Friday 17 October 2014

Ebola update - 10/16/2014

Ebola: WHO Cites Cases With Longer Incubation Period of 42 Days

EBOLA SIERRAL
A health worker wearing protective equipment takes a blood sample from a patient at a ward for patients suspected of having the Ebola virus, at Rokupa Hospital, Freetown, Sierra Leone. REUTERS/Christopher Black/WHO

By Jayalakshmi K

16 October, 2014

As questions of how many people the second Dallas nurse infected during her journey to and from Dallas throw scary possibilities, a WHO situation assessment report gives more cause for concern by stating that the incubation period of the virus has been seen to extend to as long as 42 days in some cases.

It says that recent studies conducted in West Africa have demonstrated that 95% of confirmed cases have an incubation period in the range of 1 to 21 days; 98% have an incubation period that falls within the 1 to 42-day interval.
For WHO to declare an Ebola outbreak over, a country must pass through 42 days, with active surveillance supported by good diagnostic capacity and no new cases detected in the period.
The organisation has also criticised rapid determination of infection within a few hours, noting that two separate tests 48 hours apart are required before discharging a patient or a suspected one as Ebola negative.
In assessing the situation in West Africa, WHO says fresh cases in Guinea, Liberia and Sierra Leone show that the outbreak is not showing any sign of being controlled.
On the positive side, it is all set to declare later this week that Senegal is Ebola-free, if no new cases are detected.
Nigeria will also get the green signal once it passes the requisite 42 days, with active surveillance and no new cases till Monday, 20 October.
Tracing of people known to have contact with an Ebola patient reached 100% in Lagos and 98% in Port Harcourt, a crucial step in controlling the spread of the virus.
In the case of the American nurse who took a commercial flight with 132 other passengers, the risk factor is multiplied with every contact she made, beginning with the immediate co-passengers, flight attendants and airline baggage handlers to the family members she met.
The Ebola virus is believed to be able to survive outside the body for a week or more during which time anyone who comes in contact with contaminated surface can pick up the virus.

The death rate in the current Ebola outbreak has increased to 70% with the toll at 4,447. There could be up to 10,000 new cases of Ebola per week in two months, WHO has warned.


See also: Shock W.H.O. report: Ebola has 42-day incubation period, not 21 days!


Lagos has a population of >21 million people. If this incident happened as described - and the NY Post is not exactly the NY Times - it appears that no one was subsequently quarantined and, further, that the examination was very cursory, at best. 

If it was Ebola, virtually everyone on that plane was exposed. Now, some well-informed people are saying that the worst case scenario is ~20 people will be infected in America within the next month or so. 

Personally, I don't understand why that number is so low. Why not ten times that number? Why not a hundred times that number? The assumptions the CDC is following seem impossibly arbitrary, naive and restrictive. 

The trajectory of this situation, of course, has nothing whatsoever to do with disease control but, instead, everything to do with ensuring that the ensuing pandemic will be impossible to control. 

And so it goes.

---Michael Green

Alarm after vomiting passenger dies on flight from Nigeria to JFK


16 October, 2014

A plane from Nigeria landed at JFK Airport Thursday with a male passenger aboard who had died during the flight after a fit of vomiting — and CDC officials conducted a “cursory” exam before announcing there was no Ebola and turning the corpse over to Port Authority cops to remove, Rep. Peter King said on Thursday.

The congressman was so alarmed by the incident — and by what he and employees see as troubling Ebola vulnerabilities at JFK — that he fired off a letter to the federal Department of Homeland Security demanding more training and tougher protocols for handling possible cases there.

The unnamed, 63-year-old passenger had boarded an Arik Air plane out of Lagos, Nigeria, on Wednesday night, a federal law enforcement source said.

During the flight, the man had been vomiting in his seat, the source said. Some time before the plane landed, he passed away. Flight crew contacted the CDC, federal customs officials and Port Authority police, who all boarded the plane at around 6 a.m. as about 145 worried passengers remained on board, the source said.

The door [to the terminal] was left open, which a lot of the first responders found alarming,” said the source.
My understanding was that the passenger was vomiting in the seat,” King (R-LI) said.

The CDC went on the plane, examined the dead body and said the person did not have Ebola,” King said.

It was what I was told a cursory examination. The Port Authority cops and personnel from Customs and Border Protection were there, and they were told there was no danger because the person did not have Ebola,” King said.

But their concern was, how could you tell so quickly? And what adds to the concern is how wrong the CDC has been over the past few weeks.”




