Oz Slams Door, Media Pissed

Try reading the straight facts here, then go to the Reuters link to see what the full story looks like when you editorialize all over the front page.

(Reuters) - Australia issued a blanket ban on visas from West African nations affected by the Ebola outbreak. Australia has recorded a number of scares.The decision to refuse entry for anyone from Sierra Leone, Guinea and Liberia, was [explained] by the government as a necessary safety precaution.
"The government has strong controls for the entry of persons to Australia under our immigration programme from West Africa," Immigration Minister Scott Morrison told parliament on Monday.
"These measures include temporarily suspending our immigration programme, including our humanitarian programme from Ebola-affected countries, and this means we are not processing any application from these affected countries."
All non-permanent or temporary visas were being cancelled and permanent visa holders who had not yet arrived in Australia will be required to submit to a 21-day quarantine period, he added.

Meanwhile, back home, MD officials have reported another possible US case, and they're hiding the details because it would obviously become politically sticky to admit they've either got another travelers from one of the Big Three afflicted countries bringing the disease here, or another careless do-gooder dilettante doing the same thing.

A Maryland hospital has received a potential Ebola patient, a facility spokeswoman said.A patient was transferred to University of Maryland Medical Center at the request of state health officials and was being treated in isolation, a spokeswoman said Monday night.
The spokeswoman would not say where the patient was transferred from or whether they had recently arrived in the country. Maryland announced Monday plans to quarantine and ban from public transit those who travel to the state from three West African countries where Ebola continues to spread.

The only possible reason to withhold basic details is to prevent people from finding out that "official policy" has let another infected person roam and wander their area at will with the full connivance of government authorities ostensibly responsible for ensuring such doesn't happen. It might even underline, as Thomas Duncan's arrival did, that the so-called "screening" measures are completely ineffective, and merely a sop of security theatre to placate the easily-bamboozled who barely glance at the news between consuming their bread and circuses.
And the so-called "ban on public transit" is a completely unmonitored and unenforceable policy of asking, pretty please, that people under imaginary quarantine kindly not create additional panic by traipsing all over town on busses and such when, with a tedious regularity, they suddenly show symptoms of Ebola, causing the local health officials to have to scrape egg off their faces before furiously running hither and yon to track down all the new secondary exposures. Like in New York City.

Well-done, Maryland. President Obola approves.
The sheep there are truly fortunate to have such dedicated shepherds.

A Little Link-Love: Represent!

Over on the right sidebar, you'll see a fairly short blogroll of medical/nursing blogs I regularly visit.

It's short because for whatever reason, nursing and medical bloggers simply don't last. They burn out, run out of words, time, or motivation, and then they quietly die on the vine one day. I've only been at this for about a year and a half, and I've already buried three of them, and a few more over there are on life support waiting for someone to pull the plug.

But under the heading of "A Picture Is Worth A Thousand Words" is one over on Tumbler that just seems to keep going and going like the Energizer Bunny:

                                                     What Should We Call Nursing?

If you want to understand nursing without getting a degree, and being elbow-deep in someone else's really vile bodily fluids on a holiday weekend at 3AM, go there.

The recipe is simple:
Take one Universal Nursing Truth, illustrate it with a short looped .gif/clip from somewhere in the culture - TV, movies, etc. - that didn't start out to have anything to do with nursing (but does in the right context), and get an essay on nursing that only takes about 1-3 seconds to grasp.

The results are, in a word, brilliant.
And more often than not, require a Beverage Alert, to avoid hot, cold, or carbonated fluids shooting out your nose.
I have lightened my mental load and killed a bit of time surfing that blog for a little humor when things quiet down on a busy shift. (Don't tell the hospital IT guys, that makes them crazy!)

I bring this up because the second current offering is Ebola-related. I missed it when it was new, because things have been a little busy at the keyboard lately. But since no small number of folks are tuning in here to stay current on the topic, it's appropriate. 

The site also chalks up "likes".
There are 702 for this particular offering, so far. As most of the visitors there are probably nurses, like myself, make of that informal poll what you will.

And the WSWCN blog deserves a long-overdue shout out anyways, so it might as well be for this.

Enjoy.

More restrictions, Same Level Of Intelligence - updated

MINNESOTA:

Medical Personnel potentially exposed to Ebola while treating patients in west Africa will be confined to their homes for 21 days when they return to Minnesota, state health officials announced Monday, as authorities across the nation continued grapple with appropriate safeguards against the deadly virus.

Gov. Mark Dayton, joined by experts including the Health Department’s chief attorney and a leading University of Minnesota bioethicist, said such restrictions might be burdensome, but they would give the state the best chance to keep Ebola from spreading if someone brings the virus into the state.

“My number one priority is to do whatever will best protect all Minnesotans from exposure to this disease,” Dayton said.

Restrictions would vary for other travelers returning from Liberia, Guinea and Sierra Leone — the three nations at the center of the Ebola outbreak — depending on their perceived risk levels, state officials explained. Those who simply traveled to those countries to visit relatives would be asked to submit to daily health monitoring when they return to the state. Health care providers who cared for Ebola patients but had no known exposure to the virus would not need home confinement. Health care providers with potential exposures, such as being stuck with a needle while caring for an Ebola patient, would be confined at home.                                            Minnesota has the added concern of a robust population of 30,000 residents from Liberia who might travel back to the country or host relatives from there. All travelers returning from the West African nations would be subject to travel restrictions. Those potentially exposed to Ebola during their travels would be banned from public transportation, while all travelers under monitoring would be asked to refrain from trips using public transportation lasting longer than three hours.

 Because apparently not being exposed, and travelling around for LESS than 3 hours is totally cool; like say, getting meatball sandwiches, or going bowling.
But hey, they're being "asked to refrain".
Maybe they could try that out for all other threats to the community, like robbers and such.
Jackasses!

FLORIDA:

(AP) Florida Gov. Rick Scott is ordering twice daily monitoring for anyone returning from places the U.S. Centers for Disease Control and Prevention designates as affected by Ebola.

Scott signed the order Saturday, giving the Florida Health Department authority to monitor individuals for 21 days. Scott said in a press release that his administration had asked the CDC to identify risk levels of returning individuals from specific parts of Guinea, Liberia and Sierra Leone, requesting information specifically about the risk level for four people who had already returned. His office said that the CDC had identified the four individuals who faced some risk but had not provided the levels of risk.

"Therefore, we are moving quickly to require the four individuals who have returned to Florida already - and anyone in the future who will return to Florida from an Ebola area - to take part in twice daily 21-day health evaluations with DOH personnel," he said.

Thus both states get to perform CYA, make it feel like they're "doing something", but without either actually pissing off Washington D.C. minions, or actually protecting the public.
Genius. These guys could trade Magic Beans for cows.

These beans are GUARANTEED to protect you from Ebola!

 

UPDATE:

Georgia says "Me six!":

Georgia Governor Nathan Deal is ramping up monitoring for all travelers coming to Georgia from Ebola-affected countries.
“We are taking every necessary precaution to ensure that Georgia stands prepared to manage the risks associated with Ebola,” Deal said.
Atlanta's Hartsfield-Jackson International Airport is one of five airports in the U.S. that is a designated point of entry for travelers from Guinea, Liberia and Sierra Leone.
"I have developed, in coordination with my Ebola Response Team, a policy to more aggressively monitor travelers from affected countries, symptomatic or not, and quarantine if need be. We are taking these proactive steps to protect the health of the people of our state, and this new policy is an altogether effective and appropriate response at this time," Deal said.
Previous policy for West African travelers required checking for symptoms and isolating any symptomatic passengers. In accordance with Deal's plan, travelers who show no symptoms will be placed in one of three categories for further monitoring.

• Category 1, high risk – Travelers with known direct exposure to an Ebola patient. Travelers in this category will be subject to quarantine at a designated facility.
• Category 2, low risk – Travelers from affected area with no known exposure to an Ebola patient. Travelers in this category will sign a monitoring agreement with the Georgia Department of Public Health. This agreement requires travelers to conduct temperature and symptom self-checks twice per day and report results to Public Health once per day (electronic, email or phone contact acceptable). Travelers who fail to report during the 21-day incubation period will be contacted by Public Health and issued a mandatory quarantine order if necessary.
• Category 3 – Medical personnel actively involved in treating Ebola patients returning to the United States. Individuals in this category will be issued a 21-day active monitoring order and will be visually monitored (video communications or home visit) by Public Health twice per day. Public Health will assess for the development of symptoms and adjust restrictions as necessary. Noncompliance will result in quarantine at a state-designated facility.

Tommy This

 

(Reuters) - The U.S. Army has started isolating soldiers returning from an Ebola response mission in West Africa, even though they showed no symptoms of infection and there was no incident signaling potential exposure, the Pentagon said on Monday.The decision goes well beyond previously established military protocols and came just as the White House pushed to roll back steps by U.S. states to quarantine healthcare workers returning from countries battling Ebola epidemics, even if they showed no symptoms of infection.
The Army has already isolated about a dozen soldiers at part of a U.S. military base in Vicenza, Italy. This includes Major General Darryl Williams, who oversaw the military's initial response to the Ebola outbreak in West Africa.
Williams is the head of the U.S. Army Africa, which is based at Vicenza, and the senior Army officer at the base.
"They're not allowed to leave," said Colonel Steve Warren, a Pentagon spokesman.
Dozens more troops would be isolated in the coming days as they rotate out of West Africa, where the U.S. military has been building Ebola treatment facilities to help health authorities treat Ebola victims, the Pentagon said.
"There was no single triggering event. This is really a decision that's made out of an abundance of caution," Warren said.
The Army is the only service to implement such a move. The only personnel who have rotated out of the operation so far have been from the Army, Warren said.
But a U.S. military official, speaking on condition of anonymity, told Reuters that discussions were under way about taking similar action across the U.S. armed forces.

I see. So this is fine for soldiers NOT directly working with infected Ebola patients every day for months, even those up to the rank of Major General, who can't sue over this, and are actual heroes 24/7/365/forever.

