A Look at Ebola from Inside Medicine

Image

My fellow Catholic Patheosi, Dr Tod Worner published a post today concerning the Ebola crisis. I hope you will click on the links in this post and read it.

Dr Worner gives us a glimpse of the concerns that medical practitioners face when deciding how they would treat this illness. It also evaluates our government’s reaction to Ebola without the distorting prism of political one-upsmanship and ambition.

It is precisely the kind of non-political, rational discussion of this killer disease that should be taking place everywhere, but isn’t.

Here’s a taste:

We crowded into a small room at my internal medicine clinic and looked at each other. Some decisions had to be made. Soon. We were charged to answer one fundamental question: What would we do if a patient suspected of having Ebola were to walk in our clinic door? As simple as it may seem, this is an incredibly complex question. It requires considering the well-being of the patient, the risk to other patients exposed to him (or her, but I will use him for simplification) in our waiting room, and the risks to medical and ancillary staff who are attending to him. We must concern ourselves with the risk of over-reaction as well as that of under-reaction. We need to consider the imperfect state of our understanding of the mode and ease of transmission. And we must recognize that risk and response changes daily with an ever-evolving national and international epidemic. Confronted with this question in that small room, to a person, there was sincere concern about the patient, earnest concern about personal safety and a clear sense that there is a lot of uncertainty about this virus and the epidemic that is unfolding day by day.  And yet, that has not been the message from the government leaders or the Centers for Disease Control. If anything, there has been an abundance of assurance. For example,

New York Doctor Diagnosed with Ebola

24NYPATIENT5web master180

Dr Craig Spencer

Dr Craig Spencer, who had recently been treating Ebola patients in Guinea, has been diagnosed with Ebola.

Dr Spencer is in isolation at Bellevue Hospital in New York. Health care officials are attempting to reconstruct his activities in the recent past to identify people who might have been exposed to the disease. According to reports, “at least three people have been placed in isolation” as a result of this.

Among other things, Dr Spencer used the subways for travel the day before he began to show symptoms. That highlights the ease with which an infection can be spread in crowded cities.

From The New York Times:

A doctor in New York City who recently returned from treating Ebola patients in Guinea became the first person in the city to test positive for the virus Thursday, setting off a search for anyone who might have come into contact with him.

The doctor, Craig Spencer, was rushed to Bellevue Hospital Center and placed in isolation at the same time as investigators sought to retrace every step he had taken over the past several days.

At least three people he had contact with in recent days have been placed in isolation. The federal Centers for Disease Control and Prevention, which dispatched a team to New York, is conducting its own test to confirm the positive test on Thursday, which was performed by a city lab.

While officials have said they expected isolated cases of the disease to arrive in New York eventually, and had been preparing for this moment for months, the first case highlighted the challenges involved in containing the virus, especially in a crowded metropolis. Dr. Spencer, 33, had traveled on the A and L subway lines Wednesday night, visited a bowling alley in Williamsburg, and then took a taxi back to Manhattan.

President Obama Discusses Ebola

President Obama summarizes what’s happening with Ebola in the US.

YouTube Preview Image

Between Terrorism, Ebola and Ebola Hysteria, Staycations are Looking Good

I don’t have the money to take a cruise right now, anyway.

I’ve got to hire a plumber to fix some drippy leaks and figure out why water backs up into the vents on my house when the yard is soaked. That, and not airline tickets and cruise ships, is where my money is going.

But even if I was full up on cash and aching to roll, I think I’d settle for a car trip and a family picnic. Since 9/11, travel has been punishing at best. Now it’s looking more and more like a nightmare waiting to happen.

ISIS and their desire to blow us up/behead us/take us prisoner/rape us and sell us into slavery is like the ubiquitous elevator music of our travel. We know, as we are wanded, patted down, searched and yelled at by airport personnel that this little bit of medicine is for our own good. We take it in hopes that it will ward off having us end up like the Passengers of Flight 93, careening into the earth to save the nation’s capital from attack, or like James Foley, kneeling in the sand to recite some bit of ISIS dogma before we are murdered by a satanic braggadocio.

We’ve got a handle on all that.

We’ve learned to tune the noise down low and go about our business, semi-secure in the law of averages and what has so far been well-placed faith in our government to ferret out these murdering dirt bags before they get to us.

Then, along comes Ebola, which will not show itself to the wands and metal detectors and which can not be bothered to telegraph its intentions with email and cell phone calls. Ebola travels from human to human in the silent stealth warfare of life against life.

