Ebola “The Week The Wheels Came Off”

(or, “What the EV Story Told Us About Leadership Propaganda”)

 During October, the U.S. experienced its first cases of Ebola, with surely more to come.I will give more details on all this, but to summarize,

1. The CDC healthcare worker containment protocol was insufficient, though we were assured it was.
2. The U.S. healthcare system, at the community level, is entirely unprepared by expertise, training, and equipment to protect its staff and the public.
3. Public officials, bent on maintaining a sense of calm in the face of a viral holocaust in Africa, as well as sustaining President Obama’s politically correct open-door policy for West African nations just weeks before a national election, put Americans (who disagree 2:1) at risk by speaking against quarantine of those countries. He cited the opinions of “experts” as the basis for this – experts who have lucrative federally funded positions.

Likewise, there is no discussion of closing the Southern Border with military.The events of the past week provide discussion points on Ebola virus (EV), public policy, and disinformation.

1. Dallas Nurse Broke Protocol: The CDC Chief, Dr. Thomas Freiden, insisted the first nurse who became infected “broke isolation protocol”, or she wouldn’t have gotten infected! Or, was the protocol wrong, simplified to minimize alarm? Film of Dr. Freiden seeing Ebola Virus Disease (EVD) patients in Liberia in August showed complete coverage with a HAZMAT suit, head to toe. The nurse wore headgear that did not cover the neck. Guess the virus mutated to less virulent and transmissible from August until its September U.S. arrival. Anyone believe that?Another possibility is that EV is much more transmissible than they have been insisting – but that was not even part of the conversation.
2. U.S. Ebola Collateral Damage: The handling of all 3 U.S. cases showed that the American healthcare system has been out to lunch on this building epidemic, until an EVD patient was brought into a hospital ER by an exposed EMT ambulance crew.Now, the hospital is struggling to keep its business and many of the affiliated physician practices are having difficulties. The collateral financial and psychological damage to the community of just 3 cases is also barely being discussed. With the open commercial airline policy, as these cases pull into our hospitals, where will the billions come for this care (uninsured) that is so resource-intensive and who will cover the losses of multiple community businesses? The government? When an Ebola case walks into my office unannounced and my operation is shut down by OSHA and FEMA for 3 weeks as a healthcare first-responder, do I get a federal Ebola subsidy to cover ongoing business and personal expenses? Or, am I on my own (because of President Obama’s open-door policy)? Where’s my redress for an insane, dangerous public health policy? This is what every doctor who deals with the public is thinking, as well as hospital administrators.
3. CDC Screens: The second EVD nurse was approved by the CDC for air travel because her temperature was below 100°F. CDC criteria for an EVD case is a fever of 101.7°F. Yet, the amount of fever is diagnostically immaterial in all infections. What only matters is that a temperature is elevated above an individual’s baseline… that they’re relatively hyperthermic. If they normally have a low baseline temp, they may have a low numerical fever. I am convinced the CDC’s fever criterion “number” was sufficiently high to raise the bar that must be reached to qualify a case – again, the desire to minimize the magnitude of the epidemic and the perceived problem by tightening the definition.Their temperature spot-check at an airport makes no sense, since fever is inconstant in the worst infections (varies over the day). You must take frequent temps over 24hrs to tell if a patient is febrile.Additionally, an EVD worker in Sierra Leone admitted that people there will try to go to the U.S., knowing it’s their only chance for sufficient medical care as the West African healthcare systems have collapsed. She said people will lie (as Mr. Duncan, The Dallas EVD case from Liberia, did) rather than be detained in a holding area for 3 weeks with others with overt disease.She said they already know to take fever modifying meds like aspirin, Tylenol, and ibuprofen to make it through the simple-minded airport emigration fever/symptoms screening.So, the U.S. is a magnet for EVD cases (kinda like our Southern Border for illegals).