It's just not okay for Nurse MiMi Bitchypants Crybaby, who WAS working with infected Ebola patients every day for months, because it interfered with her vente latte, a tofuburger, and cuddle time with male cohabitant, and she (horrors) had to sleep in a tent. Yeah, the Pentagon will get right on that complaint too.

Got it, thanks for clarifying how this is all "based on science".

Crunching Numbers

 

So, tiring of the Usual Gang Of Idiots screwing up everything they can with both malignant incompetence and depraved indifference, I thought I'd look at the updated numbers on the primary outbreak in West Africa (Guinea, Sierra Leone, Liberia, and momentarily, Mali) for a little mental respite.

The numbers are quite simply bollocks.
The consistency is their inconsistency, which is what happens when you depend on the honesty, intelligence, literacy and numeracy of countries where a flush toilet is an object of suspicion and wonder, and books are for kindling fires.

Liberia regularly skips entire weeks, getting their numbers to WHO on the local equivalent of "Island Time": "It gonna git dere when it get dere, brah."
And that's before it embarrasses some oafficial (not a typo), or inconveniences a family with an extra chicken for bribing whoever's filling out the death certificates today, or someone waves their arms and yells "customary burial rituals". (And here you thought Diversity was only a PITA in the U.S. of A.)

The rule of thumb has been that the actual tally of infected and dead is 2-2.5 (and lately they're saying more like 3 a  lot) times the number of "official" cases of Ebola.

Looking at the case expansion rates since September 1st, both overall and by countries, the actual modifier should be between two and eleventy. Any other attempt at precision, or claims of same, is a cross between monkeys throwing darts at a graph, and witchdoctors doing magic. It's probably in fact monkey witchdoctors throwing darts at a magic graph.

The trendline is that cases are now doubling every six weeks, instead of the former doubling of every three. Except that such happy news is modified by the fact that everyone there is screaming about how much worse it's getting, which is why they put windows in cockpits, along with instruments. When the dials all say you're doing great, but the windshield is full of the ground rushing rapidly to meet you, it isn't the windshield that's not working.

So it's gotten so bad at this point over there, that we have no idea how bad it is, or how much more rapidly that's happening.

Just to complete this coup of The Retarded led by the Illiterate, we're evidently importing fresh Ebola cases here at about the rate of 1 per week or two, pretty much precisely as the recent Lancet study suggested was going to happen.

And while our own retarded leadership is entirely to blame for that, just random probability says that pretty soon, it's going to start happening in London, Paris, Rome, and Australia, where they at least have lots of medical care worthy of the name. And in Cairo, Mumbai, Delhi, Manila, and Jakarta, where they most certainly do not.

What can be guaranteed, is that Mali will not be the exception. The caseload there will not stand at 1. Australia will not keep ducking this bullet. And eventually, it's going to get somewhere with an enormous population density, crap medical care, and zero public health ability, and drop 20 or 50 or 200 cases on them like a house falling in Oz from Kansas.

And if we keep juggling the lit road flares while standing in the gasoline-filled wading pool, we're going to get another imported Index Patient here who infects 10 or 20 people, and quietly expires in his flophouse without running to the ER, because he can't, or won't. And those people are going to float around thinking they have the flu, because flu season, and they won't be African, or have made any recent African journeys, and they'll get the Duncan Protocol.

So when, two-eight days later they come back in, bleeding out of everywhere from their eyes to their asses, all the shit-eating grins at CDC, the White House, and the hairdo news programs won't help them, or you, or anyone else. There won't be any BL4 beds for 10 or 20 people, because we don't have them. There won't be any isolation at the local hospital.
And the smart people who work there will GTFO, because they're not all the same dumbshits as Doctor Ebolawalker Spencer, or Nurse Typhoid Mary Hickox. So they'll clock out, and the people left behind will be the least bright, not the most bright. Every occupation has that ten percent at the bottom of the gene pool, including healthcare.
Just ask a malpractice attorney.

The administrators and spokesholes who've lied to everyone about "handling this problem" won't have anything to point to that explains how they can take care of people when their clinical staff elects to say "Hell no" and heads for the employee parking lot. (And if you think there's going to be loyalty to those institutions after the last few years of belt-tightening and having ObamaCare shoved down their throats, let me offer you a dose of reality: they're going to trample people on the way to their cars, and with smiles on their faces.)

And at that point, everyone else will have choices to make: go to work, knowing what assholes people are when it comes to staying home with the flu; or go on in, and risk getting a lot more than just that from the guy who's always coughing and wiping his nose on his sleeve from November to April.

Then stores start emptying out. Interstates fill up. Trucks and trains and power and water stop flowing. And government either starts putting up barricades, or abdicates, and lets the mob run the show.

How rapidly that all happens is anyone's guess, including mine.
Think of how calm and orderly people are for Black Friday shopping at Wal-Mart, or driving out of the parking lot after the ball game, and you tell me how warm and fuzzy you feel about things staying calm.

Everybody's had a dozen warning shots across the bow over this.
It's all fun and game until it lands in your lap.

So what it comes down to, as always, is what you're prepared to do to deal with this.
Ain't nobody ducking that choice indefinitely.

Carpe diem, bitches.