My congressman ran a poll asking his constituents if they were confident in the Center for Disease Control’s (CDC’s) ability to combat Ebola. He’s probably sorry he asked, because this is how I responded. Obviously these are my own opinions (aren’t they always?), although I did try to check basic facts (number of dead in World War I, etc.)
I spent 30 years in the healthcare industry, starting off in a technical clinical discipline, and later, after completing my graduate degree I moved into management and was a Fellow in the American College of Healthcare Administrators. My current position includes support for emergency management.
CDC is very good at doing certain things, but their best work has involved basic research, which doesn’t mean “simple” but getting to the root issues behind a scientific question. Basic research is often the most result oriented because instead of jumping to a search for the solution, it instead focuses on learning about the problem without preconceived notions. The classic example was when Dr. Fleming noticed that something was affecting the other bacteria in his experiment. By studying this “something” he discovered penicillin.
It appears that in recent that the attention of the leadership of the CDC has been drawn away from basic scientific research and become more focused on political issues, which well may have impacted their effectiveness. For example, there are reliable reports that CDC has spent significant effort to shut down doctors who believe in treating chronic Lyme disease. Some physicians believe that the organisms that causes Lyme disease, and an associated disease, babesiosis can become dormant in a patient, but when triggered by trauma, or other events, the symptoms become active again. Although not scientifically proven, patients have reported improvement when treated with a regimen of certain antibiotics and anti-parasitic drugs.
The CDC has not proven these conditions do not exist, which is understandable given that it is impossible to prove a negative. However, they have taken this issue on as a crusade and allegedly gone so far as to classify this as a Homeland Security issue in order to justify the use of legal authorities and law enforcement techniques.
Unfortunately, they have not been quite as enthusiastic at adhering to basic, proven infection control techniques they haven’t exerted the same amount of effort to adhere to basic protocols resulting in the exposure of CDC personnel to anthrax and the loss of at least one container of viable small pox. Incidentally, small pox was the first chemical weapon when the blankets of small pox victims were given to Native Americans, thereby intentionally introducing the disease to the indigenous population of North America.
I’ll give the CDC the benefit of the doubt. I think they can handle this IF the politically appointed and wanna-be-police types get out of the way. Should we cut off contact with western Africa and deprive them of essential expertise, medicine and equipment? I think not. While it may be politically unpopular, until effective treatments or vaccines are perfected, quarantine may be the most logical step. The health professionals actively working with Ebola patients at the handful of designated hospitals are the best trained and equipped. However, mistakes are made, equipment fails, and while the doctors, nurses, therapists and technologists may follow the protocols correctly, is it possible for a housekeeper or a maintenance person to become infected? I think so.
It may be wise to quarantine people who have been exposed to Ebola. The Ebola hospital staffs may just have to live and work within the confines of the facility for the duration. It’s an inconvenience but our military men and women have been living with such inconveniences for the past eleven years, all the while being shot at, rocketed, mortared and the target of suicide bombers and IEDs.
If the USNS Comfort and USNS Mercy – the Navy’s 1200 bed hospital ships are not being deployed elsewhere, they could provide medical care as well as quarantine. Those exposed and being monitored would not have to live in military austerity, but instead could be housed in nicer accommodations to make the experience less painful; a hotel leased by the government, or perhaps a cruise ship. Nice accommodations, but safely out of circulation until everyone is sure that the individual is not infected
If everyone exposed to Ebola were quarantined for 28 days, it just might prove to be significantly cheaper to pay for lost wages and accommodations for these people than to let the disease spread. If the CDC puts the science and safety first, they’ll succeed. If the politics and power struggles take precedence, stand by. Those who do not study history are doomed to repeat it. The “Spanish” flu of 1918 is estimated to have killed between 50 million and 100 million; by comparison, the total death toll of the Great War (World War I)— all military and civilians—is estimated at 43 million.
Bottom line—let the scientists do their job.
Well thought and well said, Steve. The CDC was formed and has always been a “support” agency for infectious disease control not only in the U.S. but the world. And even though a government-funded agency, it has never been political…until now unfortunately which is why we see this highly respected and world renown resource like a fish out of water: Tom Friedan is a “good man” and a top physician in infectious diseases, but not a politician for Obama and his purposes.
Your idea of using our Navy ships to isolate, quarantine and treat Ebola patients is brilliant and pragmatic, and must be made known. It’s the kind of common sense thinking that is not all that common. With only the few patients infected that we know of at this time, your idea is also bit far-forward: The job at the moment is a search and find mission–those persons who came in contact with the infected persons, and the other persons who came in contact with those persons, and so on–to isolate to the spread.
This will take not only an informed public but a willing and cooperative
and honest people.
Moreover, perhaps the more important part of this mission is for our frontline healthcare personnel in all workplace areas to “cover-up” (to wear nominal protective gear–mask, gown and shoe covering for each patient), and also to be cognizant of patient histories, “fevers” of all grades and patient symptoms (high grade fevers of 101 over several days, general malaise,
energy depletion, vomiting, loss of appetite, abdominal pain, etc). It will look like the Flu, with the big difference being the high grade fever over several days which cannot be controlled via normal means.
It should be suggested that while Ebola is generally not transmitted except via direct contact of bodily fluids–at this early stage healthcare staff must care for patients as if Ebola were airborne.