Hospital beds, hospital beds and more hospital beds. Get the very ill, and very contagious, out of the community. That's the only way to drop the R value.

Duncan would have been isolated, tested and hopefully treated with all due precautions to protect staff and Americans would be congratulating themselves on how well the system worked.

They totally screwed this up. If they hadn't first sent him away and then after admitting him failed to take precautions for two days. This would have been just as you said.

The new CDC recommendations are lightyears away from the previous version:
http://www.cdc.gov/vhf/ebola/hcp/procedures-for-ppe.html

It also requires a lot of preliminary work to set this up, so now all the hospitals have to work on this. CDC's recs were flat-out inadequate, but that has now been remedied. The important thing now is to ensure that intake facilities are adequately prepared, because this is not an on-the-fly care situation at all.

I strongly suspect he knew he was infected and isolated himself from the rest of the family. The two groups that are at the absolute highest risk are healthcare workers and family members in a caretaker role. The fact none of them were infected is really suspect in that light.

severely ill patient.

The family had contact with him, including shared beds. He wasn't self-quarantining in the house and nothing is "suspect" at all.

I blame the media for the panic. It has been frightening to witness how easy it is to spread fear through the public.

As a wise man once said.

the first time.

And that time could happen on an airplane, to a person with a fever of "only" 100.

As the article makes clear, it is the viral load, not just vomit that increases infectivity.

The "so what" is that people are overreacting across the country because they don't understand that people infected with Ebola start by not being infectious at all (during incubation) and become more infectious as they worsen and die, because the virus builds up. That is why the CDC approved Vinsons flight. Her fever was so low and she had no other symptoms, therefore she was not very infectious. Like living with Duncan with MUCH worse symptoms didn't infect anyone, flying next to a 99.5 temp infected person was so little a risk, the flight was fine. Get it?

Do you think they like tracing hundreds of people that flew with her? Over hundred of people are being monitored or in quarantine. Do you think they like doing all of this extra work they could have prevented by telling her to not fly?
Get it?

CDC knows the risk is slight to nil. They are covering their ass now.

Should she have been cleared to fly? Probably not. It was really poor PR.

Was anyone on that flight actually at risk or infection? Probably not.

We only know with hindsight that they most likely were not infected. But they were at risk the moment a person with an Ebola infection got on the plane -- because she could have suddenly gotten sicker during the hours of the plane ride.

And the CDC knows that, and that's why they say they should NOT have recommended that she fly.

THe only change was the media freak out.

Doctors without Borders guidelines and not the outdated WHO protocols.

The CDC should not have approved her flight, it is poor optics and fuels the lack of confidence. But, the reason they did, was because they understood that there was not a significant risk.

including full skin and head protection.

They also understand that there WAS a significant risk in letting her fly because she could have vomited during the flight. THAT'S why they're saying they made a mistake. Not because of "poor optics." They aren't manipulating public opinion now. They were just wrong to let her make that flight.

viral load -- even in the early stages of vomiting.

Get it?

And the CDC has admitted making a mistake in allowing Vinson to fly.

is suddenly going to vomit and become highly contagious. So just because the person "only" has a fever doesn't mean nearby people shouldn't be concerned.

infected.

What was unknown before she flew is known now. She didn't vomit or bleed or shit on anyone. The actual risk that anyone on the plane was infected is close to nil.

-- which is why no one who is known to have been exposed to Ebola and is in some kind of observation period and has a fever and doesn't feel well should travel in mass transportation.

Patients just suddenly take a turn for the worse.

That's why early detection and isolation is important.

It's the same exact virus.
Virus doesn't change.
It's concentration increases in later stages, making it easier to catch.
You of course are welcome to take that chance, I'd rather not.

someone with a fever . . . unless that person proceeds to vomit on you -- and then you ARE at risk.

For some reason the 21 day period really confused you.

All that changes over the course of the illness is the amount of virus in the blood -- not the infectiousness of the virus.

