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Ebola Tag

As Ebola continues to rage in Africa, one key person seems to be missing in action: Ron Klain, Ebola Czar.
Ebola was on the top of everyone’s minds five weeks ago, but now that it’s largely disappeared from the mainstream media, it continues to fade into the background in this country. But the fact remains: Ebola continues to kill hundreds of people in Africa. Ebola continues to destroy families and leave many children without parents. It was sad for me to hear about the passing of a surgeon – who was a citizen of Sierra Leone and a permanent resident of the U.S. – on Monday. From what I know, he was a dedicated health care professional who did his best to keep his patients safe and alive. But what is sadder to me is that our Ebola czar, Ron Klain, did not have the courage to publicly come out and offer a statement in regards to the death of this physician, and also has failed in keeping the American public informed about the progress in this Ebola war.
I would have expected a political operative such as Klain to at least try to "message" us. Hopefully, we won't discover videos of him calling Americans stupid for being concerned about a potential pandemic..after being paid millions in taxpayer dollars for questionably professional services. However, at least Ebola did attract some mainstream media coverage. That differs from Enterovirus-D68, which has swept through the country and has sent hundreds of American children into emergency rooms with respiratory distress. There has been very limited, local coverage. One of the few who took up the story is Sharryl Attkisson, who now reports that 12 deaths have now been linked to this pathogen.

When I heard that Dr. Martin Salia, a Sierra Leone native who is married to a US citizen and who contacted ebola while treating patients in his native country, had been flown here for treatment and was in "very critical" condition, I thought "if we can cure him, then American medicine is really onto something in the treatment of ebola." Sadly, it was not to be: Dr. Salia has died of the disease. He was very very far gone when he arrived:
"He was placed on dialysis, a ventilator and multiple medications to support his organ systems in an effort to help his body fight the disease. He also received a dose of convalescent plasma and ZMapp therapy was initiated on Saturday," the hospital said in a statement. "We used every possible treatment available to give Dr. Salia every possible opportunity for survival," Smith said. "As we have learned, early treatment with these patients is essential. In Dr. Salia's case, his disease was already extremely advanced by the time he came here for treatment."
There are two very salient facts about the case of Dr. Salia. The first is that he never knew how he got the disease; he was a general surgeon in Sierra Leone and was not specifically treating ebola patients. This reflects the fact that ebola is not always easy to spot, even for medical personnel who are well-versed in its diagnosis and are treating patients in areas where it is endemic, and therefore would be on high alert for it. That is one of the many many dangers of the disease, and you may recall that the same thing happened with Dr. Rick Sacra, who was treated here much earlier in the disease's course than Salia and has survived. The second thing I'd like to highlight is that it took four (or five; I've read differing accounts) full days after Dr. Salia first showed ebola symptoms for his blood test to become positive for the disease. By that time he was extremely sick indeed. The loss of those days of possible treatment here may have made a big difference. Here is the story:

From the "totally unofficial" Harvard Parody website, "Eve of Destruction: Ron Klain, Ebola Czar": Adding to Harvard Law School's already considerable reputation for producing "elite" lawyers who fill high-level government positions for which they are totally incompetent (in terms of the real-world practical skills and ethical...

Concern about the administration's handing of the global Ebola crisis was a contributing factor in the Republican success across the country in Tuesday's election; polls indicated Americans were more worried about the lack of a comprehensive response than they were about immigration and same-sex marriage. It is likely this concern will remain for quite some time, especially as Americans returning from Africa are still being impacted by this pathogen.
The Iowa Department of Public Health said Thursday that 13 travelers who were in West African countries are being monitored in Iowa for Ebola. The travelers were in Sierra Leone, Liberia or Guinea in the last 21 days and are now in Iowa. Twelve had low risk of having been exposed to Ebola in those countries health officials said, so they are being allowed to resume normal activities. IDPH has ordered them to take their temperature twice a day and report their health status to public health. One person had some risk of being exposed to Ebola, and has been quarantined. The person was told to stay at home and take their temperature twice daily, including at least once with a public health official observing.
Let's hope the quarantined Iowan takes the situation more seriously than the Maine nurse who fought against restrictions based on public health concerns. Meanwhile, one of the nurses who contracted the deadly virus while treating America's patient zero, Thomas Duncan, is mystified as to how she became infected and resents being thrown under the bus after she boarded a flight to Ohio:

A District Court judge in Maine has overturned a lower court ruling that restricted Kaci Hickox's movements, which means that the formerly-quarantined nurse is now free to go about her business. The reason? The science on ebola transmission is apparently settled:
Judge Charles C. LaVerdiere ruled Hickox must continue daily monitoring and cooperate with health officials if she chooses to travel. The judge said there’s no need to restrict her movements because she’s not showing symptoms of Ebola. In his ruling, the judge thanked Hickox for her service in Africa and wrote that “people are acting out of fear and that this fear is not entirely rational.” Maine Gov. Paul LePage disagreed with the judge’s decision, but said the state will follow the law... The judge...acknowledged the gravity of restricting someone’s constitutional rights without solid science to back it up. “The court is fully aware of the misconceptions, misinformation, bad science and bad information being spread from shore to shore in our country with respect to Ebola,” he wrote. “The court is fully aware that people are acting out of fear and that this fear is not entirely rational.”
No doubt the judge is also fully aware of certain statements made by Nobel-prize-winning immunologist Dr. Bruce Beutler:
It may not be absolutely true that those without symptoms can’t transmit the disease, because we don’t have the numbers to back that up,” said Beutler, “It could be people develop significant viremia [where viruses enter the bloodstream and gain access to the rest of the body], and become able to transmit the disease before they have a fever, even. People may have said that without symptoms you can’t transmit Ebola. I’m not sure about that being 100 percent true. There’s a lot of variation with viruses.”
On the subject of possible further court action by the state:

Kaci Hickox is back home in Maine. But she's as defiant as ever:
Kaci Hickox, the nurse who was quarantined at a New Jersey hospital despite exhibiting no Ebola symptoms after arriving from West Africa, won't follow the quarantine imposed by Maine officials, her attorney said tonight. "Going forward she does not intend to abide by the quarantine imposed by Maine officials because she is not a risk to others," her attorney Steven Hyman said. "She is asymptomatic and under all the protocols cannot be deemed a medical risk of being contagious to anyone." Hickox will abide by all the self-monitoring requirements of the Centers for Disease Control and Prevention and the state of Maine, Hyman said.
But I wonder how many people in Fort Kent, Maine are going to be eager to attend her "Welcome home, Kaci" party? Now that Christie has washed his hands (metaphorically speaking) of Hickox---which is beginning to look more and more like a savvy decision---what will LePage of Maine do? Treat her with kid gloves, perhaps:
Maine requires that health care workers such as Hickox who return to the state from West Africa will remain under a 21-day home quarantine, with their condition actively monitored, Gov. Paul R. LePage said in a statement. "We will help make sure the health care worker has everything to make this time as comfortable as possible," he said.
The comments to the linked article are uniformly angry. Typical is this: "She makes it REALLY easy to hate her." And that's among the nicer ones. From some of the statements in this article, however, it sounds like Maine may be ready for a legal battle with Hickox:

I am going to go out on a limb and project that there are going to be historic election results on November 4th that would have been unimaginable until this August, when reports on Ebola coming to this country began filling the news. This has transformed the women that Democrats have historically relied on, "soccer moms", into "health and safety moms". Because I am both a mother and an environmental health and safety professional, other mothers question me on the latest news related to both Ebola and the potentially deadly Enterovirus D-68. Every last one of those women say that we should have had travel bans, mandatory quarantines, and that the administration isn't being completely candid in its reports related to these pathogens. For example, there is news that the New Jersey nurse quarantined after returning from work with Ebola patients in Africa was just released:
A nurse who was quarantined at a hospital in New Jersey after returning from West Africa was released Monday, her attorney said. Kaci Hickox, who told CNN the quarantine was violating her rights, was discharged after testing negative for Ebola. Hickox was put in isolation Friday after returning to New Jersey from a month in Sierra Leone. Her quarantine, part of a days-old policy the governors of New York and New Jersey instituted for all health care workers who've had contact with Ebola patients in West Africa, has been criticized widely by health care experts. On Sunday, she spoke by phone with CNN's Candy Crowley and Elizabeth Cohen. "This is an extreme that is really unacceptable, and I feel like my basic human rights have been violated," Hickox said. She said she was flummoxed as to how New Jersey Gov. Chris Christie, who has no medical training, could describe her as "obviously ill."
This video summarizes the story from CNN:

The late September arrival of Ebola-postive Thomas Eric Duncan at Texas Health Presbyterian Hospital has caused many Americans to worry about their personal health in the event of an Ebola outbreak. Right on the heels of that worry, however, is a worry of another kind. What about your personal rights? In particular, what about that most fundamental liberty interest: freedom from confinement. As Professor Eugene Kontorovich noted at The Volokh Conspiracy earlier today, this question has caused the (now released) quarantined nurse to threaten a legal challenge to the constitutionality of her recent confinement in New Jersey. So what are your rights when faced with involuntary quarantine? The answer, while simple, is completely unsatisfying and even a bit concerning: It depends. As a result, the true “answer” is a very nuanced and fact intensive inquiry into each particular case of confinement. Books can be written (and have been) about the legality of involuntary confinement in the face of a public health crisis, but this blog post may serve as highly generalized primer for the curious. To begin, quarantining “separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.” [Emphasis Added]. Note that “quarantine” refers to the confinement of those who are not currently sick, but have been exposed to an infectious disease and may ultimately develop symptoms. “Isolation,” on the other hand, refers to confinement of individuals who are sick.

