Dallas Ebola (not a Cowboys post)

[Birdstrike]

Well, whoever it was, it was someone from the CDC. If a nurse or doctor, really? I mean I have worked with some not so swift people, but come on. If the nurse gave them her specific details, what kind of thinking process went on there? Plus, what the hell was she thinking?

This is standard-issue government incompetence, unfortunately. Remember this and any number of examples of government incompetence the next time a candidate wants you to vote for them to "do more" of anything.

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[Birdstrike]

Here's an interesting question I just thought of. If a lawsuit comes as a result of a bad outcome, such as with n=1 Ebola patient, and it is alleged there was a breach of "standard of care," what is the standard of care in relation to a disease never (at least at that time) seen before on the continental United States?

In other words, how can there be a "standard" to follow, in relation to a disease never even seen once, let alone treated often enough by the nation's physicians, to have an established standard of any kind whatsoever?

 

[Megalomis]

It was a big miss, I don't think there is any doubt about it. There were multiple points where someone could have intervened to get this guy into isolation and it didn't happen. Now, you have a potential patient zero with multiple children exposed.

Placing the blame on others is not helpful because at the end of the day it's the MDs responsibility to conduct a proper history and physical. In an infectious presentation should include the question "any recent travel?" It takes two seconds, if you're suspicious then ask more questions.

Triage is just that, triage. Sure the nurse blew it and he or she should face the consequences, but this is not the first or last time that will happen- if it's outside the algorithm then a nurse just isn't going to catch it- that's our responsibility.

They screwed up. Acknowledge, learn and move forward. I guarantee ED staffs around the country are having very serious discussions about this in the last few days and that is a good thing.

http://www.cnn.com/2014/10/15/health/texas-ebola-outbreak/index.html

Is it the MD's responsibility to keep tabs on all the nurses and all other health care workers that came into contAct with Duncan too? CDC claimed that the situation was being managed, and everyone was on close watch. Instead, they allowed for one of the nurses who treated Duncan to fly (after the nurse called in to report a mild fever). It seems like plenty of people are dropping the ball here IMO.

I read somewhere that the CDC only had 40-50 people to watch.
So much for handling that simple task...

 

[southerndoc]

All true. At this point, most of us can only hope and pray that it remains limited.

I love how everyone came down on the second nurse, when she contacted the CDC and they told her that 99.5F was beneath the threshold, so she could go ahead and get on the plane. If she was not coughing, vomiting, oozing, or spewing anything, those people on the plane are probably fine. But KNOWING that she was in very close contact with Mr. Duncan and his secretions, with substandard PPE, and then the nurse having a low grade fever, the CDC's advice was idiotic.
Seriously, what is up with the CDC?

There are rumors that everyone in contact with Duncan was told no public transportation for 21 days regardless of symptoms. I can't vouch that it's true, but if it is and she traveled, she could face felony charges.

 

[costales]

http://thescoopblog.dallasnews.com/...posed-to-ebola-no-emergency-declaration.html/
Dallas leaders on Thursday moved to sign “voluntary agreements” to restrict the movement of health care workers who have been exposed to Ebola, but stopped short of declaring a local emergency in response to the virus.
The workers will be asked to sign papers saying they will avoid public transit and public places. But if they don’t sign, county leaders will issue court orders restricting their movement...
“They can walk their dog,” Rawlings said. “But they can’t go to church. They can’t go to schools. They can’t go to shopping centers.”
Rawlings stressed that the agreements are “voluntary.”
“But if they…still break what we are going to be doing, we are going to have to move to another level,” he added.
That would include “control orders” like the ones used to isolate family members of Duncan. Those would be enforceable by police.

 

[BHB2008]

This is standard-issue government incompetence, unfortunately. Remember this and any number of examples of government incompetence the next time a candidate wants you to vote for them to "do more" of anything.

Right, that private sector hospital where the only instances of transmission have occurred is doing such a bang up job.

 

[Megalomis]

There are rumors that everyone in contact with Duncan was told no public transportation for 21 days regardless of symptoms. I can't vouch that it's true, but if it is and she traveled, she could face felony charges.

