Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas - Died

[bwilde]

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - traveled from Liberia

Thanks for the welcome. Wish I had more to add, but I am just part of the general citizenry trying not to go into total panic here...I have family in Dallas and they work with refugees, way too close to home. I am far more critical of this guy than said family, I cannot imagine holding an ebola patient in my arms and then flying home to my niece and nephew. Just ugh...

 

[MHSC]

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

According to the accounts I've read, he was exposed on 9/15. He boarded a plane on 9/19. That's four days during which he had time to ponder his fate. The person he helped died that very evening and he most likely knew she died, and knew it was ebola. So ... it's hard to believe he didn't know in advance. Whether he booked the flight because of it, or just continued with a previously-booked travel, on the moral plane, doesn't matter. Both ways he knew he would likely be exposing others to ebola.

These dates were put together early, they are not accurate now that we know more.

I agree, he knew.

 

[MHSC]

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

After all the education, all the preparations

There were no preps, that was just lip service by the higher ups.

 

[sharon sanders]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

.....I believe the correct approach is to educate oneself, read original scientific and public policy documents if possible, and believe no official statement without first verifying its accuracy.

Agreed.

 

[sharon sanders]

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

Re: US - Texas: Patient tests positive for Ebola in Dallas - travel history to Liberia

According to the accounts I've read, he was exposed on 9/15. He boarded a plane on 9/19. That's four days during which he had time to ponder his fate. The person he helped died that very evening and he most likely knew she died, and knew it was ebola. So ... it's hard to believe he didn't know in advance. Whether he booked the flight because of it, or just continued with a previously-booked travel, on the moral plane, doesn't matter. Both ways he knew he would likely be exposing others to ebola.

I think we should not concentrate on this person's state of mind around the time he boarded the flights. History will be the judge. It is too much negative energy for the site and we do not want to contribute to any negative responses directed at him or his near ones.

I think we need to focus on the current situation and how best to help those affected.

There is a lot we can do to help ourselves.

Clearly our health care industry needs to assume ebola until it is proven otherwise. All hospital intake personnel, EMT, other responders, all public transportation personnel, police and related types, need to be prepared always for an ebola case to be in their midst.

The Liberia ebola situation is out of control. This is not a surprise. It has been announced by MSF, WHO, CDC, and others for several weeks.

In general, do not expose yourself to anyone else's body fluids unless you know for a fact that they do not have ebola.

If you work in a job where you might come into contact with someone's saliva or blood - protect yourself. Ask your company for protective gear. If they have no idea what you are taking about, contact your local health department. Get them to talk to your employer about ebola.

I am sure there are more ideas....

 

[Vibrant62]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

A further point that is worth considering.

Duncan had helped a heavily pregnant woman to hospital who was sent home, and died at 3.00 am.

If he had a suspicion that he may have been exposed to ebola, he could see he had no hope of gaining any hospital treatment where he was, if he became sick.

Therefore, I suspect he believed all the PR of how great western etc health systems are that we expect that the CFR will be drastically reduced = in the US he would get treated properly and survive.

He had a visa and a good job with enough money to buy a plane ticket, so he left so that he could secure good healthcare if he became sick.

The reports indicate he DID make it clear he was an ebola risk at his first hospital appointment, but the ball was dropped.

Bottom line: anyone who can afford to leave the outbreak countries and have an entry visa of any kind, will do so to reach a developed country with good healthcare infrastructure and beds availability, if they think they have been exposed to ebola and have a real risk of contracting it - just IMHO.

Ask yourself this: if you or a close family member were in similar circumstances where you live i.e knew you could not get a bed in your area and thought you had a high risk of becoming sick, wouldnt you do all that you could to get them treatment whilst minimising exposure risk to others? Would that include visiting another state where you knew there was beds availability? Just in case?

We are asking human beings to be totally selfless in dire circumstances, by expecting them to remain where they are and not seek treatment by any means available to them. The human survival instinct is strong, and selfish. I would love it if the human race were that selfless, but the sad reality is we are not.