Ebola infected nurse Nina Pham was released from the National Institute of Health hospital today after being cured of Ebola. Great news not only for Pham, but for those of you with Ebolanoia as well. Pham contracted the virus while taking care of Eric Duncan, the Liberian who passed away from the virus in a Dallas hospital earlier this month. According to The Guardian:
Dr Anthony Fauci, infectious disease chief at the NIH, gave Pham a hug and told reporters that five consecutive tests showed no virus left in her blood. “She is cured of Ebola, let’s get that clear,” Fauci said. Pham’s release comes a day after a doctor in New York City who had been treating Ebola patients in west Africa was diagnosed with the virus. Dr Craig Spencer is being treated in isolation at Bellevue Hospital Center in Manhattan. The 26-year-old Pham arrived last week at the NIH Clinical Center in Bethesda, Maryland. She had been flown there from Texas Presbyterian Hospital in Dallas, where she became infected while treating Thomas Eric Duncan, who died of the virus 8 October. A second Dallas nurse who became infected after treating Duncan has also been pronounced free of the virus, family members said this week. Amber Vinson, who flew to Ohio and back before she was diagnosed, is being treated at Emory University Hospital in Atlanta, Georgia.
Bentley, Pham's dog has also tested negative for Ebola, but will remain in quarantine until the 21 days have lapsed:

The New York Times and CBS have both confirmed that Dr. Craig Spencer has tested positive for Ebola:
“Today, EMS HAZ TAC Units transferred to Bellevue Hospital a patient who presented a fever and gastrointestinal symptoms,” New York City officials said in a statement. “The patient is a health care worker who returned to the U.S. within the past 21 days from one of the three countries currently facing the outbreak of this virus.” Spencer, who is a physician in his 30s and works with Doctors Without Borders, came back a week ago from Guinea, where he is believed to have been treating Ebola patients. “A person in New York City, who recently worked with Doctors Without Borders in one of the Ebola-affected countries in West Africa, notified our office this morning to report having developed a fever,” Doctors Without Borders said in a statement. “As per the specific guidelines that Doctors Without Borders provides its staff on their return from Ebola assignments, the individual engaged in regular health monitoring and reported this development immediately. While at this stage there is no confirmation that the individual has contracted Ebola, Doctors Without Borders, in the interest of public safety and in accordance with its protocols, immediately notified the New York City Department of Health & Mental Hygiene, which is directly managing the individual’s care.”
Mayor de Blasio and Gov. Cuomo are scheduled to hold a news conference from Bellevue Hospital at approximately 9 p.m. (Embedded below the fold.)

(UPDATE: Officials have confirmed a diagnosis of Ebola. See our updated post here. A physician who recently returned from a Doctors Without Borders mission to West Africa is in isolation at New York's Bellevue Hospital after presenting with a 103 degree fever. Here we go again. NBC News reports:
"While at this stage there is no confirmation that the individual has contracted Ebola, Doctors Without Borders, in the interest of public safety and in accordance with its protocols, immediately notified the New York City Department of Health & Mental Hygiene, which is directly managing the individual’s care," Doctors Without Borders said in a statement. Health care workers are among those at highest risk of being infected, because they work so closely with very ill patients and are in frequent contact with infectious bodily fluids such as vomit. “The patient was transported by a specially trained HAZ TAC unit wearing Personal Protective Equipment (PPE),” the city health department said in a statement, adding that after consultation with the hospital and the CDC, they would test for Ebola. They are also checking him for malaria, salmonella and stomach viruses because they can all cause similar symptoms.
Dr. Craig Spencer, the latest patient, had been monitoring himself since his return, and thankfully did the right thing by reporting his fever to the appropriate officials. Reports haven't revealed where Dr. Spencer was practicing, but if he was in a country that was placed under recently-implemented travel restrictions, the next few weeks could be...interesting...for elected officials:

Some good news related to Ebola: The nurse who flew to Ohio while ill with an Ebola infection has been declared free of the virus.
Dallas nurse Amber Vinson is free of the Ebola virus and will be transferred from isolation at Emory University Hospital in Atlanta, her family said Wednesday. The family also said that the 29-year-old nurse, who contracted the virus from Liberian Thomas Eric Duncan, was regaining strength and that her spirits were high. "We are overjoyed to announce that, as of yesterday evening, officials at Emory University Hospital and the Centers for Disease Control (and Prevention) are no longer able to detect virus in her body," the family said in a statement hours after Vinson spoke with her mother, Debra Berry.
And as the 21-day quarantine ends for the family of the late Thomas Duncan and the healthcare professionals who cared for him during his fatal bout, new questions are being asked about the time period of isolation itself.
As the 48 patients exposed to the first U.S. Ebola patient near the end of their 21-day incubation period on Sunday, Oct. 19, a new study is questioning whether that period is sufficient to keep the public safe. "Twenty-one days has been regarded as the appropriate quarantine period for holding individuals potentially exposed to Ebola Virus to reduce risk of contagion, but there does not appear to be a systemic discussion of the basis for this period," lead researcher Charles Haas, an environmental engineering professor at Drexel University, wrote in the study paper.
In the meantime, it is heartening to learn that nobody else has succumbed to hemorrhagic fever as a result of Duncan's actions.

Today DHS imposed a set of travel restrictions that will funnel all travelers coming from countries suffering from Ebola outbreaks through 5 major airports in the U.S. Although these restrictions will not close off ports of entry to these travelers, they will force all travelers coming from those West African countries to submit to both an interview and temperature checks at Washington Dulles International Airport, Chicago O'Hare International Airport, John F. Kennedy International Airport, Newark Liberty International Airport, or Hartsfield-Jackson Atlanta International Airport. The White House is confident that these measures will help "ensure the safety and security of the American public." Via The Hill:
"This is a situation where the DHS had to work with the airlines that are flying passengers from a wide variety of countries from Europe to the United States. It did require some work with the State Department to inform other countries. So there’s a lot of coordination that had to go into developing and implementing this policy." The White House said it remains opposed to a flight ban, which the president and health officials argue would be counterproductive. "The fact of the matter is giving individuals an incentive to conceal their travel history only puts the American public at risk. ... It makes it harder for us to determine which individuals need to be subjected to the screening that we’ve described," Earnest said.

Remember all the times Obama golfed, traveled to Hawaii, vacationed in Martha's Vineyard and the liberal media insisted that it was no big deal because an executive can do their job from anywhere? Apparently, that rule doesn't extend to Republican governors and while most Americans might think the government's poor handling of Ebola looks bad for Obama, Katie Glueck of Politico is pretty sure the real loser here is Texas governor Rick Perry:
Rick Perry's Ebola test AUSTIN, Texas — Ebola came to Texas. And Rick Perry went to Europe. Now the Republican governor, a likely presidential contender, is back in Austin and scrambling to avoid a damaging perception problem like the “oops” moment that doomed his first shot at the White House. At first, Perry seemed to have everything under control. When a man in Dallas was diagnosed with the deadly virus, Perry held an Oct. 1 news conference, assuring the public that “there are few places in the world better equipped to meet the challenges posed by this case.” When more people were quarantined, he launched a task force and told Texans to “rest assured our system is working as it should.” But then he left Sunday for a long-planned 7-day trip designed to burnish his foreign policy credentials. During his absence, two more cases of Ebola were confirmed, both of them involving Texas nurses who had dealt with the first patient. The governor cut his trip short and rushed home on Thursday, only to encounter criticism for leaving in the first place; Democrats charged that he was more focused on looking presidential overseas than on fixing a big problem at home.
See? It's all Rick Perry's fault, not Obama's.

Yesterday's announcement that the Obama administration was appointing partisan bureaucrat Ron Klain as Ebola Czar was met with partisan reactions. Liberals think it's a great idea while conservatives are skeptical. Perhaps no one put the situation in perspective better than Charles Krauthammer who, by being a psychiatrist is also a medical doctor and therefore more qualified for the position than Klain. In an appearance on Special Report with Bret Baier, Krauthammer reduced the Klain appointment to what it actually is, a public relations move. Transcript and video by National Review:
“I don’t think it’s going to make any difference one way or the other. . . . It gives the appearance of motion; this is what Obama specializes in. If you have a VA scandal, an IRS scandal, a Secret Service scandal, you fire the guy at the top so you have the appearance of motion; here you’re putting a guy in who’s supposedly going to coordinate.” On Friday’s Special Report, Krauthammer derided Klain’s own assessment of his duties: “There’s a quote in the New York Times about what Klain would do, and he said his job is ‘messaging.’ So we have a virus on the loose that turns your organs into liquid, and the answer is to appoint a guy to do the messaging. . . .
Here's something you probably haven't heard about Ron Klain.

Nina Pham tested positive for Ebola. The 26 year old nurse from Dallas, Texas was among the health care crew taking care of Eric Duncan. Ebola took Duncan's life, October 8. Prior to being transported to Bethesda, Maryland to receive more intensive treatment, Pham seemed to be in good spirits. She teared up saying, "I love you guys. Come to Maryland!" This video was filmed last night before to her departure from Dallas: