Community Chat

[kze]

French for Doctors Without Borders.

[focksie]

On 11/1/2014 Lynnj said: Thanks, Focksie. I am headed to bed right behind you. Good night. I was starting to think that it would be okay for someone who is under self monitoring, with no symptoms and no temp, to be out and about in stores. But now I am not so sure. A temp could spike at any time. Maybe even being more active could help to bring it on too? For the few that we know about in the US recently, they were out, and didn't spike a temp until the next morning. I wonder what might have happened had they spiked a temp while they were out, sort of like my scenario in the post above.

Good morning Lynnj, Gee, that extra hour of sleep didn’t do me any good.

I agree with you. I am not sure either. It is a question to be considered and for which I don't think there is a definitive answer.

I don’t know how many times other posters have ascribed “fear”, “panic” and “hysteria” to some of us who are just trying to question. I will continue to research the questions I have and share what I see in the literature; others may prefer to regard posters on a shopping forum as infectious disease/ebola “experts” and listen to them. That is each person’s prerogative.

Being that the literature clearly points out that 1) Fever is the first symptom of Ebola disease and can be sudden onset; and 2) A person with symptoms is infectious, I choose to come to the conclusion that a scenario such as you outlined and that I have questioned in other threads is a possibility. Maybe not a probability, but a possibility nonetheless. And this possibility is why the authorities are choosing to wipe down doorknobs, bowling balls, and subway poles, and disinfect trains and planes -- because we don’t know at what point in time Dr. Spencer came down with his fever and was therefore infectious while he was out and about in NYC.

Some people may pooh-pooh these measures; some of us believe it is better to be safe than sorry.

This is why IMO and a lot of other people’s opinions it would be extremely prudent and in the best interest of public health to institute a 21-day quarantine period (the incubation period) for healthcare workers returning from W. Africa, which is exactly what NY and NJ decided to do. It is also why IMO it is important to consider the consequence of an infected person coming into contact with dozens of individuals. The idea of contact tracking or tracing (as scottie mentioned) is pivotal in fighting Ebola (as anyone can see by just googling “contact tracing”) and can become very problematic very quickly. I believe that I read that Contact Tracking for Ebola in Africa now involves thousands upon thousands of individuals. It would not be a very good thing to have to track an unwieldy number of individuals in this country.

While I hear the outcry about healthcare workers not wanting to volunteer any longer if they must return home to a 21-day quarantine, I am simply not understanding what to me is the simple idea of risk vs. benefit, not only in terms of spread of infection, but in light of the tedious, expensive, and potentially insurmountable task of contact tracing. Is 21 days asking too much considering what the possible alternative could be? But again, that’s my opinion – not based on “fear”, but based on prudence and consideration of the bigger picture. Of course it is a problem that returning healthcare workers may feel they are being treated irrationally or unjustly. I don’t know what the answer is.

I believe in science but I do not believe that science is absolute. If we close our minds and reach the Dead End street and say, “Okay, we know this to be true because we’ve reached these conclusions over decades. Now we can just park the car and leave it there -- it’ll be safe”, then I believe we have done ourselves a disservice. How many ideas in the history of science have been proven one way, only to be disproven at some point in the future? IMO we do not know everything there is to know about this deadly virus. No, I am not “panicked” or “hysterical”. I just like to question and keep an open mind.

In the meantime, Dr. Spencer’s condition has been upgraded from “serious, but stable” to “stable”. This is great news.

[Say Nay]

If you watch the MSF webcast you will see the treatment centers. They are basic. The buildings are constructed of plastic sheets for walls, floors and roofs and nylon mesh for windows. There are no extreme measures being used like negative pressure rooms to keep the virus contained. Disinfection is a 0.5% chlorine solution. It's simple yet very effective.

focksie, if you read pitdakota's post (#40) an infected person's viral load won't be high when the temp begins to rise. The risk of transmitting the virus to another person through casual contact (like doorknobs) is almost zero. It takes time for the virus to build up in the bloodstream.

I checked the CDC and they are saying "Controlled Movement" of persons with potential Ebola exposure means long distance travel should not be allowed. If travel is allowed it should be by noncommercial conveyance. Use of public transpiration should be discussed with and approved by local public health authority.

For the general public it's important to understand and acknowledge that we are not medical professionals. The researchers, doctors, nurses and other health care workers have years of education and work experience under their belts. We will never be able to "catch up" to their expertise by speed reading medical journals and sitting in front of the TV.

We need to listen to those who have direct hands on experience with Ebola. If we don't and we implement rules and regulations that unnecessarily slow down the battle against Ebola we are not only damaging our reputation as a leader but even worse indirectly participating in the deaths of hundreds if not thousands of innocent people.

[brii]

Great thread, Gato!

[Say Nay]

Thanks brii. Everyone has had such great input and advice!

