I am not fearful of an outbreak of Ebola in the United States as a result of the turn of events that landed an infected person in Dallas.
Public health authorities will not leave a stone uncovered along the trail of contacts left by the patient.
What I am concerned about is the assumption by public health authorities that the United States is fully capable of defeating an outbreak of the disease within our borders.
CDC Director Dr. Tom Frieden assured us in no uncertain terms that the medical establishment is up the challenge. Within days, his confidence has been repudiated.
Dr. Frieden might be the best physician in the world for all I know, but he lacks common sense when it comes to gauging human behavior.
You see, one cannot count on infected persons to share all of their pertinent, personal medical information. One cannot depend on trained medical personnel to connect the dots even when they are arrayed in front of them. Finally, one cannot depend on the government to make the lives of citizens and residents a priority.
The patient, Thomas Duncan, although he informed the ER at Texas Health Presbyterian he had traveled from Liberia, did not bother reporting he had been in contact with an infected person exhibiting full symptoms of the disease. Given the sorry state of knowledge about geography in our nation, it is possible Liberia’s location on a map did not click with the ER staff responsible for taking the patient’s information. And just why did our government allow anyone traveling from West Africa to enter without being quarantined? Taking someone’s temperature at the point of departure is ineffective screening for a disease with an incubation period as long as 21 days.
Other facts are equally disturbing regarding the dangers from this procedural breakdown.
The disease is spread by the exchange of secretions. Mr. Duncan was visiting his girlfriend. Need I say more?
He came in contact with children. Children are secretion machines both at home and in the play yard.
About 20 people had direct encounters with Duncan, no telling how many had indirect contact.
Public health workers will be hard-pressed to monitor the 20, not to mention search for other possible secondary or tertiary contacts.
The official death toll in West Africa is around 3,500, a marked increase from just a few weeks ago. All medical professionals acknowledge that the number is a gross understatement.
Would it be too much to ask our government to quarantine passengers from the afflicted areas, if not ban all non medical travel until the outbreak has burned itself out?
We have more than enough medical priorities here.
Likewise, I was uncomfortable with Dr. Frieden’s overconfident remarks that it can’t happen here. It doesn’t sound much different than those of the Secret Service’s protocols, systems and circles of security for the White House! Didn’t people say the Titanic was unsinkable?
We should be careful of hubris.
The one thing that I have not heard anyone mention to this point are the planes that Mr. Duncan flew on. I would think that those two planes should be quarantined as they did with the ambulance that took him to the hospital in Dallas. Just because he didn’t have a fever at the time does not mean that the virus was not in his system. It had to be just from the timing.
Great article, Paul.
Stuart Simen
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