Posted on 08/10/2014 12:46:23 AM PDT by Smokin' Joe
From Arutz Sheva:
http://www.israelnationalnews.com/News/News.aspx/186026?#.VDmspfldV8F
[snippet]
The WHO’s Risk Assessment makes for frightening reading. And ominously, Dr. Dausey’s exclusive-Arutz Sheva interview statement that, “We are forcing airlines to become first responders to an infectious disease outbreak,” almost sums up the entire WHO Risk Assessment.
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Reading the WHO Risk Assessment, I am really thankful that I am not flying anymore. Yikes!
Thank you, however I think both Smokin’ Joe and Black Agnes deserve most of the credit.
You’re very welcome. I haven’t posted much lately, we’ve been busy. Hopefully MSF/CDC/USArmy will get a handle on this thing shortly.
I pray they do.
Forgive me if I don’t share that hope. It sadly falls to us to educate ourselves and be alert, for our appointed and anointed leaders refuse.
“Go, set a watchman, let him declare what he seeth.”
~ Isaiah 21:6
Don't be silly. All technical professions have their jargon, and extended lexicons, particularly the sciences. It wouldn't be possible to discuss the nuances of technical issues with other practitioners using lay language. The precision is mandatory. This isn't goofing around -- it is deadly serious and determines types of protective gear required.
Sort of like the Eskimos supposedly had 19 words for snow or whatever. The variations could have life and death consequences for them. Even recreational snow skiers, like me, know more words for snow types then most people, as it affects choice of wax or even skis.
There are people here who think Joe HillBilly should make every decision -- not the CDC, NIH or WHO and their professionals. I'm personally am glad Joe HillBilly (not Smokin' Joe) isn't in charge. We'd be no better off than the West Africans if he were.
The actual genetic difference is about 1.5%, and it means very little as far as the pathogenicity of the disease goes. All viruses, especially RNA viruses, mutate quite readily, so that when a person is sick with a virus, they are sick with a population of different viruses, and not with millions of identical viruses. This outbreak is Ebola Zaire, the original strain of Ebola that was identified in what is now the DRC.
The differences we see with this outbreak have nothing to do with the virus, but everything to do with the circumstances of the outbreak. Ebola has always emerged in rural areas and died out before it could reach population centers. This time, it managed to make its way to population centers. There had never been an outbreak of Ebola in these countries before, so medical staff thought it was malaria or Lassa fever, both of which are endemic to the region. It took months before a doctor who is familiar with Ebola noticed that patients were hiccuping; this led to the appropriate testing and identification of the disease. By this time, it had been spreading for 3 months. These countries have been engaged in civil wars for years, leaving them with almost no infrastructure and grossly inadequate healthcare systems, so that they are unable to contain Ebola the way other countries can contain it. And so on.
In the case of Ebola, it is absolutely necessary to understand that droplet transmission is not aerosol transmission. Sure, you can breathe in a virus-laden droplet and get Ebola, but, technically, that is close-contact transmission, not aerosol (airborne) transmission.
As steve86 pointed out, infection control is quite different for different modes of transmission. It would do no good to treat Ebola as if it were a respiratory disease that is transmissible by aerosols; it could easily infect people who take aerosol precautions. It is a blood-borne pathogen, and the personal protective equipment reflects that. It requires a high level of protective gear because of its high infectivity.
I have followed your posts closely- thank you for taking the time to write such thoughtful insights. Since our understanding of this outbreak continues to grow I try to stay objective and informed. I work in a large hospital and admit to a new paranoia each day I walk through the door! I know it’s an emotional reaction - nevertheless it’s there- partially because I do not trust or believe anything this government tells me.
So, instead of quibbling, let's hear your concise and definitive definition of what constitutes "airborne".
The purpose of science is to increase our understanding of the world, and that can be done in layman's terms, and should be when it comes to helping people assess the risk from a potentially lethal disease.
By saying "it isn't airborne" the impression has been given that it cannot travel through the air in any form. That just is not so. You know it, exDemMom knows it, and you will kill people if you persist in obfustication.
The droplets carrying the virus can travel through the air--I'm from North Dakota, and wind here is normal. For fine droplets to travel a hundred yards is nothing unusual. That is one hell of a lot farther than 3 feet. With an ID50 of 1-10 organisms, that can be significantly different.
We will be no better off than the West Africans if scientists fail to express the risks in terms that make sense to the common folks, because, as you said, the choice of PPE is determined by the risk factor, as are other behaviours.
Not all first responders, police, tow truck drivers, cleaning crews, etc., are well versed in nuances of scientific terminology, so I challenge you to apply the KISS principle if you want to save lives.
Simply enough, Joe Hillbilly (or Joe Ghetto) will be hunting scientists if their kid dies over some nuanced definition.
Come The Terror, I'd just as soon the ropes and ammo were saved for the politicians.
It is important for specialists to distinguish between diseases like Flu that are easily and primarily spread through the air and diseases like Ebola that can spread through the air but are primarily spread through direct or indirect contact. They use a formal vocabulary for that purpose. The problem is when non-specialists assume that we know what technical jargon such as "airborne" means.
