The World Is Being Run By Crazy People

So far, 3 cases in NA, and 2 fatalities.
A CDC that spreads misinformation.
If Ebola gets out to the general population here, you will have much more to worry about than your bottom line.

It says here it was a half-million $ which the taxpayer is on the hook for.

http://www.christianpost.com/news/ebola-victim-thomas-eric-duncans-9-day-treatment-cost-hospital-estimated-500k-and-he-had-no-insurance-127885/

I'm going to pick on Ian, not because he's Ian, but for the attitude he espouses. Great you're concerned about a little downtime due to the flu. That can be managed. You can build business contingencies for it. Heck, vaccinated or not most people get through it just fine, albeit sick for 3 or 4 weeks. Yes it kills the biologically marginalized.

Ebola is noting like the flu. It kills healthy adults. Its an especially horrible way to die (and I am familiar with most of the ugliest pathogens), but most importantly, and I can't stress this enough, ITS A ZOONOSIS. A particularly nasty disease of wild animals, transmissible to man. It doesn't reservoir in humans (at least not yet), which is one of the reasons why its so virulent in people. The risk from Ebola is that it will find a suitable reservoir host in North America, something it doesn't yet have.

But, it does have a mammalian reservoir. It doesn't need an arthropod vector like West Nile (how did that work out from a single index case into New York?) or the Encephalitides like Eastern and Western Equine? So, from an epizootiological viewpoint, North America is virgin turf. We have become heavily urbanized, at the same time, population densities of small mammals in urban environments is at an all time high.

The risk from Ebola isn't the one or two cases that might come in - it's from the large number of cases that may come in trough bad management - the military being sent over, the time bomb floated out by somebody about what happens if it gets into Mexico and Central America. The reason you saw the parking lot being disinfected in Dallas is specifically due to this reservoir risk. It may already be too late.

No one, I repeat, no one, should be allowed into North America from ANYWHERE, unless they can demonstrate they have not been in a country with Ebola (Africa, now Spain, maybe Britain, and of course, the US) since more than 30 days ago and remain healthy, no exceptions. Nobody should be allowed on a flight to North America, or across a land border, if they have been in any country exposed to the virus until they've been quarantined outside of NA for at least 30 days.

Somebody should ask the good doctor how she's making out with West Nile...

Three cases? Two fatalities? Sorry, I think you're one off on both those numbers. Duncan is the first and only fatality so far, his nurse the second case. Are you counting the two people airlifted to the States for treatment as cases?

If Ebola gets out to the "general population", I still won't be concerned. Take a look at Nigeria, on the same continent as Sierra Leone or Liberia but light-years different in terms of infrastructure, customs, and trust of authority. They had their first case in July in their capital and most populous city, Lagos. Several months later, Ebola has been contained, with no new cases in a month and only eight fatalities with twenty infections.

When you express fear of Ebola in North America, which has a far more sophisticated healthcare system and is much more removed from the outbreak as Nigeria is, you are claiming we are less prepared or less able to deal with this outbreak as a developing nation which has squashed it.

Do what you will with your fear, but there are dozens of things more frightening than Ebola with more potential negative impacts to North America.

I'd bet it's a little less than $30 billion.

Ian, you truly are an idiot. The North American "health care system" has no ability to deal with Ebola if it gets to even a modestly low distribution level. As the CDC states, and Winnipeg will confirm, Ebola is a level 4 pathogen - top level - negative pressure environment, self contained air supply, full suit, complete decontam regime, self-contained incinerated waste, fo both research and patient containment. The estimate is that there are about 20 such facilities in the entire US and they will only have the capability to house a few patients. Canada has, I think, four. No conventional hospital has isolation facilities for this level of bug. Worse, critical care workers are woefully undertrained to work in this kind of environment, and few hazmat workers have substantial virological experience. A previous thread with Nancy Snyderman shows how intellectually capable the "medical community" is to handle this. Each case that gets in is Russian Roulette.

I sincerely hope to be proven wrong about all of this, because the alternative is not so great.

Here's a thought - the last number I heard of healthcare workers including doctors who have died out of the 8000 or so cases was 114. These are experienced people with knowledge who still succumbed. How many health care workers can we afford to lose trying to stop a outbreak, and what will the cost of that be to the other aspects of the health care system?

No one, I repeat, no one, should be allowed into North America from ANYWHERE, unless they can demonstrate they have not been in a country with Ebola (Africa, now Spain, maybe Britain, and of course, the US) since more than 30 days ago and remain healthy, no exceptions. Nobody should be allowed on a flight to North America, or across a land border, if they have been in any country exposed to the virus until they've been quarantined outside of NA for at least 30 days.