Between 70 and 100 passengers a day arrive at JFK from Liberia, Sierra Leone and Guinea, the three West African countries that are the epicenter of the outbreak, King said.

These individuals transit the airport with the rest of the traveling population, including using the restrooms,” King wrote to Jeh Johnson, secretary of the Department of Homeland Security, in a letter Thursday.

Only after they arrive at the Customs and Border Patrol primary screening location that they are separated and sent to secondary inspection for a medical check and to complete the questionnaire,” he wrote Johnson.

King’s letter demands that Homeland Security immediately beef up protocols for what happens to potentially infected passengers in flight and at the terminal itself, prior to their reaching the screening location.

The letter also demands that training and safety equipment improve for the Port Authority police and Customs and Border Patrol officials who can come into contact with high-risk passengers.

I believe there should be a suspension of direct flights and connecting flights from these three countries,” King said. “And maybe anyone with a visa from those countries, and who has been living in those countries, should be barred” from entering the US, he added.

No other information was immediately available about the deceased Nigerian passenger.

Nigeria is 1,000 miles east of the three West African countries suffering from an Ebola outbreak, but has had 19 confirmed cases of the deadly virus. The country has had no new cases over the past month; the World Health Organization has said that if there are still no new cases of Ebola by Monday, they will officially declare the country “Ebola-free.”




Obama Mobilizes National Guard, Army Reserves To Fight Ebola


16 October, 2014

With numerous counties and states having declared "States of Disaster" or "States of Emergency", the looming civil rights destruction of martial law domestically draws ever closer.

However, President Obama has decided that, by Executive order:

*OBAMA ISSUES EXECUTIVE ORDER FOR ARMED FORCES IN WEST AFRICA.

*OBAMA TO ACTIVATE INDIVIDUAL READY RESERVE FOR EBOLA
What is The Individual Ready Reserve? (via Wikipedia)







The Individual Ready Reserve (IRR)is a category of the Ready Reserve of the Reserve Component of the Armed Forces of the United States composed of former active duty or reserve military personnel and is authorized under 10 U.S.C. ch. 1005.
 
For soldiers in the National Guard of the United States, its counterpart is the Inactive National Guard (ING). As of 22 June 2004, the IRR had approximately 112,000 members (does not include all service IRR populations) composed of enlisted personnel and officers, with more than 200 Military Occupational Specialties are represented, including combat arms, combat support, and combat service support.

*  *  *

In other words, we are sending Vets and reservists to Africa... where they are expected to do what? Shoot at viruses?

*  *  *

Via Bloomberg Transcript,








KIRBY: Afternoon, everybody. I'm proud to welcome into the briefing room General David Rodriguez, commander of Africa Command. He's here to give you an update on U.S. contributions to the effort against Ebola -- U.S. military contributions to the effort against Ebola in West Africa. And with that, sir, I'll turn it over to you.
QUESTION: Just a clarification on that, please. Will they be in contact with individuals or just specimens?
GENERAL DAVID M. RODRIGUEZ (USA), COMMANDER, U.S. AFRICA COMMAND: They come in contact with the individuals and they do that. And they're -- like I said, it's a -- it's a very, very high standard that these people have operated in all their lives, and this is their primary skill. This is not a -- you know, just medical guys trained to do this.This is what they do for a living.

*  *  *




President Obama has issued an executive order calling up ready reserve troops to combat the Ebola crisis in Africa.
Obama notified Congress of his order Thursday. It reads: "I hereby determine that it is necessary to augment the active Armed Forces of the United States for the effective conduct of Operation United Assistance, which is providing support to civilian-led humanitarian assistance and consequence management support related to the Ebola virus disease outbreak in West Africa."
The Pentagon said it had no immediate plans to send reservists to Africa, saying that the order simply allows the military to begin utilizing reserve/guard forces in our overall response in Northern Africa.
It "doesn't mean that we are deploying these forces, but it gives us the option to do so if we need to," said Air FOrcer Lt. Col. Thomas Crosson, a Pentagon spokesman.
The White House said it didn't know exactly how many reserve troops would eventually be required.



Researchers Expect Over 20 US Ebola Cases In Weeks, "You Don't Want To Know Worst Case"
Kenya

16 October, 2014

"We have a worst-case scenario, and you don't even want to know," warns Alessandro Vespignani, a researcher creating simulations of infectious disease outbreaks, but there could be as many as two dozen people in the U.S. infected with Ebola by the end of the month. The projections only run through October because it’s too difficult to model what will occur if the pace of the outbreak changes but, as Bloomberg reports, Vespignani warns if the outbreak becomes more widespread in other regions, it "would be like a bad science fiction movie."








