As we noted yesterday, a man who flew from Liberia to Dallas has been diagnosed with Ebola. Kent Sepkowitz examines the precautions we’d taken:
The Dallas case is breaking some of our ironclad assumptions. The CDC has a well-considered algorithm that places those returning from the three endemic West Africa countries—Sierra Leone, Guinea, and Liberia—into a measure of extra vigilance if and only if the person has had exposure to a known case of Ebola. Per the press conference, the Dallas case had no such exposure. He was not a health-care worker treating patients, nor was he from a family battling active disease. Of course, more facts may emerge that contradict today’s story—but today’s facts, if they hold up, mean that yesterday’s assumptions are no longer correct. Liberia may indeed be enough of a hotbed of Ebola that anyone arriving from the area will need to be considered for extra vigilance.
Ezra recommends calming down and taking the quiz seen above:
On average, Guinea spends $32 on health care per-person, per-year. Liberia spends $65. Nigeria spends $94. The United States spends $8,895.
That money buys trained health workers, disease investigators, isolation wards, fever screening, protective gear, and much more. That money buys advanced hospitals all across the country, and labs that can quickly test for the disease, and the ability to do contact tracing and follow-up visits on a tremendous scale. That money also buys public-health officials with long experience combatting infectious diseases — both here and in other countries.
Susannah Locke imagines best and worst case scenarios:
The best-case scenario for the United States is that a patient traveling from West Africa realizes that they might possibly have Ebola as soon as they start feeling sick. Everyone else makes sure not to come in contact with this person’s bodily fluids. And the outbreak ends with just one patient. Hopefully, that’s how this Texas case will end.
The worst-case scenario, meanwhile, is that an Ebola patient comes to America, is ill for days, and comes in contact with a lot of people before anyone realizes that something unusual is going on. That would be much worse. But even in that case, it’s still much less likely that Ebola will get farther one city or town. “I don’t think we’ll have a serious public health threat in any of the developed countries,” Osterholm told mein July. The real problems are for countries like Guinea, Liberia, and Sierra Leone that don’t have the resources to contain the outbreak quickly.
Margaret Hartmann explains the next steps in our response:
The challenge now is to find everyone the Dallas patient came into contact with and begin monitoring them as well. The “contact tracing” process is how Nigeria managed to eliminate its Ebola outbreak. After identifying one Ebola patient who arrived at the Lagos airport in July, Nigerian officials were able to find 72 people he might have infected. By tracing their contact, they found a pool of 894 people potentially infected with Ebola. Eight people died, including the first patient, but the rest have been cleared.
CDC director Thomas Frieden, like the White House, has urged Americans to stay calm. Abby Haglage summarizes his statement. An important part:
Asked how many people the patient came in contact with, Frieden estimated fewer than five. “Handful is the right characterization,” he said. “We know there were family members who came in contact, and there may be other community members, but we will cast the net wide.”
And Olga Khazan cracks open the history books:
At arrival gates, border protection officers keep their eyes peeled for passengers who show signs of fever, sweating, or vomiting. They also try to confiscate any monkey meat or other bushmeat that passengers might have in their luggage.
In some ways, our approach to keeping scary diseases outside of our borders hasn’t changed much since the Middle Ages. As Defense One‘s Patrick Tuckerexplained, when the Black Death was mowing down Europeans, the Doge of Venice instructed so-called “Guardians of Health” to board arriving ships and check the crew for inflamed lymph nodes. Those considered suspect weren’t permitted to dock for 40 days—quaranta giorni. Ever since, “quarantine” has been the way to keep newer plagues from spreading once they reach our shores.
Update from a reader:
You lauded the role HealthMap played in breaking the news of Ebola outbreak before WHO. From Kalev Leetaru’s article you highlighted: “Much of the coverage of HealthMap’s success has emphasized that its early warning came from using massive computing power to sift out early indicators from millions of social media posts and other informal media.” Unfortunately, that is not quite accurate. HealthMap is not quite a “success” here, as you can see from this Foreign Policy story.
The Dish 