Felony charges? The CDC gave her the ok to fly. She didn't do anything wrong--she told them exactly what was going on, and they said to go ahead and hop on a plane lol. Also..felony charges are kind of irrelevant if you're not alive anymore. There was talk about Duncan getting felony charges too; but that's not going to ever happen since he's now 6 feet under.

 

[Birdstrike]

Right, that private sector hospital where the only instances of transmission have occurred is doing such a bang up job.

You're right. I forgot that "two incompetents makes a competent." That will help fix things the next time the federal government makes a colossal mess of things. Thanks for the snarky correction.

Oh...I also forgot that single private sector hospitals have the same resources of the entire US Federal Government.

 

[BHB2008]

In my experience, the private sector always gets credit for successes and the government for failures. The Fact of the matter is, no private organization has the extraordinary legal and administrative resources of the government, so it is the best equipped to respond. Remember, we have no "control" for what the situation would be like without government oversight, but one can look to Liberia for a suggestion.

I'd lay off the libertarian agitprop because this is hardly a colossal mess of things yet. Seems like you're jumping the gun. Two infections != disaster.

 

[rajhanda]

Doctors and nurses who treated ebola pts are now on no-fly list like terrorists. But there is zero travel restriction from the hot zone. political correctness is going out of control... the media is now publishing an op ed from mr duncan's nephew to once again denounce presbyterian' racism

breaking: All hail our ebola czar the gore/biden political opreartive Ron KLAIN... rest assured he knows that bleach kills germs...

 

[Birdstrike]

In my experience, the private sector always gets credit for successes and the government for failures. The Fact of the matter is, no private organization has the extraordinary legal and administrative resources of the government, so it is the best equipped to respond. Remember, we have no "control" for what the situation would be like without government oversight, but one can look to Liberia for a suggestion.

I'd lay off the libertarian agitprop because this is hardly a colossal mess of things yet. Seems like you're jumping the gun. Two infections != disaster.

Ok.


You win.

 

[jl lin]

In my experience, the private sector always gets credit for successes and the government for failures. The Fact of the matter is, no private organization has the extraordinary legal and administrative resources of the government, so it is the best equipped to respond. Remember, we have no "control" for what the situation would be like without government oversight, but one can look to Liberia for a suggestion.

I'd lay off the libertarian agitprop because this is hardly a colossal mess of things yet. Seems like you're jumping the gun. Two infections != disaster.

Umm, nah. Gov't pretty much facoctked it up. No way to miss that.

 

[jl lin]

There are rumors that everyone in contact with Duncan was told no public transportation for 21 days regardless of symptoms. I can't vouch that it's true, but if it is and she traveled, she could face felony charges.

Even the head of the CDC admitted that the nurse called the CDC and described her situation/who she was and that she had a low-grade temp. Personally, I wouldn't have wanted to put my family at risk. I mean I try to limit my exposure to people, whenever possible, if I get a cold. Why the hell should I make everyone else sick?
But on some level, I think she may have been in somewhat of a denial state. I mean, when people are told that they may or even do have something that is potentially fatal, they don't process it. I can't tell you of one cancer patient that really, fully took in their diagnosis first time out. People just don't process things like that right away. Denial, it's a powerful defense mechanism.
Did she intellectually think that she might have been coming down with Ebola? Probably. Did she emotionally/psychologically believe that she was coming down with Ebola, probably not.
She probably called the CDC, b/c she was hoping to get some reinforcement for what she believed or wanted to believe. Sadly enough, they gave it to her.

What a person should do intellectually, and where they are emotionally/psychologically are often two different things. It's not an excuse, but it's part of the complexity of the human mind.

 

[Birdstrike]

"Everything Will Be Alright in the End" - Rivers Cuomo, 2014

 

[BHB2008]

Is it just political correctness that is hampering travel restrictions? I've heard that world healthcare policy organizations (CDC, WHO) types are afraid it could do more harm than good by restricting the flow of supplies and personnel. Is this just an excuse for what is ultimately a politically correct decision? (Honest question).

Would a mandatory in-home 21-day quarantine be a better solution?

