandatory 21-day quarantine prior to entering the country. That applies to health-care professionals returning to Australia after serving in Guinea, Liberia, and Sierra Leone.”
prior to entering the country
Sounds like Kaci Hickox has a new career path being readied just for her. Just think of the media face-time potential for her in all this.
I was listening to Howie Carr (Boston radio talk show) on the way home today. He was chuckling over how Kaci Hickox kicked Gov Christie’s @$$. However, I thought the Gov was well rid of her and saved NJ taxpayer’s a bundle by handing her off to Maine. I believe her interaction with Maine has also been contentious. In the meantime, the Governor has discharged his obligation to the citizens of NJ, who can’t be financially on the hook for every potential ebola patient that is in transit to somewhere else.
Did MS Hickox fly commercial to Maine? Anyone?
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