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The CDC Strikes Again
Here is a story, dated 23 October 2014, from The New York Daily News:
The Harlem doctor who was rushed to a hospital Thursday with suspected Ebola symptoms had gone bowling in Brooklyn the night before.
Craig Spencer, who recently returned from disease-wracked West African country Guinea, hit the lanes in Williamsburg and used Uber taxis to get around, sources said.
The shocking revelation that Spencer was roaming around town — after first telling authorities he self-quarantined himself — emerged after the 33-year-old medic was hauled off to Bellevue Hospital in a protective suit with symptoms of the deadly disease.
Those include nausea and a 103-degree fever, sources said.
We will learn tomorrow whether Dr. Craig Spencer has Ebola or something else. But leave this aside. The man was in Guinea. He did come into contact with patients who had Ebola — and, under the protocols of the Centers for Disease Control and Prevention headed by Barack Obama’s hand-picked director Thomas Frieden, he was advised to “self-quarantine” and otherwise left to his own devices.
Would it not have made more sense to have put Dr. Spencer in a twenty-one-day quarantine in an institution operated with some rigor by the US Department of State somewhere abroad before admitting him again to the United States?
Barack Obama is not a man prepared to admit that he, the anointed one, has made a mistake. He kept Kathleen Sebelius on board as Secretary of Health and Human Services long after she had demonstrated gross incompetence in the Obamacare roll-out, and he has left Thomas Frieden in charge of the CDC long after he has demonstrated gross incompetence. What would it take for this President to admit that he has blundered and that one of his underlings has to go?
I fear that it will require that a number of Americans will have to die in anguish and that the American people will have to become enraged. I have seen a great deal of foolishness in the course of my life, but never have I seen anything to compare with the irresponsibility of our current President.
Yes, I know, I know. Ron Klain is now on the job. He came on board today, and I have confidence in the man. I believe that, as the midterms approach, he will do everything in his power to prevent us from learning about the number of people entering the US who turn out to have Ebola. But I do not have confidence that he will prevent us from being endangered. That is, after all, not his job. He is a political operative. He is not a physician.
ADDENDUM: Pravda-on-the-Hudson now reports that Dr. Spencer has tested positive for Ebola.
Published in General
How about not go out in public once they show signs of a fever? Just a thought.
21 days outside the US between time in regions with Ebola and entering the US.
To Kozak’s telling remarks, one can add that liberal jim plucked that 20% fatality rate out of thin air. We had one case in Dallas. It spread to two people. One of the three died. That would be 33%. But to generalize from an anecdote is absurd. The truth is that we do not know what the fatality rate would be should the disease spread widely here. In West Africa, where the numbers are considerable, the fatality rate appears to be ca. 70%. That is all that we really know.
Thats EXACTLY what the doctor did.
Do you expect all medical personnel who treat any Ebola patient to go into isolation for 21 or 42 days?
So, Joe Blow from West Africa, come on in. Doctors and nurses, NOT SO FAST..
Anyone else see the absurdity here?
Evidently, not. He seems to have initially claimed that he had self-quarantined but subsequently admitted that his temperature had been elevated before deciding to go out.
I expect them to be vigilant and extremely diligent about taking their temperatures and restrict their contact with the public as much as possible, especially those who have spent significant periods of time treating ebola patients in Africa.
Does this have to be an either-or proposition? The Federal government has responsibility for securing the border against threats, and it’s not doing the job. Simultaneously, there are an unfortunate number of arrogant doctors who believe the rules don’t apply to them.
I believe in personal responsibility too — and also the converse: personal consequences. The biggest lesson I’ve tried to teach my kids is: When you make responsible choices and exercise self-control, you will be given greater scope for personal choices. And when you fail to exercise self-control, you will fall under the control of others. Exposed individuals (including doctors from DWB) have not exercised self-control and behaved responsibly, and as a result, the government needs to step in and impose stricter controls.
I’m for a quarantine, but until one is put into effect I would expect those most knowledgeable about the disease and at greatest risk to exercise personal responsibility and caution. We should expect government to act according to expectations about how people are likely to act, but that doesn’t mean we remove our expectations of individuals to be responsible or forego calling individuals to account.
I agree wholeheartedly.
And by the way folks the “21 day meme” is lousy science. The graph actually looks like this…
Exposure to disease onset
So as you can see the graph tails off, there is a small but real risk of still being infected after the 21 day period. Thats why WHO uses 42 days ( twice the length).
We can’t possibly expect the CDC to figure this out without some sort of Czar in place, come on.
Not according to any of the sources I can find. Please give a citation.
Did you not read the article Prof. Rage cited?
“The shocking revelation that Spencer was roaming around town — after first telling authorities he self-quarantined himself — emerged after the 33-year-old medic was hauled off to Bellevue Hospital in a protective suit with symptoms of the deadly disease.”
Kozak,
Thanks, both you an Cuomo have been more forthcoming than CDC. Problem is I’m not sure who I should be watching for updates.
Do you have any information on the rate of death for patients under care in advanced countries. We know that in Africa about half the people diagnosed die. Everyone assumes that here in America it will be different but is it? If the death rate is still very high the rather relaxed stance that CDC is taking is going to look very bad when the people who are infected here start dying.
You are now my Ebola expert. Please keep me undated.
Regards,
Jim
The facilities that were designed to deal with disease like Ebola have not had a reported transmission. Only the regular hospital has.
As far as I’m aware the situation is the same in Europe: the Spanish transmission was in a regular facility.
