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Doctor in New York City Is Sick with Ebola

nytimes.com

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Re: Doctor in New York City Is Sick with Ebola

#31

Post by rustyconover »

blergh123 wrote: post #26
rustyconover wrote: post #25

Earlier quoted context omitted.

To borrow an idea from math, "doing good" isn't a commutative, infections and diseases are. Have some respect for others and slow your roll before going out during the 21 day post exposure window. 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 pr…

I thought it was well known that ebola can be spread through any bodily fluids and that this includes droplets from coughing and sneezing. What they don't yet know is whether ebola is 'airborne' - i.e. dried droplets that can float in air as is the case with measles for example.

If you asked 10 average people what they think "airborne" means in this context, I doubt they'd say there is a difference between wet and dry transmission. I'd say for the purposes of argument, if a guy coughs violently on you because he's sick there is risk you could get Ebola. If a guy vomits in the subway car, apparently there is a risk of Ebola transmission. I've been on the subway cars and in taxi cabs it happens more than you think. Do you think they bleach all of those things adequately? No way, the financial incentives don't align to properly do it.

The government is using semantics and spin to their advantage by saying it isn't airborne via dried viral transmission. The WHO agrees[1] that it also isn't airborne, but also admits surfaces can transmit the virus.

Most officials omit this detailed explanation since they have no adequate explanation of how to decontaminate the urban environment en masse if an outbreak does occur.

In the end we all have to assess our own risk profiles. Will I stand or sit next to somebody coughing? I doubt it. Or will I take mass transit if I can easily walk to where I need to be by leaving a bit earlier? Nope.

[1] - http://www.who.int/mediacentre/news/ebola/06-october-2014/en...

Re: Doctor in New York City Is Sick with Ebola

#32

Post by malandrew »

ChuckMcM wrote: post #27
rustyconover wrote: post #25

Earlier quoted context omitted.

To borrow an idea from math, "doing good" isn't a commutative, infections and diseases are. Have some respect for others and slow your roll before going out during the 21 day post exposure window. 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 pr…

> He knew the risks that he could possibly be infected > and decided to endanger others when he could have > easily stayed home That may be over stating things. Given that he is a doctor, and he is confident in his process with keeping clean, he might actually have a really hard time believing that he was infected. People have faith in their own abilities, that lets them do things which might put them at grave risk.…

You can fight the deleterious effects on support of quarantining by making the quarantining fun/enjoyable/pleasant. Choose a remote resort location, rent it out for the duration of the crisis, send everyone there to sit out their quarantine in comfort.

I wouldn't mind a 21 day quarantine on a beach or camping

Re: Doctor in New York City Is Sick with Ebola

#33

Post by malandrew »

akjetma wrote: post #16

Do location-based services work in the NYC subway? I suppose you could also infer locations and transfers based on train schedules and tower handoff times upon emerging from stations. I mean, if there is a 21-day gestation period between infection time and the ability to retransmit the disease, it seems like it would be worthwhile/possible to look into. Apologies for the cliche 'use technology to solve all the proble…

It would be interesting to allow people in New York to compare their phone location data with his to determine the likelihood that they had contact with this person.

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.

Re: Doctor in New York City Is Sick with Ebola

#34

Post by malandrew »

uptown wrote: post #18
akjetma wrote: post #16

Do location-based services work in the NYC subway? I suppose you could also infer locations and transfers based on train schedules and tower handoff times upon emerging from stations. I mean, if there is a 21-day gestation period between infection time and the ability to retransmit the disease, it seems like it would be worthwhile/possible to look into. Apologies for the cliche 'use technology to solve all the proble…

Not the underground tunnels. Some of the stations have service, but not most.

But you should be able to infer location from the gaps. If someone was at station A, then disappears and 2 minutes later is recorded at station be, it should be possible to know they took the train between those two stations.

Re: Doctor in New York City Is Sick with Ebola

#35

Post by capkutay »

malandrew wrote: post #29
westward wrote: post #24

Based on the timeline, he had to have contracted Ebola pretty much the day he left. 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!

