Quotes of the day

The Obama administration has a message to Americans freaking out about Ebola: Stop

“We respect your concern. We understand your concern. But the evidence tells us that that is not going to happen,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, during a press conference Friday. “And we have to say that a lot.”

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“There were things that did not go the way they should have in Dallas,” he said, but added that the U.S. health-care infrastructure should “stop Ebola in its tracks.”

Dr. Fauci also said that an early study of an Ebola vaccine has been under way for more than a month, and that it could be tested in West African patients by early next year. The vaccine, he has said, would give officials a potent weapon to protect health-care workers and combat Ebola in areas where the disease is spreading.

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Examiner: How long could it take to corral this virus?

Frieden: CDC’s models show that once 70 percent of people with Ebola are effectively isolated in treatment centers, medical facilities, or Ebola care centers, case counts will drop almost as rapidly as they increased. Even before that tipping point is reached, the Ebola epidemic will slow. It is too early to predict exactly when this will happen, but we are greatly encouraged by the magnitude and speed of the response we are seeing.

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Ten people deemed to have been at the highest risk of exposure to an Ebola patient in Dallas are now under isolation while they are being closely monitored, local officials said on Friday.

All 10, a number down sharply from the 100 initially feared to have had direct or indirect contact with the Ebola-infected Liberian man, are cooperating with public health authorities by keeping themselves quarantined without orders, Dallas city and county officials said at a news conference.

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Dallas doctors never saw a nurse’s note that an emergency room patient with fever and pains had recently been in Africa, and he was released into the community with Ebola.

The electronic records system at Texas Health Presbyterian Hospital didn’t flag the information to the physician, hospital officials said. Even so, the doctor should have known to double-check himself rather than depend on someone else, said Ashish Jha, a health policy professor at Harvard University’s School of Public Health in Boston…

The Dallas patient, Duncan, was also asked if he had been around anyone who had been ill, according to a hospital statement. “He said that he had not,” the hospital said.

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Via BuzzFeed:

dun

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In interviews with the Liberian Observer, one of the nation’s largest newspapers, both Thomas Eric Duncan’s former boss, Henry Brunson, and an unnamed coworker agree that they believe Duncan knew he had Ebola when he boarded a plane out of Monrovia with a final destination in Texas. Brunson noted that, having come into contact with a pregnant woman who died hours after her interaction with Duncan, he knew of his disease. “If he were in Liberia, he was going to surely die,” Brunson told the paper, saying he was “glad” that Duncan was in a country with adequate medical resources…

Another unnamed source, described as a FedEx worker in Monrovia, told the Observer that Duncan knew he had Ebola, as well. “A source at FedEx in Monrovia said Mr. Duncan apparently knew he was suffering from the disease and that his best chance of survival was reaching to the United States,” writes author Omari Jackson, “a position that a family source denied, when we sought confirmation.” The Observer notes that the departure to America, for the source and others consulted, appeared a “desperate attempt to survive.”

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Craig deAtley, administrator of the DC Emergency Healthcare Coalition, said the Dallas case is prompting health-care institutions across the country to look at their individual abilities to respond.

Facilities may not realize, for example, how much practical planning goes into training and staffing personnel, configuring isolation rooms, and determining what to do with dirty bedsheets and other waste, he and other officials said…

Some health-care workers around the country have expressed concern about whether the facilities where they work haven’t provided sufficient training to handle Ebola patients.

“They have these protocols and policies in place, but they don’t actually make it down to the level where the nurse is providing that care,” said Deborah Burger, a registered nurse in California and co-president of National Nurses United, the largest nurses union in the country…

CDC officials acknowledged that widespread hospital awareness didn’t kick in until the recent case in Dallas.

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Immigrants from West African countries have entered the US illegally, according to Chris Cabrera with the National Border Patrol Council…

During the 2013 fiscal year, statistics from the U.S. Department of Homeland Security website show Border Patrol agents apprehended 112 immigrants from Guinea, 231 from Liberia and 145 immigrants from Sierra Leone, which are the three countries currently experiencing the most cases of Ebola.

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“Our main concern like it’s always been is the health and safety of our agents,” Cabrera said.

He worries agents are not properly protected in the event they come across an immigrant with the Ebola virus.

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According to his Facebook page and other reports, Duncan is a 40-something, single, unemployed Liberian who applied sometime in the last year for a visa to visit his sister in the United States.

That is five strikes against his application:

1. Single
2. Unemployed
3. Liberian (5th highest overstay rate of any country in the world)
4. Has recently resided outside of his country of citizenship, displaying weak ties there
5. Sister living in the United States.

Together, all these factors should have weighed very heavily against the issuance of a visitor’s visa to Duncan. He clearly appears unqualified.

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The legendary Gord Sinclair, longtime news director of CJAD in Montreal, had a ski place near Jay in northern Vermont, and he invited his engineer on the show to come down and visit him. “What’s the purpose of your visit?” asked the agent at the small rural border post.

“Oh, just a relaxing weekend at my boss’ place,” said Gord’s colleague affably, and then chortled, “although I don’t know if it’ll be that relaxing. He’ll probably have me out in the yard chopping wood all day.”

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So the immigration agent refused him entry on the grounds that he would be working illegally in the United States…

To function, institutions have to be able to prioritize – even big, bloated, money-no-object SWAT-teams-for-every-penpusher institutions like the US Government. You can’t crack down on Kinder eggs, bagpipes and Ebola: At a certain point, you have to choose. My line with the Homeland Security guys is a simple one: every 20 minutes you spend on me, or my kids’ chocolate eggs, or Cameron Webster’s bagpipe is 20 minutes you’re not spending on the guy with Ebola, or Tamerlan Tsarnaev. The price of bagpipe scrutiny is a big hole blown in the lives of American families attending the Boston Marathon, or a bunch of schoolkids in Dallas having to be quarantined for a vicious, ravaging disease with a high fatality rate.

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With no proven drugs to treat Ebola and experimental ones in short supply, the health authorities are planning to turn instead to a treatment that is walking around in the outbreak zone in West Africa.

That would be the blood of people who have been sickened by the Ebola virus but have since recovered. Their blood should contain antibodies that might help other patients fight off the infection…

Plausibility, however, is not proof that such treatments would work for Ebola and some virologists doubt it will. The results of studies in monkeys were discouraging, they note.

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There will also be logistical problems carrying this out in West Africa, where blood banks are not well developed. One challenge will be to make sure that the donated blood, even if it helps patients recover from Ebola, does not give them H.I.V. or hepatitis.

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For now, we must pin our hopes on drugs or vaccines that are still in early stages of development.

The good news is that there are a number of promising therapeutics that have already shown activity against Ebola, from an immune-based drug called ZMapp that was given to seven infected patients, to at least two vaccines that appear ready for large-scale testing. ZMapp showed remarkable efficacy in bolstering the immune system to directly attack the virus in monkey experiments and may also have helped several Ebola sufferers recover.

There are also drugs targeting cancer called “kinase inhibitors” that show potency against the Ebola virus. One advantage of drugs working at the host level—on the person not the virus—is that theoretically the drugs can still work even if the virus mutates. This is in contrast to a vaccine that relies on targeting certain markers on the virus surface that can change as Ebola mutates.

Yet too many public-health officials still believe that they can solve the crisis with tried-and-true methods to contain an outbreak that prioritize manpower over technology. Groups like the World Health Organization have been wrong at every turn in responding to the Ebola outbreak earlier this year. We can’t take the chance that they may again be miscalculating.

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