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Sunday, October 12, 2014

I've About Had It With Race Mongers

This country is going to go hard right so fast it ain't funny.

Yesterday Jesse and the Duncan family gave a press conference saying Duncan didn't get the right treatment for racial reasons. They wanted him flown to either Emory or Nebraska. 

Well guess what - Duncan got all sorts of measures you and yours ain't gonna get, because CDC just changed their guidelines to "avoid AGPs". This means that if you get sick, you aren't going to get ventilation, intubation, or kidney dialysis unless you get very, very lucky. CDC also recommends keeping labs to the absolute minimum. You'll be lucky to even get an IV. It's more likely that when you get really sick they'll tie you to the bed and roll you into the dying ward. They may give you some liquid morphine if you are able to swallow.

I told my family a while ago to prepare for home care if this thing takes off, and that's where we are. We're working on a possible protocol at the clinic. If this gets out, hospitals are unlikely to be a good bet. It's been very clear that Ebola virus has been spreading through the clinics in the affected countries, and it will here too. That Dr. Sacra was working in a maternity ward totally separated from any Ebola cases. And he was an experienced missionary doctor. He still got infected. Which matches perfectly with our experience here and in Spain. You need special wards and special equipment to safely treat these people, and we don't have them in any quantity.

Why are we letting people come in from affected countries? I have no idea. The doctors I know are appalled and amazed at what's happening. 

What are the chances that it gets out? Well, unless the affected countries are locked down quickly, very good!  

Here's where the open southern border is a killer. If you don't let people in through the air, they can just fly to some South American country and come in over the southern border. If they do, before long it's in South America. What are our chances if this gets out dwn there? Very poor. 

Anyway, preparing for rolling quarantines is a good idea. I noticed the local supermarket started being unable to keep the bleach stocked last week. I'm sure it is health care workers and their families buying it. So get yours while you still can. 

The problem with containment is that there are carriers. If you get a small viral dose, you may not get overtly ill. But you can still be infectious with intimate contact. 

So all bets are off. Bullets and bleach and gloves. That's the ticket. If you think I'm joking, you're wrong.

The reason I've been talking to my family about this already is that a few weeks ago, the clinic started getting calls from the African immigrant families who are patients. They all had relatives who were visiting and just wanted to come in for tests. Unspecified. Needless to say, we did not take them. 

The only way you can get tested for Ebola exposure is to go to a hospital, but if you are not symptomatic you are not going to get tested. We've referred several regular patients who believed they might have been exposed, but they aren't getting tested. It's probable that we already have four or five carriers in the country. God help us if one of them tries to make a living as a prostitute. 

Bullets, bleach, gloves, masks, chastity and prayer. That's the ticket.

I am bitter, because I think there is a good chance I will get killed by the whacky sort of wishful thinking that has governed the decision making in this country for some time. I was making huge progress with what I was doing. I'm not going to quit, because the clinics have to stay open, but it's not a good bet. 

We saved two absolutely terminal patients this last year, and dramatically improved medical status of many more using this method. So I'm not going to quit. But I sure will die pissed as hell if I get killed before I get a chance to formalize this and dump it out there.

If you know a doctor, start being nice. REALLY NICE. 

Sadly, I wasn't kidding about having to relearn quarantine procedures and moral courage of the variety our great-great-grandparents had. We will be really *lucky* if we do not get a major outbreak over here. Instead of doing the sensible (cut air travel links, control borders, quarantine exposed individuals, etc.) we've committed thousands of troops to go stick their finger in the dike over in Africa so it looks like we're doing something prior to the election. Just about every recent foreign policy act by the administration can be seen as "look like you're doing something until after the election." Call it the last triumph of optics over substance.
WSJ - can't argue, but I think the optics are failing in a rather dramatic fashion.

Reality is the thing that doesn't change no matter how much you pretend, and this is a heaping dose of raw reality. Tragic reality, but we can't talk or wish it away.

Yes, this does require moral courage - a virtue now in such short supply that many don't even recognize the concept.
M-O-M, this is just the optics failing for the minority that pay attention. The CDC guideline change makes me think they know more about how the Spanish nurse got Ebola than the general population does. If this Ebola strain truly can spread via aerosol and gets loose in the lower 48, even those who don't pay attention to news will get their noses rubbed in reality in a particularly nasty fashion. That hasn't happened in a long, long time, and the reaction is likely to be along the lines of the response to Spanish flu and the Red Scare in 1918-1920.
Stay safe, stay alive. All those of us who don't conform to the standard clinical model are counting on you and SuperDoc to develop and release your treatment method.
Let's hope this doesn't end up requiring the sort of moral courage that says "me and my nation against the world, me and my cousin against the nation, me and my brother against our cousin, and me against my brother".

I know what you mean, though. Apart from the simple will to live, it's really important that I finish my work (or at least get it close to done).

I agree Ebola is a huge concern to healthcare workers, but I'm not sure it has real epidemic potential in a modern country with proper sewers and a minuscule homeless population.

I think the real outrage is EV-D68, which appears to have been brought in from Central America by the influx of illegals over the summer and has actually killed 6 American children and infected over a hundred others. So far Ebola has nothing on Enterovirus.

Of course, sending a couple thousand Marines into Liberia could quickly change the calculus. With friends like the Obama admin, who needs Russian enemies.
Bless you for the work you're doing with the "new protocols", whatever those are.

