Ebola has returned to Liberia for the first time in months, and no one is sure how.
The return of Ebola in Liberia — with three new cases reported this week in the previously Ebola-free country — is worrisome, and raises questions about whether Liberia was really free of the disease to begin with, experts say.
The real problem is no one knows where these new cases came from. Needless to say, WHO is keeping a very close eye on the whole situation, as are a lot of people. But at least, Liberia is better prepared to deal with Ebola now.
Ebola has returned to Liberia for the first time in months, and no one is sure how.
It’s still there, and getting worse.
Before the November elections in the USA, you would have thought Ebola was going to spread across the States like wildfire, judging from the politically motivated fear-mongering in the media.
But the elections are over, and Americans have put their heads back into the sand. Meanwhile, thousands of West Africans suffer from the disease.
The number of people with Ebola in west Africa has risen above 16,000, with the death toll from the outbreak reaching almost 7,000, the World Health Organisation (WHO) says.
The number of deaths is more than 1,000 higher than the figure issued by the WHO just two days ago, but it is thought to include deaths that have gone unreported in the weeks or months since the outbreak began. Most of the new deaths were recorded in Liberia.
The WHO has warned that its figures could be a significant underestimation of the number of infections and deaths. Data from the outbreak has been patchy and the totals often rise considerably when backlogs of information are cleared. The latest confirmed data shows that almost half those known to have been infected with Ebola have died.
One noteworthy tidbit from the Guardian article. Two girls who came to the UK and were suspected to be carrying Ebola were not found to be carriers of the disease. Their names and ages were not released.
Nice to know some media agencies value the public’s privacy.
When long-time HIV researcher Rick Elion looks at America’s hysterical reaction to Ebola, he says it almost gives him post-traumatic stress disorder. Just after HIV/AIDS was discovered, in 1983, schools closed down, patients were treated like untouchables, and fear-based policies were enacted to isolate those suspected of carrying the virus.
Recently, a 2-year-old girl with ebola traveled from Guinea to her home in Mali. The girl sadly died, but doctors in Bamoko, Mali, knew within hours of testing her that she was carrying the virus, enabling quick treatment of the girl’s relatives and safe handling of her body. This lab is why.
Level-3 biosafety facilities have negative air pressure. They have backup systems and alarms should a ventilator malfunction. Their humidity and temperature are controlled. Air goes in but it does not go out. There is an autoclave, work hoods, boxes of gloves, paper towels, and bottles of disinfectant. Sound doesn’t move between the interior and the exterior. Ebola is designated a level-4 biosafety virus in Europe, America, Singapore and Australia: handling it requires showers, dressing procedures and total isolation from the rest of the building. But no level-4 facilities exist in West Africa—the nearest is in Gabon. So in April, when the disease was proving its tenacity in neighboring Guinea, American doctors saw the threat and nominated Bamako’s level-3 lab capable of diagnosing Ebola. That is how a room designed to protect researchers from TB and HIV became a room where they could also defuse the world’s scariest bug.
Mali’s officials are not panicking, unlike American politicians. They have not sealed the borders. They are letting science dictate their response to the ebola outbreaks in Guinea, Sierra Leone and Liberia.
For Sarro and Kone, diagnosing Ebola is no more frightening than diagnosing anything else. They joked in the BSL2 room that Ebola is a delicate bug, easy to break. Tuberculosis, which is airborne, is far scarier. For a molecular biologist, “at our level, the virus is always dead,” said Kone. Are they surprised to have identified Ebola in Mali? “No, it was a matter of time” said Dr. Koita. They are confident that if the government and health ministries track contacts and push public hygiene, Ebola will not last. Some responders are less sure. We eat bananas and soda in the break room after pumping hand sanitizer.
Because everybody knows that healthcare professionals are looking to endanger the public. Why else would they choose their profession?
The state sent a letter yesterday to members of the American Society of Tropical Medicine and Hygiene, which is holding its annual conference in New Orleans next week. If they’ve recently been to any of the West African countries where the virus has infected more than 13,000 people, they shouldn’t attend the meeting.
“We do hope that you will consider a future visit to New Orleans, when we can welcome you appropriately,” said Kathy Klieber, Louisiana’s Secretary of Health & Hospitals and Kevin Davis, director of the Office of Homeland Security & Emergency Preparedness, in the letter.
