UPDATE 1-Texas health worker isolated on cruise ship over possible Ebola contact
1:06pm IST

(Updates with Belize statement)

Oct 16 (Reuters) - A Texas health worker who may have had contact with specimens from the first patient diagnosed with Ebola in the United States has been isolated on a cruise ship despite showing no symptoms of the disease, the Department of State said on Friday.

The Texas Health Presbyterian Hospital worker, who did not have direct contact with now deceased Liberian patient Thomas Eric Duncan but could have processed his bodily fluids 19 days ago, left on a cruise from Galveston on Sunday, department spokeswoman Jen Psaki said in a statement.

U.S. concerns have intensified after two nurses from the Dallas hospital who cared for Duncan contracted the virus, which has killed nearly 4,500 people, mostly in West Africa. President Barack Obama's administration is facing sharp criticism from lawmakers over its efforts to contain the disease at home.

The employee has been self-monitoring since last Monday and has yet to develop a fever or show any other symptom of Ebola, the statement said. The worker and a companion voluntarily isolated themselves in their cabin, and U.S. officials are arranging for the ship to return to the country.


...

The Government of Belize said in a statement hours earlier that it had denied a request by U.S. officials to use a Belizean airport to transport a cruise ship passenger considered to be a very low risk for Ebola.

....

http://in.reuters.com/article/2014/10/17/health-ebola-usa-cruiseship-idINL2N0SC0B220141017

-------------

Belize link I can't vouch for (says they are on a tender):

http://belizean.com/belize-confirms-patient-with-ebola-symptoms-on-cruise-ship-off-its-coast-1814/

on pre-planned (and paid for) travel, hotels, tours, etc, so that people are willing to stop. People who've put thousands of dollars into travel plans often have trouble getting their money back if they have to cancel out for unforeseen reasons. Which is going to end up with some people telling themselves 'Well, I'lll just 'isolate myself in my cabin', if they can't get a refund.

on board!

Perhaps they should offer travel insurance if they are so worried about keeping profits up.

Imagine that the person called the cruise liner and said that they were under voluntary quarantine for ebola and asked that they be allowed to reschedule or get a full refund, do you seriously think the response would be no. (Imagine they CC the CDC, hospital etc.)

In fact, I would expect at that point that the cruise lines would actually REFUSE to let them come. The same with the airlines. (I know from far less drastic health concerns of a relative that the airline will not charge the change penalty if the patient has a doctor's note that says they should not fly.) Seriously, what would it do to either a cruise line or airline if the person asked and was refused and they went public?

I assume that in all these cases, you had individuals that did not want to give up a long awaited trip and they personally assessed the risk to be low. The one woman flew to Ohio to work on her wedding plans - including meeting with her bridal party and getting them fitted with their dresses. It may have been hard to find a date they all could have made it -- and some may have also flown there. She may well have thought that the chances were low that she was infected and that it was far more likely that she could have taken that holiday weekend and returned with no one the wiser.

It will be a few weeks before we know how many of the Dallas hospital workers identified were actually infected. We are nowhere near the end of the 21 day period. When this nurse started her first flight on Friday, none of them had tested positive. This might suggest that even in a very educated on the risks population, that for something where the disease is this awful, that the risk to society as a whole requires that a real - non voluntary - quarantine be established for those at risk. It might be that for those who would lose pay, that the government - representing the society whose safety is being protected at a huge cost by those enduring quarantine - could reimburse them. (In this case, those exposed on the job, could obviously have been covered by their employer.)

What kind of selfishness lets a person get on a cruise ship after that?

because anyone who simply wants to change travel plans will request being quarantined.

Belize has it's head up its ass. She handled a lab specimen of Mr. Duncan. CDC only had workers concerning Mr. Duncan self-monitor. Yesterday the CDC decided that they should be quarantined. She self-quarantined on the ship yesterday because that's what the new CDC quarantine protocol requires. Belize would not allow the ship to dock. US has her being picked up along with her husband traveling with her so that she can be taken back to the US and do TWO more days of quarantine. She is NOT symptomatic, she self-quarantined because of yesterday's new CDC quarantine rule.

http://hosted.ap.org/dynamic/stories/U/US_EBOLA_CRUISE_SHIP?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT
WASHINGTON (AP) -- Obama administration officials said a Dallas health care worker who handled a lab specimen from a Liberian man who died from Ebola is self-quarantined on a Caribbean cruise ship and is being monitored for infection.

State Department spokeswoman Jen Psaki said in a statement Friday that the woman had shown no signs of the disease and has been asymptomatic for 19 days.

The government is working to return the woman and her husband to the U.S. before the ship, the Carnival Magic, completes its cruise. The White House said the State Department was working to secure their transportation home.

An administration official who was not authorized to be named and requested anonymity said the cruise ship had stopped in Belize but officials there would not allow the passenger to leave the vessel.

Texan-style stupidity, fear mongering, and Ebola are spreading due to lack of regulations. Thanks a lot, Perry and Republicans. Perry clearly have failed.

Prior to the first US case someone with these symptoms would have sat in a emergency room waiting room for hours in most every metro hospital in the US. Anyone who believes otherwise simply has never been to metro e-rooms. ...

I.e., forget "ebola" - it's folks with any severe malady, including communicable diseases, who go to a hospital and then get directed to a "waiting area" peopled with all sorts of other folks with various illnesses (who may be sitting with non-affected family members or friends who.brought the ill person there). This is where the triage processes need to be improved.

Unless it it absolutely necessary.

which limited exposure. I read something last year where some localities have physicians who are starting to go back to that model and are even using the latest tech to facilitate this. For example - http://www.cnn.com/2014/07/31/health/doctor-house-call-app/

Although I haven't yet figured out what sort of thing I'd be willing to pay the extra $50 surcharge for. Seems to me anything that I found that important, I'd want the dog out at her offices, where every possible drug or instrument is available for her.

But having people who could make 'house calls' to evaluate you for possible ebola issues would be a great thing.

to put down our rescue beagle, Barney. It was worth the surcharge since he hated car rides, vets, etc. He had just undergone treatment for heartworm that another vet had administered too fast (due to a holiday weekend). He was essentially poisoned with the arsenic based meds they used in treatment and was having seizures, organ failure, etc.

Yes, many patients spend LONG times in the waiting rooms if they have non-lifethreatening injuries/illnesses. I know I spent about an hour in one myself, with two broken wrists, years back. But...

Before I got my RN, while still a student nurse, I spent a year or so volunteering at the intake and triage desk of our local hospital. We got 'chest pain' people back into the ED without ever leaving the check-in desk, in under 5 minutes even at the busiest of times. And we certainly would have pushed the 'travel in or from the ebola areas' question to the front of the arrival interview, and the very same nurse who heard him say 'yes' would have ensured that he got into a private room as quickly as those chest pain folks, and that the ED nurses knew that he was potentially contagious. Now they possibly would have gone in with less than full-body PPE at first, maybe only gloves, regular disposable gown, and mask, until an ER doc had seen him and decided to pull him into an isolation room and decontam that private room. But at least he'd be in a solo room, not passing things along in the waiting room.

One point I don't think has been mentioned in any ebola-related posting. We need to keep it small and tight in the US. Because hospitals don't actually have a ton of isolation rooms, and even fewer ones with reverse air flow. Most hospitals might have only a few such reverse-flow rooms at best. Sure, we've got lots of hospitals, but an outbreak in one place is going to quickly fill up every such room in any given hospital, and you're going to end up spending much more time moving patients to hospitals that still have open reverse-flow isolation rooms.

(Edit: And less than 5 minutes after writing that, Morning Joe just showed a newspaper article headline pointing out that even the 4 'ebola' hospitals can only hold 9 patients at a time, although they didn't say 'each' or 'between all 4'.)

