Tag: TMC News

Epidemiology experts agree that there is no medical reason to quarantine asymptomatic health care workers who have been exposed to Eboli. Despite all the information available about how this virus is spread and the fact that it is not airborne, the governors of several states have decided to err on the side of panic that has been fostered by some media outlets, imposing unnecessary, and quite possibly, detrimental 21 one day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease.

On Friday, New York Gov. Andrew Cuomo (D) and New Jersey Gov. Chris Christie (R) rolled out aggressive policies requiring quarantines for individuals who have had direct contact with Ebola patients in Liberia, Sierra Leone or Guinea. After federal officials and the medical community slammed the policies as scientifically unnecessary, the governors clarified on Sunday that the 21-day quarantine could be completed at home.

Though New York and New Jersey have received the most press attention, they’re not the only states that have done an about-face recently. Illinois, which on Friday implemented a mandatory stay-at-home quarantine policy, clarified on Monday that the policy excludes “medical workers who wore protective clothing,” the Chicago Tribune reported. But high-risk medical workers who have had direct contact with the skin or bodily fluids of an Ebola-infected person are still required to stay home in quarantine. [..]

Not all states have moved to a mandatory policy. Virginia Gov. Terry McAuliffe (D) announced on Monday that the state would be actively monitoring travelers from West Africa, but said quarantine for high-risk patients is voluntary for now.

That some states are going above and beyond the CDC’s recommendations certainly hasn’t escaped Frieden’s notice. On Monday’s call, he offered a word of caution about unintended consequences. Quarantines, he argued, would end up discouraging health care workers from going to West Africa in the first place. And should the disease continue to ravage that part of the globe, “the risk to us will increase,” he said.

“We will only get to zero risk by stopping it at the source,” said Frieden.

Since then the governors of Florida, Maryland and Maine, where Nurse Kaci Hickox, who has tested negative for Ebola lives and will be confined, have imposed similar draconian, irrational policies. Two weeks ago Connecticut Governor Dannel Malloy declared a health care emergency giving  the state’s public health commissioner broad power to quarantine anyone exposed to or infected with the Ebola virus. Why? Because, you know, it’s an election year. It is a despicable tactic playing on the unfounded fear that something might happen. This is making the heroes in the battle to save lives and halt the epidemic in West Africa pariahs. If this sounds familiar, it is. It is precisely what happened after 9/11. The fear that there would be another terror attack let to Americans forfeiting many of their freedoms in the name of some false security.

MSNBC’s Rachel Maddow described the confusion over Ebola quarantine policy for people returning to the US from countries crisis with Ebola as state governors abandon science-based recommendations and scramble to appease irrational public fears.

Unfortunately, as Peter van Buren points out in his article at FDL’s The Dissenter, this is all legal under the Commerce Act of the Constitution and the Public Health Service Act:

The federal government derives its authority for isolation and quarantine from the Commerce Clause of the Constitution. Under the Public Health Service Act, the Secretary of Health and Human Services is authorized to take measures to prevent the entry and spread of communicable diseases.

The authority for carrying out these measures is been delegated to the Centers for Disease Control and Prevention (CDC). Under 42 Code of Federal Regulations parts 70 and 71, CDC is authorized to apprehend, detain, and examine people arriving to the United States and traveling between states who are suspected of carrying communicable diseases. [..]

That said, the power to detain and quarantine often is left to the states, and both New York and New Jersey law provide for it. New York allows the decision to be challenged in a magistrate court; New Jersey does not have a similar law, though technically any form of detention can be broadly challenged under habeas corpus. But good luck with that- the Florida Supreme Court laid down the precedent in saying “The constitutional guarantees of life, liberty and property, of which a person cannot be deprived without due process of law, do not limit the exercise of the police power of the State to preserve the public health so long as that power is reasonably and fairly exercised and not abused.”

Peter also points out the ineffectiveness of this quarantine and the obvious political ploy to gain votes from a panicked public:

The New York and New Jersey quarantine laws at present only apply to a) health care workers b) returning from African “hot zone” countries through c) only two airports, JFK and Newark who d) had contact with ebola. That’s a very select group, chosen largely because New York’s sole ebola patient fit that exact profile. Persons such as regular travelers who fit the same profile,or persons who just flew internationally with the profiled individuals, are not included.

In addition, the New York and New Jersey plans seem to rely 100 percent on individuals who fit the profile self-identifying themselves for the mandatory quarantine. Anyone who wished to avoid it, especially a health professional who knew s/he was not an active carrier based on clearly identifiable and well-known symptoms such as a high fever, could just dummy up at the airport. Alternately, s/he could route flights to land somewhere else and take the bus home to Manhattan. [..]

