Wednesday, October 1, 2014

Ebola Does Dallas

Now that the Ebola virus is in their backyard, the obscenely wealthy are expected to finally start prying open their wallets to fight a plague that heretofore had only been afflicting "the other."
A combination of factors that include a lack of a cataclysmic event, slow-building media coverage, and significant government intervention had tempered the philanthropic community’s response during the first several months of the outbreak, according to Mr. Ottenhoff and other experts.
"When you read stories that the American government is sending 3,000 military workers and spending hundreds of millions of dollars, some donors think, ‘Well good, this problem has now been addressed,’" Mr. Ottenhoff said. "Then there are other donors who think, ‘Given all this money, where are the gaps?’ and ‘Maybe we need to hold back a little while and figure out where the funding gaps are before we commit our money.’"
Bob Ottenhoff is the director of a group called the Center for Disaster Philanthropy  which in my proletarian ignorance, I'd heretofore never known existed. So far, he says, the rate of plutocratic giving to fight a disease wreaking havoc in countries in West Africa has been, to put it euphemistically, downright mean. A relatively modest $50 million from the Bill and Melinda Gates Foundation, out of its more than $40 billion stash, has been the top donation so far to fight a disease expected to strike more than a million people. First runner-up was the Paul G. Allen Family Foundation, with $9 million to the CDC,  $2.8-million to the American Red Cross, and $100,000 in matching funds to Global Giving.  The William and Flora Hewlett Foundation gave $5-million to various international health organizations in the fight against Ebola, according to The Chronicle of Philanthropy.

The American Red Cross has only raised $98,000 thus far from individual private donors (in addition to the Allen Foundation's gift) for the treatment and prevention of Ebola. Because, let's face it --  Africa is not as conveniently close as earthquaked Haiti, or flooded New Orleans, or the superstorm-ravaged East Coast of Indispensablistan. It is next to impossible to get self-promoting politicians and celebrities to go to the scene of the action for photo-ops that show them helping in some rebuilding effort. Celebrities in haz-mat suits aren't aesthetic marketing ploys.

And anyway, the media have been bending over backwards to help assure the wealthy that It Can't Happen Here. From the New York Times:
Dr.(CDC director Thomas) Frieden told the president that the C.D.C. had been prepared for an Ebola case in the United States, according to an account of the call distributed by the White House, “and that we have the infrastructure in place to respond safely and effectively.”
The Obama administration was working to prevent a public panic over the case, using social media to describe how Ebola can — and cannot — be transmitted.

“You cannot get Ebola through the air, water or food in the U.S.,” the White House said on Tuesday night in a posting on its official Twitter account. “Ebola can only spread from contact with the blood or body fluids of a person or animal who is sick with or has died from the disease.”
Another official Twitter posting said, “America has the best doctors and public health infrastructure in the world, and we are prepared to respond to Ebola.”
USA! USA! USA! What about the 30-40 million people who remain uninsured, and where even people now receiving expanded Medicaid benefits under Obamacare often can't find a doctor willing to accept their insurance?

 Was the unidentified man now being treated for Ebola in Dallas initially sent home from the hospital where he sought treatment because of his lack of insurance in a state which is refusing Medicaid expansion? Or was it just the fantastic health infrastructure? No word yet. But if one individual's inability to pay turns out to be the cause of Ebola spreading in the US, then it also might be the impetus to finally enact a true single payer health care system in this country. After all, denial of medical care to people based on their bank accounts and social status will also have an adverse affect on the healthy wealthy who dictate social policy. All the gated communities, all the private security guards, all the private boutique hospital suites with concierge service in the world will not protect them in the horrible event that Ebola (or any other mutated pathogen, for that matter) gets out of control. You can't bribe Ebola.

Meanwhile, our leaders have been doing everything in their power to actually foment a public panic over the "cancer" of ISIS, which before Ebola made its unscripted appearance, was threatening to surge over the Texas border right along with all those hideous hordes of undocumented Illegals, threatening to kill us all in our beds unless we spend trillions on bombs and tanks and drones.

Meanwhile, officials blithely assure us that once it hits the exceptionally rich soil of the Homeland (the preferred new name for USA) Ebola doesn't stand a chance. I guess they never heard the story about how the Black Plague had morphed into two forms (bubonic and pneumonic) -- the first spread by fleas, the other, then-rarer form, by human aerosol droplets. As they say in the pathogenic real estate biz: Mutation, Mutation, Mutation.

As Sophie Delauney, director of Doctors Without Borders, told NPR recently,
"It (the actual reality of the plague) is so horrific, that once you realize how dramatic the situation is, then you just keep thinking about Ebola all the time. But until you make that step, you prefer to get away from it."

The only thing we have to fear are the fear-mongers themselves, who prefer that we think instead about fake terror groups and beheadings. What we really should all be panicking about is the latest outbreak of official ineptitude, pathological denialism, and outright stupidity of government bureaucrats and self-dealing politicians.


annenigma said...

