Obama picks EBOLA Czar.... medical superstar?

[Teallaura]

Um, guys, the biggest problem right now, besides the resultant PR nightmare from the problem, is the crappy contact tracing they are doing. Seriously, you need a freaking hazmat suit but you don't assume contact? Are they idiots? That's an associate at the very least and should be treated as such. The idiotic way they did this coupled with the panicked response (the dog? Seriously, an asymptomatic contact and you're quarantining the dog?) is gonna make it harder to get any personnel to work with patients - this should have been addressed in the planning stage years ago. We have a huge bioterrorism machine - use that!

Better yet, let the TB folks take the lead. Ebola is very similar in the kind of contacts you need to look for (TB can be airborne but requires considerable exposure so it's similar to direct contact in how we do the contact tracing). It's like they are reinventing the wheel for no good reason.

[Paprika]

The transmission of Ebola in the few patients we're likely to see on US soil?

If more Africans in the affected countries had sufficient money, you'd be seeing a lot more of them on US soil.

[Sam]

If more Africans in the affected countries had sufficient money, you'd be seeing a lot more of them on US soil.

That's possibly true — though if more African citizens in the affected countries were generally wealthier, their countries would probably also have a better developed healthcare infrastructure and better treatment options more readily available. Any road, it's a hypothetical situation that we're not going to be dealing with and one that won't be a factor for the "Ebola Czar."

[Paprika]

Any road, it's a hypothetical situation that we're not going to be dealing with and one that won't be a factor for the "Ebola Czar."

The first patient followed precisely this pattern. Your confidence that it will not be repeated looks rather misplaced, to say the least.

[Sam]

The first patient followed precisely this pattern. Your confidence that it will not be repeated looks rather misplaced, to say the least.

I never claimed that it wouldn't be repeated. In fact, I expect a few more Ebola cases before this is all done. But we're still talking about a handful of patients, all of whom will be isolated pretty quickly after becoming symptomatic. None of them, arriving at a hospital with a fever, are going to lie about their origin country or potential exposure. That wouldn't result in getting the necessary treatment, losing time before their symptoms became obviously Ebola and mortality was much likelier.

So, yes, I expect we'll see some more Ebola patients in the USA. No, I do not expect a large influx of carriers. And those that do come will be quickly and efficiently quarantined, as has been the case (and the response will only get better from here). There's a lot of justified criticism about how the most recent Ebola patient was managed and a lot of unjustified extrapolation about what the scope of those missteps were. In any event, it has been a successful quarantine.

[Paprika]

those that do come will be quickly and efficiently quarantined, as has been the case

[Sam]

I see folks 'round here are still hacking sentences apart. I even went into unnecessary elaboration about the missteps in the recent case to avoid that.

So we had an Ebola patient arrive on US soil and became symptomatic. How many other people have contracted Ebola from that episode? Two — both nurses and, apparently, both people who were not provided the necessary hazmat gear as per protocol until two days after the patient's admission. Definitely a big misstep but not one that has allowed Ebola to spread to the general population. From an epidemiological standpoint, that's a pretty successful and efficient quarantine. There's a very heavy element of bias and partisan nitpicking when one looks at that effort and chooses to snicker.

[Paprika]

I see folks 'round here are still hacking sentences apart. I even went into unnecessary elaboration about the missteps in the recent case to avoid that.

I can't help your self-contradictory statement.

So we had an Ebola patient arrive on US soil and became symptomatic. How many other people have contracted Ebola from that episode? Two — both nurses and, apparently, both people who were not provided the necessary hazmat gear as per protocol until two days after the patient's admission. Definitely a big misstep but not one that has allowed Ebola to spread to the general population. From an epidemiological standpoint, that's a pretty successful and efficient quarantine.

A bit too early to conclude that until the 21-day window is cleared for all the contacts, eh?

There's a very heavy element of bias and partisan nitpicking when one looks at that effort and chooses to snicker.

Do tell.

[Sam]

I can't help your self-contradictory statement.


A bit too early to conclude that until the 21-day window is cleared for all the contacts, eh?


Do tell.

It's not a self-contradictory statement, either in context or in the logical sense. I'll focus on the former. A 2006 study estimated, among other things, the average secondary infection rate of contagious Ebola patients during previous outbreaks in 1995 and 2000. They found an average secondary infection rate of 2.7 individuals. Right now, with the three patients who have come to the USA and treated for Ebola, the secondary infection rate is ~0.7. If we're -just- talking about the Texas case (since the other patients were flown in explicitly because they had contracted Ebola), we're still talking about a 0.7 transmission rate. Now if we get through the 21 day period and that number goes higher, there will have to be a re-calibration of the average -- but that's not the data we have now and it's -highly- unlikely the average will move significantly higher. Remember that the nurses who contracted the virus weren't issued the necessary gear until the patient had progressed well past early symptoms (and other health workers in the same environment seem to be fine).

So while we can't say with absolute certainty just -how- effective this case has been managed, the best data we have at present indicates that the virus was contained and that the chance of secondary transmission has been quickly arrested. A successful quarantine.

[Cow Poke]

It doesn't sound like you have a very clear idea of what the problem is, let alone what is needed to "stop this thing." What are we stopping, exactly? The transmission of Ebola in the few patients we're likely to see on US soil? That's a problem more readily dealt with by already-existing health agencies and hospital networks. A general won't be much help making sure those groups are communicating well and acting effectively. Someone knowledgeable of the relevant departments is much better, since the talking to hospital groups is better performed by already-existing connections in HHS or the CDC.

I'm very much in favor of "medical FACT" taking a more prominent role in this situation. That way, more people would realize that Ebola panic — especially moving into flu season — is a far more detrimental and dangerous threat than actual Ebola in the US. Given how this topic has been treated by many politicians and media outlets (looking at you, FOX News (excepting Shep Smith)), I don't think any Obama appointee would be well-received in delivering that message.

This doesn't even merit a response.

[Cow Poke]

Um, guys, the biggest problem right now, besides the resultant PR nightmare from the problem, is the crappy contact tracing they are doing. Seriously, you need a freaking hazmat suit but you don't assume contact? Are they idiots? That's an associate at the very least and should be treated as such. The idiotic way they did this coupled with the panicked response (the dog? Seriously, an asymptomatic contact and you're quarantining the dog?) is gonna make it harder to get any personnel to work with patients - this should have been addressed in the planning stage years ago. We have a huge bioterrorism machine - use that!

Better yet, let the TB folks take the lead. Ebola is very similar in the kind of contacts you need to look for (TB can be airborne but requires considerable exposure so it's similar to direct contact in how we do the contact tracing). It's like they are reinventing the wheel for no good reason.

Which is why we need somebody who actually understands DISEASE and how it spreads, rather than a PR person or another community organizer.

[Cow Poke]

I see folks 'round here are still hacking sentences apart.

Yes, that's your pet peeve, Sam, but the REALITY is that you can't just spew forth a bunch of words without something particular catching somebody's attention. They'll often comment on only THAT part. Same thing happens in real life.... you can say a whole bunch of stuff, but if ONE of the things you say evokes a response, nobody's qonna quote your whole screed to finally get to the part that evoked the response.

Deal with it.

[Juvenal]

This doesn't even merit a response.

You got schooled. Deal with it.

[Cow Poke]

You got schooled. Deal with it.

As per typical, you're snitting -- that's how you deal with it.

[Juvenal]

Amid Assurances on Ebola, Obama Is Said to Seethe

WASHINGTON — Beneath the calming reassurance that President Obama has repeatedly offered during the Ebola crisis, there is a deepening frustration, even anger, with how the government has handled key elements of the response.

Those frustrations spilled over when Mr. Obama convened his top aides in the Cabinet room after canceling his schedule on Wednesday. Medical officials were providing information that later turned out to be wrong. Guidance to local health teams was not adequate. It was unclear which Ebola patients belonged in which threat categories.

I've enough friends in West Africa to keep me interested in the Ebola outbreak currently fueled by the usual suspects: corruption, poverty, and ignorance. They're looking at plague numbers. The numbers here were too small to catch my attention, so it came as something of a surprise to find it was being hyped at all —YouGov asked if I thought it was being hyped too much — let alone to the point where a political response was needed.

I don't follow fringe media, so I've no idea what the heavy breathing is about.

What are the numbers for transmission here? A couple of health care workers caught Ebola from their patients. That's why we have a CDC. They will take care of the medical issues. Public communication is another art, and no, that's not a military specialty — looking at you, CP — they can barely communicate among themselves, even with the advantage that their listeners are under orders to understand them.

The new czar's been chief of staff for two VPs. He'll do.

As ever, Jesse