On MSNBC just now, Ronan Farrow just went through listing out the locations of nine such beds and which facilities they were in and how many of them were filled, and the CDC guy he was talking to didn't correct him, so I'm still treating the number as 'not nailed down, but still very low' whether it's 9 or 18. I'm guessing that a LOT of hospitals are currently ordering or purchasing more of the highest level PPE gear, as they probably don't keep much on hand beyond the more standard airbourne/droplet/contact types.

The more details that have kept leaking out as to mismanagement and lack of common sense among both those directly caring for Duncan and those managing them, the more reasonable things you said early on sound. While I still stand by the importance of maintaining a calm demeanour while dealing with public health issues, that demeanour is never supposed to be built on denial, but on a grounding of competence and sensible behaviour that appears to still be sorely lacking among many on the ground. I'm shocked at some of the decisions of some of the nursing staff in relation to travel after potential exposure, as well as to management in assigning so many people to interacting with Duncan, and having those caring for him interact with other patients at the same time.

Texas is the worst possible place for this case to have landed for so many reasons. And I think there are a significant number of nursing AND OTHER MEDICAL staff there that have really dropped the ball. I guess I expect better of licensed medical professionals.

Pham sounds like she was on top of things as much as possible, BTW, but just had inadequate PPE especially in the beginning.

If they were all freaked out by the lack of preparedness and equipment and training, I don't get the disconnect that allows them to think travel is then ok. If you are worried about exposure, the LAST thing you do is hop on a plane (WHILE ILL) or cruise ship.

And now we see how very dangerous one hospital management team's negligence can be. Hundreds on the planes and in Cleveland. Who knows how many completely unidentifiable and untrackable at the airport. And thousands on the ship.

Shaking my head in complete disbelief.

ETA: Sorry for yelling at you before. I was pretty appalled at the whole thing as i said.

"North-fucking-Carolina. This part is the bitter coldest story regarding the hospice stories. If I ever decide to make a trip to North Carolina, I'll make sure it's drive-through in less than a day!"


With that, just don't plan on ever driving to Texas, we have been trying to lure educated professionals for all the jobs here

The panic will be unprecedented. No seaport will allow the ship to dock. The Navy will assign a carrier battle group to surround the ship while nuclear attack submarines keep armed torpedoes aimed it round the clock.

Bon voyage! Oh and call us if you're feeing sick.

How many people are on that ship?

Stewards, maids, wait staff. Then they can pass it on to the passengers.

This is just bloody stupid!

These are just folks who had regularly scheduled stuff going on, and following the guidelines they had been given.

I haven't heard one report of a worker who hasn't, yet here we are, with everyone blaming the workers instead of taking to task the people who make the decisions.

Travel?

Go forth and spread it!

Not blaming the health care worker, just why were they cleared to mingle.

was apparently told to go right ahead and fly. The one on the cruise just handled samples - and the protocol said there was no reason not to leave on regularly scheduled travel, didn't call for them to be quarantined.

There are other pressures as well. They were probably committed to their travel costs and their work and the CDC both said go ahead. Who stood ready to write them a check?

As it is, and beyond being infected, his is gonna cost them thousands out of pocket that will never be reimbursed. And a whole bunch of hate mail for just doing their job as they were told. Most of it by people who would rather blame them than wash their own hands every time they go to the bathroom.

Note: It was such a non-threat that the training session for ebola, before this, at the hospital in Dallas, was reported to be 30 minutes, which, in my experience for other medical training classes, is probably exactly what was. That's not enough time to properly get in and get out of one of those suits - with the assistance and showering you should have - much less learn anything else.

When the people at the top don't take it seriously, or prefer profit over safety, this should be exactly what we expect.

Interesting that this disease is only supposed to be transmitted through fluids, yet here we are wondering why everyone isn't in a space suit and stuck in a dungeon, which shouldn't be necessary at all, except for the accidental contact it might prevent with fluids. The largest vomiting and diarrhea takes place early, so gowns and masks should protect just find against what we were told in the past.

So has this thing changed form, and perhaps we aren't being told to avoid panic?

This person handled test tubes and put them in hermetically sealed lab equipment, she wasn't snorting his blood like it was cocaine.

Either people wanted to get away from there, or they are casting a very wide net out of an abundance of caution. Either way, I'm glad the individual in question is in good health for now.

Is it just me that thought of that?

All told there were probably about 30 people who handled the patient and/or specimens. None of them should have been allowed to mix with general population for 21 days. The hospital should have paid their wages and room/board for this. They could have been isolated in a nearby entire motel for the duration which would be cheaper than using hospital beds, only to be transferred if they developed symptoms. Inconveniencing other guests at the motel by telling them to find other accommodations is better than causing nationwide panic and exposing hundreds more.

Utter incompetence.

It would be too expensive to hire extra staff to cover three weeks of 100 downed employees and their room and board.

THP is responsible for this mess. They saw no need to follow CDC guidelines or even exercise basic common sense. Now they can accept responsibility for the consequences.

Fear and hysteria was used to get the mass public to accept the gross violations of rights for Japanese-Americans.

It's not unlike the threat of a mushroom cloud to get the public to accept the invasion of Iraq for private oil companies.

or we'll get a mindless post saying **** anyone who criticizes!1!!

after being exposed to Ebola?

THE EBOLINER

Let me see I've been around people and places with the Ebola virus, maybe I shouldn't get on a plane, train or take a fucking cruise until I know for sure that I am not contagious.

Did you have any direct contact with snot, blood, semen, sweat etc?

I'm sure they have a logo and theme music all set to go.

Non-stop excitement!!!!

night and going out to see what it is, just like you would do if you were in a horror movie!

who treated the first Ebola patients? If this disease is able to penetrate Hazmat suits, hospital gear, fly through the air, etc., where are their infected hospital staff?

Coincidence that the Nurse from Dallas is now being transferred to that same hospital in Atlanta? No offense to the people of Texas, but it sure sounds to me that the Texas hospital didn't exactly know what they were doing.

Reporters from their facility and try to get back to normal sooner. Without an ebola patient, the locals will forget about it even faster do they can start making money again.

They had no clue what they were doing, because the VAST majority of nurses in this country are not trained. The nurses union spokeswoman believes at least 85% of nurses are untrained in the treatment and containment of this disease. They didn't have the proper equipment nor did they have the proper training.

And to add to that, once the CDC arrived in Dallas, "they" didn't even follow proper protocols, which were a much lower standard than at the Atlanta hospital, which has a special ward for highly infectious disease - level 4 biohazard. I don't know of any nurse who is trained to that level unless working in a special unit.

Even if the CDC didn't exist, I would have enough consideration for other people that I'd sequester myself as well as I could for the incubation period to limit contact and to make sure I didn't have it or spread it.

To me, it's a no-brainer. It should be for everyone.

I'm the same way regarding illness in my extended family. My MIL used to have family dinner every Sunday night. It was a command performance and everyone was expected to attend (making the most of the time we have left with my FIL before Alzheimer's claims him). If someone was sick in our immediate family, out of respect for the extended members, the affected party would stay home (if it was a kid, my hubby or I would also stay home). My SIL on the other hand would bring her 5 munchkins regardless. It didn't matter if they were running a fever (sometimes a high one), throwing up, rash, etc. We would stand in a circle holding hands while my FIL said grace before dinner. More than once, one of her kids tossed their cookies during that process.

