If someone wanted to set off a public health panic in the United States they could do worse than hiring CDC Director Tom Frieden and the Centers for Disease Control and Prevention to set it in motion. If a year ago someone had told me that in 2014 we would be seriously concerned about the spread of a tropical disease, found only in a handful of countries in sub-Saharan Africa, hosted by animals not found in North America, I would have laughed in their face. In fact, two months ago I did laugh in people’s face over their worries. But thanks to the Nobel Douche Prize level of incompetence and sheer, overweening institutional hubris the CDC has succeeded in turning a non-problem into a public health crisis.
What could CDC have done differently? Other than commit mass suicide in atonement, I mean.
Back to the basics
From age immemorial, nations and communities have recognized that people with a disease more often than not carry a disease. In medieval times lepers were required to wear a bell to warn other people to stay clear. The term yellow jack, for yellow fever, comes from the requirement that any ship with a case of yellow fever on board fly a plain yellow signal flag, a “yellow jack”, to warn off other ships. When foreign ships entered harbors, a doctor had to certify the ship as being disease free before the crew or cargo could disembark. This was all prior to anyone knowing about germs. In fact, that is how Ebola has been treated in Africa prior to this outbreak when nice white people mobilized to show the locals how it is really done. US law recognizes the efficacy of quarantine, from the CDC’s helpful website:
The list of quarantinable diseases is contained in an Executive Order of the President and includes cholera, diphtheria, infectious tuberculosis, plague, smallpox, yellow fever, viral hemorrhagic fevers (such as Marburg, Ebola, and Congo-Crimean), and severe acute respiratory syndromes.
Ebola is spread through personal contact… and contact with “bushmeat.” The latter, outside areas of Louisiana and the Upper Peninsula of Michigan really isn’t a huge issue. There is an easy way to stop personal contact. Prevent persons from contacting you. The failure of the United States government to impose travel restrictions at the outset and to obdurately persist in this stupidity remains a failure that, were competence actually a requirement to work in CDC, should have resulted in the firing of everyone signing off on this decision. The fact is that the nations neighboring countries with active Ebola outbreaks have banned travel. British Airways and Air France have curtailed flights from those nations. We are single-handedly working to defeat public health measures imposed by most of the rest of the world.
All of the reasons against a travel ban that have been floated are either ridiculous or blatant lies. There has been on mass migration out of those nations because their neighbors banned travel. A travel ban doesn’t prevent help from getting in. The fact that they keep spouting these specious reasons shows they think we are stupid and it proves they are stupid.
Don’t do stupid stuff
The travel lack of travel restrictions is an obvious dive CDC took into the stupid pool. How about letting the nurse who may have been exposed to Ebola travel on a commercial airliner… after she asked and received CDC’s permission? How about this for sheer boneheadedness?
The CDC unaccountably failed to demonstrate the excess of caution needed when trying to prevent a further spread from a very small at-risk group into the general population. Duncan’s stepdaughter Youngor Jallah, a nurse’s aide who had cared for him up to the point of his hospital admission, had been exposed to Duncan’s body fluids without any protective gear. Once it was determined that he had Ebola, caution should have dictated that she be quarantined by public health officials until the 21-day incubation period was over. Instead, the CDC told Jallah that she could continue to go to work as a nurse’s aide as long as she was monitored for temperature changes.
Jallah herself decided that wasn’t good enough, and she chose to stay home until the full period was up.
If you want to embue confidence in the public that you know what you are doing, then sometimes you actually have to act like it. I chose the image for this story because it best sums up CDC hubris and incompetence. I am assuming that Mister Clipboard didn’t put himself at risk. Though, based on what CDC was saying at the time, I don’t know that for sure. What I do know is this: 1) if you are around people in biohazard suits moving a patient with Ebola, for Heaven’s sake, dress the part, 2) if you aren’t in a biohazard suit you are undercutting your own message by making yourself, and your guidance, look ridiculous.
