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A New Ebola Czar; Military deploys to plague zone. Competence in government.

View 846 Friday, October 17, 2014

“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”

Irving Kristol

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

 

“We had been told, on leaving our native soil, that we were going to defend the sacred rights conferred on us by so many of our citizens settled overseas, so many years of our presence, so many benefits brought by us to populations in need of our assistance and our civilization.

“We were able to verify that all this was true, and because it was true, we did not hesitate to shed our quota of blood, to sacrifice our youth and our hopes. We regretted nothing, but whereas we over here are inspired by this frame of mind, I am told that in Rome factions and conspiracies are rife, that treachery flourishes, and that many people in their uncertainty and confusion lend a ready ear to the dire temptations of relinquishment and even to vilify our actions.

“I cannot believe that all this is true, and yet recent wars have shown how pernicious such a state of mind could be and to where it could lead.

“Make haste to reassure us, I beg you, and tell us that our fellow citizens understand us, support us, and protect us as we ourselves are protecting the glory of the Empire.

“If it should be otherwise, if we should have to leave our bleached bones on these desert sands in vain, then beware the fury of the Legions.”

Centurion Marcus Flavinius, Second Cohort, Augusta Legion to his cousin Tertullus in Rome.  No date given.

http://www.jerrypournelle.com/archives2/archives2view/view414.html#Fury

 

 

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The premise of the liberal philosophy is that good intentions are the most important qualification for government office, and government is more competent to solve social problems than any other institution. Today President Barrack Hussein Obama appointed a political operative to be “Ebola Czar.”

Obama to Tap Former VP Chief of Staff Ron Klain as Ebola ‘Czar’

President Barack Obama will appoint Ron Klain to head up efforts to address the Ebola threat, a senior administration official tells NBC News.

Klain is a former chief of staff to both Vice President Joe Biden and former Vice President Al Gore. He left the vice president’s office in 2011. He is now the president of Case Holdings and serves as the general counsel for Revolution, an investment organization.

"It’s not solely a medical response," White House press secretary Josh Earnest said. "That’s why somebody with Mr. Klain’s credentials — somebody that has strong management experience both inside government but also in the private sector; he is somebody who has strong relationships with members of Congress; and obviously strong relationships with those of us who worked with him here at the White House earlier in the administration. All of that means that he is the right person."

http://www.nbcnews.com/storyline/ebola-virus-outbreak/obama-tap-former-vp-chief-staff-ron-klain-ebola-czar-n228151

I cannot resist wondering whether his association with Al Gore was thought to be qualification for a post involving scientific observations. Chief of Staff to Al Gore and Joe Biden.

 

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Ebola Scare at Pentagon After Woman Who Was Recently in Africa Vomits on Tour Bus

http://washington.cbslocal.com/2014/10/17/ebola-scare-at-pentagon-after-woman-who-was-recently-in-africa-vomits-on-tour-bus/

Around 9:10 a.m., a woman began vomiting in the Pentagon parking lot while on a bus tour, according to Pentagon spokeswoman Lt. Col. Valerie Henderson. The woman indicated she has recently traveled to Africa.

DC Dept Health Director says woman who got sick on bus had been to Sierra Leon.

 

This picture taken 26 December 2011 shows the Pentagon building in Washington, DC.  The Pentagon, which is the headquarters of the United States Department of Defense (DOD), is the world's largest office building by floor area, with about 6,500,000 sq ft (600,000 m2), of which 3,700,000 sq ft (340,000 m2) are used as offices.  Approximately 23,000 military and civilian employees and about 3,000 non-defense support personnel work in the Pentagon. AFP PHOTO (Photo credit should read STAFF/AFP/Getty Images)

 

That one, at least, is not a problem: she has since confessed that she has not recently been in Africa, and physicians are confident that she does not have Ebola.  Of course the Pentagon would not be a target of Ebolized jihad.

 

Belize Confirms Patient With Ebola Symptoms On Cruise Ship Off Its Coast

http://belizean.com/belize-confirms-patient-with-ebola-symptoms-on-cruise-ship-off-its-coast-1814/

 

 

Six Reasons to Panic

By JONATHAN V. LAST

http://www.weeklystandard.com/articles/six-reasons-panic_816387.html?nopager=1#

As a rule, one should not panic at whatever crisis has momentarily fixed the attention of cable news producers. But the Ebola outbreak in West Africa, which has migrated to both Europe and America, may be the exception that proves the rule. There are at least six reasons that a controlled, informed panic might be in order.

(1) Start with what we know, and don’t know, about the virus. Officials from the Centers for Disease Control (CDC) and other government agencies claim that contracting Ebola is relatively difficult because the virus is only transmittable by direct contact with bodily fluids from an infected person who has become symptomatic. Which means that, in theory, you can’t get Ebola by riding in the elevator with someone who is carrying the virus, because Ebola is not airborne.

This sounds reassuring. Except that it might not be true. There are four strains of the Ebola virus that have caused outbreaks in human populations. According to the New England Journal of Medicine, the current outbreak (known as Guinean EBOV, because it originated in Meliandou, Guinea, in late November 2013) is a separate clade “in a sister relationship with other known EBOV strains.” Meaning that this Ebola is related to, but genetically distinct from, previous known strains, and thus may have distinct mechanisms of transmission.

Not everyone is convinced that this Ebola isn’t airborne. Last month, the University of Minnesota’s Center for Infectious Disease Research and Policy published an article arguing that the current Ebola has “unclear modes of transmission” and that “there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks.”

In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it.

Yet what’s really scary is how robust the already-established transmission mechanisms are. Have you ever wondered why Ebola protocols call for washing down infected surfaces with chlorine? Because the virus can survive for up to three weeks on a dry surface.

How robust is transmission? Look at the health care workers who have contracted it. When Nina Pham, the Dallas nurse who was part of the team caring for Liberian national Thomas Duncan, contracted Ebola, the CDC quickly blamed her for “breaching protocol.” But to the extent that we have effective protocols for shielding people from Ebola, they’re so complex that even trained professionals, who are keenly aware that their lives are on the line, can make mistakes.

By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published.

(2) General infection rates are terrifying, too. In epidemiology, you measure the “R0,” or “reproduction number” of a virus; that is, how many new infections each infected person causes. When R0 is greater than 1, the virus is spreading through a population. When it’s below 1, the contamination is receding. In September the World Health Organization’s Ebola Response Team estimated the R0 to be at 1.71 in Guinea and 2.02 in Sierra Leone. Since then, it seems to have risen so that the average in West Africa is about 2.0. In September the WHO estimated that by October 20, there would be 3,000 total cases in Guinea, Liberia, and Sierra Leone. As of October 7, the count was 8,376.

Given that this is in the neoconservative magazine Weekly Standard I doubt if Mr. Klain has read it, but perhaps someone on his staff with access to the Czar will encounter it. The rest of the article is worth your time. Five of the 58 medical professionals involved in the Science Magazine study died of Ebola before the paper was published.

U.S. Soldiers Get Just Four Hours of Ebola Training

http://www.thedailybeast.com/articles/2014/10/17/u-s-soldiers-get-just-four-hours-of-ebola-training.html

As the U.S. military rushes to combat Ebola in West Africa, soldiers are receiving on-the-fly instructions on how to protect themselves against the deadly virus.

American military operations to fight Ebola in Africa are unfolding quickly—forcing the military to come up with some procedures and protocols on the fly.

