...frantically thumbing through the Yellow Pages now that the "Cleaning Guys" didn't work out.

Let us hope that whomever thought an outfit like that sounded like a professional medical waste management company was relived of his or her involvement in this case.

That's really the problem. Everyone wants to slough this off onto someone else. Bureaucracy is like that. The people who actually know what to do don't have any authority to see that it gets done. The people who have the authority don't want the responsibility. The result is inaction.

... "In 1995, President Bush issued Presidential Decision Directive 39 (PDD 39)...".

So I don't have much confidence in them to start with.

So you didn't in fact, call the number you provided and ask the question that "needs to be asked"?

to account like that. I asked a question. The incident is in Texas and I'm in Minnesota. Had the issue happened here, I might be calling.

Fortunately we also have a reasonably functional state government (most of the time, anyhow - let's not talk about the latest child protection fuckup but hope the contaminated-puke-cleanup folks are more competent).

I've been watching pretty closely. WCCO-TV did a story yesterday on preparations at Regions Hospital for any possible Ebola cases. Other hospitals already report making similar preparations. I haven't seen anything about other agencies making preparations, but it would be typical for them to have done that. Minnesota is not Texas.

Our population of people from West Africa is quite large. I'm sure that community is very concerned about Ebola, particularly in the countries of their origin. For our West African immigrants, this has to be a very alarming time.

..., but I'm afraid the answer might not be confidence inspiring (head shaking sigh). When the first thing I read about this department on its own website is

- a typo, maybe?
- a homer's wishful thinking on who won the '92 election, perhaps?
- maybe an inability to count?
- a calendaring defect?
- the absence of a history curriculum in the Texas schools...

Well....

But I'm really just having a bit of fun. Your question is legit!

Clinton was the one who implemented PDD 39 in 1995. Bush was just in his first year as governor of Texas then.

I'd say no one has ever even looked at that webpage with a critical eye since it was posted. until today that is. Too many people in Texas government take federal monies and never give a second thought to the service it was supposed to be used for.

probably cut their budget to the point where they can't afford to clean up contaminated puke from a sidewalk. Better to send a private company to do it; the private sector always does a better job with everything, right?

I do know that it looks like nobody's really in charge of this who has both the knowledge and authority to act. So, nothing happens. It's a bureaucratic failure. Perhaps we'll learn from it, but I doubt it.

Fortunately for everyone, the Ebola virus has a very low survival time outside of the body. So, by this time, it's probably inactive now on the street and in that apartment. Of course, people have been exposed. One hopes they have that threat in hand, but I have no idea whether that's true or not.

on his sheets and towels.

http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/ebola-eng.php

SURVIVAL OUTSIDE HOST: Filoviruses have been reported capable to survive for weeks in blood and can also survive on contaminated surfaces, particularly at low temperatures (4°C) Footnote 52 Footnote 61. One study could not recover any Ebolavirus from experimentally contaminated surfaces (plastic, metal or glass) at room temperature Footnote 61. In another study, Ebolavirus dried onto glass, polymeric silicone rubber, or painted aluminum alloy is able to survive in the dark for several hours under ambient conditions (between 20 and 250C and 30–40% relative humidity) (amount of virus reduced to 37% after 15.4 hours), but is less stable than some other viral hemorrhagic fevers (Lassa) Footnote 53. When dried in tissue culture media onto glass and stored at 4 °C, Zaire ebolavirus survived for over 50 days Footnote 61. This information is based on experimental findings only and not based on observations in nature. This information is intended to be used to support local risk assessments in a laboratory setting.

A study on transmission of ebolavirus from fomites in an isolation ward concludes that the risk of transmission is low when recommended infection control guidelines for viral hemorrhagic fevers are followed Footnote 64. Infection control protocols included decontamination of floors with 0.5% bleach daily and decontamination of visibly contaminated surfaces with 0.05% bleach as necessary.

Same as for other viral agents. Wash surfaces down with bleach and autoclave or incinerate contaminated fabrics and other materials. by now, any blood on fabrics or other absorbent materials virus has dried out and the virus is now dead. See, the Ebola virus isn't some sort of magical infectious agent. It can be neutralized in a number of ways, just like other infectious agents.

That's what needs to be done. It's not rocket science, really. The local fire department has hazmat suits that can be used. They're perfectly adequate for this. The bleach? The nearest supermarket has all you could need. I'm not sure what the autoclaving capabilities are there, nor what incineration facilities are nearby, but those can be used as well.

What is needed is someone with some common sense and knowledge to say, "OK, here's what let's do." And then do it.

I'm not in charge. Someone else is, or nobody is willing to be in charge. Eventually, it'll get sorted out. By then, the virus on all of those surfaces and all of those materials will already be dead and inactive, anyhow. The time has passed when decontamination measures were important. Now, it's really just a clean-up job. Next time? Well, I hope they get this sorted out by then, and have a protocol to be followed.

or else doesn't want to get itself dirty.

in handling hazardous materials and biowastes, not realize that they would need permits to transport the waste on Texas highways?

One more act in this tragicomedy of errors.

That's the problem. Never mind that the decontamination process is the same as for other infectious agents. Nobody wants to sign off on anything, so nothing happens. A failure of common sense appears to be in progress.