 

[Megalomis]

Even the head of the CDC admitted that the nurse called the CDC and described her situation/who she was and that she had a low-grade temp. Personally, I wouldn't have wanted to put my family at risk. I mean I try to limit my exposure to people, whenever possible, if I get a cold. Why the hell should I make everyone else sick?
But on some level, I think she may have been in somewhat of a denial state. I mean, when people are told that they may or even do have something that is potentially fatal, they don't process it. I can't tell you of one cancer patient that really, fully took in their diagnosis first time out. People just don't process things like that right away. Denial, it's a powerful defense mechanism.
Did she intellectually think that she might have been coming down with Ebola? Probably. Did she emotionally/psychologically believe that she was coming down with Ebola, probably not.
She probably called the CDC, b/c she was hoping to get some reinforcement for what she believed or wanted to believe. Sadly enough, they gave it to her.

What a person should do intellectually, and where they are emotionally/psychologically are often two different things. It's not an excuse, but it's part of the complexity of the human mind.

Ok so these are my thoughts--the nurse was merely following the CDC's instructions, and she did that every step of the way. The CDC's website still says that the fever must be much higher than 99F in order for it to be Ebola. She probably already knew this before she put the call out to the cdc. It's just as likely that when she made the call, she truly thought she was coming down with a minor case of the flu or something like that. Also, there would be no reason for her to assume that she caught Ebola if she followed all of the CDC's gear protocols while treating Duncan. If all instructions were followed, why would Ebola even be on her mind? It saddens me that the blame is being placed on this nurse. In my opinion she did her part--the cdc just didn't do theirs.

Lastly, would you have gotten on a plane if you thought there was a small chance you had Ebola (w/ the knowledge that you may be putting the entire country, including your closest relatives at risk?). If it were me, I believe I'd be thinking about my family first, and yes I would also take into account fellow passengers too. Call me naive, but I would think that the majority of people in this country (especially health care workers in particular), would think (and act) in a similar manner.

 

[Pons Asinorum]

It is just political correctness that is hampering travel restrictions. I've heard that world healthcare policy organizations (CDC, WHO) types are afraid it could do more harm than good to people in Western Africa by restricting the flow of supplies and personnel to those desperate cesspools because do-gooders would know that they would not be evacuated should they get infected or the SHTF. This just an excuse for what is ultimately a politically correct decision. (Honestly).

There. All fixed up for you.

 

[jl lin]

Lastly, would you have gotten on a plane if you thought there was a small chance you had Ebola (w/ the knowledge that you may be putting the entire country, including your closest relatives at risk?). If it were me, I believe I'd be thinking about my family first, and yes I would also take into account fellow passengers too. Call me naive, but I would think that the majority of people in this country (especially health care workers in particular), would think (and act) in a similar manner.

Well, I respectfully disagree. I wrote about my reason why already. Basically, people have a hard time processing actual or potential, severe diagnoses. As a clinician and health practitioner, I have seen this repeatedly over many years of work. See my POV on this above..

 

[BHB2008]

Glad not every healthcare professional shares these views ("I'd quit practicing medicine / we shouldn't evacuate our people") or else the virus would be a true disaster. Ironic that if everyone followed the lead of the chicken littles on this thread, the sky really would fall.

 

[carbonizedeyesockets]

There. All fixed up for you.

Please don't go into EM. Thanks.

 

[Birdstrike]

Glad not every healthcare professional shares these views ("I'd quit practicing medicine / we shouldn't evacuate our people") or else the virus would be a true disaster. Ironic that if everyone followed the lead of the chicken littles on this thread, the sky really would fall.

That's just General Veers being General Veers. No need to be alarmed.

 

[jl lin]

Glad not every healthcare professional shares these views ("I'd quit practicing medicine / we shouldn't evacuate our people") or else the virus would be a true disaster. Ironic that if everyone followed the lead of the chicken littles on this thread, the sky really would fall.

I cannot see how doing better and being better is playing "chicken little." Part of good physicians' and nurses' jobs are to anticipate problems. CDC said they were all set for Ebola weeks ago. Whatever. Let's just pray this thing doesn't go any further.

Also, when you have numbers of bush people in the varying parts of the areas in W.A. hit with Ebola, who reject education and have total mistrust for healthcare workers and have even killed a number of healthcare workers for attempting to help them, don't assume Mr. President, WHO, CDC, and American public, that our throwing more money at it and more people going over there will easily remedy the problem. Such things may be able to limit it in the cities and so forth, but those villagers and other groups that refuse care and are even hostile toward it could still blow up the 70% control needed to keep this thing from getting exponentially out of hand.