Alessandro Vespignani, a Northeastern University professor who runs computer simulations of infectious disease outbreaks warns there could be as many as two dozen people in the U.S. infected with Ebola by the end of the month.
...
The projections only run through October because it’s too difficult to model what will occur if the pace of the outbreak changes in West Africa, where more than 8,900 people have been infected and 4,400 have died, he said. If the outbreak isn’t contained, the numbers could rise significantly. 
If by the end of the year the growth rate hasn’t changed, then the game will be different,” Vespignani said. “It will increase for many other countries.”

The model analyzes disease activity, flight patterns and other factors that can contribute to its spread.







We have a worst-case scenario, and you don’t even want to know,” Vespignani said. “We could have widespread epidemics in other countries, maybe the Far East. That would be like a bad science fiction movie.”
The worst case would occur if Ebola acquires pandemic status and is no longer contained in West Africa, he said. It would be a catastrophic event, one Vespignani says he is confident won’t happen.

The CDC disagrees...







It’s unlikely that Ebola will ever exceed 20 cases in the U.S. or Europe because of their extensive health care infrastructures, said Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics & Policy, a non-profit think tank in Washington, D.C. The problem in the developed world will center more on the economic impact, he said.
The damage is not as much in the number of deaths as much as in the panic it creates and all the disruption it creates in trade and travel,” he said. “It’s important for public health officials to strike a balance between being serious and certainly not creating panic.”
It’s not going to be like the movie ‘Contagion,’” he said.

And Eli Perencevich, professor of epidemiology at the University of Iowa Carver College of Medicine, said average Americans shouldn’t see any risk from the virus outside of the medical community because patients aren’t terribly infectious until the disease peaks...







There’s a high probability that there will be another person who comes in, no matter what we do, but the risk is in the hospital,” he said in a telephone interview.“As long as people who know they have been exposed to the virus get themselves quickly to the hospital, even after they have started a fever, it should be OK because they aren’t that infectious.”

*  *  *

Let's hope he is right!


The Idiotic Explanation Why The "Idiot With The Clipboard" Was Unprotected


16 October, 2014

Phoenix Air has released a statement explaining why the now infamous non-HazMat-wearing 'clipboard man' seen in close proximity to Dallas Ebola patient Amber Vinson (while the rest of the members of staff are fully protected) was unprotected... and it will blow your mind.

Why is "Clipboard Man" not wearing protective gear?



Phoenix Air responds (via ABC News)...






The airline confirmed to ABC News that the man was their medical protocol supervisor who was purposefully not wearing protective gear. 
"Our medical professionals in the biohazard suits have limited vision and mobility and it is the protocol supervisor’s job to watch each person carefully and give them verbal directions to insure no close contact protocols are violated," a spokesperson from Phoenix Air told ABC News said.
"There is absolutely no problem with this and in fact insures an even higher level of safety for all involved," the spokesperson said.

*  *  *
So - in summary - due to the restrictive vision when wearing an Ebola-protective suit, one member of staff must be sacrificed/exposed to ensure no one trips?
And these are who we are supposed to trust?

Here is the full sequence of events involving "clipboard guy" via the Mail:

Is he with the CDC? Both the ambulance company and Emory University Hospital said the unprotected man with the clipboard (center) is not one of their employees - meaning he is likely a CDC employee

Is he with the CDC? Both the ambulance company and Emory University Hospital said the unprotected man with the clipboard (center) is not one of their employees - meaning he is likely a CDC employee

A man in plain clothes was seen on the tarmac Wednesday afternoon, as the second Ebola patient (in yellow hazmat suit) boarded a flight to Atlanta, Georgia

A man in plain clothes was seen on the tarmac Wednesday afternoon, as the second Ebola patient (in yellow hazmat suit) boarded a flight to Atlanta, Georgia

The man is seen boarding the flight, after exchanging several objects with the hazmat crew

The man is seen boarding the flight, after exchanging several objects with the hazmat crew

Clipboard man appears to have flown on the same flight as infected Miss Vinson, as he is seen in footage of her getting into an ambulance at an airport in Atlanta

Clipboard man appears to have flown on the same flight as infected Miss Vinson, as he is seen in footage


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