Quarantining actually infectious people, who may indeed be a danger to public health is one thing. But like taking off our shoes and other security theatre that followed 9/11, the quarantine plan seems designed more for show than any hint of practicality.

Is it just a political ploy to garner votes from a panicked public?

Oh my yes. All of the state governors who pushed the plan through without the endorsement of the CDC or New York’s mayor are in election battles. The governors of New York, New Jersey, Illinois and Florida are up for reelection in about a week, and New Jersey governor Chris Christie is famously testing the waters for a possible 2016 presidential run. New York’s mayor is not up for reelection for years.

Fear-mongering works; ask any politician who has beaten the drum of “9/11, 9/11, 9/11″ since, well, 9/11. People are scared, mostly based on ignorance fanned by media who themselves seek to profit from fear.

That sort of disease seems more dangerous in the long run than a handful of ebola patients.

Politicians, particularly a certain group of loudmouthed, no-nothing Republicans and certain irresponsible members of the news media, are pouncing on the latest case of Ebola in New York City, leaving NYC officials to quell unfounded fears. The patient, Craig Spoencer, is a 33 year old physician who is a volunteer with Médecins Sans Frontières (MSF), or in English, Doctors Without Borders, returned to the US from Guinea where he had been treating Ebola patients. MSF has very specific instructions for their staff returning from Ebola infected countries.

MSF pre-identifies health facilities in the United States that can assist and manage the care of our staff members in the event they develop symptoms after their return home. This pre-identification practice is carried out in coordination with the US Centers for Disease Control (CDC) and departments of health at state and local levels.

Upon returning to the United States, each MSF staff member goes through a thorough debriefing process, during which they are informed of our guidelines.  

The guidelines include the following instructions:

1.    Check temperature two times per day

2.    Finish regular course of malaria prophylaxis (malaria symptoms can mimic Ebola symptoms)

3.    Be aware of relevant symptoms, such as fever

4.    Stay within four hours of a hospital with isolation facilities

5.    Immediately contact the MSF-USA office if any relevant symptoms develop

These guidelines are consistent with those provided by the CDC to people returning from one of the Ebola-affected countries in West Africa. MSF is also implementing new federal guidelines outlining reporting requirements for people returning from Ebola affected countries.

Dr. Spencer followed those guidelines to the letter. When he noticed he had a fever of 100.3°F, not the 103°F as first reported by the media, he called MSF and remained in his apartment. MSF notified the CDC which set in motion NYC’s protocols for treating and removing a patient with a highly infectious disease to the hospital.

There was no reason for him to self-isolate prior to running a fever because the only known way to contract Ebola is direct contact with infected body secretions. The virus is not very hardy outside the human body, in that it cannot exist on a surface for more than 2 to 4 hours and is easily killed with bleach. The likelihood of contracting Ebola by anyone who came in contact Dr. Spencer is practically nil. Not even the family of the one fatality, who had close contact and were confined in the infected apartment, has become infected. The only people infected in the US have been two nurses, who had close contact with a patient in the end stages of the disease and may have come in contact with infectious body fluids because of inadequate personal protective equipment (PPE) or during removal of the PPE. The guidelines for PPE have since been tightened to include a buddy system putting on and removing the PPE and covering all exposed skin. Doctors and nurses caring for Ebola patients will be restricted from caring for any other patients and will monitor themselves for symptoms.

The bottom line is these infections are isolated and contained. There is no risk to the general public. So, please, stop listening to Fox Noise and Republican fear mongers like Peter King and Darrel Issa.  

Former Vermont governor and physician, Howard Dean discussed the Ebola crisis with Chris Hayes, host of MSNBC’s “All In”.

h/t Heather @ Crooks & Liars

Up Date: The second Dallas nurse infected with ebola will be transferred to Emory University Hospital in Atlanta, GA. The  Infectious Disease Unit is where the first two U.S. Ebola patients, both health missionary workers stationed in Liberia, were treated and released in August.

The Texas Department of State Health Services confirmed that a second health care worker has tested positive for ebola. The hospital, although it claims it is “equipped to care for patients in isolation,” it has become fairly apparent that there is a flaw in its protocols. The hospital has admitted it doesn’t know how the two hospital workers contracted the virus. That’s huge problem that continues to put the staff at great risk.

Dallas nurses have now come forward citing the flawed conditions in Ebola care

Deborah Burger of National Nurses United, who convened a conference call with reporters to relay what she said were concerns of nurses at the hospital, said they were forced to use medical tape to secure openings in their flimsy garments and worried that their necks and heads were exposed as they cared for Duncan. [..]