What will those gov'ts do to get those people in the periphery in line with reducing the continued spread of Ebola? How effective can they realistically be in any approaches towards this end?

I mean, really, this disease is like a war. Securing the boarders has to do with limiting detrimental expansion; especially b/c even with the best efforts worldwide, this thing has associated problems and issues that indicate control over Ebola is not going to happen for quite some time. So many people, I believe anyway, are not being realistic with themselves or with the American people. Or maybe, for whatever reason/s, they just don't care.

Sure. Let's work together to help control this thing; but don't expect it to happen any time soon. In the meantime, expansion of the infectious disease to the US and other continents is still a major issue--regardless of what you are doing over there.

It well may be that maybe the leaders of the hot zones will get tougher with their own people if the realize we are not taking people with visas from these places.

And doing so has nothing to do with limiting the sending out or removal of humanitarian, medical, and military aid. One thing does mean the exclusion of another.

I am concerned b/c if this thing doesn't go any further now in the US (hopefully it won't), it still stands a great potential for occurring again, especially if we aren't controlling our borders. What makes anyone think this won't happen again, and perhaps on an even bigger scale??? How the heck can you necessarily tell the different at first, between a cold, the flu, and Ebola??? What about all the folks without symptoms upon admission to the US, and then go on to infect many others?

It's something to think about, and it's not about the sky falling. I hate when people misapply that phrase. It's argument in the extreme, which is just as bad as arguing that two things are mutually exclusive when they are not. These are nice distraction tools, but they are just not valid here.

 

[GeneralVeers]

That's just General Veers being General Veers. No need to be alarmed.

I like to think that I'm the voice of cynical reason. I put treating ebola patients in the same category of other things in that I won't risk my life for like stopping psychs/drunks from leaving the ED. I can't think of any other disease as dangerous as Ebola that we treat.

 

[WilcoWorld]

I like to think that I'm the voice of cynical reason. I put treating ebola patients in the same category of other things in that I won't risk my life for like stopping psychs/drunks from leaving the ED. I can't think of any other disease as dangerous as Ebola that we treat.

That's very unchivalrous of you.

Also, chivalry is paternalistic, misogynistic and wrong-headed.

 

[Pons Asinorum]

Please don't go into EM. Thanks.

Too late. Sorry.

 

[Birdstrike]

Also, chivalry is paternalistic, misogynistic and wrong-headed.

Impressive neo-liberal political-correctness. Way to hit back at GVeers where it hurts.

:slowclap:

 

[Birdstrike]

I like to think that I'm the voice of cynical reason...

Well it know that, but...


The rest of these idealistic, bright-eyed bushy-tailed newbies don't know that.


By the way, did you get the lovely email from ABEM president? Seems Francis has decided that in return for you paying your $2000 to get their piece of paper, you'll be available to work some shifts in the hot zone, Bossman.

"Dear Colleague:
Each day emergency physicians are called on to serve as the frontline and safety net for the health of our nation. The American Board of Emergency Medicine recognizes and appreciates the tremendous job you do on a daily basis. Emergency physicians provide sophisticated and compassionate care to everyone, for anything, at any time. The women and men working in our nation's emergency departments do so at the risk of contracting potentially life-threatening diseases and illnesses. We are proud of you and all that you do. We also recognize the very hard work and dedication of those with whom we are privileged to work: prehospital care personnel, nurses, techs, allied health care professionals, and colleagues in other specialties.
Thank you for providing care that embraces the highest standards in the specialty of Emergency Medicine.

Warm regards,
Francis L. Counselman, M.D.
President"[/I]

 

[Birdstrike]

Double post

 

[VA Hopeful Dr]

Well it know that, but...


The rest of these idealistic, bright-eyed bushy-tailed newbies don't know that.


By the way, did you get the lovely email from ABEM president? Seems Francis has decided that in return for you paying your $2000 to get their piece of paper, you'll be available to work some shifts in the hot zone, Bossman.