Droplets are particles 5 micrometers and larger, that fall to the ground almost immediately after they are generated. If you are within range of such particles emitted by an Ebola patient—within about 3 feet—then you can catch Ebola (IF the particles contain virus, which is not a given). Such particles are produced by coughing, talking, and sneezing. You don’t have to breathe such particles—the virus can enter through any break in the skin. Droplet transmission is considered a form of contact transmission.
Aerosols are particles smaller than 5 micrometers, that do not fall to the ground immediately and can remain aloft in the air for prolonged periods and be carried on the breeze. The smaller the particle, the longer it can remain aloft. You do not have to be in the same room as someone with an aerosol transmissible disease to catch the disease. You can walk by an open window and catch it. A veterinarian friend told me that the reason animals are culled so aggressively if a case of hoof and mouth disease shows up is that the infectious aerosols can travel several miles.
Ebola is not airborne. In no case have we *ever* seen someone catch Ebola who was not in close contact (defined as being within three feet) of the patient. There are several physical reasons that Ebola does not aerosolize from the human respiratory tract. I’m not certain that Ebola would be nearly as pathogenic if it were actually a respiratory virus... but that’s beside the point. Ebola is not transmitted through aerosols; if it were, this outbreak would have already infected (and killed) millions. I saw one report that Ebola patients cough a lot—I haven’t verified that, but, if true, that fact definitively rules out any aerosol route of transmission for Ebola.
I will point out here that the laboratory studies where animals were exposed to aerosolized Ebola virus are completely artificial. Those studies have their value—look at where they took place (USAMRIID)—but they do not correspond to any natural situation. There is also a risk to healthcare workers, because certain procedures, such as intubation or extubation, can propel droplets into the air—but I would hope that healthcare workers are wearing the proper PPE before they do any procedures on an Ebola patient.
Last, let me point out that the late Mr. Duncan was symptomatic and therefore considered to be infectious for 4 days before he was finally admitted to the hospital. It has now been 13 days since anyone could have been exposed, and no one—not even the one person who is a very high risk exposure—has yet shown symptoms. The average incubation period is 7 or 8 days. In another 8 days, I expect everyone will be given a clean bill of health. Ebola really and truly is not very contagious—it’s just that it is horribly infectious in the case that one *is* exposed.
Hospitals have infection control protocols that work if everyone sticks to them. I worked in a large hospital for a while... I admit, it did make me nervous to go to the ID ward. But I never got sick.
I think this report is very illustrative of how well infection control protocols work. This woman had Marburg--sister to Ebola, but with a slightly higher death rate--and the healthcare workers treating her did not know it. Yet there was not a single secondary case. Happily, the woman recovered.
I take the time to post because caution and concern are warranted, but I see way too much fearmongering bordering on panic, and that simply is not good for anyone.
"Last, let me point out that the late Mr. Duncan was symptomatic and therefore considered to be infectious for 4 days before he was finally admitted to the hospital. It has now been 13 days since anyone could have been exposed, and no one—not even the one person who is a very high risk exposure—has yet shown symptoms. The average incubation period is 7 or 8 days. In another 8 days, I expect everyone will be given a clean bill of health. Ebola really and truly is not very contagious—it’s just that it is horribly infectious in the case that one *is* exposed."
We say they were potentially exposed. If they do not contract Ebola, then they were not exposed.
Thirteen days and counting.
yea Duncan’s family is very likely in the clear at this point.. It is my belief that they knew he was contagious and kept their distance.. However, Ebola is extremely contagious.. as can be clearly seen by the nurse in Madrid who suited up twice for two very short visits and caught the virus...
I am interested in the actual virus itself, in respect it surviving outside a host/body. Meaning what happens to it as it attempts to locate another host....how does it die then before reaching that?
I guess what I'm saying is it seems to need “cells” to attach to and pierce through.....so once it doesn't have that access what happens to it as it does, does the air destroy it, does it basically suffocate...or just shrivel up on itself?
A virus is a sort of gray area, it’s not really alive in any normal sense in and of itself. It’s more like a strand of genetic code floating around. Outside of a host with cells that the virus can commandeer and instruct to make copies of itself, i.e. reproduce, it really depends upon the environment as to whether it’s transmissible or not. If there are cells that are not desiccated due to death or being expelled from a host that the virus can “live” off of, i.e. reproduce, then it’s transmissible. If not then the likelihood is greatly reduced. They do have a way of getting into a host, though, it happens eventually.
Health care worker at Dallas hospital tests positive for Ebola
In her case, she failed to use proper procedure. After handling soiled material, she touched her face while still wearing soiled gloves.
She might not have been trained adequately in the use and removal of PPE. People normally touch their faces hundreds of times per day--and they have to have it impressed on them that they just can't do that. When you see the pictures of people who have been trained, notice how they hold their arms down and away from their bodies when they wear the PPE. That helps to reinforce the training.
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