You are advocating for clogged airports, troubled airlines due to rapidly declining sales, and likely billions spent on screening, not to mention crippling travel for millions of North Americans, Brits and Europeans. Who will foot that bill? Are airlines meant to cover the loss of sales from a decision based on imagination, not fact?

I invite you to look at Senegal—as close to the ebola outbreak as you can get without being in Sierra Leone or Liberia. They are within days of defeating ebola, with no new cases in almost 42 days, down from a grand total of one case.

Is North America less prepared for ebola than Nigeria or Senegal? Your fear says you believe that ebola will spread here at rates unheard of in those two countries. Are you willing to ante up your tax dollars on that bet?

Do you think North America is less prepared for ebola than Nigeria or Senegal, where ebola is largely contained and whose people are much closer to the outbreak than we are? Present your arguments.

There will probably be some additional "ghetto lottery" costs. Jesse Jackson has been johnny-on-the-spot promoting social justice for the oppressed family of the discriminated against man who has placed dozens, perhaps hundreds, of others in mortal peril while running up a medical bill which is well over 1,000 times the annual per capita income in his home country.

Anecdotally, the office staff of some of THP's doctors as well as the friends I have spoken with have displayed considerable anger about the apparent ingratitude of Duncan's family. I would say that it is just their white privilege talking except that some of them are Black, Latino or Asian.

Ian, the article you cite makes the case against you. Consider that one ebola patient entered the country and eight people died as a result. That the death toll was so low is the result of monitoring 900 people under the authority of an emergency presidential decree that allowed police to track down suspected patients and quarantine them.

None of those precautions are being taken in North America at the moment. The official line is "nothing to worry about". There are other differences that need to be taken into account. Summer in Lagos is very hot and sunny. The ebola virus does not tolerate heat and UV light very well. Lagos does not have a subway system and the average person has a moped. Everyday in North America tens of millions of people use mass transit; the buses and subway cars are heated to about 20C which is ebola's preferred temperature. The glass bus windows blocks UV radiation and subways don't receive any sunlight at all so ebola will be a happy passenger.

The nightmare scenario would be a traveler arriving from overseas before they are symptomatic and then utilizing the New York Subway (or the TTC) system when they become contagious. A simple trip in Toronto involves taking a bus (100 passengers) to a subway station (1,000s of people in a poorly vented man-made cave) getting on to a subway car (150+ people per car, several cars per train with the interconnecting doors open) getting off at the station (1,000s of people in a poorly vented man-made cave) getting into another subway car and then another bus.

Ian, its not fear -its experience, professional experience. I don't live in a world of fear - I've actually handled stuff like this. I know what works and what doesn't. I also know from years or research experience that you can't actually rely on the "wisdom of the day" with these kinds of bugs. Been there, done that, got the scars.

And a really don't give a rat's ass about clogged airports or failing airlines or the economic fallout. Won't happen anyway once people understand they are not going anywhere until their visa is clear. That will find its own level again after the dust settles. Properly controlled, this outbreak will burn itself out. Problem is, in Nigeria etal it's not yet in control. The alarm was sounded on the epidemiological risk three weeks after it started, two weeks too late.

This isn't a discussion about opportunity cost or economic impact -this is much more fundamental than that. You are prepared to trade the health and lives of future and current North Americans for the maintenance of your personal wealth. That makes you the ultimate rent seeker.

North America is NOT prepared for Ebola. At least in West Africa they understand what it is and how serious it can be. They simply don't have the ability to cope with it.

Maybe, if we can buy enough time, we can get organized and get ready, but I not optimistic yet that we can contain it quickly if it gets a foothold. When it comes to dealing with fatal infectious diseases, I'm a pessimist, not an optimist - you live longer that way.

Not debating this any further.

Skip, your post is the best I've read on Ebola so far. Hope you don't mind that I cut and pasted it on my FB page (with credit to Skip on SDA).

Sorry, you're telling me that nobody has sought out people Duncan or his nurse came into contact with? How about 48 people, according to http://www.ctvnews.ca/health/about-70-dallas-hospital-staffers-cared-for-ebola-patient-ap-1.2052372#ixzz3G8zh7A2A:

Until now, the CDC has been actively monitoring 48 people who might have had contact with Duncan after he fell ill with an infection but before he was put in isolation. The number included 10 people known to have contact and 38 who may have had contact, including people he was staying with and health care professionals who attended to him during an emergency room visit from which he was sent home. None is sick.

