Tuesday, 7 October 2014

And The Band Plays On

Is It Closing on Midnight in the West?  Time To Unmask?

I'm going to try my luck here by posting one more comment on the Ebola situation in the world.  A couple of posts ago in reflectimg on the actions (or inactions) of the US government to protect its population from infection, I likened the current administration to the characters of the film "The Lost Boys." 

The US has, apparently, invited Ebola in.

Yesterday, upon reading that the government of Israel has taken the opposite step, I suggested facetiously that the Israeli PM is acting to protect his people just as the fictitious Israeli government of the novel World War Z had done.

Today in the local Le Figaro, it is reported that the first diagnosed case of Ebola on European soil has been made - in Spain.  This case is in a way more alarming than the US instance, as the man diagnosed in Texas had travelled to the US from West Africa.  That is to say, he was already infected prior to boarding the flight that carried him to the US.

The Spanish case involves a nurse who had been treating an infected priest brought to Spain for treatment.  This represents a significant step in the potential epidemic, as it apparently is the first case known to date where the infected person contracted the infection outside of Africa.

From Le Figaro 
Une semaine seulement après l'annonce, au Texas, du premier cas de fièvre Ebola diagnostiqué hors d'Afrique de l'Ouest, l'Espagne a annoncé lundi le premier cas de contamination hors d'Afrique, nouvelle étape dans la progression de cette épidémie d'ampleur inédite. La malade, aide-soignante de profession, aurait été infectée alors qu'elle s'occupait d'un prêtre contaminé au Liberia, et rapatrié en Espagne pour y être soigné. Parmi les pistes envisagées pour expliquer cette infection, la presse espagnole rapporte mardi que les professionnels de santé officiant à l'hôpital Carlos III de Madrid ne portent pas toujours les équipements de protection maximale.

[Only one week following the announcement in Texas of the first Ebola case diagnosed outside of West Africa, Spain has announced Monday of the first case of infection outside of Africa, which represents a new step in the progression of the epidemic.  The patient, a nurse, was infected while she was treating a priest who had been contaminated in Liberia, and brought back to Spain for treatment.  Among the possible causes of infection reported Tuesday is that health workers at the hospital in Madrid were not yet using full protective equipment.]

This is troubling on multiple levels.

First, as the article points out, it is now official that an infection has occurred outside the initial zone of contamination.  In the evolution of an epidemic, this is an important - a necessary - step towards a pandemic.  Second, it further belies the claim that governments and departments of health are taking all steps to contain the virus.  Plainly, they aren't.  And third, it fully illustrates that agencies - whether they be hospitals or the US Marines - who willingly enter into actions in infected areas or with those originating from infected regions are put quite obviously and directly in harms way.

A report appeared a month ago on the steps that hospitals need to take to prevent the spread of Ebola (and indeed, any virus).  
  • Train frontline workers to recognize Ebola's signs and symptoms
  • Review emergency department triage procedures
  • Keep state or local health departments in the loop during the testing stages
  • Make sure lab personnel understand specimen collection/transport/testing guidelines
These are all sensible steps.  It should go without saying that I would believe that professionals would already be following all of these rules - rules two and four are, again, applicable to dealing with any infective illness.  Why not add as a rule zero, that people from infected regions will not be in our A&Es because they will not be in our countries?

My mother was a nurse; my father and grandfather were both physicians.  I work in a medical company alongside both doctors and nurses. They pledge to help the sick and therefore necessarily are at the front.  I continue to be perplexed by the total disregard of our leadership to do the one thing that is required of any government.  

To protect and defend its citizens.

It's nice to have "free" healthcare, and subsidies for universities.  It's swell to contribute to the UN and to be involved in the peace process in the Levant.  I'm glad we have Social Security and we have an SEC.  

But a government that cannot take the basic steps to keep its people as far as possible from the threat of what the CDC are calling "a world-wide health crisis [emphasis added]" - it has failed.  The WHO have already declared the outbreak an international emergency.  Apparently, these groups are alarmed about Ebola.  Those of us who say that the US ought to heed these warnings are mocked for panic.

I'm not panicking.  I'm suggesting our leaders should act responsibly towards those they are committed to lead.  I understand that there are other perhaps more immediate problems.  I know that the flu is going to kill people this winter, as it always does  Does that mean we should do nothing to stop Ebola, when a minimal action is required?  Because speeding kills more people in a year than drunk driving mean we ought to ignore the laws against DUI?  

I've read The Masque of the Red Death, and I know that totally sealing the US borders is impossible.  Friends - some right here on this blog - have offered all sorts of straw man arguments about military deployments.  

We do not need to deploy the military to keep infected people from Liberia or Sierra Leone out of the US.  I'm asked to show a passport when I board flights to the US (I live in France).  Simply refusing visas to people who have been in these regions until a quarantine period has passed would not require the military.

The headline in Le Figaro is a classic example of blame-shifting.  In French, "Contamination Par Ebola : Un Défaut d'Equipement Suspecté."  ["Ebola Contamination:  A Lack of Equipment Suspected."]  The problem in Spain - as in the US, is not a mere absence of equipment.  That is a proximal cause.  There simply is no need for our health workers to come in contact with people infected with Ebola.

Unless we choose to ignore the one step to keep Ebola out.  

We don't have a lack of equipment.  We have a lack of common sense.  A lack of will.

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