The nurses allege that his lab samples were allowed to travel through the hospital’s pneumatic tubes, possibly risking contaminating of the specimen-delivery system. They also said that hazardous waste was allowed to pile up to the ceiling. [..]

The nurses’ statement said they had to “interact with Mr. Duncan with whatever protective equipment was available,” even as he produced “a lot of contagious fluids.” Duncan’s medical records underscore that concern. They also say nurses treating Duncan were also caring for other patients in the hospital and that, in the face of constantly shifting guidelines, they were allowed to follow whichever ones they chose.

When Ebola was suspected but unconfirmed, a doctor wrote that use of disposable shoe covers should also be considered. At that point, by all protocols, shoe covers should have been mandatory to prevent anyone from tracking contagious body fluids around the hospital. [..]

The CDC said 76 staff members at the hospital could have been exposed to Duncan after his second ER visit. Another 48 people who may have had contact with him before he was isolated are being monitored.

This is unacceptable.

The CDC is now sending a team to oversee isolation procedures, especially the personal protection equipment (PPE) used by the staff, as well as, putting it on and removing it. It is the last part, removing the PPE, that is critical and, the most likely how these two nurses were infected. The PPE should be impervious to fluids. There should be no skin exposed and, as most news reporters have observed, it takes longer to take it off than don it. That’s the hard part and is done carefully, methodically and in multiple stages with decontamination at each stage.

The international medical aid organization, Médecins Sans Frontières (MSF), or Doctors Without Borders, has been in the lead with taking care of ebola patients in Africa and has written the book on safety procedures.

The New York City Department of Health has designated Bellevue Hospital in Manhattan as the center for treatment of the Ebola virus in the city. But if this picture is an example of the PPE the staff will be wearing, they are need to make so improvements and fast.

MSNBC’s Rachel Maddow examined the challenges for U.S. medical facilities of meeting the exacting protocols for handling Ebola, She pointed out how something as simple as a checklist can help as the rate of Ebola’s spread is forecast to increase rapidly.

In the day of i-pads and tablets, the use of a checklist in donning and removing PPE would help eliminate errors, make it easier to find flaws (human or mechanical) and lessen the possibility of a contagious disease like ebola from spreading to care givers and beyond.  

The 2014 Nobel Peace Prize was awarded on Friday to Pakistani Malala Yousafzai and Indian Kailash Satyarthi for “their struggle against the suppression of children and young people and for the right of all children to education.”

“Children must go to school and not be financially exploited,” The Norwegian Nobel Committee stated in a press release. “In the poor countries of the world, 60% of the present population is under 25 years of age. It is a prerequisite for peaceful global development that the rights of children and young people be respected.”

Yousafzai, 17, was shot in the head by Taliban militants in 2012 for having the temerity to seek an education. The Islamist militant group also took issue with her for publishing a blog in 2009 that promoted the right to education. [..]

Satyarthi, 60, is a children’s rights activist who has dedicated his life to helping the millions of youths in India and around the world that have been forced into slavery.

A former electrical engineer, Satyarthi has participated in countless peaceful demonstrations and protests against the exploitation of children. He has mounted raids on factories where children were forced to work, and helped free and rehabilitate thousands. Satyarthi also established Rugmark (now known as Goodweave), a group that aims to “stop child labor in the carpet industry and to replicate its market-based approach in other sectors,” and currently heads the Global March Against Child Labor, a conglomeration of 2,000 social-minded organizations and trade unions in 140 countries.

Congratulations to Ms. Yousafzai and Mr. Satyarthi for their wonderful work on behalf of children around the world.

Welcome to The Breakfast Club! We’re a disorganized group of rebel lefties who hang out and chat if and when we’re not too hungover  we’ve been bailed out we’re not too exhausted from last night’s (CENSORED) the caffeine kicks in. Join us every weekday morning at 9am (ET) and weekend morning at 10:30am (ET) to talk about current news and our boring lives and to make fun of LaEscapee! If we are ever running late, it’s PhilJD’s fault.

This Day in History

U.S. and Britain strike Afghanistan; Achille Lauro hijacked; Supreme Court pick Clarence Thomas faces damaging claims; Matthew Shepard beaten to death; Singer John Mellencamp born; ‘Cats’ hits Broadway.

Breakfast Tunes

Welcome to The Breakfast Club! We’re a disorganized group of rebel lefties who hang out and chat if and when we’re not too hungover  we’ve been bailed out we’re not too exhausted from last night’s (CENSORED) the caffeine kicks in. Join us every weekday morning at 9am (ET) and weekend morning at 10:30am (ET) to talk about current news and our boring lives and to make fun of LaEscapee! If we are ever running late, it’s PhilJD’s fault.