Disease knows no faith, nationality or cant. It does not announce itself by shouting slogans and waving weapons. In the famous words from Terminator 1, “… it can’t be bargained with. It can’t be reasoned with. It doesn’t feel pity, or remorse, or fear.”

Ebola is the latest in an endless line of attacks humanity has faced from other life forms. The virus, with its magnificent simplicity, and its half-life/half-not-life status, is particularly difficult to manage. Unlike bacteria, a virus can’t even breed itself. It cannot, as the scientists say, “multiply” on its own.

It needs a “host” and when that “host” is us, and the virus in question is a killer, you’d better, as Okies say, get back Loretta. Because things are going to get crazy. Each virus has its limits, and we, being the smarter of the two in this battle, can size up those limits and figure out how to take the thing on by getting it on our turf instead of its turf.

The turf of the Ebola virus is literally hand to hand. As in, it passes from hand to hand. So far (and hopefully from now on) it doesn’t pass by breath. An Ebola victim can’t exhale on you and infect you. It also can’t pass from one person to the next until it has reached the stage where it shows itself. When it demonstrates its presence with a fever or a headache or nausea, then it is powerful enough to reach across the divide between persons and jump, on a touch or a shared bit of bodily fluid, from one person to the next.

It’s far more infectious than HIV, but it’s not contagious like, say, the flu. However, it is deadly, and I don’t mean deadly in years the way HIV is, but deadly in days. And the death it gives is agonizing.

We don’t understand Ebola. And we haven’t been so good at doing what we don’t admit we do with these deadly diseases, which is to “contain” it among what we appear to regard as the riffraff of the world. From the nightly news to daily conversations, the horror of Ebola is not that it is laying waste whole countries in Africa. It is the all-too-human fear that it’s going to leap the fence of national borders, rivers and oceans and get to us.

The best single disease vector on our planet today is the commercial airline, which is also the vector for the social disease of terrorism. A jet plane can do in a matter of hours what once took months or even years, and in the case of isolated areas of the world, what, in centuries past, didn’t happen at all.

Plague of any type can now spread at the speed of a jet engine. And it goes everywhere on this planet. Thus we have a man from Liberia, dying of Ebola in Dallas, and a health care worker from Dallas ending up in quarantine in Belize.

That’s the latest story, you know. A poor health care worker from the same Dallas hospital where the Liberian man died and a nurse contracted the disease, went on a cruise and ended up in quarantine because she got sick. Does she have Ebola? Given the length of time since she handled the specimens (she’s a lab worker) it’s unlikely, but possible.

Her exposure, if there was one, occurred long enough ago that Ebola has almost run out its string with her. All living things, including somewhat living things like the Ebola virus have an amount of time it takes them to reproduce. In the case of disease, it takes a lot of these reproductions, these multiplications, before symptoms develop. We can measure it and predict it within parameters that allow for individual variations. If this health care worker has Ebola, her body is keeping it down well enough that it’s taken a long time to manifest.

All this raises questions. Government questions. Health care questions. And what are you and I gonna do questions.

The what are you and I gonna do questions are actually the easiest because they’re the ones we have complete control over. Holiday season is coming, and a lot of people will want to hop a jet and go to Grandma’s house. I like to take trips in October because the weather is pleasant and the tourists are thinned out. The answer for me about what I’m gonna do is largely academic. I don’t have the coin to go gallivanting. I’ve got plumbing to fix. I

may load up the car and take a couple of day trips around Oklahoma. But that’s about it for me. However, given the various complexities that are being heaped on travel, a staycation is looking more and more like the smart move, and not just for me.

I mean, who wants to go on a cruise and end up quarantined? Who wants to go on a flight and end up alerted that they have to watch themselves for symptoms for the next three weeks? Who wants to be patted down, wanded and yelled at? And I’m not even talking about squeezing yourself into those tiny seats and hauling luggage through airports.

I love to travel. But, fortunately for me, I also love to be at home. I’ve got plumbing to fix and things are in a roil on the travel front. I see a staycation in my future.

Second Dallas Nurse Diagnosed with Ebola had Just Completed Cross Country Flight

A second Dallas nurse has been diagnosed with Ebola. She had traveled on a commercial flight from Cleveland to Dallas a few hours before she became ill.

She is the second person to contract the disease after caring for Thomas Eric Duncan, who died from the Ebola.

I’m not sure how emergency room personnel, who make the first diagnosis, are going to protect themselves from potential exposure to Ebola. It may lead to masks and gloves all around, even when dealing with removing splinters and from a toddler’s toe.

