This is sort of misleading in this context, unfortunately. The WHO considers (sustained presence) within 1 meter of EBV carrier to be ~physical exposure. The young doctor appears to have been on a NYC subway within 12 hours of having a fever of 103. Creating a potential group of exposures that may be un-traceable.
Maybe someone can correct me if I'm wrong. But this would be highly unfortunate if these reports are correct. Presumably the uber driver is also in this group now, but records should be able to provide some data on that one much easier.
Though the growth of number of patients with Ebola is definitely exponential. Please note it takes 21 days for the each multiplication to happen. It started in March and has been been spreading since, 10K is pretty large for a 7 month period.
>>but the sky isn't falling just yet.
In things like this you won't know when the sky will start falling apart. And generally when that happens its already too late, and you would be staring at a pretty big damage.
No body knows how many people have been infected, or will be infected in the next multiplication.
Which is why WHO suspects ~1.4 million could get infected by January. By then it would be too late.
Was the bowling alley public subway trip really a must-do thing, for someone who had just directly worked with ebola patients? Could this kind of thinking not be part of the training for this kind of work, I wonder?
Even the NY Times got it right this time: "People infected with Ebola cannot spread the disease until they begin to display symptoms, and it cannot be spread through the air."
Prior to this outbreak, this Ziare strain of Ebolavirus, now formally known as "Ebola virus", has never infected more than 318 people at a time, and not a whole lot more than a thousand total: https://en.wikipedia.org/wiki/List_of_Ebola_outbreaks#List_o...
I guarantee that at least one of the things the usual suspects like the CDC "know" about its transmission is wrong. Consequentially wrong? Well, we'll see.
As for this case, he was not feeling well (also described as "sluggish") for a couple of days before his self-monitored temperature spiked. Which is prompting the usual suspects to say that that wasn't a "symptom" ... which is open to question.
Accounts of how he was found are a bit odd. In some articles the fire department was sent to retrieve him. According to another article, a tenant in his building claims police broke down the door to get into his apartment.
I wonder how feasible this is. Its not just the bowling alley, using public rest rooms, subway, or utensils at a restaurant. Its almost impossible to find every thing he came in contact with and disinfect it. Plus in case of stuff like utensils, whats to guarantee that they were not mixed with each other and used by other people already.
If some one has been infected due to this by now. It will become impossible to get a realistic perspective of how far this thing would have spread.
In short you are dealing with a exponential growth scenario.Which is why these sort of things are so dangerous.
It could be the case that he was infected 2-3 weeks ago, but since the average time of symptoms showing up is 8-10 days because he was symptom-free before leaving for nyc, he might have thought he was fine.
http://www.cdc.gov/vhf/ebola/symptoms/index.html
"A 21 day period for quarantine may result in the release of individuals with a 0.2 – 12% risk of release prior to full opportunity for the incubation to proceed."
http://currents.plos.org/outbreaks/article/on-the-quarantine...
It's a bit like saying, "Hey I've saved lives over here so I have earned the right to be irresponsible over here". Because you know, karma balances out. No, the world doesn't work like that. And you aren't doing any good propagating this idea either because it encourages this privileged way of thinking.
As much as this guy isn't being vilified (and say what you want about the government spinning its story of ebola being hard to transmit), lets think clearly and rationally. He knew the risks that he could possibly be infected and decided to endanger others when he could have easily stayed home or gone anywhere to a more isolated environment (upstate NY is calling). It is well known symptoms generally show up by the 10th day. Today is his day 10.
It's very interesting that the government has locked down this guys apartment, yet if you need contact with bodily fluids to contract the disease why quarantine the apartment and surroundings? Could it be that droplets are a transmission method as many people are starting to suspect. Sneezing and coughing may spread these droplets to the floors and walls? And if that is the case, what about other objects that come in contact with saliva and other fluids like utensils, door handles, glasses...
> He knew the risks that he could possibly be infected
> and decided to endanger others when he could have
> easily stayed home
In the military service you will hear it as "trust in your training." Basically you believe you won't be the guy that gets shot or steps on a land mine or what ever because you trained really hard and you know you are implementing that training flawlessly.