Err on the side of caution
The first rule of the Hippocratic Oath, back in the days when it forbade performing abortions, was “First do no harm.” This bit of commonsense has long gone by the wayside. The public health profession is so infused with the spirit of “social justice” that the first inclination is to not be all hurty-hurty to someone’s feelings, but rather let them kill as many people as it takes to preserve their self esteem. We saw this, in spades, with how AIDS was handled in the late 1980s-early 1990s. The public health gurus were so concerned about stigmatizing spreading a then-fatal disease via buggery (now I ask you, if we aren’t going to stigmatize that what in Heaven’s name are we going to stigmatize) that the very basic epidemiological steps that we use with whooping cough, tuberculosis, gonorrhea, syphilis, or any other communicable disease — monitoring, contact tracing, etc. — were not implemented and as a result thousands died unnecessarily.
Recognize that maybe there is sh** you don’t know
Yesterday, the CDC released a new string of guidelines for dealing with Ebola. Under it Ms. Jallah would have had her public activities restricted and been subject to in-person daily monitoring by a health care professional. She would not have been told to go back to work. This is just another in the seemingly daily changes in how we deal with Ebola. Under CDC guidance when Mr. Duncan was admitted to a Dallas hospital any infectious disease isolation ward in any hospital was deemed sufficient to handle Ebola. One death and two infections later that guidance has changed. The disease has not changed. The problem is that CDC has a genetically hardwired predisposition to talk like it knows what it is talking about when, in fact, it is simply blowing smoke.
This is not new. This happens every time something more unusual than an outbreak of hangnails takes place. Let’s go back to the autumn of 2001 and the anthrax attacks. The CDC then, as now, started out by giving authoritative guidance — mind you that anthrax, unlike Ebola, was a disease that had received widespread study for some seventy years as a viable biological weapon — and in the end virtually everything they recommended turned out to be wrong. The result was rolls of plastic and duct tape flying out of Home Depot and Lowe’s by the truck load and Cipro becoming a scare commodity.
The CDC and the NIH, which is complicit in this goatrope but has had the commonsense to steer clear of policy recommendations, is not a divine priesthood. It is composed of government bureaucrats doing what government bureaucrats do. That, alone, should send you screaming into the street.
Hero does not equal privilege
The CDC fact sheet on the new Ebola guidelines has this:
Returning health care workers are heroes worthy of dignity and respect. Their efforts, along our civilian and military personnel in the region is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases.
Fine. I will acknowledge that providing medical services in those nations is a worthy endeavor. The hubris of saying that these efforts are necessary is simply balderdash. Ebola outbreaks have happened before and will happen again. Elimination will come from a vaccine produced in, more likely than not, a government laboratory in the United States. Without proper clearance, these people are much more a potential hazard of “additional domestic Ebola cases” than a cure. Twenty-five percent of all domestic Ebola cases have been caused by these heroes.
Be that as it may, dignity and respect is a two-way street. You risking your life to try to help others may be noble (or you may just be a self aggrandizing f***, one of which we will discuss in a second), but you cavalierly risking my life, the lives of my family, or even the lives of complete strangers is as selfish an act as you can commit. The doctor who took his leisure about New York City while infected with Ebola is a very mild example of the sense of self-importance that leads a presumably intelligent man to decide that his comfort and convenience is more important than, for instance, causing a panic. The same with NBC’s Nancy Snyderman and her jonesing for takeout leading her to break a quarantine. The most egregious example, of course, and someone who clearly falls into the “self aggrandizing f***” category is the idiot Kaci Hickox who is so important and so heroic that the rules can’t possibly apply to her. And, as she is part of the same simmering effervescent puddle of incompetence that has mismanaged this crisis from the beginning, she is singularly qualified to decide what is best for the rest of us. This, of course, includes letting her go wherever and do whatever she wishes.
Don’t lie to us
This goes back to Nurse
Ratched Hickox. She keeps bleating about testing negative for Ebola. With the current Ebola tests you test negative until you test positive. Just because Hickox has tested negative twice, or even thrice, does not mean she will continue to test negative. Via CNN
The virus builds up in the body as patients get sicker. In fact, people in the early stages of Ebola infection often test negative for the virus, because there’s not very much in their blood.
The fact that the CDC and the White House have weighed in against quarantine when they know the tests they are using as proof that quarantine are not dispositive of anything beyond the detectability of the virus at they time the test was administered is not only dishonest it borders on criminal.
To sum up
“Our health care authorities are guilty of a combination of stupidity and hubris. They indicate that they believe they know everything there is to know about the science of the way this disease is transmitted, and are arrogant about it. But they don’t even know what they don’t know.”