In my lifetime the term "airborne" has been used by non-medical/non-scientific friends, family and acquaintances to mean "a disease that may be caught by inhaling the infected exhalations of another person." I think that's a fair definition of the layman's understanding. We both know that by that definition, Ebola is "airborne." I agree that the general public has no concept of the varied degrees and definitions applied in medicine but honestly, that makes the lies by omission that much worse IMO. Instead of announcing the facts, they weasel out of it by saying "technically Ebola is not transmitted by droplet nuclei, the most effective means of airborne transmission." That's going to be a real comfort to those who sicken and die because they inhaled infectious droplets while crammed on a subway or in an amphitheater or wherever, shoulder to shoulder with an infected (and likely unaware) person and clueless of the risk. Patients who picked up three Ebola particles from the elevator button will be relieved to know that the authorities were "technically correct."
MSF and WHO have squandered their credibility with me over the past couple of months for this very reason. MSF has the following heading their Ebola site:
What is EbolaEbola is a virus that can kill up to 90 percent of the people who catch it, causing terror among infected communities. Ebola can be caught from both humans and animals. It is not an air-borne disease. Human to human transmission occurs through close contact with bodily fluids of an Ebola-infected person. Patients need to be treated in isolation by staff wearing protective clothing. Supportive care can help the patient survive longer, and the extra time may just be what the patient’s own immune system needs to fight the virus.
The WHO, in the irony of the age, has a document on their site offering advice on official communications during an outbreak. According to their own document, creating and maintaining trust between officials and the public is critical during outbreaks. They insist that the public be given ALL relevant information to allow individuals to take appropriate precautions which in turn reduces or eliminates mass panic. Read it, it's a short document, and compare it to what we're hearing and reading from officials.
WHO Outbreak communications guidelines
I cannot count the number of times I've read statements from authorities along the lines of "as long as you aren't kissing corpses or mopping up vomit/blood you can't get Ebola." That meme is rapidly failing as we watch doctor after doctor sicken and die. The epidemiologist with no patient contact is interesting, too.
Droplets, however, fall, and so only people within a short distance of the patient (about a meter or so) risk exposure. Droplets do contaminate surfaces, but it is easier to avoid touching surfaces than it is to avoid breathing aerosols.
I simply don't know how to respond to this. How many common, everyday events meet the criteria of being less than 3 feet from someone coughing and sneezing? Mass transit, elevators, lines at a store, classrooms, school buses. . .. "Easier to avoid touching surfaces." Perhaps, if the general public knows they need to consider surfaces potentially dangerous. Have you noticed that none of the medical authorities are talking about that problem? It never comes up in offical statements regarding transmission vectors. We have a population intentionally left in the dark regarding both droplet inhalation and surface contamination risks.
Reasonably intelligent people are listening to the authorities pronouncements, watching video reports of physicians and staff clad head to toe in PPE contracting and dying of Ebola, and noticing the conflict. These people may not be scientists or medical personnel but they're smart enough to realize that it doesn't add up.
So much for that trust thing.
Panicking that Ebola is poised to start a pandemic that could wipe out over half of earth's population is *not* appropriate.
I don't know how many people will die from this outbreak but I think it will be a lot, somewhere in the millions. Given what's happened to date I see no serious effort to implement effective epidemiological controls, eg enforced quarantine. The man who took it to Port Harcourt and the doctor who treated him in a hotel room are precisely the kind of people who will spread this far and wide. I certainly don't believe that Americans are protected from it. We're just farther down the infection chain.
When I’ve seen the more elaborately equipped medical personnel using self contained breathing apparatus and oxygen tanks when dealing with these patients and I compare the statements of ‘it’s not airborne just droplets’ with the reality of the docs in space suits...I ask myself what the folks with the oxygen tanks know that we don’t?
And that actually is fairly accurate. An airborne disease is spread because viruses or bacteria within a fluid are shed when the fluid evaporates, for instance during the act of breathing when there is a high pathogen concentration in the upper airways. Airborne particles can remain suspended for hours and are carried on the breeze--you do not have to be in the same room with an infected person to breathe contaminated air.
We both know that by that definition, Ebola is "airborne."
Ebola is not airborne by that definition or any other.
I agree that the general public has no concept of the varied degrees and definitions applied in medicine but honestly, that makes the lies by omission that much worse IMO. Instead of announcing the facts, they weasel out of it by saying "technically Ebola is not transmitted by droplet nuclei, the most effective means of airborne transmission."
I do not know what these supposed "lies by omission" are. As far as I can tell, health officials making public statements about Ebola are being as accurate as possible about the disease. 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.
That's going to be a real comfort to those who sicken and die because they inhaled infectious droplets while crammed on a subway or in an amphitheater or wherever, shoulder to shoulder with an infected (and likely unaware) person and clueless of the risk. Patients who picked up three Ebola particles from the elevator button will be relieved to know that the authorities were "technically correct."
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.
To illustrate why knowing the difference between droplet/fomite/direct contact transmission and airborne transmission is important, I have linked a video: Ebola patient escapes quarantine centre in search of food. In this video, a man escaped from the hospital and went to a local market looking for food. The people at the market recognized that he was an Ebola patient, and kept their distance (about 10 feet or so). However, they were curious, and gathered in large numbers outside of that distance. The only people who got near the man were wearing the full protective gear. I noticed that several people were running around spraying (probably bleach) wherever that man walked. That's to kill any virus that he might have spit or bled.
If Ebola were airborne, that incident would have potentially exposed hundreds of people--anyone downwind of him--and spraying bleach where he walked would have no effect whatsoever.
I simply don't know how to respond to this. How many common, everyday events meet the criteria of being less than 3 feet from someone coughing and sneezing?
First of all, coughing and sneezing are not Ebola symptoms. 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?
Reasonably intelligent people are listening to the authorities pronouncements, watching video reports of physicians and staff clad head to toe in PPE contracting and dying of Ebola, and noticing the conflict. These people may not be scientists or medical personnel but they're smart enough to realize that it doesn't add up.
The physicians and other medical personnel are wearing full PPE while treating patients, but that doesn't mean they can't come into contact with someone who has Ebola and has not presented for treatment or with surfaces contaminated with virus (aka fomites) when they are not caring for patients. There are also issues with whether they are wearing the PPE properly.
I don't know how many people will die from this outbreak but I think it will be a lot, somewhere in the millions. Given what's happened to date I see no serious effort to implement effective epidemiological controls, eg enforced quarantine.
There is a lot going on--contact tracing, and so forth. I do not think this outbreak will extend into the millions. I think that as more people become educated about the disease and begin to realize that it is, in fact, real, they will be more likely to adhere to the infection control measures communicated by the authorities. The bottom line is that this disease is not spread so much by characteristics of the virus, but by human behavior.
If you look at the video I linked, it appears that people *are* getting the message about the virus--they *do* realize that it is real, and not some conspiracy against them.