Senegal and Nigeria have lots of sun, and that helped them but won't help us? Seriously? When it gets at hot as it does there, people tend to stay out of the sun. There's also plenty of it in Texas where our only ebola case resides.

All research indicates that the ebola cannot be spread if its host is not displaying symptoms. Your asymptomatic overseas traveller, like Thomas Duncan, would not infect anyone in his travels, much like Thomas Duncan infected nobody on his flights.

Your description of travel in an African country like Senegal or Nigeria is missing shared taxis and minibuses. Speaking from experience, as I've ridden these in Ghana, Trinidad and Jamaica, they are cramped affairs where people are routinely packed, sweating, into a vehicle, physically touching each other, until the van or car is full enough to be economically viable for a journey. There are also regional buses, which are usually more pleasant but often packed and routinely with no toilet paper in their washrooms. Those means of transport would be far more efficient to spread ebola than a subway.

Culturally, there is more opportunity for disease to jump from one person to another in countries like Senegal and Nigeria. Whereas we greet with a handshake or a nod, many West Africans are more comfortable hugging and touching each other for longer than we'd be comfortable with.

Skip, what proof do you have that ebola in Nigeria is not under control? Do you know of new cases in the past 42 days which haven't been reported?

A country which "understands" what ebola is but doesn't "have the ability to cope with it" is more likely to prevent its spread than one with far better infrastructure and better health facilities? If they can't cope, no amount of understanding would help.

Tell you what, let's all come back here in six months and see who stands by their words. Ebola will not be a major health issue in North America in that time. My life, yours and 99.999% in North America will be unaffected, save for some eager preppers stocking up on hazmat suits and hiding in their homes.

I've been out of the field for a few years now but I'll admit to being a little bit shrill. I've worked with several other zoonotic infectious agents and back in a day I was a working epizootiologist. The bulk of my experience and research was with rabies. When Ebola was first discovered, I made a mental note that it was probably safer to keep working with rabies - at least it was harder to catch, even though it was 99-100% fatal once clinical symptoms appeared. nobody knew what would happen if you became clinical while vaccinated. Found out the answer to that question a few years later when one of my colleagues in New York State came down with a clinical illness from one of our stock challenge viruses, even though he had shared the same vaccination history as I. That redirected my interest somewhat.

Watching the faces of university health care workers turn white when you told them you stuck a needle known to be contaminated with rabies virus into your finger and you were here for yet another booster, was one of the perks :) made that trip three times before I decided it was time to pursue something else... Lab accidents with these things can be the silliest of events, but the sweating after the fact is all too real. Working with animals (human or not) dying from these kinds of bugs is pretty sobering stuff.

If offered the opportunity to go back to the lab to work with Ebola, I would decline. Mind you, you wouldn't have to wait as long to see if you were going to die or not... (sorry, hot lab humour)

Ian, you are very likely going to be correct. My concern is not what if you are, but what if you are not. I'm a contingency planner and currently a law enforcement profiler. I've simply translated my skill set. It may well be that the epidemic is beginning to burn out over there - hopefully that is so. A concern all along has been the pattern of secondary transmissions. I don't believe we have seen the last of that yet. My fundamental concern remains environmental - there are all kinds of good reasons why it would be foolish to let it become endemic in North America, when its comparatively easy, albeit painful for some, to keep it out. Preventing Ebola from getting a up a head of steam in human populations is an own goal. Virologically that's not desirable. If any significant number of cases get here (and I have no idea at this time what "significant" means) we won't know in 6 months where we stand. You have to wrap your head around the reservoir concept. I'll be more than happy to say - "great! worse case scenario didn't happen". That is so much more palatable than the alternative.

Ian, you are missing the point. Ebola is endemic in those regions, and yes, cultural practices, sanitation and development are all factors promulgating outbreaks. But if you believe sweaty buses and cramped transportation systems are any different, from a disease transmission perspective, than the GTA lakeshore GO Train run, for example, then you might be in for a surprise one day. The key issue here is not about any of that - its about keeping Ebola from becoming endemic in North America. I will tell you, believe nothing about what you've read about Ebola in regards to transmission - at best you are looking at statistical evidence. Viruses don't read textbooks about how they're supposed to get from one place to another, and you know what, they're better at it than the textbooks would have you believe. This is one of the principal arguments for keeping it out, to not give it the opportunity to expand its travel ability.