It sounds really exciting! And with the idiocies our Beloved Gov't is inflicting on us (like the "Gee whiz, some bad people mis-use hydrocodone. I KNOW! let's make it so damn hard for law-abiding patients who NEED it to get a refill, that they give up trying" that just went into effect), We-The-Plebes are going to need whatever alternative therapies we can get.

Big Nanny Government is so busy Thwarting-Evil-by-punishing-the-law-abiding that I could just gag.

Ebola study suggests that some cases may result from healthy carriers...


Doctors Without Borders: 16 staffers have been infected with Ebola, 9 have died

Doctors/Nurses/Caregivers/Mom...call the CDC with the next Ebola patient, then go home and take care of your family. Let Frieden, who advocates continuing travel visa approvals from the hot zone, care for the patient, because if you do and you get Ebola, it's all your fault.

There was a nurse on Ace last night, giving an epic rant about people getting flu shots. She said the clinics will be swamped with people that have the flu but think it could be Ebola. She basically said that anyone claiming they got the flu from the vaccine really got it because they'd already been exposed to it. (And yes, I'm getting mine tomorrow.)

I think people should be prepared with food and supplies for a two month quarantine, bare minimum. And since most of us can't afford the expensive suits with respirators, we should at least read that article about the Liberian nurse that managed to save three in her family.Get the things that can be improvised to protect you.

The stupidity of the ruling class is just heartbreaking.
Teri said, "The stupidity of the ruling class is just heartbreaking."
= = = = =

I don't know how much is stupidity, (or maybe just complacency, ie the belief that "It can't happen here").

I also kind of wonder if, among The Deep Thinkers and Long-Term Planners of this administration, some might actually be pleased to have a crisis they can use to further their Progressive ends.

If things fall all to hell, the citizens will undoubtedly go into "Save Us, Great Leader!" mode. This would allow all sorts of non-constitutional mischief to be done in the name of "addressing the current emergency".

Maybe it's just my own personal cynicism coloring my view of the knaves and buffoons we've elected to "represent" us. But I don't trust a single ONE of them to stand up for We-The-People.

(At least, they've been silent so far, haven't they? Dems and Repubs alike ... EV-68 is killing and paralyzing kids, and Ebola is on the move, and *NOT A WORD* from our "Duly-Elected"s.
Not. One. Word.)
I don't know that anyone is going to call on big government to save us, if they are clearly incompetent. If we having been budgeting to have a medical "swat team", trained and capable of handing an epidemic, we sort of expect a response from them. It's not surprising that TSA is full of incompetents. We just didn't think the CDC was also full of them.
And yes, Enterovirus 68 is killing and paralyzing kids. Mainstream media may be doing their part to cover that up, but I guarantee that parents are aware of it.

So, I'm not panicking yet. But I can't help noticing that in Africa, there are roughly 9000 cases now, about 40 weeks into the epidemic. I did a little math.

Assuming that the infection rate is 2, and the time lapse between generations is 21 days, the equation for the number of infections is:

number infected == 2^((days since patient zero)/21)

Solving backwards for days since patient zero, given 9000 infections to date:

Log(9000)/Log(2) ~= 276, or 39.4 weeks.

That very nearly pegged the start date for patient zero.

So the infection rate in Africa is very nearly 2.0, with each infected person infecting 2 new people. Also, it looks like new infections happen about 21 days apart--it is, in fact, difficult to catch the disease until after the patient is in full-bore ballistic bodily fluids mode.

In the U.S., in a decent hospital in one of the wealthiest cities in the country, what was the infection rate?

It's at least two point zero.

I hope the CDC is feeling the same lack of confidence that I am right now.

And I hope somebody just placed a massive order for those magic virus-diagnostic machines that the Army helped develop. Looks like the best way to stop this cold is to test every single person with a sniffle, and quarantine early.

But I'm sure glad I'm not a nurse or doctor.

Oops, typo.

Log(9000)/Log(2)*21 ~= 276

I forgot to put in the multiplier for generation-days.

Not to worry, Obama just appointed a career political hack as Ebola czar. Chief of staff to Janet Reno, Al Gore and Joe Biden, pretty much a trifecta of DC wisdom and effectiveness.

He also signed off on the Solyndra investment and visit by Obama and ran regulatory interference for Fannie, so he's got his crony capitalist chops too.

Medical experience? Apparently zero.

The country is truly in the finest hands possible.
I thought this was an interesting discussion at Ace yesterday.


Someone mentioned that it's not just a question of how infectious the disease is. Measles is more infectious than Ebola. Ebola is more deadly though.
I could live with the ebola czar having no medical experience. Competence backed by judgement works. But the standard for this administration is to shuck and jive until the press finds a new Squirrel! to bark at. And he's proven he's competent at that.
Neil - one of the worst things about this current outbreak of Ebola is that it is spreading through the medical system.

So in fact they can shut it down, but only by shutting down medical treatment centers.

The only possible way to shut it down in the US would be widespread testing; FDA does not allow the use of those magical machines.

If the governors don't overrule the federal government, you may see martial law by late spring.

The cooler the temps, the longer the virus is stable in small quantities on surfaces, especially if not exposed to UV light.

The protocols we are using will not allow us to pick up the first domestic transmissions until they reach over 50 cases, which is far too late. A state health department, not the CDC, will pick it up. It will be too late.

If things continue as they have, on a geometric progression, I figure 1000 cases in the U.S. by mid-May. Concentrated, of course, among medical personnel.

At that point, all bets are off. I figure the bureaucracy will get out of the way pretty quick, but that's not likely to stop things until cases get into the 10's of thousands at least.
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