4. EV: Is It What They Say It Is?Health officials have based their response to Ebola on what was learned from prior outbreaks since 1976.However, there are now filtering to the surface some expert dissenters on the surety of what we have been told by U.S. government leaders – medical and non-medical.Dr. David Sanders, a professor of biological science at Purdue University, said that EV can exist in lung tissue, and so possibly could be transmitted airborne. In fact, in a 1989 experiment with monkeys in Reston, VA airborne transmission of EV was shown. And, apparently no one has done a study disproving that coughing or sneezing is a viable means of transmission (and EV exists in sputum)An LA Times article on 10/7/14 by David Willman detailed all this disquieting information as follows,Apparently, recently the Center for Infectious Diseases Research and Policy (CIDRAP) at the University of Minnesota advised CDC and the World Health Organization that “there is scientific and epidemiological evidence that EV has the potential to be transmitted via infectious aerosol particles, including exhaled breath.”Dr. C.J. Peters, a virologist at the University of Texas Medical Branch, Galveston, has conducted research on EV since 1989 and said he would not rule out airborne transmission.“Dr. Philip K. Russell, the virologist who oversaw Ebola research at the U.S. Army’s Medical Research and Development Command (bioterrorism unit) said, ‘Being dogmatic is, I think, ill-advised, because there are too many unknowns here. I see the reasons to dampen down public fears,’ Russell said.  ‘But scientifically, we’re in the middle of the first experiment of multiple, serial passages of Ebola virus in man… God knows what this virus is going to look like. I don’t’”(See my first Overview article).Furthermore, no one knows if some individuals shed EV without being ill – “asymptomatic carriage” (during the 21 day pre-illness incubation period). It is known that following resolution of illness, the survivors can shed infectious virus in semen up to 8 ½ weeks and in breast milk.The CDC repeatedly asserts you only get EV through “direct contact”. Of course, they concede that someone 3 feet away coughing could transmit EV on microscopical sputum or bloody droplets. That, then, is not direct contact (as in HIV acquisition, which is only by direct physical contact).So, as we go forward, we will see the foundation weaken on CDC’s pillars of faith about Ebola.For now, they are sticking to script – dumb it down for the public.
5. The CzarSo, the CDC doctors, not natural at politics, were forced to package the message on EV so that it was acceptable for the Washington Administration (the President didn’t want one more big national security thing to which he was way slow in response) just a month pre-midterm elections and would placate the American people. There were not to be uncertainties, unknowns, lack of confidence. So, we knew all about this virus. It’s been around before. It’s an African problem, not here. We have the best medical system in the world. And, so on. And, so on.Well, once reality hit and a few cases were terribly mismanaged on a public health level and the curtain was pulled back from The Wizard, we had to have a sure fix... an Ebola Czar. Ron Klain, a Harvard Law School grad whose credentials are being a Washington insider, but more importantly a darling of the Democratic Party. Debate coach to Vice President Joe Biden. A track-record of fixes for the political party.He has no public health or medical training or expertise. But, vitally, he is loyal to the President and the party. He will be able to censor and create propaganda (“message spin”) packaging to customize a distracting para-reality that will give most of the American people what they want with all this – an easy escape; wallpapering. Of course, this approach only delays inevitable truth – hard truth. But, it will be after the elections.So, we didn’t have enough of this with Dr’s Fauci (NIH) and Frieden (CDC), who enjoy high-level government pay, perks, and benefits, being used as political tools. They just couldn’t do it like an expert “spin doctor”. Now, we have a professional of the political class to trust and to parse the words for least political harm. The heck with the real-world biological catastrophe, which likely will be at everyone’s doorstep around the world in the next month or so.64% of Americans think it is medically irrational to not ban travel from infected countries (they’re right). Bet the Czar doesn’t. Either way, he and Obama will agree to the ban, out of factual necessity, but only after “the horse is out of the barn” and they have caused grievous harm to our country and its healthcare system. They should have appointed medical expertise with bipartisan backing of the Congress – like they do with Independent Counsels for government internal investigations. Someone who would be above political manipulation and who would shoot straight and earn the trust of the American people, when trust is most sorely needed on literally life and death issues.It’s enough to make you sick.

 Edward R. Rensimer, MD, FACPDirector, International Medicine Center