 

[sharon sanders]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Watch the 2nd video in this article made by a reporter who has been in Liberia for 5 days. People are routinely turned away from hospitals. Some are lying on the ground outside the clinic. There is a mention that a Red Cross crew is in the city picking up bodies from homes. This is a desperate scenario.

http://www.theglobeandmail.com/glob...ra-the-real-dramas-in-africa/article20874861/

 

[MHSC]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

I completely agree with you that temp testing is ineffective. I read today that a team of journalists (CNN? Fox?) reported that on their trip back from Liberia, none of them even received the temp test at the airport.

I read somewhere from someone on the front line that every time they and their coworkers went to the airport their temp read 87 degrees. I haven't been able to locate the article but I think its here somewhere.

 

[MHSC]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

A further point that is worth considering.

Duncan had helped a heavily pregnant woman to hospital who was sent home, and died at 3.00 am.

If he had a suspicion that he may have been exposed to ebola, he could see he had no hope of gaining any hospital treatment where he was, if he became sick.

Therefore, I suspect he believed all the PR of how great western etc health systems are that we expect that the CFR will be drastically reduced = in the US he would get treated properly and survive.

He had a visa and a good job with enough money to buy a plane ticket, so he left so that he could secure good healthcare if he became sick.

The reports indicate he DID make it clear he was an ebola risk at his first hospital appointment, but the ball was dropped.

Bottom line: anyone who can afford to leave the outbreak countries and have an entry visa of any kind, will do so to reach a developed country with good healthcare infrastructure and beds availability, if they think they have been exposed to ebola and have a real risk of contracting it - just IMHO.

Ask yourself this: if you or a close family member were in similar circumstances where you live i.e knew you could not get a bed in your area and thought you had a high risk of becoming sick, wouldnt you do all that you could to get them treatment whilst minimising exposure risk to others? Would that include visiting another state where you knew there was beds availability? Just in case?

We are asking human beings to be totally selfless in dire circumstances, by expecting them to remain where they are and not seek treatment by any means available to them. The human survival instinct is strong, and selfish. I would love it if the human race were that selfless, but the sad reality is we are not.

I understand what you are saying, and yes the ball was dropped, they should have been all over the Liberia history given what is happening.

But I think we should think about this from the point of view of the HCW at Presbyterian ER for a minute.

If he have been upfront with them and said, "I may have ebola, because I was in Liberia and two of the people I lived with and a neighbor died within a few days of each other." He should have told them details about the pregnant woman and his role. There is no doubt in my mind that if he had told the whole story he would have gotten the correct treatment. Just saying "I was in Liberia" in a hospital that serves a large area of Liberians isn't enough. I'm sure they hear that travel history all the time along with the symptoms of stomach pain, etc., and it turns out to be an assortment of nothing problems, for example, picking up a bug from the water quality.

I'm really not making excuses though it appears that I am, I'm just saying every patient is a puzzle that has to be solved and patients know more than they let on almost all the time.

 

[Vibrant62]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

MHSC - I actually completely agree with you.

I think the main point I was trying to make is that here was a man who surely knew he was at high risk, and left to go to a country where he had a certainty (rather than almost zero probability) of getting treated.... which (frankly) is understandable, when you view this episode through the lens of human nature and an over-arching desire for survival.

What I am more concerned is that this Duncan case will be the first of many such cases, where people who fear they may be incubating the disease (because they know they have been exposed) and can afford flights to Europe/ the US will travel so that they have a chance of receiving treatment.

 

[Laidback Al]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

. . .
If he have been upfront with them and said, "I may have ebola, because I was in Liberia and two of the people I lived with and a neighbor died within a few days of each other." He should have told them details about the pregnant woman and his role. There is no doubt in my mind that if he had told the whole story he would have gotten the correct treatment. Just saying "I was in Liberia" in a hospital that serves a large area of Liberians isn't enough. I'm sure they hear that travel history all the time along with the symptoms of stomach pain, etc., and it turns out to be an assortment of nothing problems, for example, picking up a bug from the water quality.

I'm really not making excuses though it appears that I am, I'm just saying every patient is a puzzle that has to be solved and patients know more than they let on almost all the time.

Most health care workers I know roll their eyes when a patient makes a self-diagnosis of a real or imagined sickness. Now, with the internet, every one can be a "self taught" medical expert.

We should leave the diagnosing to the the experts. It is the job of the experts to ask the right questions, not just check a box on the form. Hopefully, the experts can arrive at the right conclusion.

