Top U.S. health official warns of risks from (daconian) Ebola quarantines

[morningfog]

Quarantines imposed on travelers coming from Ebola-affected countries in West Africa could discourage American health workers from going there to help fight the epidemic, a senior U.S. medical official said on Sunday, warning such measures were "a little bit draconian."

New York, New Jersey and Illinois imposed 21-day mandatory quarantines in the last two days for anyone arriving with a risk of having contracted Ebola in Sierra Leone, Liberia and Guinea. They are the three West African countries that have borne the brunt of an epidemic that has killed nearly 5,000 people.

But critics worry the policies, going beyond federal regulations and intended to ease public concern over the spread of the disease, will just make matters worse.

"I don't want to be directly criticizing the decision that was made but we have to be careful that there are unintended consequences," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

"The best way to stop this epidemic is to help the people in West Africa, we do that by sending people over there, not only from the U.S.A. but from other places," Fauci told NBC's "Meet the Press." He called such quarantines "a little bit draconian."

http://www.reuters.com/article/2014/10/26/us-health-ebola-usa-idUSKBN0IF03L20141026

[morningfog]

1. In other words, ignorant-ass anti-science idiots need to stay the fuck out of the way.

[etherealtruth]

12. Exactly

My first thought when he said that was that effing morons (I am engaging in hyperbole, more accurately people that have no knowledge) need to leave this to those with expertise in this area.

[customerserviceguy]

2. They're not draconian

They would only be for three weeks, max. The problem is, the public health authorities in the US really don't have any practical experience with quarantines. The most recent significant mass quarantine in US history was for the flu after WWI. Such lack of experience with the concept makes public health officials afraid of imposing them, and it falls upon political leaders to make the hard choices.

[morningfog]

3. They are absolutely unnecessary and contrary to our scientific knowledge.

There is no hard choice for the political leader to make. The politician needs to get out of the way of science and public health.

[customerserviceguy]

4. I sure hope there is a survey out there on this

Scientific or not, the public is wary. It's fine to apply medical science to Ebola, but you have to apply social science (including political science) to the fear of Ebola.

Bottom line is, most Americans think that being protected from an overseas disease is more important than fighting that disease where it is. If there's a way to have both, they'll be OK with it, and a three week quarantine seems like it would be no big deal to someone willing to go all the way to Africa.

[Mutiny In Heaven]

5. The public panic is no more legitimate than the Republican opinion on climate change and

homosexuality. Just because the ill-informed panic and misconstrue doesn't mean everyone should follow in their footsteps.

[customerserviceguy]

6. And once we do away with representative government and elections

and just have the eggheads rule us, then dealing with public perceptions will not be important anymore.

[hedgehog]

8. In point of fact, a recent survey shows half the people in America

think the government is doing just fine, and only about a quarter are worried about Ebola at all:

http://www.gallup.com/poll/178760/americans-confidence-government-handle-ebola-drops.aspx

[customerserviceguy]

11. Thank you

I had tried to find a recent survey on Ebola, and all I was getting was a survey from a couple of months ago, about the time that Nurse Writebol and Dr. Brantly were in the news.

Two things I find interesting about that survey. First, it was taken about a week before the news that Dr. Spencer had it, and he's in the most news-intensive part of the US, with the possible exception of Washington, D. C. when Congress is in session. I'd be interested to see what the next survey on the subject says.

Second, while most Americans don't seem to be worried about getting Ebola, it's clear that confidence in the government's ability to handle it has dropped. Again, the next survey on that question will have an interesting answer.

What I'd like to see is a survey about the American public's attitude on quarantining health workers who come back from West Africa. My guess is that a majority would think it was a prudent thing to do, regardless of what scientists and doctors tell us.

The drop in confidence on handling this is what is behind the "abundance of caution" feeling that directs politicians to do things that are not 100% in line with what the experts tell us to do.

[seabeyond]

10. simple question. those in u.s. dealing with ebola, quarantine for 21 days. all supportive role,

quarantine for 21 days.

one shift. they go into quarantine. bring in the next medical staff. one shift, they get quarantined for 21 days.

is this really what you are suggesting? the ebola is the same here as there. you quarantine those coming in. you quarantine those already here caring for ebola.

one shift.... they get quarantined.

or

do you hold a medical team hostage to care for the patient exclusively, until patient no longer has virus, or dies, and then quarantine that group for 21 days?

how does this work?

[customerserviceguy]

13. I would imagine

that the four facilities in the US designed to treat highly infectious diseases already have living quarters for the staff members with direct (and possibly indirect) contact with patients. You diagnose the illness, then ship the infected person off to one of these facilities.