It might be the case that this doctor wasn’t infectious, or if he was, that he didn’t come into contact with others close enough (body fluids) to infect anyone. But maybe he was, and maybe he did. We won’t know for maybe 8-21 days.
Wouldn’t it be better if he were still in a quarantine somewhere, preferably off-shore, until we were certain that he is ebola-free? What is the harm in that? Isn’t the hysteria he is causing, as well as the actual expense of contract tracing and other efforts to contain this incident, worse than the minor inconvenience of that quarantine?
Not so, they get a 2 hour PowerPoint brief, and one try getting into and out of the hazmat suit. Plus they’re told to wash their hands and feet often, and don’t shake hands.
They get a lot more training on sexual harrassment.
At any rate that’s what my son, who deploys next week, got.
What more could a soldier want?
Yes, for EVERYONE coming to the US from those regions.
Here’s the actual timeline of events…
Tuesday, October 14
He leaves Guinea and travels through Brussels, Belgium.
Friday, October 17
Spencer arrives at JFK International Airport.
Tuesday, October 21
Spencer begins to feel sluggish, but health officials emphasize that his symptoms have not yet begun, according to the Boston Globe. He visits the restaurant The Meatball Shop, the High Line park, the Blue Bottle Coffee stand and rides the 1 train, New York City Department of Health and Mental Hygiene Commissioner Mary Bassett, M.D., said in a press conference Friday.
Wednesday, October 22
Spencer goes for a three-mile jog along Riverside Drive and Westside Highway. He has contact with three people, including his fiancee, Morgan Dixon, and two friends,CNN reported.
He later rides the A and L subway lines to The Gutter, a Brooklyn bowling alley, andtakes an Uber taxi back to Manhattan around 8:30 p.m.
Thursday, October 23
Spencer develops fever and nausea, both symptoms of Ebola. When his fever spikes to 100.3 degrees Fahrenheit (not 103 degrees, as was first reported), he and Dixon make a joint call to authorities around 11 a.m. to report his symptoms and travel history, ABC News reported. Spencer is taken to an isolation ward at Manhattan’s Bellevue Hospital, one of eight New York hospitals designated for the care of Ebola patients.
He was NOT running around in public with a fever.
Now, should we have a strict quarantine for people returning from West Africa? I’d say yes, BEFORE THEY ARRIVE IN THE US. And that would include EVERYONE coming from the area, not just heath care workers.
To give you all a taste of whats going on in the trenches, what follows are some Facebook comments from ER nurses employed at a community hospital in the midwest…
We got some “retraining” yesterday on PPE. The question was asked to the leadership training us. ” so if we are treating a pt that is positive to ebola, are we in mandatory 21 day quartentine within the hospital, or shipped somewhere, or are we sent home and our familes leave, or do they mandate us to stay until pt dies or is better to keep staff exposure to a minimum?” The answer ” we dont know, we are waiting for HR to answer that”. Our response ” well at least we can call home and tell our families goodbye” their response ” i am sensing some hosility”. Our response ” its our lives on the line”. Also, they still dont have a “protocol” in place on requiring pregnant or nursing mothers to work an ebola pt. Our response to that. ” yea, well, we are going to protect our own, no pregnant or breast feeding nurses will be forced to care for an ebola pt”. It was quite a training session. They were seriously so unorganized and not ready and no step by step and one trainer would say on thing and then another would contradict. So, the fiesty front liners that we are said to leadship, its going to be a total cluster f*** and we will make do on the fly. But we will guarentee that we will take care of ourselves no matter what the protocols say as well as take care of the pt well. They finally conceded and added some extra safety at our pushing on the PPE. And the funny thing is that they said we are way ahead of the game nationally. Yea….us…lol…”
“Where is the govt in this? if we just followed a military mindset, this would not be happening. Quarantine African nations. Regional hospitals with mobile hospitals in the exterior of the hospital to keep the hospital clean. ONE large hospital that all patient would be shipped to for obs, quarantine, and treatment. Someplace like Arizona or Nevada in a dry environment. CDC strike teams 12 hour availability to any hospital. The military can do it. WHere is the CDC?”
“Not to brag but my hospital has been running mock Ebola drills, protocols in place, designated staff, training, place for staff to stay for quarantine if they don’t want to potential infect family… Of course working for a university hospital with more resources probably does not hurt.”
“The CDC is weak. Their recommendations for gear are weaker than WHO or U. Nebraska. They recommend the cheaper “fluid resistant” hoods rather than “fluid impervious” hoods. And trust me when i say this. The resistant hoods are really flimsy and if vomit or fluid got soaked on there in an advanced pt, your skin and hair and neck will be in contact w the fluids. The CDC is not that proactive with this. Which is a bit puzzling. And facilities view the CDC as gospel. So its setting up staff to be needlessly exposed if such a pt is in the hospital environment. I love your idea about a freestanding mobile hospital. I think that in this circumstance, the military ideas have a lot of merit. They are well used to setting up mobile health care and preparedness. We could take some chapters out of how they do things and apply them as needed to civilian aspects of healthcare should it be needed”
” We have been drilling w mock pts, have ppe cart, do weekly donning and doffing. We now have only trauma and triage trained rns that will do the patient care in the ED. We just dont have the right PPE. Its on backorder, so we are piecing together PPE. Its just that we dont have a lot of hard and fast protocols and zero plan for staff quarantine etc. Thats the bothersome thing. it would be nice to be able to tell our families that if i have to take care of this sort of pt, x and y and z will happen.”
You should turn this into a proper post. No one will see it here, and folks should see it.