A patient who has recently traveled to West Africa at Texas Health Presbyterian Hospital of Dallas has a confirmed case of Ebola. There will be a CDC conference this evening with local Dallas officials.
See:
KERA News @keranews 57m 57 minutes ago Dallas patient tested for possible #Ebola.
“We want to caution Dallas County residents not to overreact.”
http://bit.ly/1rDjBEM @keranews
As my children go to a pediatric clinic across the street from Texas Health Presbyterian Hospital of Dallas, this hits close to home.
The CDC’s “Risk communications” have gone to DefCon-1. The Dallas County Health and Human Services director Zachary Thompson has been on local media this morning with the following message:
“This is not Africa,” DCHHS Director Zach Thompson said. “We have a great public health infrastructure to deal with this type of disease.”
Notably missing was any mention of the Ebola fomite threat (AKA human body fluids with Ebola in them) in an urban environment.
I will try and keep you up to date on the latest local Dallas CDC “Ebola Risk Messaging.” Don’t expect the MSM to be of any use during this outbreak. You need to start reading the PANDEMIC FLU INFORMATION FORUM and the Free Republic EBOLA SURVEILLANCE THREAD for the latest real Ebola news updates, as opposed to MSM delivered “Risk Messaging.”
See:
http://www.singtomeohmuse.com/viewtopic.php?t=5725&postdays=0&postorder=asc&start=2655
and see
http://www.freerepublic.com/focus/chat/3191066/posts?q=1&;page=1#1
Wish all the folks in Dallas good luck. We are going to need it in the days ahead.
When you really need an intelligent government, the one you have will prove ineffective.
Thanks for your good wishes — I live in Plano TX, a suburb — but I think in the absence of rather bad luck the risk isn’t a big deal. It’s not really good news, but compared to other occasionally-lethal headaches like murder, traffic accidents, or house fires that I don’t much worry about, it doesn’t seem to be serious bad news either.
The disease doesn’t seem to be subtle and contagious enough to spread well in the absence of major screwups to help it along. It could happen: e.g., Ebola could mix really, really badly with a severe natural disaster (something comparable to Hurricane Katrina). And sometimes the perversity of public policy transcends my ordinary libertarian public choice cynicism and blows my mind, so I recognize we *could* have some spectacular screwup like public schools determinedly mixing infected kids with the rest of the kids as long as they’re able to walk, and with help like that it might be able to explode pretty fast. But failing that kind of co-misfortune, it doesn’t look to me as though the US (or more generally, any prosperous country) is a friendly place for Ebola to spread even under ordinary conditions, and if it becomes an alarming problem (dozens of cases, say) then we have the resources to change the conditions in ways that make it even harder for Ebola to spread.
Also, if Ebola does manage to spread outside Africa, I will be quite surprised if the US turns out to be the place where Ebola first causes a severe problem. For ordinary epidemic spread (by casual contact, instead of by craziness like clinics sharing needles or mobs looting clinics) severe crowding seems likely to be a major enabling factor, and even among the limited number of places I’ve personally visited, I know several (esp. Manila and Mexico City) where that enabling factor seems much stronger than anyplace I know of in the US. So if it turns out that Ebola is capable of sustaining itself by ordinary epidemic spread (without being boosted by the craziness which has been reported in Africa) I’d expect it to explode catastrophically in more crowded places before it caught fire enough to cause a severe problem in the US.
It will be interesting to find out if that African case is a student. I am also not at all sure that it is only transmitted by “bodily fluids” like AIDS.
I wonder if he is a student whether he had moved into a dorm. I don’t trust the CDC to tell the truth. They have been much more concerned about guns the last few years than infectious diseases.
I won’t say it but…
The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air.
The infected is from Liberia.
The name, face and known movements of this person should be EVERYWHERE in Texas the media. The danger is not from this man, but the people he has potentially infected that are oblivious to their condition.
Good comment from the original PJ Media post.