“We do not want to have to legally enforce in-home quarantine,” Mary Mayhew, commissioner of the state Health and Human Services Department, said at a news conference. She wouldn’t comment on Hickox’s case specifically, but Hickox’s attorney told the Bangor Daily News that his client — who was quarantined against her will in New Jersey upon her return to the U.S. — “doesn’t want to agree to continue to be confined to a residence” beyond two days.
More details at ABC News: Nurse Kaci Hickox ‘Will Go to Court’ Over Maine Ebola Quarantine Rule
Andre Aggasi was once the spokesperson for Canon cameras. The tag line was “Image is Everything”.
That applies to politics as much as it does to cameras and photography.
Two politicians who take that to heart more than most are Gov. Chris Christie of New Jersey and Gov. Andrew Cuomo of New York. Both have presidential aspirations, and both appear to be using the current medical crisis in Africa (and its spillover effect locally) to distinguish themselves from other prospective and actual candidates for president.
Both are governors of states whose main airports are international gateways and are two of the five airports through which 94% of all passengers from Liberia, Sierra Leone, and Guinea travel. And both initially sought mandatory 21 day quarantines for medical personnel who are returning from working with Ebola patients.
Since Dr. Craig Spencer self-reported that he had a fever and the NYPD/FDNY took the necessary precautions that he might have Ebola (since confirmed), the governors have engaged in a shifting policy battle about who and when someone will be quarantined.
Both governors have shifted their stances in public pronouncements. First they both indicated a blanket mandatory quarantine, which later shifted to self-reporting, though Gov. Christie denies that he modified his position. That’s blatantly false. Josh Marshall points out the pretzel spin and logic of Gov. Christie:
In Florida yesterday, Christie was asked why he’d shifted his policy in releasing Nurse Kaci Hickox and allowing her to return to Maine. His answers were simply false on two counts. First he said that she’d been symptomatic for Ebola and was running a fever. Neither appears to be true.
According to her undisputed account, she was briefly shown to have a fever using a forehead strip thermometer which showed a slight fever, apparently because she was upset and stressed. Whatever the reason, a subsequent oral thermometer reading showed no fever. That almost certainly means she never had a fever. Nor has there been any suggestion that she had any symptoms of Ebola. So Christie’s claim that she was symptomatic for Ebola, but then saw her symptoms go away, is just false.
When asked if he’d reversed his decision, Christie denied any change in policy and said she would only have been forced to remain in isolation, “if she continued to be ill. She hadn’t had any symptoms for 24 hours and she tested negative for Ebola. The reason she was put in the hospital in the first place was because she was running a high fever and she was symptomatic … The minute she was no longer symptomatic she was released.” (emphasis added)
Again, based on everything we know about Hickox’s care, this is false. She was never symptomatic for Ebola and she never had a fever with the exception of one reading which was apparently contradicted a short time later by a more accurate test.
Nor was there any need for her to be symptomatic under the policy that the two Governors announced. The explicitly and expressed goal of the policy was not to hold people who were symptomatic but to hold everyone who’d treated Ebola patients in West Africa in isolation for 21 days in case they became symptomatic. Again, these are Cuomo’s and Christie’s own words.
So Christie is not only lying about the specifics of Hickox case he’s also claiming the policy says something different from what he said it was when he announced it.
Marshall further points out that it seems that both governors are pushing health policies that appear without any consultation with actual health experts. I wonder just who exactly is behind Christie’s policy here - especially since he took great pains to announce and identify an Ebola team that included top health officials in the state. Did they have a say in the policy, and what was their basis in medical and health policy? So far, they haven’t been heard from since Christie spoke.
And yes, I’ve seen the nj.com report that a Nobel prize winner in Medicine seems to support a quarantine for medical workers, though he (or perhaps it is the report itself) that seems to ignore that there are symptoms other than fever that can indicate that the person is symptomatic with Ebola. The doctor notes that there is a percentage of people who never show a fever but are symptomatic with Ebola. Omitted from the report is the bit about how there are other symptoms that include fatigue, weakness, etc.
That’s why the fever indicator isn’t a good indicator of whether someone has Ebola - there are undercounts (persons never show fever, but are symptomatic in other ways), or overcounts (person has fever from unrelated condition).
Christie instead pushed for and got a political solution to a medical issue, and says that he’s not changed his position, even though he had called for a medical quarantine in medical facilities, but changed that tune to allow the nurse to self-quarantine at home in Maine instead.