Assuming secondary cases of Ebola in the US in the future, how are health care workers going to handle the influx of patients that claim to have self-diagnosed Ebola?

 

[mixin]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Just to clarify a bit about the patient's intentions; from all the articles I've read he had his travel arrangements made before his neighbor became ill. From what I read, I wonder if his wife sent his sister to talk to him about coming to the US and he had decided to go when he quit his job. I also read that he told his friends when he quit that he was moving to the US. That may be where the confusion came in...possibly, he planned to overstay his Visa.

It seems the poor guy had equally good and bad luck.

Snips from the NYT article:
“His sister came from the United States and he asked for a day off so that he could go meet her at the Mamba Point Hotel,” Mr. Brunson said, mentioning a hotel popular among foreigners. “He quit a few weeks after that.”
http://www.nytimes.com/2014/10/02/world/africa/ebola-victim-texas-thomas-eric-duncan.html?_r=1

Snips:
Mr. Duncan is said to have traveled to the United States on an immigrant visa through his wife who is an American citizen.... The wife of the victim is said to have lived in the US for almost 15 years before sending for her husband to join her in Texas.
http://www.mytmzliberia.net/2014/10/latest-development-first-person-to-test.html

 

[MHSC]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Most health care workers I know roll their eyes when a patient makes a self-diagnosis of a real or imagined sickness. Now, with the internet, every one can be a "self taught" medical expert.

We should leave the diagnosing to the the experts. It is the job of the experts to ask the right questions, not just check a box on the form. Hopefully, the experts can arrive at the right conclusion.

Assuming secondary cases of Ebola in the US in the future, how are health care workers going to handle the influx of patients that claim to have self-diagnosed Ebola?

I agree with you on the masses that think they are dying because of some internet search. I'm just saying if he had told them more it would have raised some red flags. Maybe I'm being too optimistic, but I know the fact that EMS, who had him for all of 8 minutes, caught what they should have caught in the ER when they had him for hours, will wake them up.

I would hope HCW's would question and test any thought to be legit claims, just to be safe. But until we have a bunch of ebola cases in this country, that is definitely being too optimistic!

 

[MHSC]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

MHSC - I actually completely agree with you.

I think the main point I was trying to make is that here was a man who surely knew he was at high risk, and left to go to a country where he had a certainty (rather than almost zero probability) of getting treated.... which (frankly) is understandable, when you view this episode through the lens of human nature and an over-arching desire for survival.

What I am more concerned is that this Duncan case will be the first of many such cases, where people who fear they may be incubating the disease (because they know they have been exposed) and can afford flights to Europe/ the US will travel so that they have a chance of receiving treatment.

Agreed, I'm sure those with money are looking at leaving the area. If they have been exposed we have had the greatest success in with recoveries and those with money likely know this.

 

[mixin]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Vibrant62, from my post on the other page:

Snips:
Mr. Duncan is said to have traveled to the United States on an immigrant visa through his wife who is an American citizen.... The wife of the victim is said to have lived in the US for almost 15 years before sending for her husband to join her in Texas.
http://www.mytmzliberia.net/2014/10/...n-to-test.html

I think his sister's FB indicates she does not live in Texas.

 

[Dani]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

MHSC - I actually completely agree with you.

I think the main point I was trying to make is that here was a man who surely knew he was at high risk, and left to go to a country where he had a certainty (rather than almost zero probability) of getting treated.... which (frankly) is understandable, when you view this episode through the lens of human nature and an over-arching desire for survival.

What I am more concerned is that this Duncan case will be the first of many such cases, where people who fear they may be incubating the disease (because they know they have been exposed) and can afford flights to Europe/ the US will travel so that they have a chance of receiving treatment.

Hello Vibrant62-

I think you are absolutely correct. We have known for quite some time that this is a distinct possibility. Patrick Sawyer was trying to get back to his family in the US, but didn't make it. With our 100% cure rate thus far, the US will be a magnet for Ebola sufferers. In the future, I believe they will just get off the plane and announce their exposure so as to avoid any delays such as Mr. Duncan experienced. People are smart, and even more clever when they are desperate.