The patient flow on an airplane and came through US customs. The real threat is the abandonment of standard epidemiological practices in the 1980s. The Gay lobby successfully forced the CDC and public health authorities to give up disease prevention protocols because it might cause discrimination against gay men. Of course the real discrimination they objected to was gay men without AIDS rejecting sex partners with AIDS. They also want to keep the bathhouse culture open which provided a broad avenue to spread the disease. If you don’t believe me read “And the Band Played On” by the late Randy Shilts, a gay journalist who was shouted down by gay activists for demanding that the public health authorities apply standard protocols to stop the epidemic. Shilts died of AIDS in 1994.
This is exactly the case and I was living through it in the 80s when California passed a crazy law that not even the doctor who ordered it could get the HIV test results. Only the patient was allowed to get the result and he could then decide if he would tell the doctor. Needless to say, there were many “black market” tests done. Many of these were done by health professionals exposed to HIV. It was insane and one reason I do not trust the CDC in this epidemic.
A gay friend of mine (another physician who survived) gave me a copy of the book when it came out.
“The infected is from Liberia.”
From my earlier post.
This month, we have a new school year underway with thousands of African students at US colleges.
But overall, we can make a reasonable estimate that around 25,000 Black Africans are currently studying at colleges and universities in the United States.
That was my point. September is the start of the school year.
“It was insane and one reason I do not trust the CDC in this epidemic.” It’s the sort of thing I had in mind when I said “When you really need an intelligent government, the one you have will prove ineffective.” The “you” there is not directed specifically at the US, of course. Ours will prove dud too. And France’s. And Italy’s. And ……
The CDC seem set to burn its credibility at the beginning of our Ebola outbreak.
See:
—————
Someone Claiming to be From the CDC Called Me About the Ebola Patient in Dallas
By: Erick Erickson (Diary) | September 30th, 2014 at 09:29 PM |
http://www.redstate.com/2014/09/30/the-ebola-patient-and-a-call-to-my-show/
As you guys know, I have a radio show on the largest talk station in the country, WSB Atlanta. The CDC is based in Atlanta.
This evening, during break, an individual called the program claiming to work for the CDC and to have knowledge of the patient in Dallas, TX.
The source gave me information to lead me to establish credibility: name, occupation, background, etc. The source also gave me dates and travel information about the patient.
What makes the source seem legitimate is that the source provided accurate information including the patient’s arrival in the U.S. on September 20th and that the patient had come from a funeral in Liberia. The source provided all that information before those details had hit the wires and before the press conference.
The name of the source matches an individual at the CDC who would have this information.
You know as much about the source as I do, other than who the source purports to be.
Again, the source gave me information off the air and before it was publicly released that turned out to be accurate.
The source also gave me information that adds to the narrative. Taking my description of the source as presented, here are other details the source gave me.
The patient traveled from Liberia to the United States via Brussels and Dulles, VA, on to Dallas, TX.
The patient did not have symptoms when he arrived. But, and this is key and what did not come out at the press conference, the source tells me the patient actually did go to the hospital with symptoms on September 24, 2014. In fact, I assumed I was confused because the press conference said the 26th. I assumed I misheard the source. So I texted the source who called me back and, purported reading from the file, read that the patient arrived in Dallas, TX on the 20th of September, appeared in the emergency room with symptoms on September 24th. The patient was discharged with antibiotics and returned again days later with watery diarrhea and other symptoms, tested for both malaria and Ebola, and put in isolation on the 28th.
You know all I can tell you about the source. Perhaps the source is not legit, is pulling a prank, and was just lucky. But when the source called me back to confirm the dates, the source is insistent the patient first went to the emergency room on the 24th, the patient was discharged, and four days later on the 28th returned and was admitted and put in isolation.
Now, assume the source is just making it all up and is not legitimate. A few questions are still in the air:
From September 26th to 28th, where was the patient, if the timeline presented in the press conference was true.
From September 20th to September 24th or 26th, where was the patient?
There are a lot of unknown answers and the CDC will, I hope, err on the side of giving us vastly more information than we need instead of less.
This was on the PANDEMIC FLU INFORMATION FORUM based upon the Eric Ericson piece above:
——————————————————————————–
http://www.singtomeohmuse.com/viewtopic.php?t=5725&postdays=0&postorder=asc&start=2715
A few points about the timeline. and some questions.
