You agreed with the layman's definition of "airborne" and despite knowing that droplet infection is absolutely possible, you continue to claim that Ebola isn't "airborne"--the general public's definition of "airborne." If the "man on the street" were asked, "what do you call it when a sick person coughs or sneezes infected droplets near a healthy person and the healthy person becomes ill?" That "man on the street" is going to say, "it's airborne."
Coughing and sneezing are not common Ebola symptoms but we are moving into cold and flu season. Do the authorities assume that Ebola is kept at bay by an adenovirus? I doubt that. Coinfection is an issue.
I do not know what these supposed "lies by omission" are.
Fomites. That's the greatest omission to date. The authorities never list environmental contamination as a vector. Why is that? It's not amenable to the parsing done with the droplet vector. Then there is the droplet vector, which is parsed to be technically correct but still misleading in light of the general public's definition of the term.
Commission: telling people they are perfectly safe unless an Ebola patient is vomiting blood all over their shirts. That's so wildly inaccurate, one can only conclude that the authorities have something other than infection control as a focus. What that is I can only guess but none of the guesses are flattering.
Ebola is spread by droplets, fomites, and direct contact with infected bodily fluids, none of which are airborne transmission. While it is true that someone could be in the path of a droplet (for instance, from a patient vomiting blood) and be exposed that way, that is not airborne transmission. It is transmission through direct contact with infectious fluid.
Okay, we'll play it your way. By your own assertion you've laid out the authorities' dishonesy. I've yet to see, hear or read anyone talking about fomites or droplets. Not a single word. According to official pronouncements one must be vomited or bled upon by an infected individual to become ill. Is that not a lie by ommision?
Second, I think most people try to avoid those who are coughing and sneezing. Third, it is very unusual to be within 3 feet of someone who is vomiting blood or is having diarrhea. I don't think I would approach anyone vomiting blood--would you?
So you're asserting that viral particles are not shed until the patient is in the last stage of illness. That is inaccurate. Viral shedding, according to the authorities, begins when the patient becomes febrile. One develops the fever days, in some cases many days, before the gastrointestinal lining begins to slough off.
My scenarios are those people who are unaware of their exposure, develop a fever, toss down some Tylenol and go on about their day. The next day they're nauseated but assume it's a stomach bug so take some more Tylenol and go about their day. Those people are the ticking time bombs, unknowingly spreading viral particles everywhere they go and exposing everyone they encounter--on mass transit, in the restaurant, at the office, etc. etc.
Earlier you wrote:
There are many things that are not known about Ebola, and of course, it is impossible to make statements about what is not known. I see no problem with the MSF statement or the WHO pamphlet.
Which of your facts are known and which are assumptions? Recall that this is an entirely new strain that hasn't been studied like Zaire, Congo, Reston, etc. How much of what you're writing do you know is fact based on data? How much is assumption based upon the characteristics of Zaire?
Authorities have never once told the public, "there is much we don't know about how this new strain of Ebola spreads and behaves in the human body." That is an obscene lie by ommision. That's why I linked to the WHO communication document. Throughout that document they insist that the public be told that unknowns exist and officials should avoid making statemnts of fact that are not known to be fact. Once a "fact" has been disproven the effect upon the public's trust is severe.
I think viral shedding is occuring before the onset of fever. How long before I don't know.
In another twist, the third US physician infected believes he was exposed while performing a cesearean on an HIV+ woman who was not febrile.
WebMD: Third American With Ebola Evacuated to Nebraska
Sacra told his wife he thought he might have been infected by a patient with HIV who had also contracted Ebola, according to Doug Sacra.
One of the ways ELWA hospital tests patients for Ebola is by checking their temperature before they’re admitted. If they’re not running a fever, they’re treated as being free of the disease, he explained.
A fever is one of the first symptoms of Ebola infection. It’s the body’s way of beginning to mount a defense against the virus.
A patient with HIV, who has a weakened immune system, may not have been able to run a fever in response to the infection, and thus would have mistakenly been thought to be Ebola-free.
Sacra believes he may have performed a C-section on such a patient, his brother said.
I couldn't bring up the video you linked to, my firewall doesn't like it, but in the text it is noted that the patient was in shorts and a t-shirt. It isn't clear in the text but it seems the crowd developed when the PPE-clad followers were chasing the patient down. It's good that the people in the market have learned to keep their distance from someone known to be infected. That does nothing to stop the spread, however, since it's the unknown infected that are most dangerous.
Time will tell who among us is right and who is wrong. I think there will be an unbelievable amount of pain, suffering and death beforehand, though, and I'm not looking forward to it.