From ABC News:

A second Texas nurse who has tested positive for Ebola was on a commercial jetliner from Cleveland to Dallas the night before she arrived at the hospital with a fever and was later diagnosed with the deadly virus, officials said today.

The nurse was part of the team at Texas Health Presbyterian Hospital who took care of a Liberian man who died of Ebola. She is the second member of the hospital staff to contract the virus and a Dallas official warned today that additional cases among the hospital’s health care workers is a “very real possibility.”

“The fight against Ebola in Dallas is a two-front fight now,” Dallas County Judge Clay Jenkins said, speaking at a morning press conference.

Authorities said they are now tracking 75 people following the second hospital worker’s diagnosis. The unidentified health care worker reported a fever Tuesday and was isolated at the hospital, authorities said.

The preliminary Ebola test was run late Tuesday at the state public health laboratory in Austin, and results were received at about midnight, authorities said. The Centers for Disease Control and Prevention has begun confirmation testing.

The woman was put into isolation within 90 minutes, and she is dealing with her diagnosis “with grit and grace,” Jenkins said.

Authorities said this may not be the last case to be found among the hospital’s staff.

“We are preparing contingencies for more and that is a very real possibility,” Jenkins said.

Dallas Mayor Mike Rawlings also suggested additional people may get sick.

“It may get worse before it gets better, but it will get better,” the mayor said.

Dr. Daniel Varga of Texas Health Resources defended practices at the hospital, which has faced criticism amid the Ebola diagnoses.

“It’s clear there was an exposure somewhere, sometime in our treatment of Duncan. Let’s be clear we’re a hospital that serves this community extremely well,” Varga said at the press conference.

“We’re the first to diagnose and treat this insidious disease that has attacked two of our own.”

City workers went to the neighborhood of the second patient early this morning to knock on doors to alert people to the news and to be alert to possible symptoms. They handed out flyers and later began robo calls to the area, Varga said.

Rawlings said the community remains vigilant.

WHO: Ebola Cases Could Reach 20,000 by Nov, Killing 70% of Victims

Ebola is the disease that won’t be contained.

Today, the World Health Organizatin issue its more dire prediction so far. Unless huge improvements in control measures, the number of victims could reach 20,000 by November. WHO also revised the mortality rate, saying that 70% of those who contracted the disease will die from it. This is an increase from the previous estimate of a 50% mortality rate.

The paper, which was published in the New England Journal of Medicine also says that its possible that Ebola may become “endemic among the human population of West Africa.

Ebola is pared by close contact with an infected person or with their bodily fluids. It is much easier to catch the flu from another person than Ebola.

The usual first symptoms are fever and fatigue. The disease has a incubation period of 11 days and people are not infectious until they begin to have symptoms.

From NBC News:

World Health Organization researchers issued a dire new forecast for the Ebola epidemic Tuesday, one that sees 20,000 cases by November, much sooner than previous estimates. And 70 percent of patients are dying.

That’s a big increase over the previous estimates of a 50 percent fatality rate.

“These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from Ebola virus disease are expected to continue increasing from hundreds to thousands per week in the coming months,” the WHO Ebola Response Team, led by Dr. Christopher Dye, wrote in a report rushed into print by the New England Journal of Medicine.

This projection includes nearly 10,000 people in Liberia alone. WHO said earlier Monday that more than 5,800 people had been infected with Ebola and more than 2,800 had died of it since the virus first broke out in Guinea in December.

And it’s likely far worse, especially in Liberia, WHO says. “The true number of deaths will likely never be known, as bodies in the notoriously poor, filthy and overcrowded West Point slum, in the capital, Monrovia, have simply been thrown into the two nearby rivers,” WHO said in a separate statement.

Ebola: The 2014 Outbreak Explained

 

This video is a couple of weeks behind the curve, but it still contains information that we need to know.

YouTube Preview Image

Jihadist Flag in East London, Anti-Semitism in Europe ‘Worst Since the Nazis.”

Peter paul rubens the raising of the cross

I am overwhelmed by the news. So, I’m not going to comment on these stories. Read and discuss. Let’s see what shakes out. 

Anti-Semitism on Rise Across Europe in ‘Worst Times Since the Nazis.’

Jihadist Flag Flown in East London

ISIS is Systematically Beheading Children in Christian Genocide

Ukraine: Russian military intervention risk has risen, says Polish PM

US Warplanes Strike Militants in Iraq

WHO Declares Ebola an International Health Emergency

China: The Beginning of a Foreclosure Crisis

Bishops Move to Counter Black Mass in Oklahoma City

 

And finally, my Catholic Patheosi colleague Tom McDonald says it all with We Broke the World 

You Gotta Remember: Ann Coulter Called John Edwards “a Faggot.”