In my lab years ago we demonstrated that a fox could get rabies from eating a mouse that had fed on a dead deer carcass (died of rabies in the bush) lying in the bush for over a month (not frozen). No textbook or paper at that time could have told you that. Make no assumptions about these things based on the current science, because its at best incomplete, and since Ebola doesn't get a lot of funding (few of the zoonoses do), will only be poorly understood in the real world context.

In an earlier day, quarantine was very common - especially in the TB era. Passage by ship built in a waiting period that gave infectives an opportunity to appear. Nonetheless, Quarantine stations were common around the world.. Anticosti Island in the St. Lawrence was one for a while.

I get the economic arguments you make - I just don't buy its worth. We are fortunate in North America to be free of most of the pests that plague the tropics and subtropical regions. Truly, we are blessed to not have to endure what many people in the world have to. That doesn't justify throwing it all away by ignoring these pests when they come knocking on the door, and they will - population densities are increasing, immigration is increasing - proximity transmission will ever be with us, and will likely get worse just on densities alone. It's foolhardy to believe that medical science and our innate technological ability will forever protect us. It won't. The bug are technologically adept as well.

To use an example, one of the major problems during a catastrophic weather event in the tropics are the twin scourges of typhoid and cholera. We are only slightly less immune to these by virtue of our development, but in the SHTF scenario, we are not far from having to deal with these.

West Nile was expected to die out due to the cold winters knocking off the mosquitos. Guess what - little buggers overwinter very nicely thank you very much and keeps the virus going too. Well West Nile wasn't a risk at all but a few years ago, and now its endemic. The only reason you don't see more cases is because governments and municipalities have been telling the greenies to look the other way while they larvicide the hell out of the wetlands. You don't think there isn't a tax cost to that? One index case! If global warming turns out to be real you'll see a lot more.

For every businessman who is disadvantaged by a short term quarantine protocol, there'll be a whole bunch who'll profit. The money keeps moving; it'll just cycle through different hands for a while. The smart money is already selling futures to the preppers... :)

"Do you think North America is less prepared for ebola than Nigeria or Senegal, where ebola is largely contained and whose people are much closer to the outbreak than we are? Present your arguments."

Have you been to a Canadian hospital? Ever?

They don't clean anything, Ian. They have -carpeting-. Ward nurses consider infection control procedures to be workplace abuse and won't follow them. "Isolation" is a room with a door on it. Emergency is one big stew of germs. Fastest way to get the flu is go to any Canadian hospital in the winter.

Modern hospitals depend on antibiotics for infection control. Sanitation and infection control are lost arts here. The single living infected person in the USA right now is Patient Zero's nurse. She had all the protective gear and the "training", she caught it anyway. Because her training SUCKED. If Ebola is twice as hard to catch as the flu, we are wide freaking open.

Also there are zero health controls on the US borders, airports, trains and shipping ports. This is not a normal situation, this is -new-.

Please contrast the present situation with the last time there was an Ebola outbreak, when -no- patents with the virus made it to North America. Because HEALTH CONTROLS AT THE BORDER.

As well, I strongly question your assertion that Nigeria has Ebola "contained". I think rather that they have contained the news of it, not the infection rate. Or they just penned up all the infected and let them die. I could believe that too. Because = Africa.

However I happen to agree with you, Ebola is not the most dangerous thing out there right. Drug resistant TB is being spread throughout the USA right now, today, by the US Federal program that resettles illegal immigrant kids and their families. That's a lot scarier in my mind, because while Ebola takes three weeks to develop and kill you, TB takes months and years to do the same.

We're not ready for that either.

Ian said: "I respect your concern and desire to block any further cases from reaching North America—much like the UK battles against rabies. I don't agree that the dangers warrant the cost and ramifications of such an effort."

Oh please. Have you been to an airport lately? Seen the multi-million dollar naked xray machines, row upon row, hundreds of little unionized security weenies running around? Line ups two hours long? Those are there because it is politically expedient to do that instead of arming flight crews.

Do you think it will shortly be politically expedient to do quarantines and visa checks etc. if a couple hundred people catch Ebola in Texas? How about if there's even one (1) case in Washington DC?

I warrant you'll reconsider the cost of keeping Ebola out when you start getting serious about pricing virus-proof containment suits for the family. They're about three to five grand, with the breathing unit. I understand you can get by with the average surfer's dry suit and a full-face breathing mask. Now go find out how much a dry suit is.

Perhaps Skip could comment on the effectiveness of dry suits and 3M painting masks. I am, after all is said and done, no expert.