Regarding the temperature checks, of course it's useless because it's easy to fool in Ebola's initial stages. Tylenol or ibuprofen will do the trick- in fact most people would be self-medicating with something like that anyway, just to feel better. They may not be doing it to deliberately fool the sensors, but the end result is the same.

Now comes the news that the CDC is indeed trying to track down passengers after having said the risk of transmission is zero.

So I think what will happen is that airlines will stop flying to West Africa completely, no matter what the CDC, WHO or various departments of State have to say about it. The only major carrier to fly out of Monrovia is Brussels Airlines, and (I think) Lufthansa. Airline stock was down 3% yesterday, UAL is already off another 0.5% already today. They already came out with a statement on their own regarding the flights Duncan was on, without being prodded by the CDC. When people start refusing to fly the airlines will end this. It is very sad, but the damage this one case has done is going to hurt West Africa more than it will hurt the US, and they can ill afford it.

 

[sharon sanders]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Sharky started a discussion thread about the potential 2nd case so I moved related posts from this thread to here since this thread was getting long.

Thanks everyone for participating.

 

[alert]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Anderson Cooper on CNN television is reporting that he had an interview (that will be televised tonight) with a woman he is identifying as "Louise" (to protect her identity). Louise is one of the four individuals quarantined in the apartment where Thomas Eric Duncan stayed. Louise admits several very high risk exposures, including:

- Taking Mr. Duncan to the hospital on the evening of the 25th.
- Sleeping in the same bed as Mr. Duncan on the nights of the 26th and 27th.
- Sleeping on the same sheets on the nights of the 28th and 29th, after Mr. Duncan has been hospitalized.
- Folding up and bagging towels that Mr. Duncan used AFTER Mr. Duncan was admitted.

Louise claims the sheets are still on the bed, but that everyone has been instructed not to use the bed, and the towels are in a plastic bag in a corner of the apartment awaiting disposal instructions from the CDC.

I would assume Louise is probably the contact at the highest risk right now.

 

[curiosity]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

2 - We already have evidence that the u.S. public health system can't handle ebola. They failed on their first attempt! After all the education, all the preparations, all the hype, they failed on their very first attempt! They sent this symptomatic person home (with antibiotics no less, for a viral condition). What more proof could anyone need that our health system is woefully inadequate?

Let's look at the every day mishaps in healthcare:

1. wrong limb is amputated
2. rails aren't lifted on bed sides and people fall
3. cancer is misdiagnosed
4. septic patients are discharged
5. wrong dose of a medication is provided

There is a reason lawyers make so much money on healthcare lawsuits.

Where there is human judgment there is error. We are all susceptible to bad judgment - whether a victim or the person making the bad call.

Does that mean the US Public Health System "can't handle" Ebola? Absolutely Not - In fact, the US Public Health System is doing exactly what needs to be done to contain the disease and prevent further spread.

At this time, the response to the situation in Texas needs support.

Unnecessary, additional fear caused by doubt is scarier than the virus.

Unnecessary, additional fear caused by doubt, beyond an already scary situation, is the reason mobs in Africa stormed Ebola treatment centers and killed Ebola response workers.

 

[hawkeye]

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Re: Discussion - 1st ebola case in US (excluding health care worker transfer) Dallas, Texas

Anderson Cooper on CNN television is reporting that he had an interview (that will be televised tonight) with a woman he is identifying as "Louise" (to protect her identity). Louise is one of the four individuals quarantined in the apartment where Thomas Eric Duncan stayed. Louise admits several very high risk exposures, including:

- Taking Mr. Duncan to the hospital on the evening of the 25th.
- Sleeping in the same bed as Mr. Duncan on the nights of the 26th and 27th.
- Sleeping on the same sheets on the nights of the 28th and 29th, after Mr. Duncan has been hospitalized.
- Folding up and bagging towels that Mr. Duncan used AFTER Mr. Duncan was admitted.

Louise claims the sheets are still on the bed, but that everyone has been instructed not to use the bed, and the towels are in a plastic bag in a corner of the apartment awaiting disposal instructions from the CDC.

I would assume Louise is probably the contact at the highest risk right now.

I don't understand why health officials / CDC have not disinfected this apartment yet. Shouldn't they at least be spraying chlorinated water?