In our school district, if kids have a temperature of 100, they are supposed to stay home until their temp is normal for 24 hours. My son was had something last year where his temps were wavering between 101 and 99.6 for several days. The nurse called to find out where he was and to tell me that he should be sent back to school. I let her know that I was following district protocol and would send him back as soon as his temp was NORMAL for 24 hours. She had the nerve to get pissy with me over the phone. **Added: This was during flu season.**

Belize has it's head up its ass. She handled a lab specimen of Mr. Duncan. CDC only had workers concerning Mr. Duncan self-monitor. Yesterday the CDC decided that they should be quarantined. She self-quarantined on the ship yesterday because that's what the new CDC quarantine protocol requires. Belize would not allow the ship to dock. US has her being picked up along with her husband traveling with her so that she can be taken back to the US and do TWO more days of quarantine. She is NOT symptomatic, she self-quarantined because of yesterday's new CDC quarantine rule.

http://hosted.ap.org/dynamic/stories/U/US_EBOLA_CRUISE_SHIP?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT

WASHINGTON (AP) -- Obama administration officials said a Dallas health care worker who handled a lab specimen from a Liberian man who died from Ebola is self-quarantined on a Caribbean cruise ship and is being monitored for infection.

State Department spokeswoman Jen Psaki said in a statement Friday that the woman had shown no signs of the disease and has been asymptomatic for 19 days.

The government is working to return the woman and her husband to the U.S. before the ship, the Carnival Magic, completes its cruise. The White House said the State Department was working to secure their transportation home.

An administration official who was not authorized to be named and requested anonymity said the cruise ship had stopped in Belize but officials there would not allow the passenger to leave the vessel.


ENOUGH of this shit blaming a worker for the fuck-ups and decisions of the CDC!!! The CDC is THE authority!

Since you are so confident that she is all healthy, we'll let you stay in a cabin with her.

And you can fly with the second nurse too.

CDC? Yup...some shitty decisions but the persons involved (even if this was a lab worker) need to have more brains (and monitoring) until we are dead sure that this disease won't spread.

Twice a day. You do realize that these people still had to go work? Like they can tell the hospital, sorry, I don't want to listen to the CDC and won't be coming in for a month? Not only would they get fired they'd never work again. They're required to do what the high authority tells them to. If they don't they could lose their license to practice.

She does not have symptoms. She's been through 19 days with no symptoms. She didn't even have any contact with Mr. Duncan but handled a lab specimen. Lab workers already have precautions for lab specimens. Yeah, I would have flown sitting naked beside her on a plan after 19 days and French kissed her, too.

Seen any breaking news about her suddenly having symptoms though almost 24 hours have passed? No. That's because she's not having symptoms regardless of some Belize website deciding she must be because of her self-quarantining on the ship when she had to because that's what the new rule from the CDC required.

even exercise common sense.

It's not Civics 101 but maybe 201. REALLY basic.

THP chose to be sloppy. THP chose not to educate staff. THP chose not to hire an outside consultant to do education if they didn't feel qualified.

nightmarish.

This is why education an science are important for maintaining a reasonably sane populace. People need to get a f$cking grip. We have two cases, likely due to a breach in protocol no one will admit to. Humans make mistakes, especially if not properly trained, and even when properly trained. It doesn't help when the overlords are for-profit bean counters who's main concern is shareholders, not healthcare workers or patients. Nevertheless, people are losing their sh&it unnecessarily. The media is having a heyday doing what they do, throwing out doomsday chum to the circling masses who've been yearning for the apocalypse, and it's become a ridiculous feeding frenzy.

Will that prevent us from thinking about the dangers of ebola victims flying on airplanes? It seems to have had that effect on the people at the CDC.

...but the online hysteria has been consistently disproportionate to the actual threat on some sites. It's just weird to see some of that here on DU.

So you can't know what is a proportionate or disproportionate response. No one knows yet. Hence the rational thing to do is for the authorities to prepare for the worst. So far the CDC and the UN have dropped the ball.

walking through the grocery store as Ebola on an airplane.

as I advised another DUer, please do not use Texas as "proof" of ANYTHING