The man arrived in Dallas on Saturday, the 20th.
1. Pushing his symptom onset date back from the 26th to the 24th makes it slightly more plausible that the man was experiencing at least some initial symptoms upon his arrival on the 20th. That would mean that his fellow travelers were more at risk than has been presented.
There’s another reason to believe that the man might have demonstrated symptoms earlier. Think about it — you don’t run to an emergency room at a hospital until you’ve been sick for a few days. Not *two* days. But CDC wants us to believe that the man began to show symptoms on the 24th and went to the ER on the 26th. That idea might fly if the man had also admitted that he had just come from Liberia and had presented himself, early and worried about a possible Ebola infection, out of an abundance of caution. But he admitted to no such thing (nor did his family).
While watching cases of Ebola in Liberia, one thing that has stood out to us are the heart rending photos and videos of Ebola patients in ETUs sitting on those plastic chairs, slightly ill but not overwhelmingly so, simply waiting for their fate, for the virus to really kick in. That takes a few days, and is one of the hardest things for me, from my remote position, to watch. I can’t imagine what that must be like. But the patients do often sit there, for days, before turn really sick — say sick enough, if one was in this country, to head to an emergency room.
If the first visit to the ER really did happen on the 24th, that makes it more likely that the patient was symptomatic on arrival, or became so very shortly thereafter.
2. What was the patient doing on the weekend of September 20th? Was there a gathering in his honor on the 20th or 21st? (Saturday or Sunday?). Was there a wedding? A community celebration? Where was the man on Monday and Tuesday? Why would CDC possibly have lied and said that the man only became symptomatic on the 26th rather than the 24th?
If this has happened, CDC will believe that it can handle the matter quietly. It will ask the Liberian community in Dallas to be circumspect about it all, to decline to talk to the press. (And the press is approaching the community via social media and almost certainly in person locally). CDC could scare the Liberian community with visions of “stigmatism” should people start talking. But the Liberians should know by now that only the most open of discussion can stop this virus, whether in Liberia or here.
I agree with those who stated that Frieden’s body language and tone looked more worried than he wanted to let on. Something about the equation presented doesn’t add up. And CDC’s official dismissal of legitimate questions and concerns doesn’t help anybody, which they will figure out as the surprises tumble out in a willy-nilly fashion.
Another official doc weighs in with more good news
Second, it appears several people were exposed before the individual was placed in isolation, and it is quite possible that one or more of his contacts will be infected,” he added.
Just remember, the CDC works for these people.
On Monday, Michelle Obama came to Milwaukee to campaign for Democrat Mary Burke, who is challenging Governor Scott Walker. To the astonishment of reporter Meg Kissinger of the Milwaukee Journal Sentinel, aides to Obama and Burke told her she could not talk to the crowd at a Burke event in Milwaukee.
That newspaper is very friendly to Burke and Obama. What do you think the chances of learning more about the Ebola patient contacts are ?
Somebody seems to think there will be more than one case.
CBS46 News has confirmed the Centers for Disease Control has issued guidelines to U.S. funeral homes on how to handle the remains of Ebola patients. If the outbreak of the potentially deadly virus is in West Africa, why are funeral homes in America being given guidelines?
The local Dallas TV station WFAA is reporting a possible secondary infeaction case who is a “Close Associate” of Case Zero.
It also turns out Case Zero had children who went to DISD schools.
One more bit of bad news, the CDC Ebola simulation shows that 50% of all Ebola infected develope symptoms ibn 5 & 1/2 days.
Counting back from 1 Oct 2014 puts you ar 26 September, just in time for this “Close Associate” of Case Zero to develope Ebola.
This is the UK Daily Mail Case Zero time line based upon the CDC briefing —
September 19 – Man boards flight in Liberia
September 20 – Man lands in Dallas
September 24 – Man starts to develop symptoms
September 26 – Man goes to hospital but is sent home with antibiotics
September 28 – Man placed in isolation in Dallas hospital
September 30 – Man’s blood tests positive for Ebola
http://www.dailymail.co.uk/news/article-2775608/CDC-confirms-Dallas-patient-isolation-testing-returning-region-plagued-Ebola-HAS-deadly-virus.html#ixzz3EttoRe1P
More from CNN, although they may not realize what they are saying.
