Friday, October 17, 2014

Ebola and the CDC's Reliance on Human Perfection

I find it difficult to  believe that a trained nurse who herself had been exposed to Ebola and who was running a low-grade fever (supposedly 99.5) would have jeopardized the lives of others by boarding a plane.  Yet, she did, and was  diagnosed with the disease just hours after taking that flight.

Then, too, the first U.S. Ebola patient, Thomas Duncan, lied to the Liberian travel security about his having contact with an infected person; thus, gaining travel access to the United States.

It appears that the CDC's handling of Ebola is based on the assumption that humans are perfect and that they would never do stupid things or lie to gain access to this country. Yet, in the U.S., nearly 100,000 people die each year from diseases contracted while hospitalized.  Disease due to improper hygiene practices, unclean toilet facilities, and contaminated surfaces on reused devices such as x-ray machines and other testing equipment.

At the same time, the CDC is giving people mixed signals.

They tells us that a travel ban isn't necessary, and, that they are screening people at airports for high-grade fevers of 101.5 degrees or above.   It was no wonder then, that the nurse thought it was safe for her to fly.  She hadn't been quarantined.  She had simply been told to "self-monitor" her temperature on a regular basis and look out for a high-grade fever.   Only, then should she seek medical attention and be considered a risk to others. However, even though she did not meet the technical criteria for no air travel, she still contacted the CDC and asked for their advice. They told her to go ahead and get on the plane.

Of course, if we considered an alternate scenario, and she did not board the plane she would most likely show up at a hospital with Ebola.  Thus putting everybody in that emergency room at risk.  Not sure that is a good policy either.

I think that the CDC's handling of Ebola falls well short of considering the "human" element in trying to contain the disease.

References:

Ebola Patient Shouldn't Have Boarded Plane, Officials Say: http://www.huffingtonpost.com/2014/10/15/ebola-patient-shouldnt-ha_n_5990968.html

Liberia says Dallas Ebola patient lied on exit document: http://www.usatoday.com/story/news/nation/2014/10/02/liberia-ebola-patient-thomas-duncan-airport-screening/16591753/

Officials Relying On ‘Self-Monitoring’ System When It Comes To US Health Care Workers Caring For Isolated Ebola Patients: http://houston.cbslocal.com/2014/10/14/officials-relying-on-self-monitoring-system-when-it-comes-to-us-health-care-workers-caring-for-isolated-ebola-patients/

Hospital-Acquired Infections:  Hospital-acquired infection

CDC Q&A on Ebola: Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding: http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/qa.html

pb 




No comments: