Ebola Chaos

What's a public official to do?   They cannot have people exposed to Ebola, a virus with no vaccine and a proven high mortality rate, running around a city "self-monitoring", even if it might work.  The political fallout of a worse case is off the charts.

But how do they justify quarantines when the leader of the federal response is hugging an Ebola victim the same day she is released from the hospital? 

It should be obvious the virus isn't transmitted through the air at this point.  Even close contact might not spread it, as the relatives of Thomas Duncan can now attest.  At the same time, the doctor who assumed normal frivolities around New York City less than 2 weeks after returning from the hot zone (and somehow making it though the thermometer gauntlet at JFK) was thought to be meticulous in his protection routine, yet he came down with the virus anyway.  So there is still some uncertainty.  As a rule public officials have a hard time playing games of risk-reward with such uncertainties.  Ergo, Christie and Cuomo's bi-partisan quarantine order.

But there are political risks anyway.  Already the quarantine is beginning to blowback on Christie in the form of the nurse selected as patient one:

Hickox says she has asked repeatedly but hasn't been told how long she'll be held at the hospital. "To put me in prison," she said, "is just inhumane."

War on women!   Notice the CNN report has not one mention of New York Governor Andrew Cuomo, who was just out the other day mocking the idea of 'self monitoring', calling it an oxymoron.   Yet patient one and CNN are laying blame on the fat guy. 

At the same time, grabbing citizens and placing them into mandatory quarantine, without access to lawyers or other advocates, is a long-held fear of the conservative right. It's something Obama was supposed to do, you know, the FEMA camps. Now a GOP governor is on the leading edge.  Alex Jones' head has probably exploded.  

And couldn't Christie have at least have called Governor Perry to get some advice on how they handled the mandatory quarantine of Thomas Duncan's relatives, who didn't seem to complain much (if there were any breathless CNN stories about Duncan's relatives being denied their civil rights and being treated inhumanely they seem to have disappeared now).   Ah, politics again. 

But a solution exists that doesn't involve government, one wrapped more in personal responsibility and civics. Nurse Hickox is associated with Doctors Without Borders, a group that has provided a large number of workers to the hot zones while at the same time taking a somewhat liberal approach regards returning volunteers.  This despite the fact the group has seen 16 workers infected with Ebola in the hot zones, with 9 of them dying as of October 14.  Another humanitarian group providing workers is Samaritan's Purse, who has their own approach to returning workers:

The relief group began requiring all returning staff to stay isolated for 21 days, away from family members. The organization houses workers within an hour’s drive of medical facilities, such as Emory University or the NIH, which are equipped to handle Ebola patients, in case someone gets sick. The workers, who are paid their normal salaries, are not allowed to take public transit or touch anyone, and they must take their temperature multiple times a day.

“That’s just a part of the deal, and they have accepted that,” said Isaacs, who acknowledges that the requirements make it potentially more difficult to recruit volunteers to work in West Africa. “We’ve never felt comfortable that just coming back and letting people go about life as normal and take their temp two times a day was sufficient.”

They admit their extra rigor might dissuade more volunteers, but listen to the comments of the quarantined nurse in New Jersey:

Hickox said she worries that her experience will discourage other aid workers from going to West Africa to help quell the Ebola outbreak. ..

[snip to a few sentences down]  Someone asked me earlier would I do this again if I knew what would happen, and my answer is categorically yes," she said. "I feel incredibly privileged to be able to do this work."

So yes and no.

The bottom line is that people are scared of the unknown.  In such times they expect prudence from public officials.  They see people dressed like astronauts still getting the virus and it's worrisome. They see Obama and all the other federal officials bending over backwards to dispel any notion of a problem, first saying it would never come to our shores, then saying it wouldn't spread, then it wouldn't become 'major'.  They remember Obama saying "if you like your doctor, you can keep your doctor, period".

Then they see people who might have been exposed but are not yet symptomatic breezing into the country past thermal scans that are useless unless someone has symptoms.  And they see an approach taken by groups like Samaritan's Purse and think "that sounds reasonable".   As time goes by and an outbreak doesn't occur, things will get better, whether by chance or by quarantine.  Then all the politicians can pat themselves on the back accordingly and we can all move on to the next crisis.

Crisis management, as usual

The Pentagon just announced they are forming 30 unit rapid-response teams to be dispatched within the US to combat any Ebola non-outbreak outbreaks.  Hmmmm.  This comes a few days after Obama described CDC rapid response teams as "SWAT".   On Saturday the same guy urged Americans not to "give in to hysteria" on the issue while today he was blasting the GOP for "peddling fear". 

Words from a man who suspended his fund raiser schedule to have photo-op meetings in the White House, something that didn't even happen after the murder of an ambassador in an AQ terrorist attack or after Russia captured part of Ukraine or an American journalist was beheaded by a terror group shown on worldwide video.  So don't take that to mean anything as it would be giving in to hysteria.

