Even More on the Ebola Outbreak

Imagine for a moment that you’re a screenwriter.

You’re working on a sequel to Outbreak, and a major plot point is that the nurse who has been exposed to the disease is told by the CDC that it’s ok to fly with a low grade fever.

Do you think there would be resistance to the realism of this point in a pitch meeting?

Reality is stranger than fiction, because this has now happened.

It’s not too often that I underestimate the incompetence of a governmental agency, but I have to admit I did so with the CDC. I thought their protocols to control a potential outbreak of Ebola would follow basic common sense.

Never have I been so wrong.

Amber Vinson, an ICU nurse at Texas Health Presbyterian Hospital, was one of the people who treated Thomas Eric Duncan, the US’s first diagnosed Ebola patient. There are what appears to be reliable reports that she contacted the CDC either before her flight to Cleveland, or before her flight back, and reported that she had a low grade fever of 99.5.

Remarkably, the CDC gave her the go ahead to fly. Certainly, at the time, one would have suspected that it was the flu, or anything other than Ebola. But the prudent thing was not done, and now potentially hundreds of people have been exposed.

And, to be fair, Vinson deserves some of the blame as well. As a nurse, she knew better.

The good news is that indications are that the disease is not particularly contagious in its early stages. None of Duncan’s family members nor the ER he reported to have contracted Ebola, and we’re now beyond the usual 21 day window.

And most of these people were around Duncan with absolutely no protection.

On the other hand, it appears that the disease may be especially transmittable in its late stage. This is likely helped by coughing that causes the virus to aerosolize.

In other words, the risk to the general public is still low (although Vinson’s jaunt to Ohio was stupid), while the risk to healthcare works is real.

This latter risk is made worse by the blundering CDC. As I said in a previous post, it’s been clear for some months that Ebola was going to make it to our shores. In that time, the CDC should have been working on answers to the many questions that the healthcare system was going to have. Questions like:

  1. What is the proper way to triage and hospitalize potential Ebola patients, while maintaining the functionality of as much of your hospital as possible?
  2. How does one handle disposable items that have been exposed to Ebola?
  3. What is an effective way to disinfect non-disposable items?

These questions should have had answers before anyone was actually diagnosed with Ebola. That our healthcare system is still waiting for these and other answers is nothing short of dereliction of duty by the CDC, in its most important and core mission.

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