It is entirely possible this person was so confident in their training, and their own competence in putting that training into action, that they believed it was impossible for them to be infected. They do the self monitoring because that is what you are supposed to do, but it never comes up positive because you did what you were supposed to do. This gets worse the more times you do something and the outcome is exactly as you expect it to be.
So I can believe this guy didn't believe he was at risk. Just like I have foolishly believed this small change I am checking in can't break anything[1]. One hopes he was asymptomatic when he went out. Unlike the guy in Texas who was showing symptoms and went home, or the nurse who had a fever and got on a plane anyway.
Sure you could put anyone coming back from West Africa in an airstream trailer [2] for 21 days but that is impractical if you want to support the process of fighting it in West Africa.
[1] I know, hugely different scale, but illustrative of my fight against my own assumptions in the pursuit of better process.
[2] http://en.wikipedia.org/wiki/Mobile_Quarantine_Facility#medi...
I would have through the health agencies they volunteer with would enforce these kind of quarantines to prevent international transmission of disease.
On one hand I can't help admire these people risking their lives to help people on the other side of the world. On the other hand some of them seem content to play Russian roulette with their neighbors and family back home, which makes no sense to me. Is it as the OP suggested that doctors make for bad patients?
Why are you sure?
Please look at this first
That seems pretty unusual, isn't it? How long was he there, a couple months?
"Symptoms usually occur within eight to 10 days of infection and Dr. Spencer had been home nine days when he reported feeling ill." That's not including travel time local and international.
That's a tight schedule!
Instead of quarantining by default, I think it would be interesting to offer a free, relaxing vacation in a low population density region to people who are returning from helping in Africa. i.e. you cannot leave West Africa and return to a major city directly. Instead you fly back to your home country by way of a desirable destination and hang out there for a few weeks.
http://www.who.int/csr/disease/ebola/declaration-ebola-end/e...
Apologies for the cliche 'use technology to solve all the problems' HN comment.
It should be standard practice to give someone returning from West Africa that had contact with ebola a GPS tracking device the records their exact location for 21 days following the last know exposure.
This notion that anyone exposed to ebola is basically responsible for keeping tabs on their own well being voluntarily leaves way too much room for human error.
What is higher risk?: 1) Going to the Ebola zone in W. Africa (EDIT: And taking the proper precautions to protect yourself), 2) Walking as a pedestrian on NY streets, or 3) Sharing a subway car with someone who has been in the Ebola zone?
There are around 3 cases of Ebola in the United States. I expect most of the resultant suffering will be because the public reaction is causing us to divert resources from where they could do more good (including West Africa).
See the first three sources I found about Ebola transmission in sweat: http://well.blogs.nytimes.com/2014/10/03/ebola-ask-well-spre... (claims that sweat doesn't contain Ebola) http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemi... (claims that Ebola can be transmitted through sweat) http://www.cdc.gov/vhf/ebola/transmission/qas.html (hard to tell whether they think sweat is a transmission mechanism or not... they define "body fluids" twice, once including sweat and another excluding it)
I also heard on NPR that sweat contained a lot of the virus (don't have a reference handy).
Real experts don't shoot their mouth off with false assurances about a disease we don't know much about. The "hard to catch Ebola" mantra was going on long after that was discredited[1]. These aren't experts, they have some kind of agenda, and I'm not sure what it is. For some, it's probably just being on TV. For others, it's to feel smug about how the ignorant masses under them are panicking irrationally. As for the rest, probably political.
Again, I'm not panicking about Ebola. We'll have a few isolated cases in the West. It will remain in Africa in all of the hot zone countries until we have a vaccine. And hopefully that happens before it spreads to Nigeria, India, Brazil, or other areas where it might be hard to control.
I am not panicking. I am just mad at the irresponsibility of these "experts" we keep hearing from.
[1] No references here, but I think everyone remembers that the first story was that, unless you were engaging in some unsanitary funeral practices deep in an African village, it was impossible to catch. After doctors began to catch it, the story changed to be that they don't have enough resources to protect themselves. Then several Western doctors got infected while in hospitals in Western countries (Spain and the US at least), and the story changed into something about how the protocols will protect us, but were just not followed properly these few times (despite not knowing the specific protocol violations that lead to infection).
-Harlem
-An Uber car
-The High Line
-A restaurant
-A Train
-Jogged 3 miles
-L Train
-1 Train
-The Gutter