Here is a comment I am moving here after recently adding it to a previous post:

American doctors in Africa wore protective gear and contracted it anyway. How, if it's so hard to catch except from blood and body secretions? WHO knows, and they're not telling. Fomites? Aerosolization?

A Texas hospital already turned away an Ebola patient and simply sent him home with some antibiotics (even though he had 'unremarkable lab results'). He returned in worse condition days later after likely infecting others, and they finally admitted and isolated him. That strikes me as being the norm in our medical system - if they can't quickly determine what's wrong with you or you aren't sick enough yet, go home with some antibiotics (even if it looks viral) and come back if you don't get better. They come up with some vague diagnosis category for reimbursement purposes. That's all that matters!

Most doctors have little to NO knowledge of infectious disease and wouldn't know one if it hit them up side the head.

The office staff are the first line of defense. How many bother even asking patients to cover their coughs let alone isolate them if they have one? They leave that up to signs in the lobby - isolate yourself please. How many doctors offices staffs will turn real cases away as they try to deal with the crowds imagining symptoms, or having similar but non-Ebola symptoms as we approach the Flu season?

Will the ensuing panic here in the US cause huge losses for the insurance carriers, or will the government bail them out their lost profits instead of simply giving us Universal Health Care? Will the media cooperate with the government in covering up info to control the panic?

The health system is not prepared to cope with any infectious disease outbreak of any magnitude. Only if you've had the occasion to watch or read the government's scenario for a Flu pandemic would you know how incredibly dangerous and disruptive the public reaction alone can be, and Ebola is far worse a disease.

My guess that Homeland Security and defense contractors will handle and cash in on this instead of the government beefing up our public health system. After all, Obama sent thousands of TROOPS to Africa to help with their Ebola outbreak.

Oh, and despite what they claim about Ebola (and they may be right), many other viruses are most contagious BEFORE obvious symptoms appear, not after. And exactly WHICH symptoms of Ebola heralds infectiousness according to the experts? The bleeding out?

The shit is about to hit the fan, just in time for Flu season.

Pearl said...

My dark thoughts about the latest and possibly irrevocable plague to hit the world is AHA!there IS a divine being in charge and he/she/it has had enough and is erasing his/her/its experiment with the evolutionary development of the human species. There can be no other explanation.

Arthritic, cranky over 75 Infidel Pearl

Fred Drumlevitch said...

Karen writes in her post: "Was the unidentified man now being treated for Ebola in Dallas initially sent home from the hospital where he sought treatment because of his lack of insurance in a state which is refusing Medicaid expansion? Or was it just the fantastic health infrastructure? No word yet. But if one individual's inability to pay turns out to be the cause of Ebola spreading in the US, then it also might be the impetus to finally enact a true single payer health care system in this country. [...] All the gated communities, all the private security guards, all the private boutique hospital suites with concierge service in the world will not protect them in the horrible event that Ebola (or any other mutated pathogen, for that matter) gets out of control."

But isolation actually does significantly help reduce transmission. Given their current mentality, the rich might very well choose to just stay in place for the duration, stocking up on a year's supply of caviar, and reinforcing the perimeters of their gated communities with those armed private guards provisioned with plenty of ammo. Given their history of voting against their own interests, the more plebian portion of the populace might, instead of insisting on a properly funded and functioning health care system, simply stock up on a year's supply of rice and dried beans; since it's Texas, they will already have plenty of ammo!. Every neighborhood for itself!

Once again, at least at the international scale (and often also at the national one), if it's not a problem against which military might can be directed, there's no genuine "We're all in this together", no "coalition of the willing", let alone "coalition of the giving". And that applies whether we're talking about private philanthropy or governmental spending. I read in today's paper an AP story on what the U.S. government is sending to Africa: Besides a couple of mobile diagnostic labs, they've delivered "... equipment to build a field hospital, originally designed to treat troops in combat zones. The 25-bed clinic will be staffed by American health workers from the U.S. Public Health Service, and will treat doctors and nurses who have become infected."

Wowee! Compared to the need, and compared to our daily military spending, the U.S. contribution towards the fight against Ebola in Africa is only a drop in the bucket. But the press will undoubtedly laud both U.S. governmental and private spending as generous.

Denis Neville said...

Karen questions whether the Dallas Ebola patient was initially sent home from the hospital because of his lack of insurance.

That he was sent home, despite telling them he had been in Ebola-ravaged West Africa, is highly suspicious for a “negative wallet biopsy” focus rather than on the possibility of infectious disease.

In the for-profit inner city hospital ER where I was employed, I witnessed “negative wallet biopsies” on a regular basis.

A “wallet biopsy,” determining health insurance coverage before performing any expensive testing or procedures, or admitting that person to the hospital, was one of the first procedures performed in the ER.

A “positive wallet biopsy” means that the patient has health insurance and will be treated.