"Dear Colleague:
Each day emergency physicians are called on to serve as the frontline and safety net for the health of our nation. The American Board of Emergency Medicine recognizes and appreciates the tremendous job you do on a daily basis. Emergency physicians provide sophisticated and compassionate care to everyone, for anything, at any time. The women and men working in our nation's emergency departments do so at the risk of contracting potentially life-threatening diseases and illnesses. We are proud of you and all that you do. We also recognize the very hard work and dedication of those with whom we are privileged to work: prehospital care personnel, nurses, techs, allied health care professionals, and colleagues in other specialties.
Thank you for providing care that embraces the highest standards in the specialty of Emergency Medicine.

Warm regards,
Francis L. Counselman, M.D.
President"[/I]

Maybe I'm just grumpy after a long day, but why is your Board's president even mentioning ancillary staff/EMTs/and so forth? If my leaders (FM) started sending e-mail blasts talking about how great it is to have the PRIVILEGE to work with nurses, I'd be pretty ticked off.

Note: This is not meant to be a slight on any non-doctor health care worker.

 

[Birdstrike]

Maybe I'm just grumpy after a long day, but why is your Board's president even mentioning ancillary staff/EMTs/and so forth? If my leaders (FM) started sending e-mail blasts talking about how great it is to have the PRIVILEGE to work with nurses, I'd be pretty ticked off.

I'd file that one under political correctness.

 

[Arcan57]

Maybe I'm just grumpy after a long day, but why is your Board's president even mentioning ancillary staff/EMTs/and so forth? If my leaders (FM) started sending e-mail blasts talking about how great it is to have the PRIVILEGE to work with nurses, I'd be pretty ticked off.

Note: This is not meant to be a slight on any non-doctor health care worker.

There are definitely nurses and ancillary staff that I've been privileged to work alongside. EM is much more a team sport than FM due to the demands of having to manage multiple emergent patients simultaneously.

 

[carbonizedeyesockets]

Is it just political correctness that is hampering travel restrictions? I've heard that world healthcare policy organizations (CDC, WHO) types are afraid it could do more harm than good by restricting the flow of supplies and personnel. Is this just an excuse for what is ultimately a politically correct decision? (Honest question).

Is there ANY evidence that travel restrictions actually work to do anything other than slow the spread by a few weeks? From just a cursory search, the answer is NO. So, is it really political correctness driving the recommendations for no travel ban? Or is it that some people have considered the available evidence?

Considering that physicians should be somewhat used to considering evidence for or against doing something, it is kind of embarrassing to see how quickly that concept is shed in these discussions as if the concept of making decisions based on evidence is only applicable to medical treatments.

 

[jl lin]

Is there ANY evidence that travel restrictions actually work to do anything other than slow the spread by a few weeks? From just a cursory search, the answer is NO. So, is it really political correctness driving the recommendations for no travel ban? Or is it that some people have considered the available evidence?

Considering that physicians should be somewhat used to considering evidence for or against doing something, it is kind of embarrassing to see how quickly that concept is shed in these discussions as if the concept of making decisions based on evidence is only applicable to medical treatments.

There is nothing that can be considered real evidence either way.
What disturbs me is the notion that volunteers would not be granted the promise of return if ill or otherwise. Why wouldn't they get the same treatment as Brantly? Why couldn't they?

The truth is when anyone leaves this country, there is no guarantee that they are able to return or get right back, Ebola or No Ebola. That's the world we live in. Missionaries know this. They plan and hope to return, but there are no guarantees.

The current administration has not proven its commitment to get US citizens home. Only when it suits the current leaderships agenda is this so.

The real danger, w or w/o a ban on travel, is that current leadership will look the other way.

 

[Birdstrike]

Whether travel bans have been "proven" to work or not, or whether there's "Level I Evidence-based" data on the practice is irrelevant. The point is it might work, it could possibly work and the vast majority of our 300 million Americans, other than relief workers and medical volunteers, have no need or desire to be jet-setting to Ebola stricken hot zones and back. It's no skin off most of our backs to prevent people from vacationing from Liberia to the US. Once the spark of a pandemic is ignited, there's no putting the genie back in the bottle and getting a do-over on this. If I travel overseas I'm asked at customs if I'm bringing any food, fruit or living creatures out of the country, due to the concern that non-native diseases could be taken across borders. But to bring Ebola in, which is 50% fatal, well, that's just too offensive to ask to stop at the border?

I think political correctness has a lot to do with not trying to ban flights or travel outside of Ebola hit zones.

1- The race card has already been played in this crisis, and that's always a big concern for politicians.

2- There's a concern we'd be viewed as "abandoning the less fortunate" whereas they prefer the perception that America is always helping other countries in need.

3-The Airline industry, I'm sure, has already made their views known as to what impact worldwide travel restrictions might do to their bottom line. They donate much more money to politicians than you and I.

4-The government never wants to be seen as panicking or overreacting. They have an important mid-term election coming in a few days and want a sense that the country is moving in the "right direction" at a time the Senate could change. They want to be seen that everything is under control.

Political correctness bleeds into almost everything nowadays. It's omnipresent.

 

[carbonizedeyesockets]

Whether travel bans have been "proven" to work or not, or whether there's "Level I Evidence-based" data on the practice is irrelevant. The point is it might work, it could possibly work and the vast majority of our 300 million Americans, other than relief workers and medical volunteers, have no need or desire to be jet-setting to Ebola stricken hot zones and back.

No one's asking for level I evidence, but just any sort of evidence. There is none, and it has been studied. The hypothesis that travel bans would work is not supported by the available evidence, and it is known that there would be economic impacts. And there'd be costs associated to enforce it, which would probably be better spent elsewhere. There's also potential for making the situation worse, not just abroad, but here, too.

I think political correctness has a lot to do with not trying to ban flights or travel outside of Ebola hit zones.

While there may be political motivation for not doing it, there is also evidence that is doesn't work. Either way, I'm ok with the outcome in this instance.

1- The race card has already been played in this crisis, and that's always a big concern for politicians.

Race will always be an issue so long as racism and prejudice exists. But, worry not as I'm sure the politicians will keep up with shallow and token gestures of addressing the complex issues (i.e. not really doing much).

2- There's a concern we'd be viewed as "abandoning the less fortunate" whereas they prefer the perception that America is always helping other countries in need.

Let's not fool ourselves, the US is extremely selective in who it helps. The "less fortunate" are abandoned or ignored frequently.

3-The Airline industry, I'm sure, has already made their views known as to what impact worldwide travel restrictions might do to their bottom line. They donate much more money to politicians than you and I. A lot of them have thin profit margins.

Despite this, numerous airlines have already stopped flights. I'm sure the profit margin was not helped when an exposed passenger was identified. I'm sure they love having to take a plane out of service for cleaning and replacing upholstery, carpets, filters, etc. as was done by Frontier. I'm sure they are totally down with having to pay staff for 21 days to not work. I'm sure they love the bad press and having to track down 700+ passengers. I don't doubt that most airlines would be negatively impacted in some way with a travel ban, but I'm highly doubtful it would break them.

Political correctness bleeds into almost everything nowadays. It's omnipresent.

I tend to think this trope is more of ones imagination at work or a convenient excuse for the inability to see past the end of ones nose.

 

[Birdstrike]

.

 

[Pons Asinorum]

.

Whatever had been written, I feel like I would have liked.

 

[GeneralVeers]

A travel ban would certainly have prevented Mr. Duncan from entering the U.S. and would have prevented two nurses from becoming ill.

That is unequivocal.

 

[Chip N Sawbones]

A travel ban would certainly have prevented Mr. Duncan from entering the U.S. and would have prevented two nurses from becoming ill.

That is unequivocal.

Only if there were no options besides direct flights between the U.S. and Liberia. In reality its very easy to fly from West Africa to the U.S. through Brussels, London or Paris. That was what I always did anyway because it was cheaper than the direct flights. If someone wanted to get past a travel ban to the U.S. they'd just have to buy two separate tickets with different airlines. Even if the E.U. imposed a travel ban flights from West Africa there are ways around that, such as going through Mali, South Africa or Ethiopia. Realistically if you wanted to keep people from flying between Africa and the U.S. you'd have to ban all flights from Europe. A move that drastic will be unthinkable unless ebola reaches epidemic levels in the U.S., and by then it'll be too late.

