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A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
Ebola virus disease is not an airborne infection. Airborne spread among humans implies inhalation of an infectious dose of virus from a suspended cloud of small dried droplets.
This mode of transmission has not been observed during extensive studies of the Ebola virus over several decades.
Common sense and observation tell us that spread of the virus via coughing or sneezing is rare, if it happens at all. Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.
Theoretically, wet and bigger droplets from a heavily infected individual, who has respiratory symptoms caused by other conditions or who vomits violently, could transmit the virus ? over a short distance ? to another nearby person.
This could happen when virus-laden heavy droplets are directly propelled, by coughing or sneezing (which does not mean airborne transmission) onto the mucus membranes or skin with cuts or abrasions of another person.
WHO is not aware of any studies that actually document this mode of transmission. On the contrary, good quality studies from previous Ebola outbreaks show that all cases were infected by direct close contact with symptomatic patients.
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
Ok. Let's face it. There is a huge movement by the governments to calm everyone down.
I think the WHO statement is accurate, fair, and clear. But it is not a "sound bite". The transmission potential of ebola can not be shortened to 4 words.
I hope responsible media and government spokesman accurately describe the transmission potential of ebola in the manner that I described above in post number 11. It is accurate and it makes sense to "regular people":
"While ebola is not airborne like flu, it is possible that it can be shot through the air at close distances possibly endangering others because ebola has been found in saliva and mucus."
I also want to add that once upon a time I was invited (twice) as a representative for FluTrackers to give advice to HHS/CDC about how to message public health on social media. Both Secretaries of Health, Levitt and Sebelius, were in attendance at the 2 separate events and I spoke to them personally.
So why aren't you guys taking our advice now? Maybe no one who is running the show realizes that at one time our opinions were taken seriously?
We offer our advice as experts in risk communication on social media. We have over 8 years experience in this field. We are, daily, actively engaging: the public, health care workers, moms, dads, students, scientists, public health officials...
We know what we are talking about.
Why aren't you listening?
--------------------------------
fyi - My suggestion last week about how to present a new case of high case fatality rate disease (from another thread):
I suggest the following:
Date: October 1, 2014
1) A male patient, 45, was brought in via ambulance to Feel Better Hospital in Chicago at 8:00 pm last night (Sept. 30) with severe diarrhea, nausea, cough/breathing problems, and a very high fever. After evaluation, and pending any tests, he was isolated, as a precaution since he has recent travel history to China.
2) Last night he tested positive for flu A and we flew a sample to the CDC lab in Atlanta for further evaluation. Late this afternoon the preliminary result showed positive for H7N9.
3) We are running confirming tests but at this time he is being treated for H7N9.
4) We are conducting testing on 4 family members and beginning our contact tracing procedures. We are not sure about his symptoms, if any, on the airplanes/airports so we are not sure about the numbers of contacts there are.
5) This person took FlyLikeABird Airlines flight 452 from Bejing on September 28 to Honolulu, he changed planes and continued his flight to Chicago on flight 565 on the same airline. He landed at terminal 45 and used the bathroom after he began to feel sick, non-specific, on the flight. He picked up his luggage, met family members who then took him home.
6) The next day on Sept 29, he developed a cough, but was well enough to go shopping with his family to the Whole Paycheck on 421 Smith St at approximately 2 pm. He was there for about an hour.
6) When he awoke on Sept 30 he had a high fever. At 10 am, he went to Quickie Med Clinic at 643 Central Street where the doctor there called an ambulance to take him to the hospital.
7) If you were in any of these places around the time that the victim was, and you have a temperature and/or a cough/cold symptoms, please consult your medical practitioner. Some of you will be contacted by the local public health departments as primary and secondary contacts of this patient.
8) We are working to ..... CDC web page on this is here..... please call the Chicago health dept if you need any more information at this number.....
--------------------------------------
I can guarantee that the group on FluTrackers has a much more accurate assessment of how the general public is feeling than any consultants you may be listening to.
In, addition, if any of the HHS messaging directives to the CDC are motivated by the national elections next month....well... ...shame...shame...shame. I really hope not, but I am beginning to wonder.
Thanks CDC for publicly announcing the flight information regarding the latest ebola case.
