Two schools in the Solon School District in suburban Cleveland are closed Thursday as a precaution because a staffer "traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft," as [Dallas Ebola nurse No. 2] Vinson . . . .That's a tremendous over-reaction. In contrast, we're under-reacting to patients when they get wildly contagious: Texas Health Presbyterian workers who dealt closely with Patient Zero in last day or two of his life probably shouldn't have touched any other patients until they'd burned their clothing and submerged themselves in pure bleach for an hour. I'm not sure they shouldn't dust off and nuke the site from orbit; it's the only way to be sure. I kid, I kid, the hospital probably doesn't need to be decommissioned, but failing that, at least they should have implemented Level 4 precautions, which have proven their efficacy at Emory and elsewhere. Instead, it took a doctor a couple of days to muse mildly in some medical charts that they might want to consider wearing disposable shoe covers rather than track contamination all over the hospital. I imagine they're trying to clean the whole hospital up now, but it's not where I would choose to be admitted just now, frankly. So I was very encouraged to hear that the second infected Dallas nurse has been transferred to Emory. Now we just have to wait and see who else was infected in Dallas. More nurses? Other patients? The pizza delivery guy?
If public officials are hoping that there's a single workable protocol for dealing with a potential Ebola patient that can be implemented on the first day suspicion arises and maintained unchanged until the patient either recovers or is interred, they need to rethink their strategies. A difficult and expensive fanatical level of care is both feasible and non-negotiable for very small numbers of patients during brief, critical periods. It's neither necessary nor feasible for the general public on a permanent basis. On the other hand, we're going to have to exercise a minimum of ordinary care on a permanent basis--including appropriate quarantine for high-risk travelers--if we don't want to have to exercise the fanatical level of care for more people than even a rich country can handle at one time. If we keep out ahead of this disease, it will be a blip on the radar. If we let it get out ahead of us, we're going to do some serious damage. Do I feel personally at risk? No, I can't say I do, but that doesn't mean this is anything to be criminally negligent about. Panic is serious business, and we seem to be doing our level best to induce a fairly well-justified one.
The possibility of losing is very real- as R.Fernandez likes to point out, we have burned our design margin doing things like building wheelchair ramps in deserted cities and establishing the special legal rights of left handed Eskimo amputee jugglers. And worse, the PTB have spent decades building a facade that these things were important, the kind of stuff modern powerful societies have to do. So we end up with NASA stating Muslim outreach is their main goal, and the CDC devoting themselves to gun control. A parallel could be drawn with the military, many times a long period of peace will tend to promote the nice ass-lickers , then when a real, existential war comes along the need for all those crude, tough , randy fighters becomes apparent- if we are lucky we have time to find them again, assuming of course the will is there. The left has had the cushion of that design margin, in many cases daddy's money, their entire lives- they have never had an existential threat and may not believe it is even possible for them to be the recipients of such- "it could never happen here". Trouble, is, the money's gone.
ReplyDeleteOf course they've had existential threats! Right-to-work laws, the lack of public funding for sex-change operations, and voter i.d. laws.
ReplyDeleteYou think life as a progressive is easy?
I gather from a few things I've seen that some things (dialysis, for example) are just not worth doing for an ebola patient. (I am not a doctor.) If they need an extreme intervention that badly, they are going to die anyway, and you may as well focus on palliation. Which, since they become more infectious by the hour, should probably be done someplace outside the hospital proper.
ReplyDeleteAm I missing something?
I don't know about that. I tried reading up on it. Emory seems to think dialysis makes sense. We can't treat Ebola directly, so what we do is provide heroic support while waiting for the body's immune system to deal with it. Dialysis seems to be an effective support strategy.
ReplyDeleteHeroic measures may or may not work on the first few patients. It will cost the same regardless of success or failure- given 200, 2000, or 20,000, it will be a fantasy. At that point we will have a triage station in a tent, like Monrovia.
ReplyDeleteScale is everything.
The heroic measures have a good track record, particularly with people who were previously in good health and who began treatment immediately upon onset of symptoms. The important thing seems to be to keep blood pressure up and protect the kidneys long enough to give your body a chance to clear the virus. And that's before we even consider the use of potential curatives such as ZMapp or blood serum from a recovered patient. It's a dangerous disease, but it's not inevitably fatal, unlike (fast) rabies or (slow) HIV. Even in the horrible conditions in Africa, nearly half of the people who get it survive. Firestone did very well with its primitive clinic.
ReplyDeleteIf you like your Obola, you can keep your Obola. If you don't like your Obola, you'll be required to work and keep it.
ReplyDeleteIf you like your Obola, you can keep your Obola. If you don't like your Obola, you'll be required to work and keep it.
ReplyDelete