You gotta remember: Ann Coulter called erstwhile presidential candidate and famous adulterer John Edwards “a faggot.” 

Frankenstein angry mob

I do not think she was referring to a torch that people carry when they go to a lynching. I’m pretty sure that Ms Coulter was trying to say that former presidential candidate and besotted adulterer John Edwards is a homosexual. 

Aside from the fact that Mr Edwards’ flaming heterosexuality gifted him with a love child and put him in federal court defending his freedom, the salient point for the purpose of this post, is that Ms Coulter says stupid, mean things for their shock value. She also makes a lot of money doing this. 

Her latest sally into stupid meanness kinda goes off the cliff on the cold-blooded indifference to human suffering side of arguing. Ms Coulter is a beautiful woman, and she’s certainly talented, but her public utterances are so mean that she’s made herself into a caricature of meanness. 

She’s the non-cigar-smoking, good-looking, female version of Rush Limbaugh

In her latest sally down I-won’t-lift-my-little-finger-off-my-Bible-to-help-anybody lane, Ms Coulter levels a blast of what is almost incomprehensible hate at ebola-virus-victim Dr Kent Brantley. Her reason? His illness cost the Christian charities Samaritan’s Purse and SIM USA a lot of money, and, oh yes, America needs help, too.  

She soundly and roundly condemns Dr Brantley for going to serve in Africa, asking the question “Can’t anyone serve Christ in America anymore?”

Then she goes off on a round of arm waving and diatribing about how god (little “g” god) is an american (little “a” american), and america’s got problems and we need to take care of our problems and let the rest of the world go to hell. What she leaves out of this nifty little analysis is that if we do that, we won’t have to go to hell. We’ll already be there. 

Because that’s what hell is: A world without the real (big G) God. 

You know: The God who stepped down from heaven (a higher plane than america, by the way) to become one of us. The God who worked as an ordinary carpenter and consented to be tortured, mocked, shamed and murdered to save us from the exact kind of world Ms Coulter is lobbying for: A world where the biggest and meanest make all the rules and the rest of us are bugs that get squashed under the wheels of the biggest and the meanest’s overweening greed, indifference and narcissism. 

Why did Dr Brantley go to Africa? I don’t know the man, but I think it’s just possible that he went there because God called him to go there. It’s also more than likely that the reason these Christian charities spent all that money is because God has also called them to do things like that.

It may be that the reason God allowed Dr Brantley to get sick in the first place was to give those of us in the “developed” world at poke in the side; a wake-up call that we need to get serious about stopping the suffering in Africa. 

Of course, there is nothing new under the sun. Everything Ms Coulter spits out has already been said, and not in a “letter” to the public. The first time these words of Ms Coulter’s were spoken, they came out in one sentence in a very private conversation.  

Am I my brother’s keeper? 

The answer to that question is the same today as it was then: Your brother’s blood cries out to me from the ground. 

You either believe God meant what He told us, or you don’t. You either follow Him and do as He commands, or you won’t. Justifying your refusal to follow the real, big “G” God by waving around little “g” god rules some little g god media preacher made up to lead you astray doesn’t get you out of anything. It only hardens you in your sin. 

Tumblr mghitfVDTF1qbhp9xo1 1280

What have you done? Where is your brother?

How should I know where he is? Am I my brother’s keeper? 

Don’t follow Ann Coulter and her little g gods of narcissistic greed and indifference to human suffering. 

Political gods are demonic gods. 

All of them. 

From Human Events:

I wonder how the Ebola doctor feels now that his humanitarian trip has cost a Christian charity much more than any services he rendered.

What was the point? 

Whatever good Dr. Kent Brantly did in Liberia has now been overwhelmed by the more than $2 million already paid by the Christian charities Samaritan’s Purse and SIM USA just to fly him and his nurse home in separate Gulfstream jets, specially equipped with medical tents, and to care for them at one of America’s premier hospitals. (This trip may be the first real-world demonstration of the economics of Obamacare.)

There’s little danger of an Ebola plague breaking loose from the treatment of these two Americans at the Emory University Hospital. But why do we have to deal with this at all?

Why did Dr. Brantly have to go to Africa? The very first “risk factor” listed by the Mayo Clinic for Ebola — an incurable disease with a 90 percent fatality rate — is: “Travel to Africa.”

