If Ebola Arrives In The U.S., Stopping It May Rely On Controversial Tools

Forbes ^ | 8/12/2014 @ 7:53AM | Dr. Scott Gottlieb

[Qiviut]

Considering the nature of the Ebola virus, and the medical infrastructure we have to combat its spread, the diagnosis of some cases on American soil shouldn’t be reason to panic. We have a plethora of tools and public health practices to readily combat its spread. Yet because the virus is so dangerous, and feared, its arrival in America would likely to trigger a robust response from our public health establishment.

[pfflier]

Both HIV/AIDS and ebola started from a "patient zero".

AIDS was spread first through ignorance of the vector mechanism then denial that a certain group was prone to spread it. By the time the mechanism was firmly defined the disease was way out of control and is now embedded (accepted) in our society.

I predict that the civil libertarians will dilute any effort to contain ebola by quarantine as race based . The outcome will be the same as AIDS. We will be forced to accept it through social pressure rather than prevent it's spread through sound medical practicees.

[I want the USA back]

Wanna take bets on how long it takes before you read “First Confirmed Case of Ebola in USA”?

Wanna take bets that the first thing the pres says is “There is no danger to the public”?

[grania]

Do you trust the CDC (etc) to appropriately use regs?

I don't trust all hospitals and insurance plans to not play it for maximum profit when one ends up in quarantie.

[NormsRevenge]

Pure set-up.. let diseased cross our borders and even fly them here.. then declare martial law and a national emergency, no travel allowed.

never underestimate the ends the evil Left and its operatives will stoop to..

[Bill93]

One thing I learned from going though hurricanes, grocery stores only carry enough food to feed the surrounding communities for about 3 days under normal circumstances, not 30. Of course, some people will end up with plenty of food and others will have none.

For the record, in my aforementioned experience with hurricanes I had plenty of food, but ended up getting bored with eating the emergency stuff we had stored up. We weren’t able to obtain fresh meat or vegetables (or anything with sugar in it) for at least a week after the grocery stores reopened. Two and a half weeks of eating mostly canned food sure makes you appreciate a good steak, that’s for sure.

[stanne]

Controversial steps. Right.

How about the controversial step of no flights out of the area until it has abated? Or closing the border? Or not bringing it here?

Oh no we can’t do that we have no right to infringe on others

We CAN infringe on the rights of Americans, though. That’s not a problem. Americans deserve abuse for neglecting the world

We

[stanne]

Eh, last week.

[Political Junkie Too]

Step 1 will be to confiscate all the guns. Just because.

-PJ

[Qiviut]

Step 1 will be to confiscate all the guns. Just because.

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For sure, this is one crisis they wouldn’t let go to waste in a big way

[Billthedrill]

This is a difficult and very controversial area of legislation, as it has to do with the suspension of clear constitutional rights (i.e. no confinement without due process) in the case of a public emergency. Of course that sort of thing is subject to outrageous abuse; that's why it's controversial.

One reason it hasn't been "fully updated" in decades is that back when these laws were originally written they were tested up through the Supreme Court (and largely upheld). A full review of these would probably need to include that process, especially given the changes both in medical science and in politics since the Yellow Fever days (those, incidentally, go back to the country's founding).

The balance and the controversy are exemplified by the response to AIDS in the 80's. Reagan is widely criticized in the gay activist communities for "not doing enough" to abate the epidemic, for that's what it was. What he could have done under the old legislation did include house arrest, mandatory quarantine, even confinement to quarantine camps, for those who showed symptoms of the disease. Does testing as HIV+ apply? Never been tested in court, it wasn't possible when the law was written. Now gay concentration camps, which is how they would have been portrayed in the media, would have been obviously politically infeasible, and so the federal government did not proceed along those lines. But the flip side of that issue - few gay activists want to broach the topic, but Randy Shilts did - is how many gay men who would be alive today if they had, who died because they didn't.

That's why this sort of legislation is so difficult to get any sort of consensus on, much less passed through the courts. It's very dangerous stuff. Am I paranoid enough to think that an administration so blatantly corrupt as the 0bama administration would attempt to achieve political and social engineering goals under its cover? It isn't paranoia at all, a cursory look at how they have behaved since 2008 could lead to no other conclusion. That trust is all gone, and it was vital to accomplish an honest review of the laws. What we did have was not an honest review, it was the loophole-laden patchwork that the article details. This is, as I stated, very dangerous stuff, but it is also dangerous to let it continue in this state, with all those little surprises that are exploitable by those of evil intent.

