EBOLA CONTROVERY GROWS

One never hesitates to take on the mighty New York Times and their higher-than-high claim about printing accurate information.

The Times recently, commenting on the infectiousness of the Ebola virus, published the following, "people infected with Ebola cannot spread the disease until they begin to have symptoms, and it cannot be spread through the air."

The good editors at the Times obviously have never heard of--or worse yet, chose to ignore--the term "viral sloughing." In the case of  a well-known and widely spread affliction today, Herpes, it is believed to be infectious during a "sloughing phase" when the person infected with the virus is totally asymptomatic.

People can debate what they want about the differences, but they are viruses and viruses, like you and me, want to survive. And viruses mutate. Some of the information from the recent outbreak suggests that's already happened since the last outbreak owing to the increased temperatures being recorded in those newly infected cases.

In fact, one could argue that we humans are just giant two-legged viruses roaming the planet and every time we build up antibodies to fight off an infectious disease it's a form of mutation to survive.

As the Ebola controversy heats up, here are some guidelines being provided to health care workers who work in certain clinic environments to follow when a patient may come in complaining of Ebola-like symptoms or expresses he might have been exposed to someone with the disease.

 1. Make every effort to keep your distance from the patient--at least three feet--and avoid any contact with possibly contaminated surfaces and any direct contact with the patient.

2.  Get the history and review of systems from a distance at least three feet away from any contaminated area or the patient.

3. Based on your evaluation, categorize the patient as a) unlikely infected b) likely exposed or possibly infected

4. If infection unlikely, proceed as usual

5. If asymptomatic but may have been exposed to Ebola, notify local health officials.

6. If symptomatic and possibly infected, place patient in room, put Do Not Enter sign on door, immediately notify local public health officials or call 911.

7. Do not make any attempt to decontaminate room once patient is gone and do not enter room until cleared by public health officials.


Does any of this sound reassuring to you? It's taking precautions at best.

Another issue is how long will it take public health officials to decontaminate a room or an entire area?  In a worse case scenario one can see whole areas shutdown and people quarantined, not to mention a logjam that might well develop owing to the volume of places that need to be decontaminated.

The controversy about quarantining health care workers returning from areas where they have been helping victims is now pitting the White House against various states like New York, New Jersey and Mr. Obama's home state, Illinois. The states are right on this one.

In the new millennium, the centuries-old strategy of quarantine is becoming a powerful component of the public health response to emerging and reemerging infectious diseases. During the 2003 pandemic of severe acute respiratory syndrome, the use of quarantine, border controls, contact tracing, and surveillance proved effective in containing the global threat in just over 3 months. For centuries, these practices have been the cornerstone of organized responses to infectious disease outbreaks. However, the use of quarantine and other measures for controlling epidemic diseases has always been controversial because such strategies raise political, ethical, and socioeconomic issues and require a careful balance between public interest and individual rights. In a globalized world that is becoming ever more vulnerable to communicable diseases, a historical perspective can help clarify the use and implications of a still-valid public health strategy.

http://www.cdc.gov/quarantine/historyquarantine.html

The other controversy here is whether Ebola is an airborne threat. And the real answer to that is no one, not the New York Times or 60 Minutes or Mr. Obama's top advisers, virologists or otherwise, at this point knows for sure
  
One can call it precaution all he or she wants. But precaution is often a euphemism for: "We don't have a f****** clue!" And like it or lump it, that's just about where we are right now.

If Ebola turns out positively not to be airborne, it will be the exception, not the rule.