New Ebola screening is an epic failure

ebola screeningIt certainly didn’t take long for that system to break down. On Wednesday, CDC Director Tom Frieden announced new screening for all passengers traveling from one of the nations with an active Ebola outbreak:

People arriving in the U.S. from Ebola-affected countries in West Africa will be actively monitored for symptoms for 21 days after they land. The new monitoring regime announced by Centers for Disease Control Director Tom Frieden on Wednesday is similar to the approach Nigeria used to contain an outbreak.

The protocols, Frieden said, would have more rapidly identified the Ebola symptoms of Thomas Eric Duncan, a Liberian man who was misdiagnosed during an initial visit to a Dallas hospital and eventually died. If the new CDC monitoring rules had been in place at the time, Frieden said, it “would have in all likelihood resulted in that first emergency department visit not resulting in [Duncan] being sent back home.”

The roughly 150 daily travelers coming to the U.S. from Guinea, Liberia, and Sierra Leone are already screened when they board their flights and when they land. Now, at customs, those travelers will receive “care kits” from the CDC containing thermometers, instructions for taking and recording their temperatures in a log book, and a “distinctively colored card” that can be presented to health-care providers if symptoms develop.

How well will this system work? Not too well it turns out. Via CDC:

The patient has been notified of the test results and remains in isolation. The patient is currently at Bellevue Hospital in New York City.  Bellevue Hospital is one of eight New York State hospitals that Governor Cuomo has designated to treat Ebola patients.  A specially trained CDC team determined earlier this week that the hospital has been trained in proper protocols and is well prepared to treat Ebola patients.

Confirmation testing at the Centers for Disease Control and Prevention’s laboratory will be done. The healthcare worker had returned through JFK Airport on Oct. 17 and participated in the enhanced screening for all returning travelers from these countries. He went through multiple layers of screening and did not have a fever or other symptoms of illness. The patient reported a fever to local health officials for the first time today. The patient was transported by a specially trained HAZ TAC unit wearing Personal Protective Equipment (PPE) to Bellevue. The New York City Health Department has interviewed the patient regarding close contacts and activities.

What is lost in all the “look how squared away we are” talk are these salient facts. The patient went through enhanced screening at one of the airports designated to be a screening center for all passengers with potential Ebola exposure. And the post arrival monitoring didn’t go all that well either:

At the news conference, Gov. Andrew Cuomo said officials believe Spencer came in contact with four people during the time he was infected and symptomatic, and state officials are already talking to those four people.

Those four people include Spencer’s fiancée and two friends – all of whom are healthy, but have still been quarantined, New York City Department of Health and Mental Hygiene Commissioner Dr. Mary Travis Bassett said.

The fourth person who is in contact with the state is the driver of an Uber car, which Spencer took when he went bowling Wednesday night in Williamsburg, Brooklyn, Bassett said. The Uber driver had no direct contact with Spencer, and is not believed to be in any danger, she said.

….

Spencer was well and asymptomatic until Thursday, but started feeling “tired” on Tuesday, Bassett said.

Still, Bassett went on a three-mile jog on Wednesday. He also went to the High Line and may have stopped at a restaurant on Wednesday before his bowling excursion, Bassett said.

Bassett emphasized that Spencer was well aware of the Ebola risk in his work, and took precautions from the beginning.

“He did attempt to self-isolate and we’re still getting clear the amount of time he spent outside of his apartment,” Bassett said. “But our impression is that he spent most of his time in his apartment and he was taking his temperature twice a day, he was being mindful about contact with people.”

But Spencer was not shutting himself off, Bassett said.

“During the time that he was leaving his apartment he had no fever. He was monitoring his temperature twice a day, as has been recommended and he had no fever,” she said. “I don’t want to give the impression he was self-quarantining because he did leave his apartment.”

But never fear. In the words of New York Governor Andrew Cuomo:

“The more facts you know, the less frightening this situation is,”

Really. Because the more I hear the of the facts the more it scares the bejeezus out of me that somehow we’ve selected a group of mental deficients to run public health policy for the United States. In this case we have a medical doctor who was experienced in treating Ebola, who knew the dangers, who went through enhanced screening upon return to the US, and who still managed to possibly infect other people. He took a cab and a subway and a restaurant and a bowling alley. How successful do we think the program will be when the casual traveler… or the traveler who knows he is infected but wants to receive care in the US and not in Africa… is processed? Not very well.

The assclowns in this administration have made a political, not an epidemiological, decision in how to deal with Ebola. A travel ban would place the United States in consonance with how Africa is dealing with the problem. Had such a ban been in place this man would have been quarantined upon his arrival in the United States… oddly enough JFK International has a CDC quarantine station. Much as they killed Mexicans to prove US gunrunning caused border violence and killed Syrians and Iraqis to prove they could overthrow a dictator with little effort they are now willing to kill as many Americans as it takes to prove that closing our borders in response to a disease threat, whether it originates in Africa or Latin America, is not necessary.