Wednesday, October 15, 2014
President Roosevelt famously said in his March 4, 1933 Inaugural Speech that “ The only thing we have to fear is fear itself.” By this reasoning, and the repeated reassurances of the Obama Administration, the only thing we have to fear about Ebola is fear. I submit we have four things to fear about Ebola: 1) Ebola itself; 2) The CDC; 3) Dr. Thomas Frieden, Director of the CDC, and 4) Dr. Nancy Snyderman Disease has shaped civilization. The Bubonic Plague (Justnian’s Plague) destroyed Justinian’s goal of restoring the Roman Empire. The Black Death ravaged Europe 800 years later, killing over 100 million. It struck Constantinople in 1347, weakening the remnants of the once great Byzantine Empire, leading to the ultimate Ottoman conquest a century later. Small Pox was finally eliminated through vaccination. The deadly polio of a century has almost been eliminated. The Spanish Flu of nine decades ago was an exceptionally virulent influenza. AIDS has been with us for 3½ decades. We’ve lived with Leprosy since Biblical Times, and syphilis and gonorrhea for centuries. Malaria kills millions, mostly children, annually. Today we hear of SARS, MERS, Dengue Fever, Marburg virus, H1N1 (Swine Flu), and H5N1 (Bird Flu). All can be deadly, but Ebola poses the greatest risk. No vaccine exists and fatality rates, even with the best of treatment, will often exceed 50%. At least 413 healthcare providers contracted Ebola as of a few days ago. At least 233 of them died from Ebola, a rate over 56%. If medical staff, taking the best precautions available, and receiving the best treatment available, catch the disease fairly easily and then have a 56% fatality rate, then we are witnessing a horrific threat. CDC tells the disease in theory, or so we are told, is transmitted through contact with bodily fluids and is not contagious within a 21 day incubation period or as long as it is asymptomatic. Now we learn that the incubation period may be less than 21 days or as long as six weeks. It is also unclear if Ebola may be contagious before symptoms occur. We are told that airline passengers arriving to the United States from West Africa are screened for fevers, which risks over and under containment. The under containment comes through taking aspirin, Tylenol or Advil during the transit. The over problem is that high temperatures will be common during flu and cold season. The early symptoms of Ebola mirror those of the flu. We also learnt today that the testing is for fevers of 100.4 and higher. Amber Vinson, the Ebola suffering nurse who flew from Cleveland to Dallas tested at 99.5. Thus, she would pass the screening. Amber contacted the CDC prior to the flight, saying she had a temperature. Someone at the CDC did not tell her not to fly. If the virus mutates to aerial transmission, then the effect could rival that of the Plague. If the incubation period is shorter than 21 days, and if transmission can precede a fever, then the risk will have been severely underestimated. Dr. Frieden, Director of the CDC, repeatedly assured us that the risks were low, protocols existed to respond to the virus. He also said that He said that “virtually any hospital in the United States that can do isolation can do isolation for Ebola.” He spoke with smugness, arrogance, contempt, consumed by his own contempt. His statements were either knowingly false, or based on ignorance. The tragedy of Dallas’ Texas Health Presbyterian Hospital illustrates how grossly unprepared we are. The Dallas hospital is a major 898 bed acute care hospital. Thomas Eric Duncan checked into the ER with a 103 temperature and mentions he flew in from Liberia. He’s sent home with antibiotics. He returns a few days later and sits in the waiting room for hours before treatment. 76 hospital workers are exposed to him during his 10 day hospital stay. We learn the staff had no protocol to follow. They “winged” it along the way. Many lacked the total protection called for by the CDC. So far two nurses, Nina Phan and Amber Vinson, contracted Ebola. More are still at risk. Nurses, including the large nursing union National Nurses United, report that nurses at many hospitals lack protocols or training to deal with Ebola patients. Hospitals also lack the requisite protective wear. We are unprepared. Dr. Frieden has engaged in the standard Obama Administration practice of shifting the blame. First was his remark that Nina Phan’s exposure occurred because the protocol was not followed, although he could identify the breach in protocol. He then blamed the outbreak on Republican budget cuts. We have been told that you cannot get Ebola by sitting next to someone on a plane. Maybe? Ebola has been a threat for over a decade. Yet, despite of Dr. Frieden’s statements, the country is unprepared. Only four hospitals, Emory in Atlanta, the Nebraska Medical center in Omaha, St, Patrick Hospital in Missoula, Montana, and the national Institutes of Health in Bethesda, Maryland. The major airports of entry into the United States are Boston, New York, Philadelphia, Washington, D.C., Miami, Atlanta, Houston, Dallas, Los Angeles, San Francisco, Seattle, Minneapolis, Chicago, and Detroit. Yet, only Atlanta and Washington, D. C. have hospitals equipped with bio-containment units. The capacity of the four hospitals is a dozen beds. The nation is unprepared. President Obama was so concerned earlier today that he postponed a campaign stop and fundraiser to remain in the Capitol to do his job, to protect the American people. The Administration was as unprepared with Ebola as it was with the Veterans Administration, IRS, Benghazi, Fast and Furious, and ISIS. The tone is set by the President: 200 fundraisers, more golf matches, weeks of vacations. He’s simply not interested in governing. He proposed cutting the 2014 CDC budget by $270 million. The Congressional republicans increased the CDC budget by $567. Dallas is a wakeup call.