THE EBOLA SCARE: When Common Sense is Nonsense

I wrote about the Ebola “crisis” only about two weeks ago, but now it seems like ancient history.   Here’s a history question:  Regarding Ebola, do you know the significance of Nov 7?   That was the final day for those who had had any contact with Thomas Eric Duncan, who died of Ebola in Dallas,  to show signs of Ebola.   I assume no one did.   Otherwise we’d hear all about it.  That’s really good news, but now Ebola stateside is a distant memory and news that isn’t bad isn’t really news, with the rare exception of great news, like astronauts landing on the moon or VE Day, the end of the European front of WW II.

In retrospect, some of the Ebola scare was good, in that it pressed hospitals around the nation to actually think through the question:  What do we do if an Ebola patient walks in through our doors?  In a previous post, I referred to the “Dallas debacle”, but most hospitals would have reacted in the same chaotic way.   If anyone had come in off the street with Ebola to a hospital before I haven’t heard of it.   Ebola cases get shipped here to one of our specialist facilities. They just don’t appear out of nowhere. At least hadn’t.

Surely, that question must have been raised by medical staff in hospitals here and there throughout the country, but in typical bureaucratic fashion, that got lost in the shuffle. The changes needed would have cost money and staff time, perhaps a lot, and the likelihood of it happening must have seemed small, so …

With that one case in Dallas the likelihood suddenly seemed huge. With many Americans thinking it was only “common sense” to make everyone who traveled from those afflicted west African countries remain in 21 day quarantine.   Well, common sense to a point maybe, but when it came to doing that with health workers who had volunteered to go to Africa, it was just plain wrong headed.   As President Obama said, those medical volunteers should be treated as heroes.  Instead they tended to be treated like criminals.

Centuries ago common sense  supported the notion that the sun revolved around the earth because when we looked at the sky we could see the sun moving.   That’s not a fair analogy, but while common sense has valuel, the evolution of science has come in contrast to so-called common sense. i. e. common sense is often misleading, such as in the case of eye witnesses of crimes who used to be thought of as providing great evidence until studies showed different eyes can see events differently.   Thank God for the discovery of DNA.

The problem with the “common sense” angle prized by politicians like the governors of New Jersey and New York, is that an abundance of caution would likely dissuade medical volunteers to go to West Africa where the real problem, the biggest danger to us all in the future, needs to be eradicated.   It is “penny wise and pound foolish,” to apply an old expression.

Common sense was actually head-in-the-sand thinking, but popular with the people, so certain politicians had to slop it up like pigs at a trough.   According to polls 70% of Americans thought it a good idea.   I wonder how many of those polled were libertarian leaning with a strong belief in reducing governmental meddling.

…..except when each of them gets scared enough to demand more meddling.  That’s only common sense.

Advertisements

EBOLA IN THE U. S.: An Abundance of Caution Can Prompt Excessive Fear

No doubt you’ve heard that an Ebola case has developed in New York City, that of Dr.  Craig Spencer, who had worked with Ebola victims in Africa.  Of course, that has prompted another media frenzy (“first Ebola case reported in New York!”) that is supposed to calm our nerves but makes us more nervous (think of the teeming million of potential victims).

But not me.   So far, here is what the Ebola crisis has added up to in this country, one Ebola death of a man who came to the U. S. with the disease and two infections of nurses who treated him after he had full blown symptoms, and they did so in a hospital that was not prepared to deal with a surprise visit of that virus (which seemed true of most of our hospitals at the time).

The good news is that was a wake up call.

From articles I’ve read, training for dealing with a walk in Ebola case has sky rocketed since then, with Belleview Hospital where Spencer has been treated, an excellent example.  In my previous post, I pointed out that only four hospitals were considered specialists in dealing with an Ebola case, but prompted by the Dallas debacle Belleview seems to have upped it s preparedness enough to become a “designated Ebola Center”.

I have read about three Maryland hospitals  that have attained the same status, and are “listed as second options for the treatment of Ebola patients who are unable to go to one of the federal health facilities.”   I suspect a number of hospitals in other states have followed suit.

To me, that is the big news as to what is going on with Ebola, not a doctor who has been monitoring himself twice daily and finds he has a fever (100.3, not the 103 initially reported) and is taken into Belleview for treatment immediately.    From what I can tell, his chances of infecting anyone prior to having that fever are virtually nil (note, despite even his having a fever no one close to Thomas Eric Duncan in Dallas, including his fiancee, caught Ebola and all are now cleared of quarantine).

The problem is that with each case of Ebola we go into maximum response mode with quarantines and watch lists of anyone who might have had some contact with the victim, implying a sense of wide spread danger when really it is the hospital workers who deal with vomit and diarrhea who are much, much, much, much more likely than anyone else to catch the virus.  The doctors who wind up on TV say as much, or at least imply it.

The reason they don’t stress it more adamantly is that no matter how unlikely, it is theoretically possible the disease could spread through casual contact, so they tout the value of an “abundance of caution”, while simultaneously producing an excess of fear fueled by the media’s always implying they will share special insights and news just after the next commercial, which is seldom more than a rehash of what they have repeatedly covered.

There is an element of c.y.a. in all of this, of course, as a doctor who criticized all the attention paid to the wrong things would be crucified if someone did happen to get Ebola in a surprising way.   So, from this self-protective angle too, better to show an excessive amount of caution.

Ashoka Mukpo, a free lancer from  NBC and another who caught Ebola in Africa and is now cured, is no doctor, but I think he got to the nub of this issue better than most doctors in a recent tweet:  “People get Ebola by being around very very sick people.  Not people who felt a little funny and then became symptomatic later that night.”

Again, the only two people who have caught Ebola in this country fit that bill.

——————————————————————————-

(1)  The national CDC offers a guideline for the possible transmission of the Ebola virus, located here.    If you read the page you can see how it is conceivable that someone could catch Ebola from touching the same surface as did an Ebola victim, but from what I can tell that victim would have had full blown symptoms for this to possibly happen.

By the way, some of the fear regarding Dr. Spencer’s case stems from that initial report that he had a temperature of 103 when contacting the hospital, implying that he might have had a temperature well before that.   Now it seems it was 100.3, a big difference because by all reports the chances of contracting the virus get much greater as symptoms worsen.