Soldiers preparing for deployment to West Africa are given just four hours of Ebola-related training before leaving to combat the epidemic. And the first 500 soldiers to arrive have been holing up in Liberian hotels and government facilities while the military builds longer-term infrastructure on the ground.

For soldiers at Fort Campbell and Fort Bragg preparing for their deployments to West Africa, Mobile Training Teams from the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), based out of Fort Detrick, have been tasked with instructing them on Ebola protocols.

A team of two can train as many as 50 personnel over that four-hour time frame, USAMRIID told The Daily Beast. The training includes hands-on instruction on how to put on, remove, and decontaminate personal protective equipment, followed by a practical test to ensure that soldiers understand the procedures.

“All training is tiered to the level of risk each person may encounter,” said USAMRIID spokeswoman Caree Vander Linden.

The training process sounds daunting: One USA Today report described soldiers being told that Ebola “basically causes your body to eat itself from the inside out” and that Ebola is “worse” than what soldiers encountered in Afghanistan. Others reportedly heard that the disease is “catastrophic” and “frightening… with a high fatality rate,” though the chances of contracting it are low.

“I’ll be honest with you,” one soldier told the newspaper. “I’m kind of scared.” [emphasis added]

* – * – *

Soldiers based in Liberia have their temperature measured several times per day, and are not permitted to shake hands.

The military maintains that American service members have only limited interactions with locals on the ground. But some American soldiers are working with the Armed Forces of Liberia on a day-to-day basis, and others are training health-care providers on how to combat the virus.

Further, the military acknowledges that it is currently sharing hotels and businesses with foreign nationals.

"We are here with the permission of the Liberian government and we do not clear out local hotels and businesses during our stay," said an Army spokesman. "We chose hotels with the safety of our service members in mind, and the hotel staffs monitor all employees and guests and allow us to conduct safety inspections of their facilities to ensure they meet our safety criteria."

Instead, the military spokesman focused on the precautions that they are already taking: Soldiers based in Liberia have their temperature measured several times per day, and are not permitted to shake hands. They are also are required to frequently wash their hands with a chlorine solution. Some locations even employ chlorine mats that service members are required to wipe their feet on in order to enter.

“The facilities that we’re in have been vetted by our doctors. [They] have gone through the facilities to make sure that they’re safe for our soldiers,” Army spokesman Lt. Col. Michael Indovina said. “We’re very confident. We’ve had very good luck from the time when we’ve arrived on the ground.”

Congress has been slow to give the green light to funding for military operations combating Ebola in Africa, in large part due to initial skepticism over whether there was a sufficient plan for protecting American service members in Liberia.

In mid-September, the Obama administration submitted a $1 billion request for Ebola funding. The request was for a movement of leftover funds from an overseas war spending account, requiring a sign-off from several key congressional figures.

When the Obama administration briefed staffers of the Senate Armed Services Committee on Sept. 19, it was criticized for not adequately explaining what steps the military would take to ensure soldiers’ health.

“If they had bio-security procedures in place, they weren’t adequately articulating them to Congress,” said an aide to Sen. Jim Inhofe, the top-ranking Republican on the Senate Armed Services Committee. “When they first came over, they were not able to answer a lot of questions about what procedures were in place.”

Of course it was not long ago that high government officials assured us that any decent hospital in the United States would be able to care for Ebola patients. Yesterday Nina Pham, the first American known to have contracted Ebola in the United States, was taken out of her hospital where, as a nurse, she contracted Ebola, and was sent to Bethesda. Her condition, previously reported to be “good” has now been downgraded to “fair”. Unlike typhus and cholera, Ebola basically turns internal organs to liquid and expels them through diarrhea. There is no known treatment, although there is empirical evidence that the plasma of Ebola survivors can be effective. Experimental drugs but not plasma was given to Mr. Duncan, from whom Ms. Pham contracted Ebola; he subsequently died.

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Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much, although some of you generously pay that and even more. My thanks. . How to subscribe is described here: PAYING FOR THIS PLACE.

 

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Once the Sixth Grade Reader of what was considered the world’s best public education system: California in 1914.  Recommended to home schools up to 9th grade.

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Nine Doctors Without Borders physicians, all equipped with the best of isolation and prophylactic gear, have died of Ebola.  Of the  physicians and nurses who have died of Ebola in this epidemic, most (more than 60%) had what was considered more than adequate protective gear and were instructed in its use. The US Military being sent into the plague zone have had four hours of instruction.

The U.S. military’s plan to deal with Ebola in Africa

http://www.usatoday.com/story/news/world/2014/10/17/ebola-military-pentagon-reservists-liberia/17426929/

The U.S. military is prepared to provide up to 3,000 troops to help deal with the Ebola crisis in West Africa.

There are 547 U.S. troops there, primarily in Liberia though some are in Senegal, according to the Pentagon. Their assignments include building 17 treatment centers in Liberia, training local professionals in how to handle Ebola patients and conducting tests to verify diagnoses of the virus.

U.S. forces will not treat Ebola patients directly, but medical personnel will be trained to care for and transport American service members back to the USA if they contract the disease.

All branches of the military contribute to the effort:

•Navy "Seabees" (Construction Battalions) build the treatment centers, and Navy medical personnel conduct lab testing.

•Army soldiers from the 101st Airborne are being sent to West Africa, and others are already on hand, performing civil engineering and logistical duties.

•Airmen coordinate military flights in and out of the country.

Thursday, President Obama signed an order allowing reservists to be called into active duty to support the Ebola effort. "The authorities that have been invoked will ensure the Department of Defense can properly sustain the military operations required in this effort," Obama said in a letter to House Speaker John Boehner.

The Pentagon said the order allows flexibility to draw on the reserve force for specialists in areas of technical engineering, communication systems, logistics, comptroller duties and religious specialties.

The reservists provide special skills not available among active-duty forces and can augment or replace personnel sent to Africa, the Pentagon said.

The military is good at breaking things and killing people. They are not particularly well trained for managing contagious disease outbreaks.

Kobani may fall to militants, top U.S. officer says

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WASHINGTON — It is "highly possible" that the besieged Syrian city of Kobani could fall to Islamic State militants, the commander of U.S. military forces in the Middle East said Friday.

Army Gen. Lloyd Austin, who leads Central Command, said Islamic State fighters have made Kobani their "main effort" in a move to expand the territory they hold in Syria and Iraq. Austin said attacks by the militants on Kobani have given the U.S.-led air war opportunities to blast the terror group — also known as ISIL or ISIS.

In his first remarks on the air campaign that began in August in Iraq, Austin said progress is being made and called for "strategic patience." The U.S.-led effort is designed to allow security forces to secure Iraq’s borders, then retrain, re-equip and retake ground lost to Islamic State fighters, he said.

http://www.usatoday.com/story/news/world/2014/10/17/is-iraq-syria-air-war/17429941/

A regiment of Marines with air support could accomplish wonders in this battle. For that matter, selected units of the 101st Airborne could, on 24 hours notice, completely change the course of the war against the Caliphate. Whether that would be a good use of the troops can be debated; but if saving Kurds is an American goal, this would be a more appropriate use of troops than sending them into a plague zone.

The question is not the competence of the troops, nor of their officers; but one can question the competence of their civilian controllers, both civil service and political. And perhaps our new Ebola Czar can reconsider whether sending them into a plague zone is the best use of our Army. No, that won’t work. But he reports to Susan Rice, National Security Advisor; perhaps her expertise as a diplomat has determined that sending soldiers to Liberia and not sending help to the Kurds is good national policy.