Level has dropped off! More boring I know!

and report to me where it says the virus changes over the course of the illness, not the amount of the virus in the blood.

By the way, the WHO Ebola guidelines are the outdated guidelines that the CDC has now discarded, in favor of the protocols developed by Doctors without Borders.

So I wouldn't view the WHO report as the last word.

Dallas Ebola infection/incubation timeline so I can see all the errors that you apparently think MorningFog has made.

They would prefer the post be much scarier and sensationalist.

then you'll stop typing misinformation.

It's the amount of the virus in the blood that changes over the course of the illness,not the virus itself.

which is more than he can say.

But it's lethal enough that it's better to not screw around with it. A small unnecessary risk is still too high when you're talking about such a horrific potential outcome.

On the flip side, it was obviously more transmissible later on than someone thought, because now 2 nurses are infected with it.

The early criticism I read about some of the first CDC guidelines involved Nurses not having shoe covers. It doesn't take a genius to see where you might have a problem with a nurse walking into a room with a very sick ebola patient, cleaning them up, and then walking around the rest of the hospital.

So yeah, I'd put what you said in that category. Which is not to say that anyone caught it that way, this time.

Thanks for posting this. I wish the media would promote this sort of thing instead of fearmongering. Good for USA Today.

When I can listen to random internet kooks?

They're funny.

And why we're not supposed to follow that conversation where it inevitably leads, is beyond me.

Frankly the full-court press coming down from the media around stuff like suspending visa travel, is kind of strange, you know, about what a terrible awful no-good horrible idea such suggestions are... the only other times I've seen this kind of inexplicable media unanimity is in the early days of people talking about legalizing pot or ending the drug war (TERRIBLE idea!) or the early days of talking about invading Iraq (GOTTA DO IT, just.. because!)

It's... weird.

It has not escaped my attention that many of those stoking the Ebola panic are DU's most vehement anti-vaccers. I eagerly await their arrival in this thread.

ETA: never mind, they're already here.

Out here in California there's a really easy shorthand for reading ballot propositions: Anything the Howard Jarvis Taxpayer Assn. endorses it's a safe bet sane people will want to vote against. The poster in question is the DU equivalent: if she posted that the sky was blue I'd dig my rain gear out of the closet.

Zero patients infected by those who treated him and became infected.

This is not an easily transmitted virus despite all the "experts" here on DU who said otherwise.

Fairly low odds of disaster....but that small chance can be a disaster.

Duncan spent two days in the apartment...after he felt so terrible he felt the need to go to a hospital. And he threw up when the paramedics picked hin up. He was probably very infectious....and its just a miracle nobody else was infected.

I consider it a near miss...not confirmation that ebola is harmless.

That would be silly.

I don't care if somebody is in day 1 or day 15 after infection. They should both be treated as highly infectious. This notion that its 'ok' to fly with only a low Ebola fever....because it 'probably' won't infect anyone is truly what is silly.

Zero.

You don't know if someone had been infected until usually day 7-10 after exposure. And if they only show a fever that are not "highly infectious." The virus builds in the body overtime, eventually to the point were they are highly infectious. But it doesn't start that way.

I agree that she shouldn't have flown. It is bad optics for those trying to portray competence and control.

But, she did. And most importantly, the risk to others on the plane was extremely low. So low, in fact, that I am comfortable saying no one on the plane was infected. Everyone will see that to be so in a couple of weeks.

It technically cannot be zero. Vinson did indeed have the virus in her, albeit in small quantity. But all it takes is that one unfortunate expulsion of that virus and somebody else is infected.

There is alot that is not known about Ebola...like where it hides between outbreaks. There are theories but nobody knows for sure.

Have you ever considered that the means of one patient's infection changes how infectious they are? For example, mayber Pham got it in her mouth and the infectiin is completely internal for the first few weeks. But what if Vinson got it in here eye...and her tears have been infectious from the very beginning. You can't tell me that you KNOW it couldn't happen this way....because nobody does.