Paramedics who transported the patient to the hospital have been isolated, Dallas Mayor Mike Rawlings’ chief of staff said. They have not shown symptoms of the disease so far, Frieden said.
The ambulance used to carry the patient was still in use for two days after the transport, city of Dallas spokeswoman Sana Syed said.
But she emphasized that the paramedics decontaminated the ambulance, as they do after every transport, according to national standards.
The ER did not ask him about travel and he didn’t volunteer information. Why ? No accent ? Travel questions are standard with the medical students I teach.
As usual, Tom Clancy was way ahead of everyone on this one.
Is this a poor time for some quotes from the esteemed Emmanuel Bros.? It would plum turrible if a major bloc of the hostile voting public were quarantined due to serious illness or pandemic. Obstructionist Republican congress be damned, the hope n’ change gang gonna get their licks in!
>Mr. Duncan, the first person to develop symptoms outside Africa during the current epidemic, had direct contact with a woman stricken by Ebola on Sept. 15, just four days before he left Liberia for the United States, the woman’s parents and Mr. Duncan’s neighbors said.
In a pattern often seen here in Monrovia, the Liberian capital, the family of the woman, Marthalene Williams, 19, took her by taxi to a hospital with Mr. Duncan’s help on Sept. 15 after failing to get an ambulance, said her parents, Emmanuel and Amie Williams. She was convulsing and seven months pregnant, they said.
Turned away from a hospital for lack of space in its Ebola treatment ward, the family said it took Ms. Williams back home in the evening, and that she died hours later, around 3 a.m.
Mr. Duncan, who was a family friend and also a tenant in a house owned by the Williams family, rode in the taxi in the front passenger seat while Ms. Williams, her father and her brother, Sonny Boy, shared the back seat, her parents said. Mr. Duncan then helped carry Ms. Williams, who was no longer able to walk, back to the family home that evening, neighbors said.
The family of Marthalene Williams said Thomas Eric Duncan helped carry her to and from a hospital in the capital, Monrovia, last month. Marthalene died the next day. Liberian health officials said Wednesday that Mr. Duncan was the man who flew to Dallas and was later found to have the Ebola virus. Credit Daniel Berehulak for The New York Times
“He was holding her by the legs, the pa was holding her arms and Sonny Boy was holding her back,” said Arren Seyou, 31, who witnessed the scene and occupies the room next to Mr. Duncan’s.
Sonny Boy, 21, also started getting sick about a week ago, his family said, around the same time that Mr. Duncan first started showing symptoms.
In a sign of how furiously the disease can spread, an ambulance had come to their house on Wednesday to pick up Sonny Boy. Another ambulance picked up a woman and her daughter from the same area, and a team of body collectors came to retrieve the body of yet another woman — all four appeared to have been infected in a chain reaction started by Marthalene Williams.
A few minutes after the ambulance left, the parents got a call telling them that Sonny Boy had died on the way to the hospital.<
http://www.nytimes.com/2014/10/02/world/africa/ebola-victim-texas-thomas-eric-duncan.html?_r=0
Nothing new here. No reason to stop air travel from Africa to the US.
The White House said Wednesday it will not impose travel restrictions or introduce new airport screenings to prevent additional cases of Ebola from entering the United States.
Spokesman Josh Earnest said that current anti-Ebola measures, which include screenings in West African airports and observation of passengers in the United States, will be sufficient to prevent the “wide spread” of the virus.
The chances of a U.S. epidemic are “incredibly low,” he said.
Doctor Earnest will be available to treat any cases, I assume.
There are currently 80 people who have been identified as being exposed too Ebola via contact with Thomas Duncan.