[LambSlave]

The Problem is that the CDC does not have the infrastructure or personnel to provide for the safety of the persons involuntarily quarantined, even with a limited outbreak. With an epidemic, they would be the enemy.

They would need to provide individual rooms, with walk through autoclave for persons going in/out, autolock/airtight doors, ability to rapidly and throughly sanitize between patients, uninterrupted power supply, dedicated non-recirculating ventilation system,etc. They could not have people share rooms with even one other patient (or the innocennt uninfected would wind up infected as well). Such involuntary quarrantine areas would likely be crowded death camps. I'd die before I voluntarily became involuntarily quarrantied, unless I suspected I actually had the disease, and even then my odds might be better at home.

[Kartographer]

There are already plenty of dead from the neck up at least.

[Qiviut]

Great post .... I absolutely agree, especially with this (why I posed the last questions ... ‘do you trust ...’):

“This is, as I stated, very dangerous stuff, but it is also dangerous to let it continue in this state, with all those little surprises that are exploitable by those of evil intent.”

For me, the threat from those of “evil intent” (many in our present government”) is scarier than the threat of Ebola itself.

[LambSlave]

See my post #32. Legislation or not, Supreme Court testing or not, any rational person who values their life would fight and die before they submitted to being involuntarily quarrantined if they did not believe they were infected.

[angry elephant]

I don’t think it will spread far here. Our cities are not nearly as densely populated, and in our culture we don’t touch each other or have as close of contact,”

It probably would be a good idea not to use buffet style restaurants or restaurants with a lot of Hispanic looking people. Also to wash all store-bought fresh produce more thoroughly in case it has been improperly picked and handled.

[LucyT]

Ping to post # 31.

.

[VideoDoctor]

This all looks and sounds like the stage is being set, here in America, for the emergence of it and acceptance of it.

If that happens you have just received a MAJOR SIGN that America has LOST its COMMON SENSE.

[Neidermeyer]

The public health system in this country didn’t appropriately use quarantine to control AIDS. Why would we expect things to change for Ebola?
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The public health system in this country encourages the spread of HIV/AIDS by demanding that infected persons be released from informing others of their infection.

[Smokin' Joe]

Ebola spreads throught the same mechanism as AIDS, contact with bodily secretions.

Yes, and no.

Unfortunately, Americans have been conditioned to think "sex" when the term "bodily fluids" is used.

There is no indication that contact need be sexual in nature at all to contract Ebola, and considerable reason to believe that direct contact with the infected person is not even necessary.

It only takes 1 to 10 viral organisms to infect a person with the disease. Any break in the skin, contamination of any mucous membrane (the eye, for instance), or ingestion of the virus and you are done. If someone is sick and there are droplets in the air and you inhale one, that could be all it takes.

That's a far cry from the more intimate bloodborne pathogen exchange with AIDS.

The virus can live on surfaces, even after the blood, sweat, tears, or spittle have dried. With that in mind, consider the surfaces of common contact in an American urban environment.

Door handles, keypads, handrails, elevator buttons and ATMs, checkout counters and currency, the list is endless, right down to the seat on the bus.

Effective isolation would not only mean isolating the infected and symptomatic person, but anyone they had had direct contact with (shake hands?), and anyone those persons had had contact with would have to be watched as well.

Considering the potential numbers, area exclusion and isolation would be a minimum to contain the disease with a high probability of success, and that would depend on whether anyone traveled out of that area.

Nigeria may show us how far things can spread, and teach us more about how it spreads if more cases appear. It is not yet fully understood if infected people shed the virus even before becoming symptomatic, but it is suspected to be a possibility.

We do not know how easily the virus can be transmitted because most of the known victims have been in situations where opportunities for contact with heavy viral loads abound (especially funerary preparations and medical caregivers)--the latter have been heavily represented in the victims, and 170+ are dead in this outbreak--people who generally were taking some sort of precautions and who understood as a rule that there was risk of contracting a lethal disease.

I think we may be at greatest risk if we become complacent, even careless comparing Ebola to say, AIDS (which requires deviant behaviour as a general rule to contract), because Ebola does NOT require such behaviour.

In one of the affected countries ten motorcycle taxi drivers have died of the disease, and the possibility that in at least one case, the only contact was the passenger hanging on and sweating on the driver raises the question of transdermal absorbtion of enough virons to become infected without requiring either sexual contact or an open wound.

Likely the biggest obstacle in controlling Ebola would be the people themselves--those who perceived themselves as healthy would not want to be within the cordon and would make every attempt to escape it, and if infected, carrying the disease with them in an attempt to escape what they believed to be certain death by remaining.