[brii]

It's been a very informative discussion.

[focksie]

On 11/2/2014 MomTo2Dogs said:

If you watch the MSF webcast you will see the treatment centers. They are basic. The buildings are constructed of plastic sheets for walls, floors and roofs and nylon mesh for windows. There are no extreme measures being used like negative pressure rooms to keep the virus contained. Disinfection is a 0.5% chlorine solution. It's simple yet very effective.

focksie, if you read pitdakota's post (#40) an infected person's viral load won't be high when the temp begins to rise. The risk of transmitting the virus to another person through casual contact (like doorknobs) is almost zero. It takes time for the virus to build up in the bloodstream.

I checked the CDC and they are saying "Controlled Movement" of persons with potential Ebola exposure means long distance travel should not be allowed. If travel is allowed it should be by noncommercial conveyance. Use of public transpiration should be discussed with and approved by local public health authority.

For the general public it's important to understand and acknowledge that we are not medical professionals. The researchers, doctors, nurses and other health care workers have years of education and work experience under their belts. We will never be able to "catch up" to their expertise by speed reading medical journals and sitting in front of the TV.

We need to listen to those who have direct hands on experience with Ebola. If we don't and we implement rules and regulations that unnecessarily slow down the battle against Ebola we are not only damaging our reputation as a leader but even worse indirectly participating in the deaths of hundreds if not thousands of innocent people.

Hi Gato,

If you read my post #45, I state my understanding of a person's infectiousness at the outset of symptoms vs. in advanced disease. To quote myself from my previous post:

"Lynnj, this is what I found on the WHO website. What I'm reading from this is that a person can be infectious once symptoms appear (i.e., once they have a fever), although I understand they are not as infectious as when the viral load is much greater in advanced disease."

I have understood this information from the WHO and CDC websites for at least a couple of weeks now and I have expressed this information in other threads.

Yes, a person is most infectious in the late stages of Ebola disease when the viral load is greatest. It is even so after death which is why handling corpses is so dangerous.

NEVERTHELESS (not yelling at you; just trying to make my bottom line point, lol)...IMHO this is not to say that a person is 100%, without any doubt, completely non-infectious at the outset of symptoms. Again, it may not be a probability that a person will be infectious at the onset of symptoms (i.e., fever), but it is a possibility...and what I would like to see done vs. what another person here would like to see done with that information (in terms of protocols or policy) is a matter of different opinion. One person may feel it is prudent to take every precaution and the next person may feel it is totally unnecessary.

I agree with the CDC's policy regarding "Controlled Movement".

Finally, I fully respect all the healthcare professionals who have worked in this arena, whether behind the scenes or on the front lines. And again, all I am saying is that IMHO all we have is the best information, to date. IMHO we don't know everything there is to know about Ebola and its transmission and nothing we know about this disease is 100% sure from now 'til the end of time.

This is not an argument with anyone else. I am not trying to change anyone else's mind. This is just my opinion and I respect that others may have a different opinion and may feel completely safe and secure in their opinion that Ebola poses no risk or close to zero risk in certain situations. Might I change my opinion? Maybe, but right now this is my opinion.

[Say Nay]

Hi focksie! I totally respect your opinion. It is different from mine. MSF has been extensively involved in hemorrhagic fever studies and patient care for decades. This includes Ebola. They have hands on experience in dealing with it. As was stated in the webcast they do not believe that Ebola is not fully understood.

I think a big part of the public's difficulty in understanding the illness is the result of stupidity in the media. Instead of interviewing random ""experts"" to sensationalize they should have stuck with the few who know the facts. At this point they can't unring the bell.

[LilacTree]

What I clearly object to is quarantining being described as a "loss of freedom," just as smoking used to be (and still is, I imagine).

What about the "loss of freedom" of the innocent people who may be exposed, who did not go to Africa, and are just out and about experiencing their daily lives? They are not even thinking twice about a fever they may run a week later, especially during flu season.

IMO, quarantining is just common sense (and common courtesy, if you will).

[millieshops]

On 11/1/2014 MomTo2Dogs said:

On 11/1/2014 scotttie said:

He just said that over there if they can give immediate treatment at first sign of fever they can save 70 percent but they are not able to catch those oftentimes because they are too busy taking care of the sickest.

Yes. They are so overburdened. And did you see the ill waiting outside because there are no beds?

I think that if our media had shown more of those overburdened hospitals as many times as they showed personnel in hazmat suits, the public would have understood way better why the epidemics occurred where they did and would have been less fearful of such a thing happening here.

An article in today's Newsday has an ebola forecast for the US this winter - we could see as few as 20 cases and even as many as 120. Given that we've already handled all but one case extremely well and have learned lots from those errors, I'm less and less afraid of ebola going forward.