I think the motivation is pretty clear, almost transparently so.
On August 16, 2014, the CDC sent out a health alert message that contained the following language:
NEW Stigma Key Messages
West Africans in the United States and elsewhere may face stigmatization (stigma) during the current Ebola outbreak because the outbreak is associated with a region of the world.
Stigma involves stereotyping and discriminating against an identifiable group of people, a product, an animal, a place, or a nation.
Stigma can occur when people associate an infectious disease, such as Ebola, with a population, even though not everyone in that population or from that region is specifically at risk for the disease (for example, West Africans living in the United States).
Stigma occurred among Asian Americans in the United States during the SARS pandemic in 2003.
Communicators and public health officials can help counter stigma during the Ebola response.
Communicate early the risk or lack of risk from associations with products, people, and places.
Raise awareness of the potential problem.
Counter stigmatization with accurate risk information about how the virus spreads.
Speak out against negative behaviors.
Be cautious about the images that are shared. Make sure they do not reinforce stereotypes.
Model good behaviors; engage with stigmatized groups in person and through social media.
In April 2003, when SARS was spreading in North America and 166 suspect cases were under investigation in the US, Julie Gerberding, Bush's CDC chief, said the following:
"There are some very specific issues that are of concern to CDC right now. One is that we are hearing reports, internationally, about some stigmatization that's occurring among people in the Asian community.
It's very important that people appreciate that this is a respiratory illness caused by a virus, probably a new virus, and is a disease that is an infection of great medical consequence but it is not a disease that is in any way related to being Asian or to the fact that Asia happened to be the place where we first recognized cases.
So we want to ask people's support and help in appreciating how difficult this is for the affected people and how we really need to take the high road here and recognize that this is a time when all of our communities need support and empathy, not stigma or bias or shunning that has been reported in some international press.
In part to address that, CDC has established a community outreach team and we are working with various communities, in particular the Asian community, to understand what are the issues, what are the best ways of providing information to the community and languages, and formats that are accessible to the individuals who are concerned or affected by this problem, and we will be continuing to work aggressively to provide factual information and hopefully reduce some of the stigma that could evolve."
So, consistently over 11 years (actually much longer), a major concern of the premier disease control entity on the planet has been avoiding discrimination.
Okay, at this point, it looks like you have a mental block against understanding the difference between airborne and droplet transmission.
Airborne is something that infects by particles suspended in the air. It is like smoke, but invisible. Think about how smoke fills a room and stays in the air until you open a window and let it out. If that smoke were an airborne virus like measles, anyone walking into that smoky room would get sick. If someone outside were close to the window when you opened it, that person could get sick.
Droplets are like a spritz of Windex from a spray bottle. You can stand at one end of the room and spritz Windex into the air all day long, and the most that will happen is that a big wet spot appears on the floor a short distance from where you are spritzing.
In the case of Ebola, the patient isn't even sneezing (analogous to spritzing the Windex). Since the virus is in the blood, not the epithelial cells of the respiratory system, even if the patient developed another illness (unlikely, given that he/she is in isolation where no exposure to a respiratory virus will happen), a sneeze or cough can't aerosolize virus or expel it into droplets. I've seen some reports that Ebola is highly susceptible to drying, meaning that even if it were shed into aerosols, it would not survive to infect someone else.
Almost all cases of Ebola can be traced to direct contact with a sick person. The few remaining cases either do not remember touching a sick person, or may have been infected through fomites. The transmissibility of Ebola in fomites, although recognized as a potential, has not been established through rigorous research.
Coughing and sneezing are not common Ebola symptoms but we are moving into cold and flu season. Do the authorities assume that Ebola is kept at bay by an adenovirus? I doubt that. Coinfection is an issue.
Colds and flus are not seasonal on the equator.
Fomites. That's the greatest omission to date. The authorities never list environmental contamination as a vector. Why is that? It's not amenable to the parsing done with the droplet vector. Then there is the droplet vector, which is parsed to be technically correct but still misleading in light of the general public's definition of the term.
Fomites are routinely mentioned as a potential vector, despite the fact that fomite transmission has not been established through rigorous research. Even if fomites exist, one reason that researchers won't find them is that surfaces in patient treatment areas are routinely sprayed with bleach. When a patient is removed from a house, the house is sprayed with bleach. No one is taking chances. It's pretty hard to establish that fomites can be vectors when everything is disinfected daily, if not more often.
I should point out that Africans refuse to enter houses where someone has had Ebola. They're refusing to pick up dead bodies. Not much of a chance of them getting Ebola like that, but they are subjected to the stench of rotting flesh.