There are sacrifices that one makes in order to work in various fields, I have no doubt that Nina Pham accepted those limitations when she volunteered for service to Mr. Duncan in Dallas.

[seabeyond]

14. all across the country. those who handle the infected person then, should be quarantined?

this would be before shipping to the four places, that you are clueless if the medical staff, and all supporters that handle the infected person, are quarantined. from the time of dealing with the person, until health, or death, then 21 days after?

doubt it.

[customerserviceguy]

15. I'm not sure how the mechanics of it all would work

But being as this is the United States, and we freak out over all kinds of things, is why I favor travel bans and such things. The public sees the bungled way that the Dallas hospital and the CDC have handled this, and they are rightfully distrustful of the experts.

If we ever had a truly easy-to-transmit epidemic, the kind they have in science fiction movies and TV shows, do you think most people would believe what the government experts had to say?

[seabeyond]

16. the bungled way in what? one person died. two contacted virus. ebola was contained?

that is what we are going to create a lie of fear for us to all live in a reality?

no

we cannot validate lie, because people are afraid, creating it all for us to live, even when fact adn science adn experience tells us otherwise. no

[customerserviceguy]

17. Certainly

the way Mr. Duncan was handled when he first went to the Dallas hospital was a bungle, wasn't it? Also, whatever the protection used by the nurses who treated him failed, I'd call that a bungle.

As for the CDC, they've looked like they've been changing their story every few days, at first, they believed that the average American hospital could handle Ebola, but clearly, that's not the case. A bungle, in my opinion.

Now, there are various reasons for these, and I expect that full reports on what went wrong, and what we learned to prevent it from happening again will be forthcoming, but in the short term, the unscientifically trained American public is feeling somewhat skeptical.

[seabeyond]

18. Even with mistakes it was contained, quickly. That should be informative all in itself

1 dead, that walked into country ill, two infected, disease contained

[customerserviceguy]

21. At this point

the only Americans who have contracted Ebola have been those involved directly with West African victims of the disease, but if that ever changes, then katy bar the door.

At this point, the focus is on keeping the disease from coming into the country again. I agree that Dr. Spencer very likely caught it in time, before possibly spreading it to the his fiance and the two friends being isolated, now we focus on how to keep the next Dr. Spencer from rambling around in public until we can be sure of that person's condition.

Yes, so far, there has only been a tiny handful of people in the US with Ebola, and except for Duncan, I believe that they are all going to be all right. However, when you add up the number of people on Amber Vinson's and Dr. Spencer's airplanes, etc., you have a very large number of people who have had an alert from a public health agency, and that's going to leave most of them pretty uneasy. Surely, they've been on Facebook, Twitter, and the good old fashioned telephone to describe their fright to friends and family, and while the virus itself can be relatively easily contained, fear cannot.

It's going to take a lot of these 'abundance of caution' efforts to allow the fear to dissipate.

[seabeyond]

20. further, having dealt with crisis and problem solving? dallas "bungle" was the first experience

in the u.s. out of the blue, ebola is here. it is not clearly defined first visit, in a busy ER when no cases have ever been in the u.s. prior.

IMO... for anyone not to take that into account, when looking at what happened in dallas, to me, ??? being unreasonable. and i do not think now is a time for unreasonable. not in dealing with a crisis or a mere situation from a pragmatic, informed position to solve problems.

[customerserviceguy]

22. I stand by what I say

If a survey were done tomorrow, you would find a low confidence rating for the CDC on the handling of this.

[seabeyond]

23. ignorance cannot be hte dictator of our policies. we have seen the fail in that too many times.

we are living the repercussions of it, today.

[hedgehog]

9. Ebola is not head lice!

It is hard to catch Ebola without serious exposure to the bodily fluids of someone with an active case.

It is very easy to catch head lice; just ask any parent with a kid in grammar school.

Quarantine makes sense with head lice, not with Ebola.

[Warpy]

19. Yeah, but he's a pointy headed EDUCATED wonk, EDUCATED IN MEDICINE.

Obviously MEDICALLY IGNORANT grandstanding politicians and angry mobs whipped into a frenzy by disinformation by what passes for news in this country have better opinions and, as we all know these days, opinion always trumps FACTS.

Politicians should never have the power to do things like insist on blanket quarantines and put people in conditions that are worse than prison just to make points with a bunch of total boobs out there who are panicky because nobody ever tells them the truth on the evening "news."

Quarantine is a health care decision that should be handled by health care practitioners.

You know, people who are educate to do the job.