But so much of his has been crazy.

infectious agents. Ebola isn't on that list. So there's no check-box on the permit application for it. For a bureaucracy, that means that no permit can be issued, since the agent isn't on the list. That's how bureaucracies operate. Everything that is not covered means that no permit can be issued.

That is how bureaucracies handle things. Nobody wants to take any responsibility for anything that is out of the ordinary.

Ebola contamination can be handled exactly the same as any other infectious agent.

So, issue a permit to a carrier licensed to transport that stuff. Nobody in the local area? Bring in someone from outside.

looking for their heads to pull out.

"Thomas R. Frieden, the Director of the U.S. Centers for Disease Control and Prevention, told ABC News today the Ebola diagnosis offers new challenges for authorities.

“It’s the first time we’re having Ebola in this country and the challenges are real in terms of what do you do with the waste, how do you move it, how do you dispose of it and we want to make sure that everything is done correctly,” Frieden said. “I’m confident that will get sorted out today.”

http://abcnews.go.com/Health/texas-ebola-patient-now-weak-talk-phone/story?id=25938924

A lack of planning is expected, really. Now that the situation exists, that planning will finally take place and protocols will be developed.

What bothers me is that what those protocols will be should already be understood. Ebola is a biohazard just like most other biohazards. Protocols exist for other biohazards, and they should be sufficient for this clean-up. In fact, it will probably be handled the same as most other biohazards. It's mostly that nobody wants to take responsibility for saying, "Do this." That's the bureaucratic dilemma. Nobody wants to be the one to make a decision, so the decision is to do nothing.

Ebola is a viral disease. Cleaning up isn't rocket science. The virus can be destroyed through use of chlorine solutions, autoclaving or incineration. So, they should be doing those things. The procedures exist already and are in use. Fortunately, the Ebola virus doesn't remain infectious long outside the body. That's fortunate. By the time they finally decide what to do, the threat will probably be over from this particular patient. However, others have been exposed, so they really need to decide how to proceed.

Bureaucracy is what it is, though.

that they're on top of this, and that our system is set up to handle emergencies like this? It obviously isn't.

What I know is that this infectious agent can be handled just like any other. It's a relatively fragile virus and it's not as contagious as some. Someone just needs to decide to treat it like other agents. The error is in not doing so and just doing nothing.

biohazards on Schedule A to be transported on public highways. So this problem would affect everything that's on that Schedule.

Almost everything hazardous requires a permit before being transported on public highways. Trucks carrying all sorts of stuff travel the highways daily. Permits are issued and regulations must be followed.

This is an unusual situation, and nobody's prepared in advance for it. So, nobody's willing to issue the permits. Bureaucracy.

"What bothers me is that what those protocols will be should already be understood. "

They've been acting like they had everything under control but even the most basic issues are still to be worked out. But unlike you, I don't think this is only true for the Ebola virus. I think we may be lucky that our conflicting protocols were tested on a virus that is, at the moment, only infecting a single person.

This is about the fact that the DOT doesn't allow Schedule A hazards to be transported on highways, with or without a permit.

But they said in the article that this should be resolved TODAY. Hopefully, it has.

By the way, all those new CDC regs are interim regulations, developed on the fly and subject to change. It would have been nice if they had worked them all out months ago, instead of telling us that we had nothing to worry about because they were top of everything.

http://www.wcvb.com/health/cleaning-crew-delayed-at-ebola-patients-home/28383914

Brad Smith of the Cleaning Guys, which was hired to sanitize the apartment, said his company is ready to go but a permit issue has stopped them from entering the home. Smith says a specialized permit, which is handled by the state government, is needed to transport this type of unprecedented hazardous waste on Texas highways. Cleaning Guys specializes in hazmat and biohazard cleaning services, but it does not transport the materials.

Ebola can spread through contact with an infected person's bodily fluids like blood, feces or vomit. CDC spokeswoman Abbigail Tumpey says the CDC considers materials contaminated with Ebola as regular medical waste, and as such, can be disposed of as medical waste. But she said the Department of Transportation considers Ebola to be a Category A agent, which means it's illegal to transport.

"The CDC and the DOT regulations have been in conflict. It's been an ongoing issue that we've been dealing with. We hope to have a resolution on that literally today."

I don't really think that the agency at the link I provided is probably equipped or staffed to actually handle this situation. I was really just pointing out that it exists. I'm sure they have been called, but odds are that nobody there has a clue what to do or any authority to make anything happen. It's a mandated agency that probably exists more in name than in reality.

As you point out, rules that would have given them that authority were squashed. So, it appears that nobody has much authority at all over such incidents. That's unfortunate.

At the local level, nobody wants to take responsibility for deciding what to do. The result is that nothing is done for a long time. By now, the contamination from the original patient is probably inactive, although the hospital is certainly generating its own waste that needs to be dealt with.

Eventually, it will all get sorted out. That's how this kind of thing goes. Someone will finally decide on what to do and that will become the standard. Odds are it will be the same as other decontamination protocols. It is just a viral organism, after all, and we know how to render such organisms unable to infect people.

If I were in charge, I'd order that the stuff be handled like any other infectious waste materials. That should be adequate, despite the fearsome nature of the actual disease.

Urgency doesn't seem to be much of a factor