Commission: telling people they are perfectly safe unless an Ebola patient is vomiting blood all over their shirts. That's so wildly inaccurate, one can only conclude that the authorities have something other than infection control as a focus. What that is I can only guess but none of the guesses are flattering.
You won't get Ebola by being in the same room or next room as an Ebola patient. You have to be within a few feet, or actually physically touch that patient.
Are you aware that there have been at least 25 outbreaks of Ebola prior to the two current outbreaks?
Think smoke. If Ebola were airborne, we would have seen a pandemic starting in 1976, at the time of the first outbreak. We cannot stop airborne viruses--have you never noticed that every year, influenza sweeps around the world in a few months, and we've never been able to prevent its spread?
Okay, we'll play it your way. By your own assertion you've laid out the authorities' dishonesy. I've yet to see, hear or read anyone talking about fomites or droplets. Not a single word. According to official pronouncements one must be vomited or bled upon by an infected individual to become ill. Is that not a lie by ommision?
I am utterly amazed that you know more about the spread of Ebola than the researchers and health care providers who work with it every day. I'm amazed that you know more about it than even the experts and authorities who read the medical literature about Ebola every day. How do you know so much that the experts don't?
So you're asserting that viral particles are not shed until the patient is in the last stage of illness. That is inaccurate. Viral shedding, according to the authorities, begins when the patient becomes febrile. One develops the fever days, in some cases many days, before the gastrointestinal lining begins to slough off.
The virus is shed in contaminated bodily fluids--blood, fluids derived from blood, and fluids which are contaminated with blood (for instance, sweat from an area next to a minor cut). Symptoms include vomiting and diarrhea--all it takes is for a little blood to get mixed in with those fluids for them to become contagious. BTW, not all patients become hemorrhagic, not even all those who die. They die of multiple organ failure.
My scenarios are those people who are unaware of their exposure, develop a fever, toss down some Tylenol and go on about their day. The next day they're nauseated but assume it's a stomach bug so take some more Tylenol and go about their day. Those people are the ticking time bombs, unknowingly spreading viral particles everywhere they go and exposing everyone they encounter--on mass transit, in the restaurant, at the office, etc. etc.
Highly unlikely. When symptoms appear, they hit hard. And if a person has a mild case, no vomiting, no diarrhea, they are unlikely to be shedding.
Which of your facts are known and which are assumptions? Recall that this is an entirely new strain that hasn't been studied like Zaire, Congo, Reston, etc. How much of what you're writing do you know is fact based on data? How much is assumption based upon the characteristics of Zaire?
My facts and statements are based entirely on extensive reading of the relevant medical literature about Ebola. This outbreak is Zaire, which is the most thoroughly characterized of all Ebola viruses.
Authorities have never once told the public, "there is much we don't know about how this new strain of Ebola spreads and behaves in the human body." That is an obscene lie by ommision. That's why I linked to the WHO communication document. Throughout that document they insist that the public be told that unknowns exist and officials should avoid making statemnts of fact that are not known to be fact. Once a "fact" has been disproven the effect upon the public's trust is severe.
Really? I watched a panel discussion of Ebola on CSpan yesterday. Everyone on that panel was very careful about what he said about Ebola. They stuck to what is known. One even referred obliquely to Donald Rumsfeld's "unknown unknowns." I have not seen a single instance in that panel or anywhere else of experts claiming that everything is known, or omitting to mention known facts.
I couldn't bring up the video you linked to, my firewall doesn't like it, but in the text it is noted that the patient was in shorts and a t-shirt. It isn't clear in the text but it seems the crowd developed when the PPE-clad followers were chasing the patient down. It's good that the people in the market have learned to keep their distance from someone known to be infected. That does nothing to stop the spread, however, since it's the unknown infected that are most dangerous.
Here is the youtube video. In case you cannot watch the youtube video, I will describe the scene. The man is clad only in t-shirt and shorts, no shoes. Any cuts on his feet can contaminate soil. There are a LOT of people at that market. Remember smoke, and how it penetrates everywhere? If that man were aerosolizing virus through the respiratory route, everyone in that sizeable crowd that gathered to watch would have been exposed, and there would already be a few cases. He is trying to escape four heavily clad health care workers, while another man in scrubs is following them, spraying the ground where the man walked with bleach. They finally corner him, talk to him, and wrestle him into a pick-up, while the crowd cheers.
The spread of Ebola is almost always through direct contact. The reason this outbreak continues is because we haven't managed to spread the message to everyone in the area about avoiding contact. Many of those people STILL do not believe Ebola is a real disease. We have to get on top of those two issues to stop the outbreak, and that is where we are having difficulty.