Can’t anyone serve Christ in America anymore?

 

For more on this topic, check out Elizabeth Scalia, whose book Strange Gods is about our practice of turning away from God to follow little g gods, rightly labels Ms Coulter’s “schtick” as a danger to our souls while Simcha Fisher contrasts Coulter’s message with that of Jesus. 

Ebola. The Family Disease.

Ebola virus

It’s been cooking for months.

The question now is whether it will get out of the box.

“It” is the long-smoldering Ebola outbreak in West Africa. The box, of course, is West Africa itself.

Will a disease vector — meaning, an infected person — manage to infect someone else who is going to, say, Sudan, who infects someone else who is going to Egypt, who manages to get on a plane and end up in Instanbul?

There are many routes this disease could take out of that box. In this age of air travel and high mobility, disease can spread at the speed of a jet engine. But that is the worst one I can imagine. If, through one of the many routes available to it, this thing ends up unnoticed in Istanbul, the potential for it to go on to the airport in Frankfurt, and from there to the whole wide world is enormous. Istanbul is the roadway between Africa and Europe. Always has been.

That’s the nightmare scenario. It’s the one that tantalizes us like a real-life disaster movie as we watch this unfold. I’ve been reading about this killer disease as it has slowly built itself into an out-of-control epidemic for a long time now. The death toll kept rising, the affected area kept spreading. But it was slow. It sludged from one godforsaken arm pit of a country to another and nobody much cared.

The world has become inured to horror stories from Africa. We don’t know what to do about these things, and it beats us up to watch them. So we watch, feel bad for a moment, and then go on. What else can we do?

Ebola

But the trouble with these human horror stories is that, if they are allowed to fester, they reach a critical mass and begin to spread. It doesn’t matter much if the illness is terrorist serial killers posing as religios, or an actual virus that we can only see with an electron microscope, the death and sickness will fester and smolder like a fire in the attic until it bursts out and takes somebody’s house down in a conflagration.

Ebola is out of control in West Africa. I read today that Sierra Leone is using troops to quarantine the sick. Medical teams from all over the world, but most especially the United States, are out there fighting the fight in their hazmat soldier suits. At the same time, frightened villagers have been known to turn on the docs and even burn down aid stations.

I’m guessing that these villagers have their reasons for feeling this way. But I don’t know enough to speculate what those reasons might be.

All I know for sure is that there’s a fight going on to stop a virus before it gets out of the box and begins a run down pandemic highway, killing a huge percentage of humanity as it goes.

I honestly think that the boys and girls in the hazmat suits will shut this thing down. It’s almost never the thing we see coming that gets us. It’s the blind-side that takes us down.

But the lessons in this horror story are obvious. You can’t consign any part of humanity to the waste bin and get away with it. Not forever. Like it or not, these people in West Africa are part of the human family. That’s why their long-smoldering virus scares us. Because what kills them will also kill us, and — here’s the big one — what kills them will spread to us just as if we were the same as them. 

Which, of course, is the point. We are the same as them. Same DNA. Same human body. Same human immune system. We are them. They are us. These aren’t a bunch of infected bats or monkeys. These are human beings. Just like us.

And what kills them, can and will kill us.

There’s a moral here, and it’s not hard to find. It doesn’t matter whether it’s the blight of inner city neighborhoods, drug cartels in Central America or a killer virus in Africa, what happens to other people will come around and happen to us if we ignore it.

Take, for instance, the blight in inner city neighborhoods. Much — not all, but much — of that soul-killing blight is linked to the use of addictive and illegal drugs. These drugs come from South of the Border. The drug cartels south of the border, who are financed by our drug use north of the border, kill and terrify whole populations, who in turn head up north to get away from the violence and hopelessness. We, in turn, stand at the border with signs, yelling at them and telling them to go back where they came from.

We’re all connected. What happens to them, will bite us too.

A virus in the poorest and most hopeless countries on the poorest and most hopeless continent in the world is cooking up a storm that will kill a lot of us if we don’t shut it down. The immediacy and the terror of this virus has our attention and we’re doing what has to be done to get it stopped. We are racing against time. Hurrying to get this thing pinned to the ground before that one infected person takes a pickup ride into the Sudan and meets someone else who goes to Egypt, who talks to someone who decides to take a short flight to Istanbul.

Because if that happens, we’re staring down the gun barrel of a conflagration.

We. Are. One. Highly-Dysfunctional. Family.

That is not poetry. It is absolute biological fact.

Ebola 1


CLOSE | X

HIDE | X