Anyway, they made a big production of a formal White House meeting with all the big-wigs sitting around the long table looking stupid.  The NY Times filled in the blanks by informing us Obama was angry (no doubt after reading about Dallas in the paper)--matter of fact he was so furious he appointed a Democrat political fixer with no medical background as an "Ebola czar", a move that can focus blame elsewhere if needed while allowing him to get back on the links and the campaign fund raiser circuit so he can resume hurling barbs at the GOP for cash from people with names like Rich Richman.  If the Ebola virus peters out it will be "Ron who?'

In other words, crisis management as usual.   Hey, the reason people are fearful is the thought of a killer virus with over a 50 percent mortality rate being 'handled' by the current administration, who couldn't even handle building a web site. 

Aviation Update

The temperature screening at five airports has finally commenced, although it's doubtful the program will have a very soothing affect on the public at large, especially after today's Ebola hearings in Congress.



The question of why the administration has not restricted travel to the hot zones was asked of White House spokesman Josh Earnest today, and briefly provided a moment of levity..




But the question remains open.  The administration seems fine with taking a risk that some asymptomatic Ebola victims will arrive in America despite the screening efforts, expressing confidence the system will protect Americans if they later present at the local hospitals with symptoms.  This despite the FUBAR with index patient zero, Mr. Duncan, in Dallas.  That's not a very comforting assurance.  It almost has the impression of a cost-benefit analysis, ie, a few American deaths are worth trading to prevent a collapse of west African governments, which could lead to a bigger world problem.  Just hope you're not collateral damage.

But isn't there almost a de facto travel ban in place already?  Here's some information on current airline services into the hot zone countries...

For Monrovia, Liberia, it appears there are only two: Brussels Airlines, with flights to Brussels, and  Royal Air Maroc, with flights to Freetown and Casablanca.  It's a bit humorous to see that Delta suspended its much-heralded flights from JFK to Monrovia on August 31st due to "weak passenger demand".

For Freetown, Sierra Leone,  the same two still flying to Monrovia, Brussels and Royal Air Maroc to the same destinations as from Monrovia.

And for Conakry airport in Guinea, it appears Air France with service to Paris, Royal Air Maroc with service to Casablanca, and Brussels Airlines with service to Brussels is the extent of it.

So it's not like Obama could use his pen and phone and shut down Brussels Airlines, Royal Air Maroc and Air France operations to west Africa.  As of this minute there's no American flag carrier service to this area already and no non-stop flights on any airlines.  Maybe that's why they can come across so cavalierly in opposing a travel ban--it's basically in place already.  In today's hearings (and other media questioning) CDC chief Frieden stressed that a ban would make it harder to track people arriving here from the hot zone countries and cause a widespread world outbreak.  Thing is, the surrounding countries have already imposed bans, which they credit with keeping the spread under control so far.

That doesn't leave many ways for sick people in the hot zone countries to get out.  They can't drive out of their area and can only fly to 3 or 4 cities if they can get past screeners.  In other words, maybe US authorities feel they have the few conduits of passage well viewed, perhaps even with the assistance of FBI or DHS tracking.


Of course, if law enforcement or transportation agencies are actually monitoring people it didn't work too well for Mr. Duncan.  One could even question why he wasn't moved to one of the top-notch Ebola treatment facilities as have all the other American cases so far.  Were they rigidly trying to follow a stupid protocol that was later changed, or was someone trying to send a subtle message to foreigners that coming here via deception might not result in a good outcome?   The Pentagon was only yesterday warning about a mass migration across our borders should Ebola spread to our southern neighbors, which would be based on the notion that once here they would have to be treated.   But treated how, like Duncan or the Americans?  

But let's end this on a positive note.  We are coming closer to the end of the 21 day incubation period for Mr. Duncan's friends and relatives who at last check were spending some quality time in an undisclosed quarantine location.  As far as the media has been told none of them have come down with the virus.  Also, nobody on the plane with Duncan came down with it.  So it's entirely possible the public quasi-panic will begin to subside soon if none of the casual contacts with Duncan or his nurses show any symptoms.  Other nurses or doctors working close to the patients coming down with it would not spread the same panic. 

Taken another way, if in a few weeks Obama takes full credit for solving Ebola that will actually be a good thing for the nation because it will mean, 1) we know more about the virus and how to handle it, and 2) it didn't become a widespread outbreak, none of which would be blamed on Obama if things get worse.  Politically speaking, this good news would not likely affect the mid-term elections very much because people expect the government to act when bad things come up and everyone knows the initial reaction was poor. If things get worse nobody will care about the elections.

BANS..   10/16/14

To co-opt an Obama phrase, let me be clear.  This blog called for Visa/passport bans weeks ago.  Those are not travel bans.  As pointed out above, there are no US carriers running flights into the hot zones anyway.  Flights will still run if the overseas airlines want to run them.  That's why the State Department's incessant argument that banning travel would cause huge problems in fighting the disease there deserves a big "how"?  The only thing that would change would be the delay of people in the hot zones getting into the US.  Run a quarantine, like the relatives of the Dallas index patient.  How f-ing hard is that?  We've heard our military will be subject to quarantines.

Simply standing there at the podium and arrogantly refusing while admitting that as many as 100 Visa applications are coming in per day in the hot zones is beyond the pale.