Christie and others have pointed to the medical correspondent from NBC News as proof that a voluntary quarantine isn’t enough. People should minimize contacts where possible, but if they’re not symptomatic, then they aren’t going to spread the disease. The guidance is to check for symptoms regularly and to check in with health authorities at the slightest change in condition.
To date, there have been far more false positives - those who were taken to facilities with suspected cases that were later ruled out (such as the five-year-old in NYC that was suspected of having Ebola but was found to have a respiratory ailment instead), than false negatives - such as where someone got Ebola from unannounced cases that came into the country and spread from other as yet unidentified sources.
Moreover, is Gov. Christie imposing quarantines on any of those health workers at Bellevue who live in NJ and are working in direct contact with Dr. Spencer? After all, they’re at risk of contracting the disease and spreading - without going to the epicenter of the epidemic in West Africa. Somehow, I doubt he’d have much success with that - and spin furiously to distinguish the two.
Since writing this yesterday, the confusion over exactly what New Jersey is doing has only grown. Despite the governor saying that they haven’t changed their policy since announcing it over the weekend, it’s not clear what even that policy is and who’s formulating it.
That contrasts with the NY policy, which clearly spells out what people should do.
Yet four days after he and the governor of New York announced the 21-day quarantine for high-risk travelers, neither Christie nor state health officials have offered details about how this will be accomplished.
If people are quarantined at home, can their families stay with them and still go out? If they are alone at home, is someone going to bring them food? What about high-risk travelers who are passing through the airport in Newark — should they be allowed to continue to their destination?
Those and many other questions remain unanswered — Christie officials said specifics about how the mandate will be enforced are “internal documents” and are not public.
What’s more, some of the agencies that are supposed to be enforcing the plan say they are uncertain about protocols because no policies have been presented. There is growing frustration, officials said. The Port Authority, for instance, had received no guidance from New Jersey health officials about the state’s Ebola response protocol as of Tuesday afternoon, a person familiar with airport operations said.
“Clarity would be incredibly helpful,” said the person, who requested anonymity because the person was not authorized to speak about the protocols.
In contrast, New York health officials circulated guidelines for screening at JFK International Airport on Tuesday, in a document that stresses “a respectful and supportive approach” to implementing the quarantine rules. It provides steps for agencies to follow to determine who should be quarantined, where they will stay and even how they will be transported.
And that they haven’t made it public also adds to the legal woes facing the state for trying to enforce a policy that appears to be thrown together with no actual input from health officials or legal staff, despite the Governor putting together a committee that has both health and legal officials involved.
The way New Jersey is going about this quarantine isn’t going to pass legal muster, because those rules should be available and distributed to all relevant agencies and departments so that there’s uniform understanding of what they are. Rather, the governor is going to approach this ad hoc. That’s no way to run things.
Elsewhere, a Connecticut family has filed suit after their child was told to stay home from school over Ebola fears. The family recently returned from a trip to Africa, but had not traveled to one of the three countries struggling with the current outbreak. They had visited Nigeria, which managed to stop a cluster of cases in Lagos several weeks ago. They have been outbreak free since then.
But it points to the ludicrous lengths to which some people will deny access on account of Ebola. People, including politicians, seem to have no idea of the geography involved, or that there are separate countries involved in this outbreak. Others think that all of Africa is somehow affected, even though it’s a tiny portion of a continent with more than one billion people living there.
A 5-year-boy who recently visited West Africa tested negative for the Ebola virus on Monday, said the New York City Health Department and the city hospital where he underwent screening.
“By forcibly detaining people we are also frightening the public and may deter genuinely sick people who fear quarantine from seeking the treatments they deserve, while also discouraging caregivers and first responders from helping sick patients who need their assistance,” said Ofer, adding, “This is a challenging time for New Jersey, but decisions must be made based on sound medicine, and not on fear. Governor Christie must provide more information to the public about how the state came to the conclusion that mandatory quarantine of our healthcare workers was medically necessary.”
The headline may sound like more fear-mongering, but the message is not, “Close the borders and go into panic mode,” like we hear on American media.
The reason we should be scared is the piss-poor, close the barn doors after the horses run off job the developed nations are doing in West Africa.
We have one chance to stop this awful disease in its tracks, this year.
In 2015, that option will be gone.
Mass media is too busy generating the wrong panic — the infinitesimal chances of Ebola in the US now, rather than how to roll it back it in West Africa.
The UN is reduced to begging and being ignored.