... and not religiously profiling the passengers

No need for profiling and searches Al. Because armed air crew. Some bunch of guys tries to take over the plane, the air crew shoots them. Job done, total cost is half a box of ammo.

You can buy a lot of .40 S&W frangibles for the price of a naked xray scanner.

Now if the Social Justice Warriors and the race hucksters and the Leftie academics get all upset because only young radical Mooselimb men seem to be getting shot by these armed air crews, well that's just an added bonus in my book. I live to upset those guys.

Actually, A dry suit probably wouldn't be too bad, as long as you could work in it without overheating... Its primary advantage, with appropriate head gear, is that you would be able to wet sterilize it before climbing out of it - really - I mean hosing you down with a disinfectant solution top to bottom. Getting out of one unaided and staying away from the crud would be tricky, but if the disinfectant routine is done properly the risk is minimal.
I have a concern with the use of standard hospital gear - gloves, gowns, even armshields, surgical mask and face shields, even aprons over top. The problem is there are too many edge breaks and the whole rig is too cumbersome to disinfect. Most of that gear was originally conceived to not infect surgical patients, not the other way around. The more cumbersome it is, the easier it is to break the infection barrier. The info available about the nurse indicates she likely got only a very small dose, but its an open question where in the chain she picked it up.

Modern hospitals are impossible to sterilize. There is so much junk littering the halls that obtaining a clean facility just isn't going to happen.

My lab back in a day, was a concrete block bunker coated with a sealing epoxy resin layer, negatively pressurized, with double steel doors that had an antechamber between the doors, also negative, that contained a footbath. It opened into a small lab space that contained all of our lab hardware. The floors were designed as tubs which could be flooded, and the windows were few and shaped as concave portholes. All of the light fixtures were gas-proof lamp housings. Adjacent to that was an animal holding room, all built the same way. The whole facility was built with a clean side and a "dirty side", and you didn't exit the dirty side without an appropriate decontam, depending what was being worked on.
Waste and whatnot went to the dirty side directly from the lab to an incinerator.

Only three people were allowed in my lab, and no one was allowed who couldn't show a recent proven antibody titre. Because we were vaccinated, we were a little less agressive in personal gear = standard was coveralls, high boots, surgical mask, face shield, surgical gloves, and lab coat. I wouldn't have considered that sufficient in the absence of vaccination. In the lab we did vaccine trials, diagnosed field cases, prepared antigens (live virus reagents), and in an adjacent "dirty" necropsy theatre, carried out necropsies on confirmed or suspected cases. When we were done with animal trials, the rooms were scrubbed top to bottom and pressure hosed with a disinfectant solution until the entire room was washed down everywhere.

That facility is not sufficient for Ebola. We did not have a contained air system (didn't need it for what we were doing) as the aerosol risk was low with most of our stuff and "we were vaccinated".

A well set up hospital with a couple well set up rooms with a good infection break and competent staff and good safety gear can handle a couple of Ebola patients, but as Dallas showed, there is no guarantees any of it will work. Bring Ebola patients into North America is a crap shoot. Certainly, the risk to the population at large is low AS LONG AS YOU CAN CONTAIN IT. That's a big if, and you most certainly don't want it getting out in to the critters in the neighbourhood woods.

Have you been to a Canadian hospital? Ever? They don't clean anything, Ian. They have -carpeting-. Ward nurses consider infection control procedures to be workplace abuse and won't follow them. "Isolation" is a room with a door on it. Emergency is one big stew of germs. Fastest way to get the flu is go to any Canadian hospital in the winter.

Phantom's hyperbole may well apply to the Canadian hospitals he has visited, I'm not challenging his limited experience. I suspect he's referring to his experience in large cities. Canada is a big country.

The hospitals in my part of Canada are not like that at all. There is no carpeting. Ward nurses consider infection control procedures important and follow them. "Isolation" is a room with a sealed door on it and a dedicated ventilation system that keeps that ward negatively pressurized relative to the rest of the hospital. Emergency is specifically designed for routine cleaning procedures that control germs.

I have no doubt that what Phantom describes is common in Ontario and Quebec, the most corrupt parts of Canada. People get the government they deserve, the best that greed, and corruption can buy.

John, I was being a little facetious with that comment. Bt has been well used for years - major app in southern Ontario is for tent caterpillar. I have some video somewhere of the helos doing my neck of the woods, which was pretty interesting. Getting caught under th sprayer while shooting up with the camera as the helo came over the house was a little disconcerting... :) When they started using it for mosquitos,I was a bit surprised some of the local enviros didn't have something to say. Some did chirp until they found out it was a biological.