Tuesday, January 1, 2019

Year End/New Year's Ebola Update

As multiple commenters elsewhere have observed, we've brought an M.D. exposed to Ebola in DRC, but asymptomatic and not contagious, back to Nebraska for observation.

Ok, fine, so far.

This is how it's supposed to work for everyone exposed, even TV spokeshole doctors and whiny Mimi Crybabypants "nurses" who think they should have the right to run hither and yon and hopefully not start infecting people when they pop a fever. Or not. Because they're special, and the sun shines out of their anuses, apparently. Contrary to quarantine policy and black-letter health laws going back 700 years.

Sending the guy to quarantine at Nebraska Medical Center is fine too, as it's home of one of the four BL-IV treatment centers with the 11 actual BL-IV beds extant in North America, should that become necessary, and their patient becomes symptomatic.

The gaping flaw in what they're doing is that they plan to observe Doctor Oopsie for two weeks - fourteen days.

But Ebola Virus Disease incubates for between 1 and 25+ days, NOT JUST 14 DAYS(!), and while 99% of cases appear in 25 days or less, 1% of cases don't show up until after 25 days.
(Another very small but non-zero percentage of persons exposed are asymptomatic, but may still carry the disease and be infectious without symptoms. Nobody is talking about that last part, either, because if you pretend it doesn't exist, you don't have to deal with it. Until you do.)

Geniuses in action, right there.

It will be cold comfort to anyone subsequently infected if they stop checking Dr. Oopsie on Day 15, and he doesn't become symptomatic, and thus infectious, until Day 18, or 23. Especially if he celebrates the end of his quarantine at the mall or movie theater, coughing out virus onto random passersby.

If you're going to half-ass a quarantine (and clearly, they ARE doing exactly that in this case), better to not do one at all, and just tell people to kiss their asses goodbye, because - EXACTLY LIKE IN 2014 - TPTB are playing roulette with the entire populace, because for them, that's more convenient.

Sleep tight.
And cross your fingers.

Oh, and that Congo outbreak itself?
As we warned, it's accelerating out of control, growing from 503 cases on 11/30 to 692 cases as of 12/21, a week ago. IOW, more new cases in the last 21 days than the total number of cases for the first ten weeks from August to mid-October.
The experimental vaccine is still, AFAIK, 100% effective, but the outbreak has blown through every containment ring like a brushfire in a gasoline-soaked forest.
Buckle up. 2019 is looking seriously fugly.
And that doctor is just the first case we're watching.
He won't be the last.

And for those unwilling to follow this closely, bringing him here is not the problem.
Bringing back 12 or more symptomatic patients is the problem - because we don't have that 12th Ebola bed - as is cessation of his/their infection monitoring before the likelihood of infection gets to at least a 99% chance of safety.

And if you bring 100 exposed people back, that statistically guarantees that one of them will be the 1% long period incubation that you'll release into the wild here, and we're off to the races.

A quarantine has traditionally meant 40 days ("You could look it up." - Casey Stengel), and that standard should apply yet again, in this case. Six weeks' surveillance, not two.
Anything less is rolling the dice, and we're all the chips in that wager.

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