Nancy Snyderman's troubles not over for her breaking Ebola quarantine, says
TPM.
Nature:
Just as air travel brought the Ebola virus to Dallas from Liberia, where the pandemic is spreading out of control, air travel could spread the virus throughout the US and the world by travellers who don't know they are infected. Travel restrictions, isolation of the infected and quarantine of those known to have been in contact with the infected are a few of the measures that have been suggested for stopping that spread.
The director of the US Centers for Disease Control and Prevention (CDC) has the authority to impose such a travel ban between states to contain 'viral hemorrhagic fevers' such as Ebola. That authority, which then President George W. Bush put in place in 2000, has yet to be invoked or tested in court. Apprehending, detaining or even examining travellers has typically been confined solely to those travelling outside the US, not between Texas and Ohio. The CDC operates 20 quarantine stations for international travellers throughout the US, including one in Dallas.
The CDC is also in charge of a potential 'Do Not Board' passenger list for commercial airplanes (but not buses or trains). This listing has been used to keep 33 people with tuberculosis from flying in the US. But, in general, imposing and monitoring any quarantines or travel bans is left to the individual states. How much power state governments have to do so varies widely from one state to another. The laws that grant states these powers are old, having been instituted from 40 to 100 years ago, according to a Congressional Research Service report issued on 9 October.
The last legal test of the constitutionality of such a quarantine came in 1902, when the US Supreme Court upheld the power of states to impose quarantines regardless of impact on interstate commerce. More recently, a federal district court in New York upheld the power of New York state to confine a patient with tuberculosis to a hospital against his will in 2003. The CDC is also authorized to step in if the agency feels local authorities - state, county or municipal - are failing to prevent the spread of disease, although that authority has yet to be tested.
Jon Cohen:
NIAID’s high-profile director challenging the NIH director is the kind of political contretemps that easily explodes into a great inside-the-Beltway brouhaha. Witness the story in The Washington Post story today, “A public dispute between NIH officials over Ebola,” that references several other related stories.
More politics and policy below the fold.
As it turns out, Fauci and Collins agree that big pharma’s lack of interest in Ebola vaccine development is the main reason no product was ready for this epidemic.
Texas Presbyterian will not be handling Ebola patients any time soon.
Located just off Campbell Road, one of Richardson's busiest streets, the Methodist Campus for Continuing Care was the original Methodist Richardson Hospital.
Its intensive care unit has been vacant, making it ideal home for an the Ebola treatment center, state officials said Tuesday.
"it's a fully-equipped ICU," said Sam Bagchi, chief quality officer at Methodist Health Systems, "With a dedicated and fully contained lab; radiology capability; a special area for donning and doffing personal protective equipment; and has been specially designed with input from the CDC and with our colleagues from UTSW and Parkland."
The unit will be staffed by more than 50 caregivers who are trained in biohazard response and infectious diseases.
AP:
Among the travel ban skeptics is former President George W. Bush’s top health official, who coordinated the government’s response to bird flu in 2005 and 2006. At the time, it was feared that the H5N1 flu strain, capable of jumping from birds to humans, could become the catalyst for a global pandemic.
A travel ban "is intuitively attractive, and seems so simple," said Mike Leavitt, who led the Health and Human Services Department from 2005-2009. "We studied it intensely in preparation for H5N1. I became persuaded that there are lots of problems with it."
CDC has a
Review of Human-to-Human Transmission of Ebola Virus with key points:
• Human outbreaks of EVD are hypothesized to begin through direct contact with an infected animal or its body fluids, and human transmission chains are driven by direct contact with the blood or other body fluids of infected patients.
• The risk of EVD transmission from direct skin contact with an EVD patient is lower than the risk from exposure to blood or body fluids and may be more likely in severe illness (when the Ebola virus RNA levels are highest).
• Airborne transmission of Ebola virus has been hypothesized but not demonstrated in humans. While Ebola virus can be spread through airborne particles under experimental conditions in animals, this type of spread has not been documented during human EVD outbreaks in settings such as hospitals or households.
What about coughs and sneezes. Politifact, of all places, has a great review.
Have you read the Hot Zone? Tara C. Smith has. Have you read her book? Probably not, but as a microbiology expert, she has some interesting things to say about the Hot Zone:
The Hot Zone was first released in 1994, the year I graduated high school. Like many readers, that book and Laurie Garrett’s The Coming Plague* really sparked my interest in infectious diseases. In some sense, I have those books to thank (or blame?) for my career.
But I’m still going to criticize The Hot Zone, because as a mature infectious disease epidemiologist and a science communicator in the midst of the biggest Ebola outbreak in history, The Hot Zone is now one of the banes of my existence. A recent article noted that the book is back on the bestseller list, going as high as #7 on the New York Times list recently, and #23 on Amazon. It’s sold over 3.5 million copies, and it’s reported as “a terrifying true story.” Many people have gotten almost all of their Ebola education from just The Hot Zone (as they’ve told me over, and over, and over in the comments to this blog and other sites).
Here’s why The Hot Zone is infuriating to so many of us in epidemiology and infectious diseases...
The clinical picture of Ebola that people take away from The Hot Zone just isn’t accurate, and with 3.5 million copies sold, is certainly driving some (much? most?) of the fear about this virus.
And in non-Ebola news,
Robert Costa follows Scott Walker into a really tough election:
Survival would leave Walker poised to ascend to the top tier of the presidential sweepstakes early next year, touting victories in two general elections and in an unsuccessful recall attempt in 2012 over his reductions in bargaining rights for most public workers.
But first Walker, 46, has to get past Burke, 55, who has remained strong in polling despite a brief uproar over a partially plagiarized jobs proposal put together by a consultant.
The Fix:
On the left, MSNBC doesn't carry near the same weight as Fox with "consistent liberals." Just 38 percent say they had consumed news from the liberal-leaning cable news outlet. These Americans have more mainstream tastes, consuming news from NPR (53 percent), CNN (52 percent), local TV (39 percent), NBC News and PBS (37 percent apiece), the BBC (34 percent), ABC News and the New York Times (33 percent apiece).
The only other outlet approaching the kind of ideological, commentator-driven news of the Hannitys, the Becks and the Limbaughs on the left is the Daily Show, which 34 percent of "consistent liberals" cited as a news source they had tapped in in the past week. And while the Daily Show certainly has a liberal-leaning point of view, its express purpose is entertainment -- not news.
See also:
Media habits of liberals, conservatives: 'different worlds from
Brian Stelter.
Greg Sargent:
“I support covering a population of people who are drug-addicted and mentally ill. I support eliminating preexisting conditions,” said [Ohio Gov John] Kasich. “But that doesn’t have anything to do with my feeling and support to the ACA.”
This perfectly captures one of the one of the under-appreciated subplots of this election cycle. Many Republican Senate candidates have played this same rhetorical game on Obamacare, one that enables them to profit from the general unpopularity of the law — and its chief author — while fudging madly on the true implications of their own stance on its proper fate. They are running against the word “Obamacare” while leaving the general impression that of course folks can keep the good stuff in the law without the bad. At the same time, they need to keep telling core GOP voters (whose enthusiasm is crucial to GOP midterm hopes) that of course they are still gung-ho for repeal.
This straddle finally got some serious press attention with Mitch McConnell’s widely mocked evasions at the recent Kentucky debate. But it has been widely and stealthily employed by other GOP candidates, too, with little media scrutiny. Kaisch’s candor neatly gives away the game.
Greg Sargent:
In a memo about the focus groups, Newhouse and Romero write that “Ebola has replaced ISIS as a worry about instability and government leadership.” But it is not a factor in their vote:
In our early September focus groups, ISIS was a dominant concern. It has almost been completely replaced by worries about Ebola…but they do not necessarily feel it is an imminent threat — that is, this is more of a threat to the country, not to them personally.
The CDC — somewhat more than Obama — takes most of the blame, for being “too relaxed” and unprepared. While Ebola is certainly lessening moms’ confidence in government, not one cites it as a reason to vote against (or for) Democrats in November.
So ISIS is out, and Ebola is in. But Ebola is not driving their vote.
and
A new Pew poll finds that, while worries about Ebola have increased a bit, majorities express little or no concern about becoming exposed to the disease, and majorities have confidence in the federal government to deal with it. So maybe it won’t be much of an electoral factor after all, as the focus grouping of Walmart moms suggests.