After all, the premise is that government is competent.

But I do wish I heard a bit more about objectives, not merely in Syria/Kurdistan/Iraq, but for control of the Ebola outbreak in the United States.

Lawmakers urge an Ebola travel ban, Obama opposed

http://www.usatoday.com/story/news/nation/2014/10/17/ebola-travel-ban-obama-cdc-faa/17433901/

House Dems side with Obama, oppose Ebola travel ban

http://www.theblaze.com/blog/2014/10/16/house-dems-side-with-obama-oppose-ebola-travel-ban/

I remain unrepentantly in favor of quarantining dangerous contagious diseases.  I hope the new Czar shares that belief, but I have no real hope that he will.

 

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Boots

http://www.defenseone.com/ideas/2014/10/what-could-us-boots-ground-do-iraq-and-syria/96515/

The author is correct, "boots on the ground" is a capability. Thus, US troops in Iraq could be used much as the 1st Marine Provisional Brigade was used in defense of the Pusan Perimeter during the Korean War; as a ‘fire brigade’ to shore up, reinforce, and exploit successes of the Iraqi army/militias.

David Couvillon

Colonel, U.S. Marine Corps Reserve, Retired.; Former Governor of Wasit Province, Iraq; Righter of Wrongs; Wrong most of the time; Distinguished Expert, TV remote control; Chef de Hot Dog Excellance; Avoider of Yard Work

What Could US Boots on the Ground Do in Iraq and Syria?

In discussions of America’s current conflict with the Islamic State of Iraq and the Levant (ISIL)—which, like the Vietnam conflict, Washington does not consider an official war—a phrase heard frequently is “boots on the ground.” It is a direct challenge to those who believe wars can be won by airpower alone. Critics of the current air campaign in Iraq and Syria argue that boots on the ground—the physical presence of soldiers on the battlefield—is a prerequisite to military success. But how many?

There are currently somewhere around 2,000 American military personnel deployed in Iraq, protecting the U.S. Embassy, helping the Iraqi forces coordinate military operations and assisting the air campaign. They have no direct combat role, although some may engage in special operations, such as attempting to rescue hostages. Strategists outside of government have suggested the need for 10,000 or 25,000 American combat troops.

Boots on the ground represent a capability, not a strategy. The question is, what would 25,000 American ground forces do that nearly 300,000 Iraqi soldiers cannot do?

They could bolster local defenses in critical areas, reinforcing Iraqi or Kurdish forces that are hard-pressed by ISIL fighters. This is not just a matter of added firepower. Their presence on the ground could also enhance the effectiveness of the air campaign. And with American combat units at their side, Iraqi units might fight harder—or they might fight less, leaving it to the Americans to do the bloody work.

American combat forces could also be used as a mobile strike force to follow up the bombings or destroy concentrations of enemy forces. In this kind of deployment, the combat units would be moved from place to place to exploit opportunities, rather than to hold terrain.

A more ambitious and costlier task for American forces would be to drive ISIL forces out of the cities and towns they now hold. Urban warfare, especially against dug-in defenders, chews up armies. As we have seen on numerous occasions, from the battle of Hue in 1968 to the second battle of Fallujah in 2004, urban engagements can become ferocious fights. More than 13,000 American, British, and Iraqi forces were engaged in Fallujah, and they suffered nearly a thousand casualties.

http://www.defenseone.com/ideas/2014/10/what-could-us-boots-ground-do-iraq-and-syria/96515/

There is considerably more, all worth your time if the subject interests you.  Needless to say the point of the story is you must have objectives in mind or choose them when you have assessed the situation; simply putting forces into an area doesn’t accomplish a lot.  Armies are good at breaking thing and killing people.  They are also good at building roads and temporary bridges. In disasters military people are useful at first because they are versatile: but their primary skill is in breaking things and killing people.  It’s what they do. The important thing, then, is to choose wisely the things to be broken and the people to be killed. That is usually known as strategy, and the first principle of military strategy, at lest as taught at West Point for decades, is The Principle of the Objective.  Before you break things, it is well to have a good grasp on what you will gain from having them broken. 

 

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Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much, although some of you pay that, and have my gratitude. How to subscribe is described here: PAYING FOR THIS PLACE.

gremlin

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http://www.weeklystandard.com/articles/six-reasons-panic_816387.html

So my earlier research was correct — this is indeed a separate strain of Ebola from the Zaire strain some have claimed it to be. Which also explains the different level of fatality percentages. And if it happens to be more like the Reston strain, then it may well transmit airborne.

…Oh $#!^. And it’s mutating. Fast.

"In August, Science magazine published a survey conducted by 58 medical professionals working in African epidemiology. They traced the origin and spread of the virus with remarkable precision—for instance, they discovered that it crossed the border from Guinea into Sierra Leone at the funeral of a “traditional healer” who had treated Ebola victims. In just the first six months of tracking the virus, the team identified more than 100 mutated forms of it…By the by, that Science article written by 58 medical professionals tracing the emergence of Ebola—5 of them died from Ebola before it was published."

…And spreading.

"The latest WHO projections suggest that by December 1 we are likely to see 10,000 new cases in West Africa per week"

Epidemic: (of a disease) affecting many persons at the same time, and spreading from person to person in a locality where the disease is not permanently prevalent.

Pandemic: (of a disease) prevalent throughout an entire country, continent, or the whole world; epidemic over a large area.

(Dictionary.com)

"In September, the CDC ran a series of models on the spread of the virus and came up with a best-case scenario in which, by January 2015, Liberia alone would have a cumulative 11,000 to 27,000 cases. That’s in a world where all of the aid and personnel gets where it needs to be, the resident population behaves rationally, and everything breaks their way. The worst-case scenario envisioned by the model is anywhere from 537,000 to 1,367,000 cases by January. Just in Liberia. With the fever still raging out of control."

Liberia’s population is only about 4.3 million. Worst case, that’s 12.5-32% of the total population.

"…if the four pillars—contact tracing, case isolation, safe burial, and effective public information—fail, no one seems to have even a theoretical plan for what to do."

I have an idea or two but it isn’t pretty, nice, or politically correct. It may wind up being expedient.

Who the hell ARE these people?!?

"A travel ban is not the right answer. It’s simply not feasible to build a wall—virtual or real—around a community, city, or country. A travel ban would essentially quarantine the more than 22 million people that make up the combined populations of Liberia, Sierra Leone, and Guinea.

When a wildfire breaks out we don’t fence it off. We go in to extinguish it before one of the random sparks sets off another outbreak somewhere else."

That is EXACTLY what you do! A quarantine confines people who may or may not be infected, to keep everyone ELSE safe, until it can be determined if they ARE infected, and what to do about it! And you don’t go in to extinguish a wildfire! You set up FIRE BREAKS — effective WALLS around the fire — to deprive it of fuel!

I’ve just located a paper studying Ebola’s susceptibility (when dried on surfaces) to UV. There’s a lot of people out there believing that if the victim, e.g. throws up on the sidewalk, if you just expose it to the sun for a day, it’s safe. I have my doubts, especially if it is capable of staying around for 3 weeks. I’ll pass on the paper in a minute; I’m trying to get the gist of the important parts.