It is a really good step to take.
From: "Media@cdc.gov (CDC)" <sohco@CDC.GOV>
To: MMWR-MEDIA@LISTSERV.CDC.GOV
Subject: CDC Statement: CDC and Frontier Airlines Announce Passenger Notification Underway
Date: Oct 15, 2014 11:11 AM
Attachments: image001.png
For Immediate Release
Wednesday, October 15, 2014
Contact: Media Relations
(404) 639-3286
CDC and Frontier Airlines Announce Passenger Notification Underway
On the morning of Oct. 14, the second healthcare worker reported to the hospital with a low-grade fever and was isolated. The Centers for Disease Control and Prevention confirms that the second healthcare worker who tested positive last night for Ebola traveled by air Oct. 13, the day before she reported symptoms.
Because of the proximity in time between the evening flight and first report of illness the following morning, CDC is reaching out to passengers who flew on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth Oct. 13.
CDC is asking all 132 passengers on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on October 13 (the flight route was Cleveland to Dallas Fort Worth and landed at 8:16 p.m. CT) to call 1 800-CDC INFO (1 800 232-4636). After 1 p.m. ET, public health professionals will begin interviewing passengers about the flight, answering their questions, and arranging follow up. Individuals who are determined to be at any potential risk will be actively monitored.
The healthcare worker exhibited no signs or symptoms of illness while on flight 1143, according to the crew. Frontier is working closely with CDC to identify and notify passengers who may have traveled on flight 1143 on Oct. 13. Passengers who may have traveled on flight 1143 should contact CDC at 1 800-CDC INFO (1 800 232-4636).
Frontier Airlines Statement
“At approximately 1:00 a.m. MT on October 15, Frontier was notified by the CDC that a customer traveling on Frontier Airlines flight 1143 Cleveland to Dallas/Fort Worth on Oct. 13 has since tested positive for the Ebola virus. The flight landed in Dallas/Fort Worth at 8:16 p.m. local and remained overnight at the airport having completed its flying for the day at which point the aircraft received a thorough cleaning per our normal procedures which is consistent with CDC guidelines prior to returning to service the next day. It was also cleaned again in Cleveland last night. Previously the customer had traveled from Dallas Fort Worth to Cleveland on Frontier flight 1142 on October 10.
Customer exhibited no symptoms or sign of illness while on flight 1143, according to the crew. Frontier responded immediately upon notification from the CDC by removing the aircraft from service and is working closely with CDC to identify and contact customers who may traveled on flight 1143.
Customers who may have traveled on either flight should contact CDC at 1 800 CDC-INFO.
The safety and security of our customers and employees is our primary concern. Frontier will continue to work closely with CDC and other governmental agencies to ensure proper protocols and procedures are being followed.”
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
First on CNN: Obama will name Ron Klain as Ebola Czar
By Jake Tapper, Chief Washington Correspondent
updated 10:25 AM EDT, Fri October 17, 2014
President Obama will name Ron Klain as "Ebola Czar"
The president had opposed the creation of such a position
Klain works for an investment group, but has worked for Vice President Joe Biden
Washington (CNN) -- President Barack Obama will appoint Ron Klain his "Ebola czar," knowledgeable sources tell CNN.
Revolution builds leading brands in each industry we target, achieving broad, mainstream appeal. We will embrace an existing brand on its way to market recognition, but sometimes we will use our own Revolution brand to jumpstart market acceptance."
First on CNN: Obama will name Ron Klain as Ebola Czar
By Jake Tapper, Chief Washington Correspondent
updated 10:25 AM EDT, Fri October 17, 2014
President Obama will name Ron Klain as "Ebola Czar"
The president had opposed the creation of such a position
Klain works for an investment group, but has worked for Vice President Joe Biden
Washington (CNN) -- President Barack Obama will appoint Ron Klain his "Ebola czar"
----------------------------
If true - A BIG MISTAKE. This person has NO MEDICAL EXPERIENCE.
His expertise is POLITICAL and NOT MEDICAL.
<snip>
Klain is probably a really great guy....but he has no medical experience that qualifies him as Ebola Czar for the US.
