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.
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.