 

[Pons Asinorum]

Only if there were no options besides direct flights between the U.S. and Liberia. In reality its very easy to fly from West Africa to the U.S. through Brussels, London or Paris. That was what I always did anyway because it was cheaper than the direct flights. If someone wanted to get past a travel ban to the U.S. they'd just have to buy two separate tickets with different airlines. Even if the E.U. imposed a travel ban flights from West Africa there are ways around that, such as going through Mali, South Africa or Ethiopia. Realistically if you wanted to keep people from flying between Africa and the U.S. you'd have to ban all flights from Europe. A move that drastic will be unthinkable unless ebola reaches epidemic levels in the U.S., and by then it'll be too late.

Pretty sure you could take a peak at the visa stamps in our pre-hemorrhagic traveller's passport and deduce where he has traveled from/to. Customs could certainly be beefed up to catch the ones that slip through foreign hubs, although their mechanism usually looks to perform better/more efficiently than our own.

 

[GeneralVeers]

Only if there were no options besides direct flights between the U.S. and Liberia. In reality its very easy to fly from West Africa to the U.S. through Brussels, London or Paris. That was what I always did anyway because it was cheaper than the direct flights. If someone wanted to get past a travel ban to the U.S. they'd just have to buy two separate tickets with different airlines. Even if the E.U. imposed a travel ban flights from West Africa there are ways around that, such as going through Mali, South Africa or Ethiopia. Realistically if you wanted to keep people from flying between Africa and the U.S. you'd have to ban all flights from Europe. A move that drastic will be unthinkable unless ebola reaches epidemic levels in the U.S., and by then it'll be too late.

Wrong. If you are not a US citizen you still need a valid travel visa to enter the country. A travel ban would have less to do with flights, than with refusing to issue Visas to citizens of those countries. Additionally anyone with an itinerary that includes a stop in those place would be refused entry.

 

[carbonizedeyesockets]

A travel ban would certainly have prevented Mr. Duncan from entering the U.S. and would have prevented two nurses from becoming ill.

That is unequivocal.

You have no way of knowing that with any certainty.

 

[WilcoWorld]

A travel ban would certainly have prevented Mr. Duncan from entering the U.S. and would have prevented two nurses from becoming ill.
That is unequivocal.

He lied to gain entry to this country. How do you know he wouldn't have falsified documents?

 

[BHB2008]

Good news today: the 21-day quarantine for those initially exposed has expired with no other infections. Not out of the woods yet, but Senegal and. Nigeria have contained the outbreak and stopped its spread, so I have no doubt we can do the same. The hand-wringing in this thread is understandable, as it is a frightening disease, but I trust HCW in the US have learned the lesson and are being very vigilant.

 

[Birdstrike]

Whatever had been written, I feel like I would have liked.

Oh, you have n o idea, buddy. No idea.

 

[Birdstrike]

Only if there were no options besides direct flights between the U.S. and Liberia. In reality its very easy to fly from West Africa to the U.S. through Brussels, London or Paris. That was what I always did anyway because it was cheaper than the direct flights. If someone wanted to get past a travel ban to the U.S. they'd just have to buy two separate tickets with different airlines. Even if the E.U. imposed a travel ban flights from West Africa there are ways around that, such as going through Mali, South Africa or Ethiopia. Realistically if you wanted to keep people from flying between Africa and the U.S. you'd have to ban all flights from Europe. A move that drastic will be unthinkable unless ebola reaches epidemic levels in the U.S., and by then it'll be too late.

What about preventing SOME of the Ebola from coming in? Who says that perfect, needs to be the enemy of good? Can't we just agree on giving a shot at keeping some of the Ebola out? How's that for a bold and shocking goal?

We've lost our pharking minds. Lost 'em.

What the hell are you guys worried about, by closing off the border to Ebola? Gonna mess up your Christmas vacay to Liberia? Wtf?

 

[carbonizedeyesockets]

What about preventing SOME of the Ebola from coming in? Who says that perfect, needs to be the enemy of good? Can't we just agree on giving a shot at keeping some of the Ebola out? How's that for a bold and shocking goal?

We've lost our pharking minds. Lost 'em.