I'd like to suggest that we wait and see. It sounds as though his forte is communication, and we could use some expertise there. If he's getting accurate medical information, then his ability to communicate may well turn out to be more of an asset than a medically trained person who keeps putting his foot in his mouth.
I'd like to suggest that we wait and see. It sounds as though his forte is communication, and we could use some expertise there. If he's getting accurate medical information, then his ability to communicate may well turn out to be more of an asset than a medically trained person who keeps putting his foot in his mouth.
Unfortunately, the issues with the handling of Ebola cases in the US has not just been communication problems, they have been medical protocol and treatment problems. An Ebola czar will need to be much more than a great communicator.
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
Thanks Liz...but from my experience...we are screwed. I think Frieden was already saying scripted comments - which were his downfall...like "The enemy here is a virus" repeated over and over. Whose stupid idea was that?
This admin has taken a medical problem and made it a political one. I could say so many things.....I have seen a lot.
I am not the only one who has this opinion:
Vincent Racaniello @profvrr · 5m 5 minutes ago
If we hear nothing from CDC or NIAID it means they don’t like it @MarxLovesLipton
Vincent Racaniello @profvrr · 34m 34 minutes ago
There are plenty of MD scientists with great leadership skills @RegReader
Vincent Racaniello @profvrr · 34m 34 minutes ago
I do not wish to be involved, I just want the correct person chosen @JediPD
Vincent Racaniello @profvrr · 48m 48 minutes ago
Those are very big ifs @RegReader this needs to be treated as a medical issue, not political
Vincent Racaniello @profvrr · 60m 60 minutes ago
Obama will name Ron Klain as Ebola Czar http://cnn.it/ZHMB3F - if true, a disaster. A lawyer who knows nothing about viruses
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
I am not going to shut up. This was a bad choice due to Mr. Klain's lack of: public health and preparedness experience, and formal education in any related field. In addition, there may be numerous conflicts of interest here.
FluTrackers is an independent site. No one here is paid 1 penny. We are not selling anything. I have no career aspirations in public health. I do not have a resume or a linkedin account. I am free to say what I think.
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
THANK YOU SHARON!!! I BACK YOU 100%.
THIS IS A TRAVESTY. I HAVE BEEN PEAKING IN NOW AND THEN TO SEE IF I WAS THE ONLY ONE FEELING LIKE COMMON SENSE NO LONGER EXISTED.
THE ADMINISTRATION'S RESPONSE TO THIS HAS ENDANGERED LIVES.
WE NEED GOOD HONEST INFORMATION. EVEN IF THAT INFORMATION CONTAINS STATEMENTS LIKE "WE JUST DON'T KNOW AT THIS POINT".
THESE STATEMENTS OF "NEVER CAN HAPPEN, NEVER WILL HAPPEN' ARE UNBELIEVABLE. I TAKE ISSUE WITH ANYONE WHO USES THE WORD NEVER IN ISSUING GUIDANCE THE CONTEXT OF A DISEASE.
ESPECIALLY ONE, THAT IN PERSPECTIVE WITH OTHER DISEASES, WE ARE JUST ON THE FRINGE OF AND STILL HAVE MUCH TO LEARN ABOUT.
NO, WE DO NOT NEED FEAR MONGERING, BUT WE DO NEED HONESTY, EVEN IF THAT MAY BE DISCONCERTING.
I DON'T KNOW IF THIS HAS BEEN LINKED ANYWHERE ON THE SITE BUT THIS IS A LINK TO A C-SPAN AIRING 3 DAYS AGO featuring Micheal Osterholm of CIDRAP discussing Ebola at John Hopkins in Maryland. Osterholm is the director of the Center for Infectious Disease Research and Policy (CIDRAP).
He hits all the nails on the head of what has been wrong about the ?never can happen? propaganda we have been hearing from officials and why it is dangerous talk.
This runs 22 minutes, is very professional, credible, informative and very honest in all terms of what is known and unknown about Ebola. One interesting thing is that the last known genetic sequencing that was done was on a sample way back in May of this year.
Also the mention of some preliminary results of a recent ongoing Canadian Ebola primate study being done using a recent strain of Ebola. The study is process but he announces some concerning statements about it at the symposium.