At the same time, I wouldn't be surprised if people tend to let their guard down in the days and hours before they leave the country. 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 y…

Given gov't budgets in disease prevention, they're more likely to quarantine people in prions than a relaxing vacation

Re: Doctor in New York City Is Sick with Ebola

#36

Post by steve19 »

rustyconover wrote: post #25
googler_314 wrote: post #12

Before judging this man for going bowling etc., we should bear in mind that he caught Ebola working for Doctors without Borders in Guinea. I would guess that without workers like him, the risk to Americans and others outside Africa, would be much higher, since the disease would be spreading much faster within Africa. Hopefully he recovers and we can improve travel policies if necessary.

To borrow an idea from math, "doing good" isn't a commutative, infections and diseases are. Have some respect for others and slow your roll before going out during the 21 day post exposure window. 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 pr…

I don't know much (well, anything really) about disease transmission, but should these health workers not quarantine themselves away from the immediate vicinity of the infection, but before taking a cross-Atlantic/Pacific flight where they could infect a number of other people in close proximity?

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?

Re: Doctor in New York City Is Sick with Ebola

#37

Post by droithomme »

sigmar wrote: post #11
msie wrote: post #2

The doctor should have known better than to go to a bowling alley soon after he returned. Whether or not he was contagious now they have to perform contact tracing and disinfect the place.

well, he went to a bowling alley eight days after getting back to NY. What is more egregious is that the NYTimes is reporting he was feeling sluggish on Tuesday, why didn't he self-quarantine or contact someone earlier than today?

Also, when he says he called DWB on Thursday his temperature was 103. Did it go from 99 to 103 overnight? Or was he running a low grade temperature for several days.

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.

Re: Doctor in New York City Is Sick with Ebola

#38

Post by stevewepay »

msie wrote: post #2

The doctor should have known better than to go to a bowling alley soon after he returned. Whether or not he was contagious now they have to perform contact tracing and disinfect the place.

Everything I've read suggests that this doctor is conscientious, selfless and kind. I don't believe he would have exposed others to Ebola if he had any inclination that he was infected. He measured his temperature twice a day as was required and didn't feel sick until today.

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.

Re: Doctor in New York City Is Sick with Ebola

#39

Post by 001sky »

ChuckMcM wrote: post #27
rustyconover wrote: post #25

Earlier quoted context omitted.

To borrow an idea from math, "doing good" isn't a commutative, infections and diseases are. Have some respect for others and slow your roll before going out during the 21 day post exposure window. 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 pr…

> He knew the risks that he could possibly be infected > and decided to endanger others when he could have > easily stayed home That may be over stating things. Given that he is a doctor, and he is confident in his process with keeping clean, he might actually have a really hard time believing that he was infected. People have faith in their own abilities, that lets them do things which might put them at grave risk.…

"Given that he is a doctor, and he is confident in his process with keeping clean, he might actually have a really hard time believing that he was infected."

Unless you are in proper (BSL-4) lab, the sad reality is there will always be risk. I hope that MSF doctors and volunteers are well protected. But it worries me that they would even contemplate believing that they have zero risk of exposure. That's simply not scientific or a professionally responsible. Although, to be fair, the CDC was guilty of making this same assumption up until about two weeks ago.

It makes more sense for them to spend 21 days self monitoring (in a secluded environmnet) locally in country. There is no need for a complete travel ban, but a staged ingress/egress process would make sense. And certainly we don't need to be issuing sight-seeing or tourist visas etc. Critical business travel could also be easily arranged for with a built in waiting period (most visas take 2-6 weeks anyway to issue).

Re: Doctor in New York City Is Sick with Ebola

#40

Post by jberryman »

westward wrote: post #24

Based on the timeline, he had to have contracted Ebola pretty much the day he left. 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!

I think this is something like selection bias: had he contracted ebola earlier he wouldn't have returned to the US, or maybe would have been shipped back for treatment, which would be a very different headline.
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