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

I would have thought that avoiding the importation of new infection sources would be a first order of business. It’s hardly sufficient, but I would think it necessary.

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Quick Tests Versus Effective Procedures 

Jerry,

Earl misreads my statement that quick tests "are an essential part of any effective Ebola entry-prevention policy"

My point in emphasizing the need for such tests, since it apparently wasn’t obvious the first time, is that cheap, quick, local finger-prick tests are far more useful (far easier to use early and often, and thus more likely to be so used) as part of an overall entry-screening process than current tests that require drawing a vial of blood, sending it to a lab, then waiting two to three days.

I had not been aware that Ebola virus detectability could lag visible symptoms by days; my thanks to Earl for pointing that out. CDC seems to think that the lag is "up to three days" for their tests (see

http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collection-submission-patients-suspected-infection-ebola.html)

and I’d be interested in pointers to any info on the reasons for this delay and on how likely it is to apply to the new fast tests. But yes, this would obviously complicate screening procedure design.

Worth noting here is that one study I previously cited on asymptomatic Ebola infections (http://www.ncbi.nlm.nih.gov/pubmed/10881895) clearly indicates that both the antibodies and the viruses themselves can be tested for and identified in asymptomatic individuals. The problem may then not be fundamental, and some possibilities may exist for higher-sensitivity quick initial screening tests.

My understanding is that other viral initial-screening tests tend to go for extremely high sensitivity, and deal with the accompanying high false-positive rate with more precise follow-ups tests. If such an approach is currently difficult for Ebola, I’d be curious to see more about why.

Porkypine

This is not really the place to debate specific procedures and quarantine practices.  Those are generally left to be decided by locals familiar with their resources and the people involved: the best may not be good enough, and in fact often the best is the enemy of the possible.  Developing and employing such procedures is truly a matter for experts, which does lead me to wonder what led to the appointment of the current Czar; I would have thought it better to appoint a technical expert and someone like Klain as his/her chief of staff. 

 

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Ebola quarantine

Jerry,

Anyone willing to put down odds on an Ebola quarantine being put into effect just in time for the first deployed US military Ebola case to become the political football "proving" that we need to have an open door policy to let in Ebola patients? I ask because the lack of training and cavalier attitude the govt and CDC has towards Ebola pretty much guarantees multiple Ebola infections among our troops deployed to the Ebola zones.

Newt Gingrich pointed out on Hannity something that I think is in one of the articles you linked – Of the 25 Ebola specialists who authored a thoroughly comprehensive medical paper about Ebola, 5 of them are already dead from Ebola. Think about that. In a group of 25 doctors who may be regarded as the most knowledgeable experts in the world on Ebola, who can be expected to have 100% adherence to ALL protocols and safeguards, 20% still contracted and died of Ebola. Only an idiot would say we shouldn’t be terrified by this, even if our govt was doing everything right.

It is the height of arrogance and ignorance for ANYONE to say "we got this", expecting that the magic of American medicine is an effective and reliable countermeasure against Ebola.

The question remains, why would our govt, in the face of global astonishment at how childishly ignorant and dangerous our Ebola response is, continue down this path of suicide. One cruise ship has already been denied port rights due to a single American on board, because Belize things we’re a bunch of suicidal idiots and they don’t want to have anything to do with anyone from the US who has had anything to do with Ebola, symptoms or not. Belize is utterly correct – we’re dangerously incompetent and any government who cares about its people probably ought to implement a 100% ban on travel from the US because we’re the only country on the planet who thinks its ok to transport Ebola patients around the globe as if its nothing worse than the common flu.

Plus, the update from the world health organization… 70% fatal, 42 day incubation. That’s horrible, but why is that more scary than 50% fatal and 21 day incubation given that you can travel around the world 5-6 times and interact with thousands of people in dozens of countries in 21 days, let alone 42? The world has every right to be terrified of American travelers at this point.

Serving Officer

 

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Ebola Czar

Dr Pournelle

RE: http://www.jerrypournelle.com/chaosmanor/a-new-ebola-czar-military-deploys-to-plague-zone-competence-in-government/

The fact that President Obama named Ron Klain as "Ebola Czar" rather than fill the empty post of Surgeon General tells me he wants not a medical solution but a political solution.

Live long and prosper

h lynn keith

 

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Ebola and Luck

In Ringworld the Puppeteer Nessus tells Louis Wu that the Puppeteers have bred humanity to be lucky as they saw no other hope for the long term survival of humanity. And, they did like humans.

After reading about how we are dealing with Ebola and this link

http://www.huffingtonpost.com/2014/10/15/obama-ebola-nurses-atlanta_n_5990584.html?ncid=txtlnkusaolp00000592

I wonder if the puppeteers haven’t started earlier than documented in Ringworld.

Peter Wityk

God protects fools, drunks, and the United States of America.  Of course we were a much more devout nation when Bismarck made that observation.

 

 

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Freedom is not free. Free men are not equal. Equal men are not free.

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A New Energy Revolution? Ebola and Competence: a discussion

View 846 Thursday, October 16, 2014

“I have observed over the years that the unintended consequences of social action are always more important, and usually less agreeable, than the intended consequences.”

Irving Kristol

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

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This is an exemplar of many letters I have received recently.

Lockheed – Commercial fusion in 10 years?

Hi Dr. Pournelle,

After all the decades of disappointments, is the era of fusion power now actually within reach? Lockheed sounds very confident in this article:

http://www.theguardian.com/environment/2014/oct/15/lockheed-breakthrough-nuclear-fusion-energy?CMP=fb_gu

They expect to have a commercial 100 MW deuterium-tritium reactor that will fit on a truck in 10 years. I’ll go out on a limb and predict that if they do, the “environmentalist wackos” will find some reason to oppose it.

Bill

I intend to look into this: clearly if it were true, it would change the world. Science fiction writers and academic futurists have speculated about the consequences of cheap energy. One of the earliest was Heinlein. I have written about the Second Industrial Revolution: the First made energy available for manufacturing. One consequence was big cities, because much of the big energy of that revolution was centralized and concentrated, and required large capital investment before you could make use of it. The Second Industrial Revolution, which I call “the quarter inch drill”, came about with the development of widely distributed low cost high energy devices that could be used nearly anywhere and which were affordable by nearly anyone.

Both these Revolutions – and they truly were – depended on energy production and that remained dependent in turn on great industries: mining, transportation, drilling, refineries, power plants and distribution grids.

Cheap distributed energy production from low capital devices would be another Revolution.

For most of the history of mankind, something like 90% of mankind lived at the edge of survival. Historians call this the Malthusian Era. Most of the population worked in agriculture and the distribution of agricultural produce. Peasant had perhaps one change of clothing, and labored six days a week (seven in cultures uninfluenced by the Bible) relieved only by holidays. There was no science of medicine. Lives tended to be short. Food consumption was not much above survival rates.

As Gregory Clark observes in A Farewell to Alms, “The average person in the world of 1800 was no better off than the average person of 100,000 BC. Indeed, the bulk of the world’s population was poorer than their remote ancestors.” This condition prevailed across the world. “Jane Austen may have written about refined conversations served over tea in china cups. But for the majority of the English as late as 1813 conditions were no better than for their naked ancestors of the African savannah. The Darcys were few, the poor plentiful.”

The industrial revolution changed all that. Mr. Darcy was wealthy, but even the poorest in America have, or can have if they take the trouble to work the system, television, access to transportation, more than enough to eat along with some discretionary income for cigarettes and liquor, and some access to medical care that the very wealthiest could not have afforded before 1930. Mr. Darcy had little of this.

All this change was brought about by the various industrial revolutions.

Cheap energy widely available, plus human initiative, added to the Computer Revolution, will have similar effects – or potentially could. Of course the likelihood that all the good will be absorbed by bureaucracy and the effects will not happen is reasonably good.

The history of civilization has this thread: more and more of the output of the society is converted into structure. The structure is controlled by rent seekers who become a bureaucracy. The Iron Law of Bureaucracy prevails. Sometimes – the discovery of the New World, the inventions that inspired the first three Industrial Revolutions – productivity is so great that the structure is evaded. The bureaucracy doesn’t have the means to control and regulate and redistribute. That happened in the Computer Revolution, but it appears that the regulators will gain control of that, too.

Look for the Iron Law to assert itself if small cold fusion becomes possible.

 

Of course none of this applies if the technology is not there.  The Lockheed effort is not the only possible “small fusion” effort. http://www.extremetech.com/extreme/191754-cold-fusion-reactor-verified-by-third-party-researchers-seems-to-have-1-million-times-the-energy-density-of-gasoline

I do wonder why there is not a larger ferment within the scientifically cognoscente press.  Most of that press is controlled by the regulatory aristocracy, but surely there are some independents. We can hope.

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Ebola

 

Ebola

Dear Mr. Pournelle;

I don’t want to minimize the danger of Ebola — I’ve suspected for some time that a pandemic might be sufficient to collapse our civilization. But I do want to ask: is it the responsibility of the Federal Government to prevent its spread? If so, how far does that extend? Should the CDC have not only advisory but enforcement authority? Should the Federal Government dictate procedures to all hospitals anywhere near an airport?

Granted there are less intrusive measures already available to Federal authority. However, it has seemed to me on more than one occasion that when something frightens or enrages us, we are prone to demand that The Authorities fix it — using powers which, in saner moments, we never gave them.

If we want a non-intrusive government, it seems to me we will also need to find ways to respond to genuine emergencies which don’t require government intrusion.

Yours,

Allan E. Johnson

I would say that it is the responsibility of the federal government not to import Ebola, since the states don’t have the authority or the ability to control international travel.  So far as interstate travel is concerned, that has to be federal again; the states are not permitted to erect immigration barriers against other states.  Should they be? The Constitution gives interstate commerce to the Congress.

I would suppose that a wise federal government would try to avoid direct regulation and responsibility for hospitals within the states (other than federal facilities such as the VA), but I have little expectation of wisdom from the current bureaucracy and even less from the administration.

I would presume that the Federal excise tax on medical equipment (20%) would impose a moral obligation on the federal government, but I doubt anyone feels that.

 

Have any of you noticed the elephant in the room?

We have two nurses infected and sick with Ebola.

We have a family that was in contact with Duncan while he was getting sick even after his temperature spiked to 103.5. So far none of them are sick.

While I am sure this is premature one tentative conclusion I draw is that the patient is not particularly contagious until well into the "I’m sicker than hell" state. It’s worth thinking about.

{^_^}

True of his strain. Not of other strains. [JEP]

 

At the moment the head of the CDC is adamantly testifying that Ebola is both undetectable before they are symptomatic and can not transmit Ebola during the period they cannot detect it. They are currently defining 100.4 degrees (If I recall correctly) as a critical temperature. So the nurse with a 99.5 fever probably would not be a danger to people around her. At 101.5 she’d be a danger to people around her if, for example, she stumbled and somebody tried to help her by grabbing her to steady her.

But, then, we do have the families that are not affected (so far) even with the patient spiking to a fever of 103.5 and nurses over exposed due to inadequate protection early on to consider. This hints you really have to try hard to become infected. West Africans with their funerary procedures seem to go out of their way to be exposed to Ebola. Doctors and nurses are in intimate contact with patients which puts them in extreme danger, God bless them every one!

With that as a background, I am inclined to the opinion that the media are toning this to panic the populace and sell their newsware rather than provide the word that the danger really is minimal if the responses of the medical profession are carefully considered and well trained. It is actually rather difficult to transmit Ebola, at least this strain and probably all five strains.

I also rather like the CDC’s advisory role. "We advise you not to fly and we are notifying the airlines of this. It will be up to the individual airline to let you fly or not. If they do not our warning will shield them from lawsuits over refusing to let you fly." Inform the public if a person advised not to fly actually is allowed to fly after the warning. The public tries and convicts the airline "for free."

If the CDC does maintain stocks of materials both written and equipage that can be requested by states or medical facilities on short notice, that is also a very good thing.

Our Constitution should prevent the CDC from moving in and taking over on its own initiative.

{^_^}

By the way – I take issue with what I’ve read of the protocol for taking off the medical moon suits. I suspect they need to rethink it for Ebola at least. I suspect duct tape and Velcro are your friends here. The Velcro is to allow the suit to part at the shoulders so it can be peeled (and rolled) down the body with the contaminated surface in side. That allows the hood to come off first over the head while the wearer leans forward and pulls a tab connected down to the lip of the head gear’s cowling. Expose skin only to the inside surfaces.

Once the cowling and hood is off pull on the suit below the shoulders to pop the shoulder Velcro loose. Pull the hands partway out of the gloves that are duct taped to the sleeves of the garment. Peel the suit off like a condom rolling the contaminated surfaces inside. Once it is down step out of the booties. Only uncontaminated insides should be exposed at this time. Have tabs off the front of the shoes maybe an inch or so to allow the wearer to step on one tab with the other foot to free the feet from the booties.

Then take off the inner layer of protection that’s not normally called for.

Then toss everything into a barrel of chlorine water using long tongs or whatever.

{^_^}

I would suppose that there have been engineering studies of this, or at least of removing protective gear contaminated with corrosive substances; but that supposes more competence than I am finding in examining the health care bureaucracy. There are competent people in the bureaucracy, but the Iron Law still prevails, and it has worked its will on administration and bureaucracy alike; or appears to have. Why does the chap who told us all the hospitals are ready for Ebola still have a job? And who is the supervisor of the people who told Nurse Amber that it was all right to fly with a 99.5 F fever even though she had probably been exposed to Ebola? Is that person still employed and answering health questions?

But then we have been led to expect competence in many parts of this administration

But then I tend to take an engineering approach to problems.  First you have to define an objective.

http://www.foxnews.com/politics/2014/10/16/cdc-considers-adding-names-people-monitored-for-ebola-to-no-fly-list/

The move is being considered as a response to Wednesday’s disclosure that Dallas nurse Amber Joy Vinson was cleared to fly on a commercial airliner earlier this week despite having been exposed to the Ebola virus while treating Thomas Edward Duncan at Texas Health Presbyterian Hospital.

On Monday, a CDC official cleared Vinson to fly from Cleveland to Dallas on board Frontier Airlines Flight 1143 despite the fact that she had called and reported having a slight fever, one of the common symptoms of the Ebola virus. Vinson’s reported temperature — 99.5 degrees — was below the threshold of 100.4 degrees set by the agency and she had no symptoms, according to CDC spokesman David Daigle.

 

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Problems Quarantining Ebola

Jerry,

My thanks to reader Earl for his pointer to the WHO release that mentions 5% of recently studied Ebola incubation periods not (I’m stating this carefully) provably falling within the nominal 21 days.

The actual wording in the WHO release (at

http://www.who.int/mediacentre/news/ebola/14-october-2014/en/) is "Recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42 day interval."

(It’s easy to take the missing 2% and infer those cases incubated for even longer than 42 days. Note though that any such study necessarily will include some uncertainty as to when infection actually first took place; some or all of the missing 2% might also be that. Regardless of that uncertainty, the 3% of cases WHO does specify at 22-42 days incubation is alarming enough.)

Also worth noting is another recent study (story at

http://www.naturalnews.com/047281_Ebola_symptoms_incubation_period.html)

which says that between .2% and 12% of recent cases may still not show symptoms 21 days after infection. That’s quite a wide range of uncertainty, but FWIW the median 5.9% is quite close to WHO’s overall 5% non-21-day cases.

There are also studies showing significant numbers of individuals infected with Ebola who have remained asymptomatic indefinitely.

http://download.thelancet.com/flatcontentassets/pdfs/PIIS0140673614618390.pdf?id=aaadpDXSyNZVP5Qg76oKu,

and http://www.ncbi.nlm.nih.gov/pubmed/10881895.

The now-known longer-than-21-days incubation periods (plus the real possibility of transmission by asymptomatic individuals) may well account for a problem I’ve seen reported from the current West African outbreak: Localities that were thought to be past their crisis with sharply declining infection rates have seen renewed outbreaks.

Meanwhile, the implications for US quarantine attempts are clear – simply waiting 21 days will not work. Further, it’s not clear that there is any practical quarantine length that will be effective.

The immediate conclusion I’d draw is that fast-turnaround (minutes not days, on-the-spot not lab) tests for virus presence are an essential part of any effective Ebola entry-prevention policy.

The immediate policy implication is that mass-deploying such tests (in the works from at least two different sources, http://khon2.com/2014/10/14/tulane-doctor-developing-faster-ebola-test-detection-in-minutes/

and

http://denver.cbslocal.com/2014/10/14/colorado-test-for-ebola-could-speed-up-diagnosis-to-10-minutes/)

should be a crash priority.

It’ll be, uh, interesting to see how long it takes the CDC and White House to reach the same conclusion. Or, more likely, be forcibly led to it… Whatever works.

porkypine

Porkypine

Never waste a crisis.  If this one causes some reforms of the bureaucracy it may increase the competency of an important federal agency and our confidence in it.  I fear I do not have high hopes for this.  The Iron Law is pretty implacable.

 

There are several flaws in the fast tests mentioned by Porkypine

First. Present data indicates that a victims will not test positive to Ebola for as much as 4 days after frank symptoms. One shudders at the thought of a Real Case of Ebola being turned away because of a quick negative result, free to cough all over folks on the bus or subway.

Second> WHO defines a negative result as TWO tests taken 48 hours apart. This is quite different from the sloppy results that CDC is pushing. A quick test would not provide any advantage except to point out the obvious positives. You would still need 48 hours (or the 4 days after symptoms) to safely pronounce a negative result. This was a point where the bureaucrats at WHO castigated the bureaucrats at CDC as not being careful. (such a delightful image – bureaucrats facing off with automatic weapons at 2 paces and may God protect the Right )

Earl

 

 

Ebola Visas

Jerry:

Regarding State Department protocols permitting visa issuance: I am a retired Immigration Officer. State can (and has) revoked visas that have already been issued. It would be a fairly simple matter to cancel all visas issued at consulates in the affected countries. Normally, people who reside in those countries must receive visas only from their own consulates. I suppose exceptions would have to be made for diplomatic visas.

The mechanism whereby this would be implemented would be to notify all common carriers of such cancellation. The carriers would be liable for substantial fines for allowing persons with such cancelled visas to board a flight to the US. This would be more effective than stopping direct flights, since it is easy for people to connect through another location such as Brussels.

Best Regards,

Greg Fiorentino

Why is this not being done?

In this: http://www.foxnews.com/politics/2014/10/16/lawmakers-grill-health-officials-over-ebola-response-resistance-to-travel-ban/

Is this quote: "But health officials continued to downplay the need for flight restrictions for flights to and from West Africa, arguing that officials still would have a difficult time tracking where travelers have been. "

Having just been through customs in two countries, that’s a non-starter. If it’s an electronic passport, just check the records – and if not, check the date on the customs stamp! This is not rocket science. Sure it’s not perfect, but it’ll be a darn sight better than nothing. There’s another agenda here, and I wonder just how much of the information we’re being fed is truth and how much is spin.

Doug

I would think that not importing new strains would be a high priority move.

 

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Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much. How to subscribe is described here: PAYING FOR THIS PLACE.

 

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Freedom is not free. Free men are not equal. Equal men are not free.

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Ebola and the Competence Crisis. A Visit to Harlan

View 846 Wednesday, October 15, 2014

“Transparency and the rule of law will be the touchstones of this presidency.”

President Barack Obama, January 31, 2009

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EBOLA OUTBREAK? Stock Market Plummets

A second health care worker who treated Mr. Duncan has now come down with Ebola. This has so concerned the President that he has cancelled a fund raiser and a golf game and will hold a cabinet meeting concerning public health.

Meanwhile, confidence in the competence of the government, which has repeatedly assured us that all the necessary protocols for preventing an Ebola outbreak in the United States are already in place, has collapsed and the stock market reflects that.

A ground swell of demand for sealing the borders against Ebola is developing, but no public official seems to be proposing that. Public officials are saying that we cannot refuse visas to those who wish to come to the United States. Of course those who come in through Mexico need no visa, but Ebola has a way of preventing vigorous travel. One can hope that the Texas, New Mexico, Arizona, and California National Guard could make that trip even more vigorous, but it is unlikely in California.

Whatever protocols are in place, they did not prevent someone well known to have been exposed to Ebola – she was treating a patient when he died from it – they did not include “monitoring” those known to be exposed to Ebola. We are repeatedly told about the competence of our meritocracy of unionized government workers.

Health care worker with Ebola flew on commercial flight a day before being diagnosed

The second health-care worker diagnosed with Ebola had a fever of 99.5 degrees Fahrenheit before boarding a passenger jet on Monday, a day before she reported symptoms of the virus and was tested, according to public health officials.

Even though there appeared to be little risk for the other people on that flight, she should not have traveled that way, Thomas Frieden, director of the Centers for Disease Control and Prevention, said during a news conference Wednesday.

“She should not have flown on a commercial airline,” Frieden said.

This health-care worker flew on a Frontier Airlines flight from Cleveland to Dallas-Fort Worth with more than 130 other passengers. She did not have nausea or vomit on the plane, so the risk to anyone around her is “extremely low,” Frieden said.

The health-care worker was not identified by public health officials, but family members told Reuters and the Dallas Morning News that her name is Amber Vinson, a nurse at Texas Health Presbyterian Hospital. She was part of a team that had cared for Thomas Eric Duncan, a Liberian man who flew to Texas and was diagnosed with Ebola last month, during his hospitalization in Dallas. Duncan died last week. Nina Pham, a nurse who also cared for Duncan, was diagnosed with Ebola on Sunday.

Vinson, who flew from Dallas to Cleveland on Friday, flew back to Texas on Monday, a day after Pham was diagnosed. She reported a fever on Tuesday and was isolated and tested for Ebola.

http://www.washingtonpost.com/news/post-nation/wp/2014/10/15/ebola-stricken-nurse-flew-on-a-passenger-plane-a-day-before-being-diagnosed/

It is now reported that Ms. Vinson had a low grade (99.8 F) fever on Monday when she took the commercial flight; there is argument over whether that is a symptom of Ebola, and whether or not she was contagious on Monday. One would assume this is a ‘breach of protocol”. And there is this:

Sorry to say this but it appears that our Government has been lying to us about Ebola once again.

In a recent report from WHO ( http://www.who.int/mediacentre/news/ebola/14-october-2014/en/ ) there is the little noted announcement that the 21 day incubation period is an error.

The REAL period appears to be much longer.

95% of the cases are under 21 days

3% of the cases are up to 42 days

2% fall in the other long period (something longer than 42 day)

Plus there appear to be infected individuals who never develop symptoms ( like Typhoid Mary ) but who are still infectious (that is possibly where the 2% comes from). That would be something to be feared — with 8000 cases that means there are 160 individuals walking around with no symptoms but who are spreading the disease. Just imagine one of them catching a flight to Europe and maybe on to America – nothing to identify them other than they came from West Africa. And they keep infecting those around them.

so it seem that areas of Nigeria that were declared cleared are having flare ups from the tail end of the sample curve that was over 21 days.

With 5% over the 21 day limit we have to be a lot more cautious than accepting the statistical 5% test. Our lives depend on it!

The problem with the Biological Sciences is that unlike Physics and Chemistry you end up with exceptions to just about any rule, and the data is never clear cut and definitive. Schrodinger achieved fame as a Physicist, if he were a Biologist he would be regarded as just another picky German who wanted a precise answer.

I am really not trying to sound overly pessimistic, but it is better for the truth to be told rather than live under government lies that will surely kill us.

Earl

See also this correspondent’s letter on the Ebola question in yesterday’s View; it is important. http://www.jerrypournelle.com/chaosmanor/questions-about-ebola-questions-about-an-essential-reading-list/

Re: Earl’s note (here: http://www.jerrypournelle.com/chaosmanor/questions-about-ebola-questions-about-an-essential-reading-list/)

I was struck by Earl’s analysis of preparation strategy.. namely using the survivors to care for the those coming down with the virus. That brought to mind stories that my father told about his time in the Navy in the early 50s. They sent the ship he was on back and forth between climate extremities, in part to achieve what he thought was an experiment in adaptability. The administration and the Navy department then had no problem experimenting with personnel for the ‘greater good’. It’s quite possible he and his shipmates were a part of the experiments that led to the establishment of ‘wind chill’ calculations that are now a standard adjunct to all weather reports.

Now take that philosophy in concert with the deployment of troops to ‘help’ with the Ebola outbreak in Africa. If the administration were worried about a massive outbreak here and needed to build up a cadre of immune, command-able individuals that could handle the sick, this would seem to be the perfect laboratory to incubate such a cadre. The possible loss of half the deployed troops could just be attributable to ‘bad luck’.

Yes, I am aware that this sounds like ‘black helicopter’ reasoning, and while I do suspect the current administration is more than capable of such a move, I doubt they have the cunning to pull off such a measure. Yet, they have demonstrated they have the hubris to attempt a great many underhanded things that were unthinkable with in past administrations. In any case, I think this is a line of thought worth keeping in mind.

Liberian Ebola Survivors Return to Help the Sick

Former Patients Like Salome Karwah, Who Lost Her Parents to the Virus, Offer Comfort and Counseling at Clinic

MONROVIA, Liberia—Six mornings a week, Salome Karwah gets up and goes to work at the Ebola treatment unit where she watched her parents wither and die just three days apart and where she almost died of Ebola as well.

Ms. Karwah, 26 years old, who had been a nurse’s assistant at a private clinic before the outbreak, recovered from the virus and was discharged on Sept. 5 as a patient from the Elwa treatment unit here. Less than a month later, she returned as one of seven Ebola survivors hired by the clinic, run by Doctors Without Borders, to counsel and comfort those suffering from the disease.

She and the other survivors are paid for their work at the Ebola unit, but few see it as a job. They are part of a select group that have withstood the virus here and they want to help.

(Update: Second health-care worker at Texas Hospital tests positive for Ebola).

http://online.wsj.com/articles/liberian-ebola-survivor-now-comforts-other-patients-1413301824

A collection of Ebola survivors trained in working with the disease would be valuable for many reasons including as a plasma supply, but it is unlikely that anyone has this intent.

This government seems more concerned with intentions than accomplishments. 

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Can All U.S. Hospitals Safely Treat Ebola?

http://mashable.com/2014/10/13/can-us-hospitals-treat-ebola/

 

 

 

ABC Chief Medical Expert: CDC Wrong, All US Hospitals Can’t Treat Ebola Safely

http://www.breitbart.com/Breitbart-Texas/2014/10/12/ABC-Chief-Medical-Expert-CDC-Wrong-All-US-Hospitals-Cant-Treat-Ebola-Safely

Dr. Richard Besser, the chief health and medical editor for ABC News, told WFAA-Dallas on Sunday that he found the second Texas Ebola case "very concerning." As reported by Breitbart Texas, the latest patient diagnosed with Ebola is a female nurse at the Texas Presbyterian Hospital who treated Thomas Eric Duncan before he died from the disease. Besser, having recently returned to the United States after visiting Ebola-stricken areas of Liberia, expressed sharp disagreement with the protocols being followed by the Centers for Disease Control and Prevention (CDC), dissatisfied with their admission that they needed to adopt enhanced protocols in a press conference Sunday.

Besser told WFAA that he had been anticipating the news of a second Ebola case. "I don’t find it surprising, but I find it very concerning," he said, continuing that it was necessary for health authorities to cast "a very wide net" to search for anyone who may have had even the most incidental contact with either Duncan or the nurse. The difficulty in containing the spread of the disease, according to Besser, is that it takes special training and experience to follow the isolation protocols and use the protective gear properly.

"The idea that this could be done by any American hospital that has an isolation room and can be done safely, I was skeptical about that," said Besser, in a clear departure from recent statements by the CDC that any American hospital can safely care for Ebola patients. Besser mentioned the highly specialized biocontainment equipment and advanced training available at at Emory University Hospital in Atlanta, where Fort Worth doctor Kent Brantly was successfully treated for Ebola exposure, and the Nebraska Medical Center in Omaha, where an NBC photographer is currently getting treatment.

Besser agreed with Dr. Tom Frieden, the CDC head, who had said that the new Ebola case was caused by a "breach in protocol." "You cannot get sick without a breach in protocol, [however] you can’t implement that protocol without training and practice. It’s very difficult to take off the protective gear in such a manner that you don’t potentially contaminate yourself." Besser cited this new Dallas case and the case of a nurse in Spain who had contracted Ebola from a patient, and the fact that health care workers at the Emory and Nebraska facilities had not gotten sick, as illustrative of the vital difference that the training can make.

 

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Ebola Is Coming. A Travel Ban Won’t Stop Outbreaks

J V Chamary

 

Ebola has officially gone global.

The World Health Organization recently confirmed that a Spanish nurse was the first case of transmission outside Africa. Now it seems the first patient diagnosed in the United States transmitted the disease before he died.

More outbreaks are on their way.

While nations struggle to contain the epidemic in West Africa, other countries are discussing how to protect their own citizens, with governments and health authorities repeatedly asked the same question:

Why don’t we just ban flights from Africa?

