Ebola Spreading, or No Problem?

Dr. Kent Brantly is the Samaritan’s Purse doctor who was transported to Emory hospital in early August 2014 after contracting Ebola in Liberia.  He recently told Greta Van Susteren that he contracted the virus from evaluating patients in the emergency room, outside the isolation unit where they treat Ebola patients.

His comments have received little to no attention:    

I am convinced I didn't contract Ebola inside the isolation unit. I was still also evaluating patients.  In Liberia. I was taking care of patients in the isolation unit, the Ebola treatment unit, but I was also evaluating patients in the emergency room and I had contact with a lot of patients without all the protective gear who later were confirmed to have Ebola. And I'm very confident that I contracted Ebola from one of those patients in the emergency room. [Emphasis added.]

I was surprised that I had contracted it also but again, I felt confident and still do feel confident that our procedures, our process, our equipment in that isolation unit following NSF protocols, we were safe in that unit and I will continue to say I contracted Ebola outside of that isolation unit.

While nothing is 100% perfect, this confirms that health care workers can treat patients with minimal risk as long as official protocols are meticulously followed, but face a very high risk of infection if they don’t adhere to protocols and are subsequently exposed to infected bodily fluids or droplets that worm their way into one’s mucous membrane.  Tell us something we don’t know.

Yet the seemingly intelligent, thoughtful doctor treated people in the emergency room without any PPE (personal protection equipment).  It had to be a known risk that some of the patients he’d be treating outside the isolation unit might end up inside if diagnosed with Ebola.  Why would he do this?  Weren’t there enough hazmat suits for both inside and outside the isolation unit?  Was the equipment for use only in the isolation unit?  That’s hard to believe.

Experts have advised the American public ad nauseam that medical professionals dealing with Ebola are well-informed and familiar with protocols regarding protection.  It strains credulity that doctors would wear the proper gear only when treating those known to be infected and not those who were a high-risk but not yet diagnosed.  That would be akin to drawing blood at a lab in an urban area with a high incidence of Hep C and wearing gloves only for patients already diagnosed with Hep C but not for the general population. 

How could a rational medical professional like Dr. Brantly – working in the hot zone and familiar with the region – be surprised that he contracted Ebola after being in close contact with so many potentially sick Liberians in the emergency room?  Some of them might have had malaria, cholera, or the flu; odds are that some would have Ebola, too.

As shocking as it was to hear that he treated people in Liberia without any protective gear, maybe it’s not as absurd as it sounds.  Megyn Kelly asked CDC Director Dr. Tom Frieden: “You would go into a highly infectious patient's room without covering your head, with only wearing one pair of gloves and with your feet exposed?"  And Dr. Frieden boldly asserted: "Absolutely.  More is not always better.  Better is better.  Sometimes you put on more layers, it's harder to put on, harder to take off, you increase your risk of exposure. That's what the science tells us."

It turns out Dr. Frieden’s braggadocio didn’t quite live up to reality, as pictures quickly surfaced showing him visiting a West African facility, fully covered and protected like a hermetically sealed casket. 

Drs. Frieden and Fauci have been telling us since they invaded our living rooms that the evidence is ironclad: failing to use protection or follow proper protocols while treating Ebola-infected patients has predictable and devastating consequences.  And their assurances have been corroborated by the two nurses in Dallas who contracted Ebola after treating Thomas Duncan without adequate PPE and, of course, the case of Dr. Brantly.  It is no surprise, even to the least informed of us, that the healthy can catch Ebola simply by being in close proximity to infected individuals or those at high risk, like the patients in Dr. Brantly’s emergency room in Liberia.

Why the bluster by Dr. Frieden about not needing PPE to prevent the spread of this germ, when he has repeatedly acknowledged its necessity? 

More than anything, the American public health community wants the rest of us to go about our daily lives as normally as possible, unaffected by the existence of Ebola.  They don’t want panic.  They don’t want Ebola to be front-and-center news – especially on the eve of elections.  They don’t want to implicitly acknowledge that this is now a problem in the U.S.  They don’t want to implement travel bans and 21-day mandatory quarantines because it goes against their entire ideology about disease in the Third World and our responsibility for dealing with it.  They want us to be unfazed by any mention of this silly bug.

In all fairness, they do make some valid points:  It is not easy to catch Ebola, and only four to seven Americans have actually been infected.  So far only one has died.  In their sanitized, bureaucratic view of the world, the hundreds of lives that have been disrupted by only four cases are statistically insignificant in a population of over 350 million…and a small price to pay for keeping travel wide open while directing vast resources toward containing the spread in West Africa.  It would be their preference, if the general population regarded Mr. Duncan and Dr. Spencer as outliers unworthy of our valuable time and attention.