Michael Osterholm of CIDRAP discusses Ebola 10-14-14 AT John Hopkins.
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
Michael Osterholm (Director of CIDRAP) is the only authority speaking in public or making statements that is WELL GROUNDED and has the critical perspective essential to taking effective actions.
He quoted Richard Feynman and he quoted Nassim Taleb's Black Swan (two of the very best authorities on how to stay grounded in reality and deal with highly unusual and unanticipated events).
He noted that we've only previously followed Ebola for a maximum of five generations. [Meaning that everyone who's been speaking with assurance about what the virus can or can't do or could do is just blowing hot air to give false reassurances.]
?This virus has only pinged us!?
?The virus doesn't (hasn't?) change(d), Africa's changed.? [meaning we're not just fighting the virus, we're fighting the changes in conditions that are allowing it to run rampant this time ]
?We have to become more comfortable with uncertainty.?
?I categorically reject the idea that you can't tell people you don't know, because you'll scare them.?
"People are never frightened by if you tell them ?I don't know, but this is something I'm willing to learn? or ?this is something and it might be very scary.? [paraphrased: what scares them is if you tell them with certainty A or with certainty B and they don't happen ? then they wonder about your credibility.]
?One of the worst enemies we can have today is dogma."
Anyone who wants to do something to help the situation should communicate with their senators and congresspersons to see that Osterholm gets and and everything he asks for *immediately*
---------------------
As for what people can do to increase their personal chances of surviving if they get infected, IMHO the single most effective measure would be to, if you smoke, STOP IMMEDIATELY (and give your lungs time to recover as much as possible before you might get infected). If you wait until you get infected 1) obviously it's not going to help prevent infection 2) it's too late to reduce the vulnerability to the disease that the tissue damage from smoking causes 3) stopping smoking at that point would add to your stress but continuing would greatly exacerbate the disease. This is not only to reduce your susceptibility to getting infected if it does go(or is already) airborne but also to increase your ability to survive it if you get it. As with influenzas, smokers are proving to be much more vulnerable than non smokers both the catching the diseases in the first place and to increased severity when they do.
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
hat tip to Michael Coston for the link.
Finally..... FT first posted about this messaging on August 4.
Droplet spread happens when germs traveling inside droplets that are
coughed or sneezed from a sick person enter the eyes, nose, or mouth of
another person. Droplets travel short distances, less than 3 feet (1 meter)
from one person to another.
A person might also get infected by touching a surface or object that has
germs on it and then touching their mouth or nose. Droplet spread diseases include: plague, Ebola.
Re: A Note to HHS/CDC - Please stop saying ebola is "not airborne" in your messaging - close proximity and droplet size matter
NYC Mayor's Office @NYCMayorsOffice 7m7 minutes ago
Remember, you cannot get Ebola without coming into direct contact with the bodily fluids of an infected person. http://nyc.gov/ebola
NYC Mayor's Office @NYCMayorsOffice 7m7 minutes ago
Remember, you cannot get Ebola without coming into direct contact with the bodily fluids of an infected person. http://nyc.gov/ebola
This is deceptive in context of the other messages provided along with that message. Technically they are 100% correct in their statement but THE IMPLIED MEANING OF THEIR STATEMENT COMES ACROSS AS SIMULTANEOUS DIRECT CONTACT WITH THE INDIVIDUAL and THEIR BODY FLUIDS.
This is why we scratch our heads wondering why we see the public health systems immediately following up with intensive and thorough disinfection of of the infected individual's place of residence and destruction/removal of their personal items.
As well, the very thorough contact interviews and historical logistical tracing of the individual after the fact. Also, the heavy focus on contacts that were within the 3 foot radius (recent aircraft passenger interviews).
They know that the virus has the ability to be infectious on surfaces for sometime after being deposited. As well, we see they need to define, what manner of contact other individuals might have had with environments of places the infected visited.
I.e. Were they sneezing and/or coughing?, did they have a runny nose? did they share food or drink with anyone? did they kiss anyone? did they use a public bathroom? which ones? who else used it?
If the risks were ONLY having simultaneous direct contact with the infected, and their body fluids, we would not being seeing some of these other activities play out.
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