The CDC isn't quarantining people for 'optics'....they do it because nobody really knowshow contagious it is.

There is not a high enough viral load for it to leave the body. An asymptomatic person is at zero risk of infecting another person. Zero. None.

In casual contact, of course the risk is very low. You really aren't going to get the virus by sitting on the bus or whatever to a person who isn't overtly symptomatic.

But the risk of transmission comes if bodily fluids are exiting the body with virus in them and you are exposed to them. A person may have no extreme symptoms but a level of virus high enough in the blood to infect.

In the HC system, a lot of infections have been transmitted before an individual was ill enough to generate a suspicion of Ebola, most commonly in OB/GYN clinics & wards in Africa.

In the common spaces under normal conditions, the isolation procedure is necessary to prevent accidental exposures only (such as cut, fall, etc). You're saying something that is not true, which is why quarantine facilities have been set up all over Africa, and why public health have instituted isolation procedures for those who may have been exposed here. There's no other way to do it.

...yet they are. And asking them to self monitor. And as far as I k ow, the boyfriends of both infe ted nurses have been self quarantined.

These things are not done because the risk is zero. They are done because, while the risk is extremely low, it still is there.

The risk of someone who is asymptomatic is zero.

The risk of someone with a low fever and nothing more is very very low, but I not zero.

And trying to clearly say you are wrong.

An infected person even without symptoms has the virus in him correct? Even if its just one, he is carrying it around....and the risk of transmission cannot by definition be zero.

I can tell you don't believe that - but its true.

If I got Ebola on Monday, and you put me in a wood chipper on Tuesday, and a group of people ate my raw remains in ten minutes, somebody in tbe group will have ingested a live Ebola virus. Why? Because the virus was in me...sure in small quantity, but its there...and in this scenario exposure to the virus is unavoidable.

Now that is an umrealistic example. But I gave a much more realistic one about being I fected in the eyes. Just about everything known about Ebola is anectdotal....which leaves alot of gaps in our knowledge....so my eye theory isnt outrageous and its quite possible. Or particles of snot from a sneeze could transmit the disease, if the virus had recently entered the nose. Etc...etc. Whatever part of the body that first got infected could rapidly become infectious to the external world, long before its spread throught the body.

It doesn't infect at the entry and spread. It gets into the blood and then spreads to organs. Early on there is simply not enough in the blood to spread and infect someone else, not by any means.

The "Ebola song" plays constantly across Africa, no contact, no sharing food.

tired of the fearmongering here.

there's not enough people in that anecdote to prove anything. especially when 2 other people got ebola from the same guy.

We know that family members in Afrcia get infected all the time.

Read the OP.

Some family members get it and some don't.
You can't make the conclusions you are making based on a single case.

Why do people have a hard time understanding that the person progresses from not contagious to extremely contagious as the virus builds up in the body.

You don't know when exactly this point takes place.

There is minimal risk,thiugh still very low risk,before showing symptoms. When symptoms appear, there is enough risk to be risky. As the disease progresses, the risk increases. After death, the bodies are very risky and now not only caregivers but other family and friends are exposed and infected by patting and kissing the dead person. Not something commonly done in the USA, but cultural norm in many places in W Africa where it is spreading.

There is a risk or a meteorite falling through my roof and hitting me on the head. Not much risk, but still a risk. There is a higher risk of me being in a car accident on the way to work. The first of these I spend no time worrying about, the second I take precautions to avoid.

There is risk, but I would rather spend my energies avoiding the higher risk sort.

I'd be very focused on the safety gear the caregivers are wearing. Identification of folks with Ebola, isolate, and be very careful when treating. From the diagrams/photos I've seen it looks like the nurses in Dallas weren't wearing enough or correct protective gear. That is something that can be immediately corrected in future cases.