True, only two people who traveled to the U.S. without fever or other symptoms became contagious after arriving, and only two others caught the disease (the word is still out on the contacts the ebowling doctor had).  Mr. Duncan and Dr. Spencer could just be outliers.  Or they could be warning signs that there are lethal holes in our system that, left to stand, will allow the inflow of more Ebola-infected individuals.  Or they could be the progenitors of what could grow into an outbreak as the potential for human error remains ever-present and notions of full containment are threatened by thousands of untraceable contacts in crowded urban areas.  Let’s not forget that cunning viruses like Ebola require only one Patient Zero.

Adding to the chatter from experts telling the public to take a chill pill, NPR has a chart circulating around the internet and social media that highlights our risk of contracting Ebola in the U.S. this year, assuming there are 12 imported cases: 1 in 13.3 million.  We have a higher risk of being killed by sharks, bee stings, car accidents, air plane crashes, and lightning.  This is supposed to soothe our hysteria, but it really arms the intelligentsia and punditry with the ammo they need to demean anyone who raises concerns about the administration’s feckless policies on travel bans and quarantine.

We can stipulate that the cases have been few and seemingly contained, and Ebola is hard to catch.  But it also doesn’t take much for this wily virus to work its way through the population, and air travel is its best vehicle.  

The authorities tell us that Ebola cases will double every 3-4 weeks.  Liberia, Sierra Leone, and Guinea have had 10,114 cases of Ebola as of October 24.  Simple math tells us that by Thanksgiving, we can expect close to 20,000 cases of Ebola in West Africa – therefore, even more of the region’s inhabitants will be exposed to the contagion.  The more dire it gets in West Africa, the more likely it is that greater numbers will flock to the U.S., where the medical care is superior.

As long as travel bans and mandatory 21-day quarantines have not been implemented, we can be certain that more bodies from Ebola-riddled nations will seek a haven in the U.S., and they will bring with them a higher probability of carrying the infection than had been the case during previous migrations.  As a result, more of the people they encounter on their journeys and during their stay in the U.S. will have a greater risk for catching the virus than they did when the number of Ebola cases was lower.   

While our risk today is admittedly low, why are so many of us worried?  As numbers climb in West Africa and travel between West Africa and the U.S. remains unimpeded, more of us will be placed at risk than had been a month ago or three months ago.  More of us will be at risk than would be the case if travel bans and 21-day mandatory quarantines were in place.  This is indisputable, and states like New York, New Jersey, Illinois, Florida, Connecticut, Maryland, and Virginia have all instituted mandatory 21-day quarantines and monitoring to varying degrees.  Protecting the nation from a foreign and deadly disease falls squarely within the purview of the federal government’s authority.  While it would have been reassuring if this administration had taken the lead on bans and quarantines weeks ago, at this late date, it is now duty-bound to follow the examples set by these states.

We cannot ignore the fact that, while the risk is low compared to getting run over by a car or killed by a shark, the risk of getting Ebola here in the U.S. is higher today than it has been and is likely to be higher tomorrow than it is today.  And we cannot forget to factor in all sorts of variables that will affect that risk:  do you work in the medical care industry?  Do you live in an urban or rural area?  Do you travel a lot?

As the number of infections increase in West Africa, it’s just a matter of time before someone becomes symptomatic and contagious while flying the friendly skies – especially during a lengthy trek from West Africa to some final destination in the U.S., through several airports, on multiple airplanes.  The fact is, a traveler who has been exposed can become symptomatic just as easily during the long journey as after, when he feels safe and sound in his Dallas or Manhattan apartment.  Because of  Ebola’s lengthy incubation period and the general fickleness of the incubation gods, it just hasn’t happened…yet. 

And that’s just for Thanksgiving.  By Christmas, Ebola cases in West Africa will likely reach 40,000, and the risk to each and every American will increase dramatically – in fact, how will the doubling of cases there impact the 1-in-13.3 million risk here?  Two simultaneous approaches are required to keep us safe, and it’s time someone in the administration sees the light: (1) reduce the number of Ebola cases in West Africa and contain the virus as quickly as possible, and (2) restrict travel and impose mandatory 21-day quarantines for anyone with a “right to return.”  The omniscient naysayers at NPR might laugh at the call for bans and quarantines, but I’ll bet my money on the wiles of this virus over the gray matter in their heads any day.

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