The idea seems logical. Prevent sick people entering the country, keep your loved ones safe. It’s selfish, but understandable. A survey of over 1000 people by NBC News found that the majority of Americans (58%) support a ban on flights from countries where the Ebola virus has broken out.

Dr Tom Frieden, director of the US Centers for Disease Control and Prevention, has tried to explain why he doesn’t support a travel ban:

Importantly, isolating countries won’t keep Ebola contained and away from American shores. Paradoxically, it will increase the risk that Ebola will spread in those countries and to other countries, and that we will have more patients who develop Ebola in the US. People will move between countries, even when governments restrict travel and trade. And that kind of travel becomes almost impossible to track.

Simply put: you can’t seal the country. If you blocked air travel, it would force desperate individuals to use alternative routes – over land and sea – to escape the epidemic. They’ll still end up in the US, except you won’t know where.

An attempted travel ban would be like locking yourself in a cabin on a sinking ship and praying the flood doesn’t seep through the gaps, and that the water pressure won’t be enough to burst through the door.

http://www.forbes.com/sites/jvchamary/2014/10/13/ebola-travel/

 

I would not have thought it impossible to quarantine those from plague ridden areas, and to refuse them visas to the United States, but I am not familiar with the current Department of State protocols.  I suspect that the Joint Chiefs of Staff could devise a way.

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Chaos Manor Reviews, and The View from Chaos Manor, operate on the Public Radio model: they are free, but we are supported by patronage and subscriptions. If you have not subscribed, this is the week to do it. If you have subscribed but can’t remember when you last renewed this would be an excellent time to renew. KUSC asks for $10 a month. My costs are much lower so I don’t need that much. How to subscribe is described here: PAYING FOR THIS PLACE.

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Who says Ebola isn’t airborne

Tuesday, September 23, 2014 by: Ethan A. Huff, staff writer

"The fact of the matter is that Ebola has never been proven not to transmit through the air, which is reason enough to assume that it does for the safety of workers on the ground. The two doctors explain that, scientifically speaking, Ebola currently has "unclear modes of transmission," meaning nobody truly knows all the ways that infections can emerge. "

"We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators <http://www.naturalnews.com/respirators.html> , not facemasks," they wrote, citing an earlier paper Dr. Brosseau published in the American Journal of Infection Control".

http://www.naturalnews.com/046986_Ebola_airborne_transmission_respirators.html

In November 2012, they say it is airborne!!!!

http://healthmap.org/site/diseasedaily/article/pigs-monkeys-ebola-goes-airborne-112112

http://www.naturalnews.com/046986_Ebola_airborne_transmission_respirators.html

And, YOU don’t think Obama isn’t playing the typical game of total deceit keeping the people from panicking? If the cold virus is airborne, logic and common sense mandates that ANY virus can be airborne. Why don’t they tell why this virus isn’t airborne while all others are? ASSUME IT IS!!!!!

Google the Internet for more :<Ebola is airborne>

http://www.endalldisease.com/cdc-caught-lying-airborne-transmission-of-ebola-confirmed/

 

There’s nothing hidden about that fact. But the records don’t show that any humans grew ill from the Reston strain. Might be the cowpox version of Ebola. In which case maybe it’s what the researchers need to concentrate on for a vaccine.

Stephanie Osborn

Rommel And Ebola 

Jerry,

The German general Erwin Rommel famously said that Americans knew less but learned faster than any other opponents he’d faced. This was, of course, shortly after the first major WW II battle between US and German troops, at a place called Kasserine Pass – a fiasco for the US.

We can only hope our current medical leaders still learn fast. I made the (apparently common) error over the last couple of months of assuming that the West Africans’ growing problem with Ebola killing off their medical personnel was a matter of primitive conditions, scarce protective gear, and sloppy procedures. Perhaps so – but the second Dallas hospital worker diagnosed (so far) tells me we are not near as much better than them as we thought.

Our government’s position that any decent US hospital is intrinsically able to handle Ebola seems to have been abandoned overnight. I now see signs that our new government policy will be massively centralized, and resource-intensive to the point where if there are any significant number of cases the resources will quickly run out.

One of the immediate results of the Kasserine disaster was that heads rolled among the US leaders responsible. It’s probably too much to hope for here in 2014; we don’t seem to do that anymore.

I do hope that local medical people around the country are now seriously planning how to at least keep the transmission rate below 1.0 with resources at hand as outbreaks occur. I do not see any way we will escape this thing unscathed, but we should still be able to prevent epidemic spread here.

good luck to us all

Porkypine

 

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Meanwhile in the Middle East

 

Subject: RE: Gruesome photos may show ISIS using chemical weapons …

Date: Mon, 13 Oct 2014 21:52:03 -0400

Chemical weapons are quick relative to what else is going on…

http://www.foxnews.com/story/2009/08/17/human-rights-watch-gay-men-systematically-tortured-and-killed-in-iraq/

http://themuslimissue.wordpress.com/2013/10/14/punishing-gays-rectums-are-glued-shut-and-they-are-force-fed-petrol-and-set-alight/

Stephanie Osborn

Interstellar Woman of Mystery

http://www.Stephanie-Osborn.com <http://www.stephanie-osborn.com/>

We continue to break things and kill people, but without apparent objectives.

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Ebola in columns and talk shows today

http://www.anncoulter.com/columns/2014-10-15.html

http://www.breitbart.com/Big-Government/2014/10/11/Michael-Savage-on-Ebola-Third-World-African-Dictators-are-Smarter-than-Barack-Obama

http://www.marklevinshow.com/common/page.php?pt=2nd+Ebola+Nurse+Called+CDC+Before+Boarding+Plane%2C+CDC+OK%27ed+It&id=11423&is_corp=0

http://www.rushlimbaugh.com/daily/2014/10/15/obama_s_deadly_ebola_failure

 

I have read your thoughts on Ebola with interest. Indeed, why not restrict travel from places where Ebola is endemic? At first glance it surely seems like politically-correct insanity. But here is another view on the topic…

http://globuspallidusxi.blogspot.com/2014/10/obama-is-letting-diseases-enter-united.html

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John De Chancie and I are working on a space opera, and he came over for lunch, after which the two of us went to the hospital to see Harlan Ellison,  As reported yesterday he had a stroke last week and is in recovery.  We called his wife first to be sure it would be appropriate,  Harlan is in a Catholic hospital, and at his request the nurses – he hasn’t seen any Sisters yet – covered the crucifix in his room.  One of them with a sense of humor used the standard pain estimation instructions as the cover.  John and I both went to Catholic schools in our youth so we have a somewhat different set of expectations…

Harlan looks good.

 

2014-10-15 16.24.35

He’s sitting up in a wheelchair, with a hospital table in front of him.  I pointed out that there’s a 20% Federal excise tax on all medical equipment including his chair and that table and any other stuff they have to use in his physical therapy sessions.

He is recovering the use of his right arm and leg, and it looks as if all the neurological pathways are intact so it’s a matter of practice to get back full function.  Nothing wrong with his head.  He can still dominate a conversation for two hours, with me in the room, and that’s a rather large feat.  David Gerrold was there when we got there, and we had a fine afternoon talking about everything from the old days and taking Robert Silverberg to dinner to comparatively modern times.

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Freedom is not free. Free men are not equal. Equal men are not free.

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