A “negative wallet biopsy” means that the patient has no health insurance. After discovering that a patient has no health insurance, the prescribed treatment was GOMER, “Get Out of My Emergency Room.”

Give the patient prescriptions (unlikely to be filled due to lack of $$$) and refer to an overwhelmed free clinic (with long waiting times for follow-up appointments).

Welcome to the harsh reality of healthcare USA!

Pearl said...

The reason that this second patient was not initially admitted to the hospitals was because his symptoms were not severe and could indicate a number of possibilities and when the admitting nurse took information from him she asked him if he had been in a foreign country and he told her where he had been. When the medical committee had to decide whether or not to admit him they did not receive that nugget of information and sent him home. As things worsened he returned two days later and was then admitted.
Doesn't speak well for hospital procedure and those extra two days at large could have infected many more people.

Pearl said...

Correction: Should have read:The reason that this patient (not second patient)as there was only one patient but he was at the hospital twice.

Denis Neville said...

@ Pearl – “When the medical committee had to decide whether or not to admit him they did not receive that nugget of information and sent him home.”

The Dallas hospital failed to follow the Ebola protocol issued by the Centers for Disease Control and Prevention. The patient should have been placed in an isolation unit and tested for Ebola immediately.

CYA time at Texas Health Presbyterian …

"A nurse, using a checklist, asked whether the Dallas patient had traveled from Africa. He answered yes but was released. Regretfully that information was not fully communicated throughout the full team," said the hospital's Dr. Mark Lester.

The time-honored tradition of blaming the nurse! When anything goes wrong, the nurse always gets the blame. SNAFUs and FUBARs always roll downhill.

“That a nurse was given this information and let him go is just stunning. He or she really needs to be stripped of his/her nursing privilege and move on to something that requires exactly zero critical thinking.”


The nurse wrote down the information and the MDs (aka Medical Deities) ignored it. The discharging ER MD was ultimately responsible.

Anonymous said...

A thought comes to mind that perhaps the black non-American non-insured Liberian knew he was becoming ill and his family encouraged him to come to the U.S. for treatment. That the man is black, not American, and not insured was why he got sent away. Now, of course, the taxpayers pick up the treatment bill--not the hospital.

annenigma said...

I agree with the suggestion that the patient probably came here for treatment knowing he was likely infected. We call it Medical Tourism when the rich do something similar, whether it be childbirth to get their child American citizenship, or Americans going abroad for discreet plastic surgery.

Ever since they flew those infected Americans across the world for 'the best care in the world' here despite the risk to their lives from flying while deathly ill, expect others to travel here while they still can - before they develop symptoms.

The authorities don't want to rock the economy or negatively impact the profits of airlines, so expect travel from those areas and others to follow suit.

(Sell your airline stock now.)

annenigma said...

OMG. I just watched the tail end of the press conference with Texas authorities. After they went to the family and read some kind of isolation 'order' to them which they indicated they understood, the family already broke it by sending their kids to school. It must be advisory and not legal. The Texan added "People do have their freedom".

He was also asked about the patient's sheets (at the home) and he stated that they were bagged along with his clothes and would be disposed of. Would be? By whom? The same family who did not stay home in isolation? I guess they have the freedom to do what they want with the bagged Ebola too. I wonder if the CDC is ok with that. Who is in charge anyway?

That's when it struck me how dangerous and valuable those contaminated items are. Talk about a cheap and easy WMD. How can our government be so hyped up about bioterrorism but take such a lackadaisical approach here? They don't seem to appreciate how easily this could blow up in their faces. Let's hope no shady character shows up to help the family dispose of that bag of Ebola with a bag of money.

Neil said...

Ebola is a game-changer, and we need a change, unfortunately. Stay safe. Rubber gloves and a N95 face mask, while out and about?

Fred Drumlevitch said...

Tongue-in-cheek, some additions to Neil's list of resources:

annenigma said...

This explains why CDC is NOT yet in charge of the Ebola situation in our country and Texas yahoos still are:

"According to Ben Knowles, a spokesperson for the Centers for Disease Control and Prevention (CDC), as long as an outbreak remains outside the United States, the organisation in charge is the World Health Organisation. When a new outbreak occurs in the US – such as the patient in Texas infected with Ebola – the first point of control is the individual state governments. “They are the primary responders,” Knowles said.

When a disease on US soil spreads to multiple states, as happened with H5N1 Avian Flu, then the federal government takes over using the Incident Command Structure, a complex mechanism of interlocking agencies including Fema, the CDC, the Department of Homeland Security and others – the same mechanism that is triggered in the event of a natural disaster or terrorist attack."

Neil said...

Here’s a story on the Daily Mail with good coverage of the Ebola outbreak in Dallas, and has a lot of photos. My brother lives about 50 miles from the apartment that is quarantined for 21 days. He is staying out of Dallas and hopes he doesn’t have to travel through the airport any time soon.