What the hell are you guys worried about, by closing off the border to Ebola? Gonna mess up your Christmas vacay to Liberia? Wtf?

The issue is that it most likely doesn't work and it costs lots of money. I'm not against spending money, but I'd rather it be used elsewhere (building temporary hospitals, providing proper PPE, etc.). Why are you so intent on blowing lots of cash on something that at best just delays things a little? (Then again we're doctors, so I guess blowing a ton of money to delay something a matter of weeks is right up our alley, amirite?)

Also, when it comes to West Africa, you can be sure that there is already a defacto travel restriction when one considers that the per capita income around 500$. That's probably why it took 7 months for ONE person with ebola to make it to another continent.

Wrong. If you are not a US citizen you still need a valid travel visa to enter the country. A travel ban would have less to do with flights, than with refusing to issue Visas to citizens of those countries. Additionally anyone with an itinerary that includes a stop in those place would be refused entry.

Your imagination is letting you down. Of all the places in the world, getting a fake passport is probably pretty easy in countries as poor as Liberia. You really think that a travel ban would stop someone who is determined to get out? If their life seemingly depends on it, you can bet many people would do their best to get out. A travel ban is at best just going to add a couple days to their trip.

 

[jl lin]

Please, please!
By all means, PLEASE show us the research that clearly demonstrates that denying visas will decrease humanitarian, medical, and military aid to the hot zones. Please show us that this statement repeated at nauseum by leadership and others is something more than a non-scientific guess. Umm.. .not even a hypothesis.

This kind of noise is exactly why all Americans should be from Missouri--especially when it is something coming from the government.

See, I don't think it will be any more of any issue than what it could already be or is now for those Americans over there helping out.

Again, whenever you leave the country, you have left your sovereign state/land, and you are at risk for not being able to return--at least not necessarily when you want. Those of us that have willingly left country knew/know darn well that this was/is an inherent risk with traveling overseas. How much more might this be a possibility in regions like the hot zone or any other number of places. As I said earlier, missionaries know this going in. They have faith and hope that they will get out when they need to do so, but they are realistic enough to understand that it may not happen--again, at least not right away.

I don't care if the POTUS signed a contract in blood that you would be able to return at said time-range and date or under X, Y, and Z circumstances, it's never a guarantee.

Essentially then, you have no difference as what people have going over there to help right now. You can have people fighting to bring you home, and you can have paid extra for the proper insurance, but there are never any guarantees, and only an naive would think otherwise.
Hence the claim is weak, false, without merit.

 

[BHB2008]

First of all, the experts in this field are in agreement that it would do more harm than good, so the onus is on you to show studies proving the contrary. Second, it's quite possible that a simple idea--travel ban to keep Ebola out--would come with unintended consequences that could make it more likely that Ebola would actually get in. Consider the danger that Ebola would pose were it to gain a foothold in India, or another more developed nation. The best way to keep it from spreading is to contain it where it is. The experts in the field believe a travel ban would stymie this goal, and considering what a complex question it is, with administrative, legal, logistical, and medical factors, it would be prudent to consider that they know more than you and might, just might, be making a reasonable point rather than sacrificing world health for mere political correctness.

 

[Birdstrike]

How on God's green Earth can you even try to argue, that trying to keep as many cases of Ebola out of this country, is not a good idea? This is a matter of politics and public health. This is not the medical school research project some of you all think this is. It's not sensitivity training either. "Data" doesn't apply. We haven't ever faced this situation in this country before. We don't have and "retrospective reviews" or "blinded trials" to tell us what to do. What we need is leadership with guts, not the spineless wimpy type.

It's expensive? Who gives a sh¡t? "It's expensive" didn't cross the politicians minds before they ran up a $17,000,000,000,000 national debt. You all want to use the health of our Nation and a possible plague as a pawn to advance your political agendas. It sickens me.

You all want more Ebola to get in this country? Well you're going to get it. Especially if the survival rate on these existing cases is better than over there in Africa, you'll see as many who can possibly get over here, buying plane tickets to drop themselves off in an EMTALA governed ED near you.

It's pathetic and spineless leadership we have in this Country and in this profession.

Somebody with guts and brains needs to take the captains wheel. All this that's going on here is a bad joke.