This Day in History

Breakfast Tunes

Welcome to The Breakfast Club! We’re a disorganized group of rebel lefties who hang out and chat if and when we’re not too hungover  we’ve been bailed out we’re not too exhausted from last night’s (CENSORED) the caffeine kicks in. Join us every weekday morning at 9am (ET) and weekend morning at 10:30am (ET) to talk about current news and our boring lives and to make fun of LaEscapee! If we are ever running late, it’s PhilJD’s fault.

This Day in History

O.J. Simpson found not guilty of murder at his criminal trial; St. Francis of Assisi dies; Germany reunifies; Baseball’s ‘shot heard ’round the world’; ‘Captain Kangaroo’ and ‘Mickey Mouse Club’ hit TV.

Breakfast Tunes

Welcome to The Breakfast Club! We’re a disorganized group of rebel lefties who hang out and chat if and when we’re not too hungover  we’ve been bailed out we’re not too exhausted from last night’s (CENSORED) the caffeine kicks in. Join us every weekday morning at 9am (ET) and weekend morning at 10:30am (ET) to talk about current news and our boring lives and to make fun of LaEscapee! If we are ever running late, it’s PhilJD’s fault.

ek is visiting family. He’ll be back next week with TechSci Thursday

This Day in History

Mohandes Gandhi born; President Woodrow Wilson suffers stroke; Thurgood Marshall sworn in as US Supreme Court justice; Rock Hudson dies; Peanuts comic strip debut.

Breakfast Tunes

The National Football League (NFL) has a problem with not just holding its players responsible for domestic abuse but with investigating itself on the issue.

On her show MSNBC’s Rachel Maddow reported that it isn’t just the Ravens’ Ray Rice beating his then fiance unconscious in an Atlantic City casino elevator but other players who have not only been charged but convicted of abuse and assault who are still playing.

In light of all the attention that the Rice incident has drawn and the inconsistent statements by NFL Commissioner Roger Goodell, there are calls for Mr. Goodell to resign or be fired. One of the NFL’s sharpest critics, ESPN’s Keith Olbermann took to the airways over the last several nights to chastise Commissioner Goodell

Last night, ESPN’s Keith Olbermann called on NFL Commissioner Roger Goodell to resign over the domestic abuse scandal surrounding Baltimore Ravens running back Ray Rice. In a new segment set to air tonight, Olbermann changed his mind: Goodell should not resign, the host argued – He should be fired.

It was a report from the Associated Press, claiming that law enforcement sent the video of Rice beating his then-fiancée unconscious in an elevator months before it was released by TMZ this week, that made Olbermann argue for the commissioner’s termination. Goodell had claimed that he had not seen the video until now.

“You have already forfeited your privilege of resigning,” Olbermann said to Goodell, saying that the only way for the NFL “to restore just the slightest credibility to the den of liars” that is the league would be for them to “fire you.”

Keith also ripped the commissioner for his appointments questioning the independence of the former FBI Director Robert Meuller and two team owners, who are his friends, to investigate.

And the calls for Goodell’s resignation go on: from David Haugh at The Chicago Tribune

Forgive me for not waiting with bated breath for the outcome of the so-called independent investigation of the NFL’s handling of the Ray Rice case.

Independent implies free of bias, which seems implausible for the panel the league assembled to evaluate the accountability of Commissioner Roger Goodell.

It will be led by former FBI director Robert Mueller, a partner in the law firm WilmerHale that recently helped the NFL negotiate a Sunday Ticket deal with DirectTV worth billions. It will be aided by two Goodell supporters who also happen to his bosses, owners John Mara of the Giants and Art Rooney II of the Steelers.

Apparently, Goodell’s uncle and cousin were busy. [..]

The idea of crisis management is to control damage, not create more. The NFL hiring rich, white male cronies as a checks-and-balance system for Goodell only enhanced the perception that the commissioner can’t be trusted regarding the Rice case. In trying to protect “the shield,” as Goodell likes to call the league, he keeps diminishing its brand. How many newspapers and websites in the country Thursday referred to the NFL as the National Football Liars? What’s the cumulative effect of universal criticism? [..]

When punishing the Saints organization in 2012 for the bounty scandal, despite denials by many that they were not aware of such a system in place, Goodell famously said that ignorance is no excuse. Ironically, Goodell’s words resonate loudest now. Ignorance is no excuse. [..]

Many owners probably will continue to back Goodell unless sponsors such as Marriott or FedEx threaten to sever ties with the league. Short of sponsors fleeing, the old boys’ club will point to the NFL’s second-least-valuable team, the Bills, selling recently for $1.1 billion as a sign that Goodell excels at the part of the job they consider most important.

Effective commissioners find ways to make money and a difference. Goodell no longer qualifies as one and should step down.