And we also have this piece of timing by the Obama Administration. Barack Obama issued a presidential memorandum on September 26th to defer deportations of Liberians on the same day Thomas Duncan first visited Texas Health Presby —
——————-
MEMORANDUM FOR THE SECRETARY OF HOMELAND SECURITY
SUBJECT: Deferred Enforced Departure for Liberians
Since 1991, the United States has provided safe haven for Liberians who were forced to flee their country as a result of armed conflict and widespread civil strife, in part through granting Temporary Protected Status (TPS). The armed conflict ended in 2003 and conditions improved such that TPS ended effective October 1, 2007. President Bush then deferred the enforced departure of the Liberians originally granted TPS. I extended that grant of Deferred Enforced Departure (DED) to September 30, 2014. I have determined that there are compelling foreign policy reasons to again extend DED to those Liberians presently residing in the United States under the existing grant of DED.
Pursuant to my constitutional authority to conduct the foreign relations of the United States, I have determined that it is in the foreign policy interest of the United States to defer for 24 months the removal of any Liberian national, or person without nationality who last habitually resided in Liberia, who is present in the United States and who is under a grant of DED as of September 30, 2011. The grant of DED only applies to an individual who has continuously resided in the United States since October 1, 2002, except for Liberian nationals, or persons without nationality who last habitually resided in Liberia:
(1) Who are ineligible for TPS for the reasons provided in section 244(c)(2)(B) of the Immigration and Nationality Act, 8 U.S.C. 1254a(c)(2)(B);
(2) Whose removal you determine is in the interest of the United States;
(3) Whose presence or activities in the United States the Secretary of State has reasonable grounds to believe would have potentially serious adverse foreign policy consequences for the United States;
(4) Who have voluntarily returned to Liberia or his or her country of last habitual residence outside the United States;
(5) Who were deported, excluded, or removed prior to the date of this memorandum; or
(6) Who are subject to extradition.
Accordingly, I direct you to take the necessary steps to implement for eligible Liberians:
(1) A deferral of enforced departure from the United States for 24 months from October 1, 2014; and
(2) Authorization for employment for 24 months from October 1, 2014.
BARACK OBAMA
————–
The Republican candidate who becomes the Republican Presidential nominee is going to wave this as a “Bloody Shirt” right into the Oval Office,
How to lose credibility with the Dallas public in an Ebola epidemic in one easy step.
Texas Public health officials said the EMT Ambulance that transported Thomas Duncan transported was cleaned and “Returned to service.”
However, see the following —
http://www.nbcdfw.com/news/health/Dallas-Fire-Rescue-Crew-That-Transported-Ebola-Patient-Quarantined-Ambulance-Pulled-From-Service-277675341.html
Chopper 5 showed Dallas Fire-Rescue ambulance 37 parked away from all other vehicles at the training center in the 5000 block of Dolphin Road. The ambulance was wrapped in red caution tape and blocked in.
The Republican candidate who becomes the Republican Presidential nominee is going to wave this as a “Bloody Shirt” right into the Oval Office
Trent, he should, but unless the candidate is someone like Ted Cruz or Mike Lee, he won’t on the advice of the Rove bunch who really runs the Republican Party. Would not want to appear combative and ungracious now would we………
The Dallas public health folks seem to be on a run of screw-ups
Pressure washer to clean up Ebola vomit ??? No protective clothing? Woman in sandals watching ?
Mike K,
They have nothing on the CDC.
This link has a screen shot of the chart showing “Ebola Symptom Onset Distribution Days After Infection”
http://fluboard.rhizalabs.com/forum/viewtopic.php?f=5&t=12475
It was originally at this CDC Mortality and Morbidity Weekly link and got scrubbed by the CDC after the time line for Thomas Duncan’s exposure to Ebola came out.
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6303a1.htm?s_cid=su6303a1_x
Short form — the five highest days of Ebola manifestation are Day 5, Day 4, Day 6, Day 7 and Day 3 in descending order.
Thomas was exposed to Ebola 15 September.
Thomas arrived in Dallas 20 September.
By day 5.5 50 % of people manifest active Ebola symptoms and are communicable.
We have a cumulative 40% chance Duncan was communicable on the flight from Northern VA to Dallas.
My link seems not to be working. Maybe this is better .
Plus, an NBC crew with Nancy Snyderman has been has been confirmed to be infected.
Snyderman is under “observation.”